Machine-to-Machine Solutions Case Study

eCardio Helps Keep Patients' Lives in Rhythm (Cont'd)

About eCardio

eCardio Facts

Business Needs

Rapidly and efficiently monitor patient heartbeats, analyze data and report to physicians

Networking Solution

Machine-to-Machine wireless data and mobile connectivity supports remote cardiac monitoring

Business Value

Increased accuracy and speed of diagnoses; enhanced patient care; reduction in total cost of patient care

Industry Focus

Remote cardiac diagnostic solutions

Size

More than 300 employees serve up to 20,000 patients at any given time

Founded in 2004, eCardio Diagnostics is one of the nation’s leading providers of remote cardiac monitoring products and services to aid in the diagnosis and ongoing management of arrhythmic heart conditions. The company enables physicians to remotely monitor cardiac functions with flexibility, speed and accuracy from the pre-diagnostic stage to post-procedural follow up. Headquartered in Houston, eCardio provides devices to patients in all 50 states.

Situation

Traditional heart monitoring systems required patients to connect their monitors to a phone line or even return to the cardiologist’s office to deliver their monitor with data. Physicians waited on paper-based reports and technical analysis, while some patients made potentially unnecessary trips to the hospital hoping for a faster diagnosis. The founders of eCardio perceived that such practices required excessive time and effort for patients and physicians, and they believed that mobile technology could increase efficiencies for both groups.

Solution

eCardio developed a remote cardiac monitoring solution that brings together leading-edge wireless technology, credentialed in-house technical analysis and top-notch customer service for patients and physicians. It was important to them to choose a wireless provider with those same qualities. In 2010, the company chose to work with AT&T to provide the wireless network with machine-to-machine (M2M) connectivity and project consultation. These services are instrumental to automatically transmit the data from eCardio’s remote monitoring devices which record patient heartbeats to its 24-hour Monitoring Center. In the Monitoring Center, credentialed technicians interpret patient data, notify physicians of serious events, and upload reports onto a web portal for physicians to access quickly and easily from anywhere.

Solutions That Help

From product development to implementation, eCardio works hard to meet the evolving needs of physicians. “Physicians rely upon us to monitor their patients quickly and accurately,” said Larry Lawson, Founder, President and Chief Executive Officer. “We are continually seeking new technology and better ways to provide our services.” eCardio’s products and services are integral to the detection of arrhythmia.

We’re really trying to drive the activity directly to where the doctor is rather than make the doctor go to where the data is."

Andrew Arroyo, Vice President and Chief Technology Officer, eCardio Diagnostics

Arrhythmia is a malfunction of the heart’s electrical activity that can range from harmless to life threatening—from a one-time occurrence to an indication of serious illness. Monitoring cardiac function while a patient goes about daily life can be critical for accurate and timely diagnosis. Patients wear eCardio’s remote monitoring devices to track and record their heart function while away from the hospital or doctor’s office.

A wide variety of patients may need cardiac monitoring. “We've had patients that are months old, all the way up to patients over 100,” said Andrew Arroyo, Vice President and Chief Technology Officer. eCardio’s solutions help make remote cardiac monitoring a flexible—even customized—process. And the process needs to be manageable, as patients wear devices anywhere from 24 hours up to 30 days.

Finding Gaps in Efficiency

Cardiac monitoring technology was introduced in the 1940’s through the use of Holters, and that technology is still in use (and even offered by eCardio) today. Yet while it is functional, it is not near optimal for many patients because of the time delay in uploading or sending in data from the Holter devices. So, eCardio’s founders set out to identify updated technology and deliver the data with greater efficiency. “Wireless monitoring allows us to see what’s happening with a patient’s heart in near, real-time, and then notify their physician of a critical event within minutes,” said Lawson.

For its clients, the physicians prescribing the studies, eCardio asked them to name their biggest challenges with existing processes. It quickly became apparent that every step of the process was very manual. Physicians were taking home and analyzing stacks of paper to make time-sensitive choices about patient care. Decisions took longer simply because the information took longer to get into the doctor’s hands. “Wireless technology not only allows us to receive the monitoring data more quickly, but we are able to notify the physicians more efficiently as well,” Lawson said.

For patients, the monitoring process could be equally clumsy. “Patients shouldn’t have to put their lives on hold to be monitored,” said Lawson. The traditional technology required patients to manually enter their device’s recorded data by holding it up to a landline phone or delivering it back to their doctor’s office in person. Compliance took significant effort, and in the meantime, there was risk of extra trips to the emergency room, longer stays in the hospital and undiagnosed arrhythmias.

