Medtronic has announced a pilot programme with Mpirik to address disparities in care associated with the prevention of sudden cardiac arrest (SCA), a condition in which the heart suddenly and unexpectedly stops beating. SCA is caused by a disturbance in the heart’s electrical system, and can be deadly if not treated by defibrillation within minutes.
Globally, cardiac arrest claims more lives than colorectal cancer, breast cancer, prostate cancer, influenza, pneumonia, auto accidents, HIV, firearms, and house fires combined. Proven treatment options include implantable cardioverter defibrillators (ICDs) or cardiac resynchronisation therapy-defibrillators (CRT-Ds), established therapies that have been in use for more than 30 years.
However, Medtronic-sponsored research has shown that patients who are medically indicated for these implantable heart devices often do not receive them. Recent studies have shown treatment disparities tied to gender and race: women and men of colour, along with white women, receive devices at lower rates than white men.
The Medtronic collaboration with Mpirik also involves Vizient, a healthcare performance improvement organisation that provides data and analytic insights. This pilot programme aims to identify patients at higher risk for SCA, and identify them earlier in their care journey. Mpirik’s proprietary artificial intelligence platform, Cardiac Intelligence, will screen electronic health records (EHRs) data at five pilot hospitals, including three Vizient member hospitals, to spot patients, regardless of race or gender, who meet prespecified clinical criteria for being at risk of SCA. Mpirik will provide an automated alert through the EHR system for these patients, enabling clinicians to determine appropriate follow-up care. The identification process will continue to protect patient health information, none of which will be shared with Medtronic or Vizient.
“This pilot programme offers an innovative and scalable method to use real-world clinical data—and more sophisticated approaches than traditional manual chart reviews—enabling earlier, appropriate care for at-risk patients, while also improving quality and reducing potential disparities,” said Kweli P Thompson, general manager of Defibrillation Solutions within the Cardiac Rhythm Management business, which is part of the Cardiovascular Portfolio at Medtronic. “This exciting technology provides the ability to improve care pathways, digitise population health management and collect a robust set of data to leverage for publications.”
“Collaborating with both Medtronic and Vizient in this pilot offers at-risk patients a best-of-breed programme for improving outcomes through timely referral,” said Logan Brigman, CEO at Mpirik. “Ensuring adherence to a care pathway, assessing personalised disease progression and screening potential cardiac disease, without differentiation for gender or race, are complex issues that our machine learning and natural language processing help to solve.”
“Collectively our organisations are aligning around a program using AI to quickly identify at-risk patients based on multiple clinical factors,” said Doug Beinborn, associate principal at Vizient. “Our progress will lead to opportunities to enhance patient care in sudden cardiac arrest at these member organisations.”
ICDs deliver lifesaving shocks or painless pacing to stop life-threatening fast or irregular heartbeats that can lead to SCA. Cardiac resynchronisation therapy is a treatment for heart failure that uses an implantable CRT device to improve the pumping efficiency of the heart; the device can be a CRT-pacemaker (CRT-P) or CRT-defibrillator (CRT-D). Typically, these devices are implanted by electrophysiologists, cardiologists who specialize in identifying and treating heart rhythm disorders, after patients are referred by general practitioners or general cardiologists.
Medtronic also is collaborating with hospitals in four US cities to develop and implement solutions that address racial and ethnic disparities in the treatment of aortic stenosis, a common heart valve disease. The pilot program uses Mpirik Cardiac Intelligence to identify and manage patients in the hospital system who may need additional follow up. Once complete, the pilot program will quantify the impact with insights and key learnings that can be applied in other markets to address disparities of care.