Smartphone gadget can transmit EKGs to Springfield heart doctors

Smartphone gadget can transmit EKGs to Springfield heart doctors

A medical device only slightly larger than a stick of gum could help Prairie Cardiovascular patients avoid unnecessary visits to doctors and emergency rooms and alert health care providers to potentially worrisome heart rhythms.

The wireless Kardia Mobile device, which links to patients’ smartphones and can immediately transmit one-lead, 30-second electrocardiograms to Prairie doctors, will be offered to thousands of patients of the Springfield-based cardiology group beginning in August.

As part of a partnership between Prairie and the maker of the device — AliveCor Inc. of Mountain View, California — Prairie doctors will use the technology to monitor patients for early detection of atrial fibrillation and other heart-rhythm problems. Atrial fibrillation leads to a five times’ greater risk of stroke, Prairie doctors said.

The goal, they said, is to give doctors the opportunity to add or adjust medicines and take other steps to help patients avoid strokes, heart attacks and other heart-related events.

“Early diagnosis is important,” said Dr. Ziad Issa, a Prairie cardiologist and executive director of cardiac electrophysiology at HSHS St. John’s Hospital’s Prairie Heart Institute of Illinois.

AliveCor’s Kardia Mobile device, especially when incorporated into a large physician practice such as Prairie’s, represents the latest in 21st-century care because of its convenience, said Doug Biehn, AliveCor’s chief operating officer.

“The health care system is not designed for consumers,” he said. “This enables patients to be more engaged and participate in their care. That’s profound, and that’s industry-leading. Everybody goes where their phone goes.”

Efficient treatment

The mobile device costs $100 and isn’t yet covered by health insurance.

Prairie patients who are offered the device will need to pay for it out of pocket, or through their flex-spending or health savings accounts, and the price will include 90 days of monitoring interpreted by a doctor.

Patients who need or want additional monitoring will be charged $15 per month, according to Kristin Doster, executive vice president of Prairie Heart Institute.

Prairie Cardiovascular joins a handful of major health care providers in Illinois and nationwide in rolling out the technology for patients. The others include Mayo Clinic, Chicago’s Northwestern Memorial Hospital, Cleveland Clinic, Texas Health Resources and Los Angeles’ Cedars-Sinai Medical Center, according to Biehn.

The medical-grade Kardia Mobile device has been cleared by Food and Drug Administration, and for the past two years has been available for purchase through the AliveCor website and other online sites without a prescription.

What’s new is AliveCor’s Kardia Pro software platform, which has been incorporated into Prairie’s practice and will automatically receive the patient’s Kardia Mobile EKG readings, according to Dr. Gregory Mishkel, a cardiologist and executive medical director of Prairie Heart Institute.

The device, when linked to a free app for Apple smartphones, iPads and Android devices, tells the patient whether his or her heart rhythm is normal, whether an atrial fibrillation is occurring or whether some other heart problem might be present.

The device isn’t sophisticated enough, at least not yet, to allow doctors to diagnose a heart attack, but the EKG readings can be helpful when doctors need to document a problem to justify prescribing a medicine or performing a procedure to reduce a patient’s risk of stroke or early death, Mishkel said.

Until now, doctors could ask patients to take their temperature or blood pressure at home, but there was no way for doctors to have regular, easy access to EKG readings outside a medical setting, Issa said.

“This will allow us to treat the patient more efficiently,” he said.

With scheduled or on-the-fly readings from the device, patients worried about whether their symptoms justify a trip to the doctor’s office or ER can be reassured and often avoid those trips, Mishkel said. A typical EKG in the office can cost $350, he said.

“We’re going to replace the expensive testing that we currently provide,” he said.

‘Two-tailed problem’

There hasn’t been enough research to prove whether monitoring through the Kardia Mobile results in fewer strokes and heart attacks, Biehn said.

But Mishkel said the ability to get patients more interested in their care and provide that care at the right time was attractive to Prairie.

He said the AliveCor technology platform can make it easier for doctors to monitor and analyze patients’ blood pressure, weight and activity levels.

This more comprehensive approach to preventive care will better position Prairie as public and private insurance plans transition to pay health care providers based on how healthy they keep patients rather than how many services and procedures are performed, Mishkel said.

Dr. H. Gilbert Welch, a general internist at the Dartmouth Institute for Health Policy & Clinical Practice, has researched problems that can be created by efforts to detect disease early. He told The State Journal-Register that the advertised benefits of the AliveCor device and the associated monitoring system may turn out to be true.

“But I think it is also entirely possible that the device will produce unnecessary doctor visits, unnecessary testing and worry patients unnecessarily,” he said.

“It’s a two-tailed problem,” Welch said. “More medical care may help some and may hurt others. The key question is who are the patients who will be subjected to this monitoring. If the device is confined to a genuinely high-risk group who are already experiencing frequent symptoms and receiving multiple visits and multiple EKGs, it might be very helpful.”

“On the other hand,” Welch said, “if the device is used expansively — say everyone over 55 — I’d expect more physician visits, more testing, more false alarms and more overdiagnosis and overtreatment.”

Doster said that only “appropriate” patients will be offered the device, as well as access to Prairie’s monitoring system and related follow-up care.

— Contact Dean Olsen: [email protected], 788-1543, twitter.com/DeanOlsenSJR.