Latest / Becker’s Healthcare Podcast / How Cardiac Remote Monitoring is Evolving Beyond Episodic Models

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How Cardiac Remote Monitoring is Evolving Beyond Episodic Models · Becker’s Healthcare Podcast

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  Hi, everyone. This is Brian Zimmerman with Becker's
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  Healthcare. Thank you so much for tuning into
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  the Becker's Healthcare podcast.
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  Today, we're going to talk about how cardiac
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  remote monitoring is evolving beyond episodic models.
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  Joining me for today's discussion is Todd Butka,
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  cofounder and CEO of Merge. Todd, thank you
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  for being here today. Hey, Brian. Thanks for
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  having me.
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  And and and to get started here, can
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  can you share a bit about your professional
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  background and and emerge for folks that that
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  may be less familiar?
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  Sure. Not to digress too far, but I
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  started
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  my work career at Apple
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  and somehow found my way into the medical
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  device world.
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  And, ultimately, I think my time at Apple
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  had a profound impact on how I thought
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  about products,
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  how we develop things there, and,
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  solve problems. Right? Created different solutions, thinking differently
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  about the problem you're trying to solve.
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  And getting exposure to the
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  implantable
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  cardiac space and,
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  spending a number of years,
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  observing
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  how data was handled and how patients were
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  managed.
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  There just seemed to be an opportunity,
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  to reshape how
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  we approach care in managing
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  patients.
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  So I started MERGE,
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  and, I think we've done a good job
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  in sort of
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  progressing this industry to think differently about
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  how to monitor patients and manage the data,
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  enhance care, and ultimately
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  seek a higher, you know, reimbursement
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  of, an ROI.
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  Yeah. Appreciate that background, Todd, and and I
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  think we'll dive into that sort of problem
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  solving mentality here in in just a bit.
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  If thinking specifically
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  in this remote cardiac monitoring space, it it's
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  certainly
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  expanded
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  quite quite a lot in the last decade.
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  So more devices, more data, more patients being
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  monitored across more settings.
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  But this growth doesn't necessarily mean clinical progress
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  by itself. Todd, from your perspective, what is
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  the most fundamental thing that needs to change
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  in how health systems
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  manage cardiac patients over time in order to
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  see that that really truly meaningful clinical progress?
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  Yeah.
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  Great question. We
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  we see a lot of clinics
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  providing great care
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  on a daily basis, and,
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  the workflows that are in place
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  become very familiar and almost automated in a
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  sense, but they're very manual.
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  And they're
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  they're they have evolved
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  over time,
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  with
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  what I would call, like, a premise based
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  solution
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  or in person follow-up. So
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  when you think about this remote monitoring and
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  these this proliferation of devices and capabilities from
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  implantable cardiac devices
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  to heart failure monitoring and physiological
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  data monitoring,
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  What's changed is
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  it it it no longer is I schedule
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  you, I see you, and I write a
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  report.
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  It's more
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  it's evolved through this interval.
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  You're looking at a patient over time
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  on a frequency that is the variable. They
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  could transmit once.
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  They could transmit 10 times.
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  The fact is is you only get paid
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  once for a duration of monitoring.
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  And to think that
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  you have to schedule that patient
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  and not get reimbursed
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  for all of the other times that you've
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  actually provided care,
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  if it didn't happen on that specific day,
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  I think is misplaced.
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  And what has really shifted
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  in care and remote monitoring is is no
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  longer
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  based on a schedule.
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  It's based on a period of time or
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  what we think about is called interval based
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  care.
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  Yeah. And and what you're talking about here
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  too is really
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  sort of, over time, achieving
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  genuine continuity in care. Right?
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  Can you talk a little bit more about
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  what that looks like in practice when that
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  that is able to be achieved when it's
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  not just, you know,
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  monitoring a patient through a discrete episode of
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  care, but achieving that that program, that continuity.
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  And and given that that is so obviously
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  beneficial for patients, why is it so hard
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  to bring that into reality?
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  Oh, well,
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  change is hard. Right? I think
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  thinking different in health care can be,
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  a bit nerve wracking, especially to a compliance
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  officer who's, you know,
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  has a model of being reimbursed.
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  And the one thing you don't wanna do
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  is disrupt reimbursements
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  at the health care system.
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  So so change in that philosophy
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  of how you're being
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  reimbursed for the care provided
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  creates great pause. And and and so those
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  are hurdles where it takes time and understanding
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  of the evolution of remote care,
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  again, versus sort of this scheduled base that
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  that you're not managing
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  one moment in time.
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  You're managing
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  a a a a cadence
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  that is ongoing in perpetuity for patients with
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  implantables.
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  So it's it's not a static moment, that
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  you look at.
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  And, I think that's where we've
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  reshaped how people think because they realize now
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  like, Wait a second.
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  I've looked at 10 reports over ninety days,
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  but because something didn't come in on the
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  ninetieth day, I don't get paid. Like, that
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  doesn't make any sense. These patients have had
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  VT and AFib,
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  and care has been provided. And the ability
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  for software to look back,
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  see the activity taking place,
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  coalesce that, summarize that, and be able to
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  automate the charges.
