Costs, Consequences & Cures: Heart Failure moving to the home

According to the American Heart Association, approximately 6.2 million adults in the United States have heart failure. In other words, nearly one in every fifty people you know is living with and managing congestive heart failure.

Congestive heart failure (also referred to as heart failure) is a chronic, progressive condition in which the heart muscle is unable to pump enough blood to meet the body's needs for blood and oxygen. It is not that the heart has failed entirely, but rather that the heart is not pumping as well as it should. Think about it as if your heart just can’t keep up with the workload. Here is an example of a normal heart vs. a heart with heart failure.

Once diagnosed with heart failure, a person has a 2 year mortality rate of 20%. In other words, 1 in 5 people diagnosed with heart failure will likely die within 2 years.

These grim data on prognosis have remained true despite scientific advances in heart failure therapies. Experts have commented that these trends continue due to multiple factors including a need to monitor individuals with heart failure at home, people having several chronic medical conditions simultaneously, and healthcare professionals’ hesitation to add on new therapies without knowing how patients are physiologically responding at home. Current non-invasive tools for managing health at home, also known as remote patient monitoring (RPM), place the burden on the person living with heart failure to remember to take their vitals, write them down, and to actively share them with a care provider. Most RPM tools require clinical teams to constantly remind patients to take their measurements. Additionally, several large national studies have shown that medications that are scientifically proven to improve survival and quality of life in people living with heart failure are widely underutilized. Healthcare providers feel nervous or unwilling to add additional therapies that may lower a patient’s blood pressure at home, or result in side effects, without their knowledge. We at Casana seek to provide healthcare teams with reliable, consistent data and the confidence care teams need to improve medication optimization.

The average congestive heart failure hospitalization costs ~$14K. The high costs of heart failure care is and will continue to be a driver for new home health solutions.

Over the last 3-5 years, healthcare has been moving from the hospital and doctor’s office to the home. A driving force behind this shift is the rising cost of in-person visits and hospitalizations. In addition, for heart failure patients, hospitals are incentivized to keep post-discharge patients out of the hospital for 30 days given the penalty they must pay if a patient is readmitted within those 30 days. Several studies have shown that interventions aimed at improving the management of patients with congestive heart failure treatment after hospital discharge, in particular the consistent monitoring of vitals and symptoms, have been related to a significant decrease in hospital readmission rates. However, keeping heart failure patients out of the hospital without the proper tools in the home, does not necessarily lead to better care (one study even showed mortality increased). This raises the question as to whether people living with heart failure may need more touchpoints, not fewer. COVID19 helped to illustrate that moving healthcare to meet patients where they need us - in the home - is not only necessary, but also truly possible with the right innovative technologies.

Casana has a new approach to home health monitoring. Introducing The Heart Seat™ - an effortless and noninvasive health monitoring solution embedded in a toilet seat.

Congestive heart failure requires lifelong management. Proper treatment and management can help patients live longer and reduce the chances of dying suddenly. If people living with heart failure and their clinical teams had the ability to monitor and predict health deterioration earlier, coupled with real-time intervention, could we avoid hospitalizations and fatal outcomes?

There is a wave of companies that are taking advantage of high tech sensors, advanced algorithms, and artificial intelligence to capture medical grade health signals from the home and predict deterioration to allow for earlier intervention and improve overall care. The primary choice of heart failure specialists to get clinical-grade measurements from the home has been implantables, which track the heart’s health passively, but require a procedure to implant the monitor. It’s time for the next wave of noninvasive effortless health monitoring technologies.

Casana’s founder, Nick Conn discovered the need for effortless home health monitoring and leveraged his expertise in signal processing and algorithm development to build the world's first noninvasive, passive and inexpensive home health monitor - all in a toilet seat. Austin McChord met Nick and recognized the value of such innovative technology. He took an active role in the company’s next chapter, as CEO of Casana. Remembering to keep track of vitals such as blood pressure or oxygen levels on a daily basis, at home, is a challenge on the best of days. If your toilet seat could measure blood pressure, heart rate, blood oxygenation, and other measures of cardiac health with medical grade accuracy, and then notify a doctor to alarming changes in your heart health, could it be a game changer?

There are few new medical technologies that have the potential to improve patient outcomes and experience, and reduce costs. We believe this is one. Sitting on a toilet seat to monitor vitals could be an effortless and noninvasive way for patients and their care teams to help manage congestive heart failure and other comorbidities at home by highlighting trend data in a comfortable environment (goodbye white coat syndrome, hello better medication adjustments). We hope to look back ten years from now and be able to say that we did our small part in improving the quality of life and extending the lifespan of people in our communities living with heart failure.

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