iRhythm: Reinventing Arrhythmia Monitoring

Article preview from IN VIVO - October 1, 2011

There has been a tendency in the health care products industries to design products that serve the maximum number of patients, in order to create the biggest markets. In pursuit of that all inclusive goal, medical device companies have often overengineered products, adding features - and costs - not necessary for the majority of patients. This has been the case in the field of arrhythmia monitoring. By challenging previous assumptions about arrhythmia monitoring, iRhythm believes it's developed a device that improves the diagnostic efficiency and ultimately the economics of arrhythmia care.

iRhythm: Reinventing Arrhythmia Monitoring

Article preview from IN VIVO - October 1, 2011

With the advent of new treatments for arrhythmias, it is becoming increasingly important, from both a clinical standpoint and from the perspective of device companies offering therapeutic options, to diagnose this condition.

Current monitoring systems for diagnosing arrhythmias are cumbersome, result in an inefficient use of health care resources, are subject to inaccuracy due to lack of patient compliance, and fail to reach many patients who need them.

iRhythm rethought the problem, challenging assumptions about the form factor of traditional devices, the ideal length of testing, and how data are delivered to clinicians.

As the company solved each piece of the puzzle, it kept in mind one important goal: increasing the diagnostic efficiency of arrhythmia testing. iRhythm's device is not for every patient, but for the bulk of patients, company executives believe it will be better than conventional testing methods.

There has been a tendency in the health care products industries to design products that serve the maximum number of patients, in order to create the biggest markets. In pursuit of that all inclusive goal, medical device companies have often overengineered products, adding features – and costs – not necessary for the majority of patients. This has been the case in the field of arrhythmia monitoring, where over time, testing evolved from the gold standard Holter monitor, a wearable ECG (electrocardiogram) device that can store two days' worth of heart tracings, to mobile cardiac outpatient telemetry (MCOT), wireless systems able to monitor patients for several weeks at a time, and using cellular technology, to alert, in near-real time, patients and caregivers about abnormal heart rhythms.

While MCOT offers useful enhancements that are invaluable for certain patients with a high risk of lethal arrhythmias, the additional features come at a cost that's at least five times that of the older stand-alone Holter monitor, and for the vast majority of patients, real-time alerting is not necessary. More to the point, the addition of functionality to the high-end product doesn't actually solve the greatest problems hindering the diagnosis of patients with arrhythmia. At the heart of the inefficiencies in the field is the design of current monitors, which are cumbersome to apply at the point of care (for example, physicians' offices, clinics and emergency departments) and difficult for patients to use. Hurdles at the point of care often mean that patients aren't tested, or at least not as early in the process as they should be. An awkward patient interface creates issues with patient compliance and therefore diagnostic accuracy.

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