Mayo Clinic’s Cardiac Monitoring Service sets stage for future of remote patient care around the globe
Eye on Innovation
Traditionally, heart patients have been tasked with wearing a harness fitted with a cardiac monitoring device, often for weeks at a time, to track any heart anomalies. The harness is then returned to the doctor’s office, where information from the device is uploaded. The patient then comes in for a follow-up consultation. If the device didn’t capture anything abnormal, the process starts all over again, costing the patient more time, stress, and money.
Mayo Clinic has turned such standard practice on its ear with its cardiac (CV) remote monitoring service. Instead of wearing a cumbersome (especially while sleeping) harness, the patient is mailed the MoMe Kardia cardiac monitoring device, a compact, discreet, device that provides a continuous, 24/7 stream of a patient’s ECG and motion data. Any troubling or burgeoning events are observed virtually the moment they occur, allowing one of Mayo Clinic’s certified rhythm analysis technicians to intervene and facilitate care in near real time.
Other healthcare institutions offer remote cardiac monitoring services as well. So what makes Mayo’s different?
“There are a lot of technologies on the market right now, and many of them rely on a patch, which might just be a single-lead ECG,” says Peter Noseworthy, M.D., medical director of Mayo’s Electrophysiology and Heart Rhythm Monitoring Lab. “And although that’s convenient, we found that we don’t necessarily get clinical grade signals off of those devices. And sometimes we’re left only saying that the heart rate is too fast or too slow. But we can’t really tell a patient what the rhythm is. With a leaded device and with this technology, we get high-quality, high-resolution signals, and we have a lot of confidence in a gold standard diagnosis at the point of care.”
The monitoring device allows for a seamless, remote transition between all modalities of ambulatory cardiac monitoring, with no additional office visits required of patients.
Paul Friedman, M.D., chair of Mayo Clinic’s Department of Cardiovascular Medicine, offers a few examples of the value of this service.“You’re going to see a 27-year-old woman with fainting spells and palpitations, or a 76-year-old man who’s had a stroke, or a 48-year-old man who, every time he goes for a jog, his heart’s racing,” he says. “These are the kinds of cases where if you prearrange for a monitor, the single most useful thing is knowing what their heart rhythm is doing at the time that they’re having the symptoms. Sometimes, we actually get a phone call from a patient while they’re having symptoms and we can log in and see the tracings in near real time.”
Dr. Noseworthy adds, “People put a lot of trust in us with cardiac monitoring. I think if they’re wearing a device and they know the data are coming to us, they want to make sure that we have eyes on that and that we’re being careful about the interpretation. If something happens, they want us to be on the other end of the line responding and taking care of them.”
Mayo’s remote cardiac monitoring service is meant to reach people, for example, in rural areas who cannot easily get to Mayo, or who don’t live near an affiliated hospital. Thus, the service gives healthcare partners access to Mayo’s cardiology and standard of care.
“We found that this technology allows us to reach patients no matter where they are in the country,” says Dr. Noseworthy. “In fact, we recently completed a clinical trial in which we mailed patients these devices to look for atrial fibrillation. And over a short period of time, we enrolled patients from over 40 states across the nation. And we were able to make diagnoses regardless of where people were and without them having to travel to a Mayo Clinic site.”
This is only the beginning. Remote patient services are the way of the future, and the future is already here.
William Morice, M.D., Ph.D., is president and CEO of CV monitoring services as well as Mayo Clinic Laboratories. “Cardiac remote monitoring is really exciting because it’s a diagnostic modality,” he says. “It has all the forward-looking elements when we talk about AI and scalability and patient access. But it’s a totally different signal than someone putting a specimen into a tube and sending it to us here in Rochester. With COVID-19 as an accelerant, we’re really seeing diagnostic information being created outside of the traditional healthcare setting, whether it’s at the home or it’s in the community in some way.
“We know that people are interested in this. They want more control over their healthcare. It’s already in the activities of our daily lives through wearables, smartwatches that can monitor things like heart rate oxygenation. They can even do a rudimentary EKG. But we’re taking it up to a medical-grade diagnostic that someone can wear, and you can obtain real-time data. I think that’s really where we need to be as a society.”
Mayo Clinic’s vision is to make its best-in-class remote cardiac monitoring service available to physicians all over the world who want a new and better way to monitor the heart rhythms of their patients. The service comes from partnering, rather than competing, with Mayo’s diagnostic expertise. In the future, other remote patient services will follow, using this same collaborative, noncompetitive model.
“I’ve been able to see, firsthand, the unbelievable impact that we’ve had on patients and their families through our really advanced and novel approach to monitoring,” says Mary Jo Williamson, chief administrative officer of Mayo Clinic Laboratories. “We have been dipping our toe in the water to understand how we can best help transform clinical practices outside of Mayo Clinic by extending some of the work we do in the monitoring space.
“Beyond that, there are all sorts of opportunities to capitalize on new practice developments that have happened within Mayo Clinic and to see how we can impact patients with a much broader footprint, patients who will never have to come here for care. And we can impact them by expanding this business and keeping our eye on this space. It’s going to be exciting and interesting, and I’m confident it’s going to evolve in the coming months and year.”
Ultimately, Mayo wants to share and collaborate for the greater good of patient care. Dr. Morice sums it up this way: “Mayo Clinic is not about trying to compete. We’re about trying to use what we know and share it with others to elevate healthcare, both for Mayo Clinic and for our partners across the country and across the world. So that is really what we’re about. The beauty of things like remote diagnostics for cardiovascular health is that, by sharing it with the community and our peers across the country, this can only benefit the patient.
“And as the technologies are used, that information comes back to us and we learn as well.
We have built what I believe is a really great model of healthcare, of healthcare delivery, and this allows us to get that off of our campuses and out to more and more people.”
In short, digital technologies like remote CV monitoring remove barriers that exist in healthcare, so more patients can get access to these technologies without having to travel to a brick-and-mortar location.
“We’re not alone in wanting to do this,” says Dr. Morice. “Most people in healthcare want to do exactly this, even those who haven’t traditionally been in healthcare as a business. And so we need to open our doors, we need to open our minds and we need to open our hearts so that we can create something that is of value to patients.”
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