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  It it really removes a a manual burden
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  from staff to track all of those elements,
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  and it allows them to really just focus
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  on delivering care. And, you know, it's a
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  novel idea for a physician.
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  Yeah. It it's it's easy to picture the
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  way you describe it, Todd. It's like just
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  this very beneficial thing for for both patients
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  and physicians,
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  staff too. So I guess for someone listening
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  to this who's maybe thinking about
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  evaluating a a cardiac monitoring strategy,
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  whether from a technology decision standpoint or an
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  internal program perhaps or or even them just
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  interrogating perhaps a vendor relationship,
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  What questions should they be asking? What advice
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  would you give those folks in terms of
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  what should they be asking that maybe they're
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  overlooking right now?
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  I think it can be
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  difficult
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  to understand
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  the intentions
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  of an organization when you're being sold.
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  And,
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  you know,
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  one one thing I've always learned was,
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  you know, when you wanna see the true
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  behavior of someone,
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  look at their revenue model. What
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  where are they driving revenue? What is their
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  behavior?
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  And so does that organization
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  align with yours
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  in the behavior you're seeking with this technology?
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  I think that gets overlooked
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  because there's a lot of opportunities to, you
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  know, say, hey. We do this, or, oh,
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  yeah. We do that too.
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  But, in the end, when you when you
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  really pull back the curtain and say, well,
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  okay. Well,
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  as a company, where do predominantly you make
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  your revenue?
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  And
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  and if those actions
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  deliver revenue that aren't aligned with your intentions,
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  then I I think,
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  I think a lot of people need to
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  really
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  look deeper into that and and,
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  recognize the intentions of an organization.
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  And is it fair to Todd to say
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  that to ask that question of another organization,
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  you have to be able to answer it
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  for yourself. Right? Is there It really you
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  know. Is there an internal question asking that
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  that you need to begin with before before
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  you you take that question to someone else?
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  Yeah. Absolutely. And and and it it it
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  can change, and that's okay too. But you
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  really have to understand what are the needs
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  of my organization,
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  and,
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  are they best aligned for me through my
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  journey. Right? Because my my needs will change
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  as an organization.
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  And we see it all the time
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  that health care,
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  staffing changes and they fluctuate. So needs change
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  and can this organization enable,
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  me to continue to deliver high standards of
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  care through periods of time that that fluctuate
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  in staffing needs.
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  Excellent.
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  Todd, it's been a pleasure having you on.
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  We're gonna close with a forward looking question,
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  sort of challenging you to to to get
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  out your crystal ball over there.
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  But looking to the future, what do you
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  believe will define the next generation of cardiac
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  remote monitoring programs?
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  For for someone listening to this right now
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  who wants to get sort of ahead of
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  that curve also, where should they start? So
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  two part question.
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  What what's gonna define the next generation of
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  cardiac remote monitoring, and how can leaders get
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  sort of advanced on that on that curve,
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  on that on that path towards that future?
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  Well,
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  I I believe
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  you have to take a look at
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  you know, look in the mirror and look
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  at your staff
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  to understand what is their capabilities to adopt
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  new technologies and new ways of thinking.
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  Look at your institution as a whole to
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  say, can we adopt this? You know, changing
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  selecting software doesn't actually always equate to,
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  you know, being future ready
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  if it hasn't
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  really changed the way in which the behavior
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  is moving for patient care. So
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  in an example, I would say something around,
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  you know, you can
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  you can be future ready, but but
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  can you manage
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  the data flow? You're no longer managing,
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  you know, devices or a specific patient
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  per se. You're managing a flow of information
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  that is just ongoing and coming at you,
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  and it's across your entire population.
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  So, you know, as you're thinking about the
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  future, you really have to think about is
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  this technology being disruptful
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  in a way that is helpful?
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  And
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  and not just buying technology to do the
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  same things I'm doing today, but
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  really shaping
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  how we might do something more efficient
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  with a better impact to patient care and,
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  again, a return on that investment.
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  Yeah. I I think a a a theme
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  that's running through this conversation is just
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  this need for iteration, this need for nothing
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  is static, constantly interrogating
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  your your own organizational behaviors and and technology
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  as well. Is is that a fair assessment
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  of a portion of our conversation today, Todd?
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  It is. It is. I I you know,
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  we always talk about digital literacy,
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  you know. And, again, adopting technology doesn't mean
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  you have digital literacy. It's do you understand
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  the right questions to ask someone?
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  Do you understand
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  thoroughly how it impacts the workflow of your
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  staff? Because that's where the technology is gonna
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  get really used.
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  And, again, does the staff have the
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  ability and the health system the ability to
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  enable the change in the behavior shift of
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  the workflows
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  to make improvements. I think those are all
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  things that
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  you have to consider
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  before you, you know, make too many changes
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  too fast.
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  Well, Todd, thank you so much for coming
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  on the podcast today. It's been a pleasure
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  speaking with you. Hey, Brian. Thank you as
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  well. I really appreciate the opportunity and, the
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  the conversation we had.
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  Absolutely. I also wanna thank our podcast sponsor,
• 11:51
  Emerge. You can tune in to more podcasts
• 11:53
  from Becker's Healthcare by visiting our podcast page
• 11:56
  at beckershospitalreview.com.