Support For a Unique Solution

eCardio developed its solution—an end-to-end service that provides physicians with wireless heart monitors, automated data transmission and professional technical analysis of the data. For integrating wireless technology into its services, eCardio wanted a company that could do more than provide a secure, global network. “We looked for a wireless provider that would actively engage with us to identify key areas where we can optimize our services on their network, and increase efficiencies while bringing our monitors to a wider audience,” said Arroyo. “And that's where AT&T really shined.”

To support eCardio’s solution, AT&T provides M2M connectivity for rapid and reliable data transmission. eCardio’s wireless monitoring devices automatically transmit data to the company’s Monitoring Center for technical analysis and report generation. This near real-time reporting enables faster diagnosis and can sometimes even be life saving. The solution is supported by a dedicated AT&T healthcare account team as well as the AT&T Machine-to-Machine Center of Excellence.

AT&T also worked with eCardio to provide a custom Commercial Connectivity Service solution that segregates, aggregates and hands off the company’s traffic to its Monitoring Center  via a private connection. This offers an additional layer of security, helping ensure devices are only used by the proper party. This is critical for eCardio, as its products and services must meet rigorous medical industry standards including clearance by the FDA.

Other companies in the remote cardiac monitoring field also promise rapid data transmission, but eCardio sets itself apart in the quality of data that doctors receive. “The key for us was to deliver the service wrapped around a better product,” Arroyo said. The eCardio 24-hour Monitoring Center employs the talents of credentialed technicians who receive, analyze and interpret patient data. These technicians then upload the preliminary reports to eCardio’s web-based Physician Portal which gives doctors the tools to securely access reports from any location where they have Internet service.

More Convenient, Better Results

eCardio puts a high priority on ease of use for patients, supporting user compliance in hopes that increased compliance will translate into better health outcomes. “We always want to ensure that the patient wears the monitor as prescribed by their doctor,” said Arroyo, “When patients do their part, we can do ours in getting the information to the doctor quickly.” The Monitoring Center staff is available to answer questions and offer instruction on device operation at any time of day.

eCardio professionals use advanced technology to track patients in near real-time. Continuity of data is key for accurate analysis, so the monitoring staff watches for disruptions in device use, and checks in on patients if a device appears to be turned off or not transmitting data.

The process is more convenient for physicians as well. The stacks of paper data are history. eCardio’s web-based Physician Portal makes reports accessible from any Internet-enabled computer, smartphone or other mobile device. “We're really trying to drive the activity directly to where the doctor is rather than make the doctor go to where the data is,” said Arroyo. Through the portal, physicians have access to layers of information. They can choose to look at one layer of data or to search further. They can also make changes to the reports and upload the information into the patients Electronic Medical Record.

Building efficiency into the data gathering process, eCardio gives physicians control over what kinds of activity the monitors are tracking. Based on doctor requests, the devices can be programmed for patient-specific parameters. They can look for and record one-time events, such as an out-of-range heartbeat, or record continuous cardiac activity. In the device development phase, eCardio listens closely to physician needs. “We specify what algorithms a device is going to run, what arrhythmias we're looking for, what capabilities it will have – all tailored to what the physicians are asking us for,” explained Arroyo.

Rapid Growth to Meet a Growing Need

eCardio currently operates about 20,000 devices at any given time. The Enterprise on-Demand portal by AT&T is used to manage device activations and service plans. “It helps us to control the costs,” said Arroyo. “If we know a device is going to be sitting on a physician's shelf for a month or two, we can turn it off and pay for it only when it is needed.”

The company continues to grow and continues to add new products to its line up of monitors. “We’re always looking holistically at the patient, their care, and the continuum of services that the doctor needs to have watched for that patient over a period of time,” Arroyo said. “Those are key ingredients to our development of new products. We’re continually evolving to meet the needs of patients and physicians.”

Heart disease remains a growing societal and economic concern. In a report commissioned by the American Heart Association and issued in January 2011, it is predicted that the costs of heart disease in the United States could triple between now and 2030, to more than $800 billion a year. The life-saving solutions eCardio has introduced are part of the answer. “As the number of patients requiring cardiac care grows, we must constantly challenge ourselves to provide more efficient and effective monitoring solutions,” said Lawson.

Whether monitoring thousands of patients each day or lending its devices for research studies and awareness events, eCardio is at the forefront.

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