Device-Enabled Disease Management for Heart Failure
This article was originally published in Start Up
Service-based heart failure management initiatives are evidently unable to deliver economic benefits, as evidenced by the "South Texas CHF Disease Management Project", results of which were presented at the American Heart Association meeting in November, but device companies think they can. Several , including Medtronic and CHF Solutions are setting out to demonstrate the benefits of device-enabled fluid management in congestive heart failure patients. Fluid overload accounts for 90% of hospitalizations for heart failure, and heart failure is the number one reason for hospital admissions in the US.
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Remote patient monitoring technologies, have, for years held the promise that they would improve health care by providing physicians with data that would help them intervene and maintain the health of groups of patients who are otherwise prone to exacerbations of illness that land them in the hospital from time to time. In particular, health care constituencies have been looking to telemonitoring to solve problems of chronic illnesses. The premise is that the information gleaned from remote monitoring devices can help keep the chronically ill out of the most expensive care settings like the emergency room. But the remote patient management markets have been slow to materialize for several reasons, not the least of which is lack of reimbursement. For in chronic illnesses, remote patient monitoring technologies become tools of a disease management framework, with all of the uncertainties around the economics and business models of disease management.
Clinicians are increasingly recognizing that the combination of renal dysfunction and heart failure appears to hasten the decline of patients with chronic heart failure (CHF), and even to increase their death rates. This is a significant observation because in one million annual hospital admissions for acute decompensated heart failure each year, 80% of patients have some degree of renal insufficiency. Now, several new device companies targeting cardio-renal syndrome hope to attack heart failure from a new vantage point: the kidney.
For a selelct group of patients undergoing interventional procedures or cardiac surgery, the risk of acute renal failure, caused by the body's inability to flush out high doses of contrast agents, represents a major, and potentially life-threatening complication. FlowMedica hopes to make prevention and treatment of acute renal failure a standard of care with an innovative technology that links drug and device therapies.