Charley Taylor, Founder and Chief Technology Officer of HeartFlow, shares his predictions on where med-tech is headed as we approach 2021
2020 has been a year unlike any other, and one we will undoubtedly be discussing for decades to come. As SARS-CoV-2 spread across the globe, the medical world was thrust to centre stage. In a way that could never have been predicted, ordinary people suddenly took an interest in the technicalities of disease management and day-to-day conversations became filled with jargon previously reserved for medical specialists.
With multiple coronavirus vaccines in final stages of development and success rates so far looking promising, we may say – with caution – that the end of the crisis at long last appears to be in sight. However, even if the UK government and others do successfully launch the roll out of a vaccine in the near term, it’s safe to say that the effects of the crisis will be with us for a long while yet. And implications extend far beyond the realm of respiratory disease.
Emerging health trends have been rapidly accelerated by Covid and the med-tech industry in particular has been irrevocably changed. So, as we begin 2021, just what could a post-Covid world look like?
Telehealth and Virtual Care
We are now all too familiar with the concept of social distancing and, unfortunately, the adherence to this practice will remain necessary even in the event of a successful vaccine for some time. This is especially so in hospitals and other medical environments populated by large quantities of vulnerable individuals.
Treating patients while respecting social distancing evidently presents challenges and in some scenarios is simply impossible. Physicians are looking to technology that allows them to treat patients while keeping as much distance as possible and the adoption of telehealth and virtual care practices have consequently proliferated.
Telehealth signifies the use of technology to enable healthcare professionals to remotely monitor data on certain aspects of a patient’s health. It is a broad term that comes in a wide variety of styles, from a simple virtual check-up to complex robotic surgery performed through remote access.
In terms of cardiac care, this has manifested in the shape of the CT-first approach – one recommended by the NHS. Coupled with technology such as the HeartFlow Analysis, many patients can be diagnosed with CHD within a matter of days and in one hospital visit. Initial discussions can be conducted virtually, and patient needs to visit the hospital for a CT scan, which takes approximately 90 minutes and requires minimal interaction with the clinical team. The physician can review and interpret the CT scan remotely, and if additional information is needed, the data from this scan is then sent to HeartFlow where an interactive, 3D digital model of the patient’s arteries is created.
The HeartFlow 3D digital model is then sent to clinicians, so they can remotely review the model and determine the appropriate treatment, playing a critical role in giving them greater confidence in their diagnosis. It is a good example of how the NHS’s approach of adopting leading digital technologies is helping the public health service become more efficient. The whole CT-first approach reduces patient waiting times and the amount of time spent interacting with medical professionals in person, which has been a critical advantage during the global coronavirus pandemic. Further, as described in the recently completed FORECAST trial conducted in the UK, this approach can significantly reduce the need for invasive cardiac catheterisation without adding additional costs and further lessening interactions with the clinical team. Fewer invasive procedures is good for patients, but also good for physicians and other healthcare providers trying to conserve precious resources.
Data and privacy
The pandemic has served as a stark reminder of the immeasurable value of data. It has been central to our understanding and management of the crisis. From the monitoring of case numbers, deaths and hospital admissions, to the harnessing of data to control outbreaks via the government’s NHS track and trace system. The NHS has clearly recognised the potential of data and AI and invested accordingly – this trend is likely to continue into 2021.
As data and AI have become more commonplace across all sectors, there has been a general unease around the issue of privacy that this raises. However, the pandemic has engendered a cultural shift. The use of data for health reasons has become normalised and the crisis has underlined the benefits of giving up such information, potentially resulting in the life of a loved one being saved. While the dichotomy of data and privacy clearly presents a trade-off, Covid-19 has tipped the balance in favour of data.
However, trust in medical professionals to handle data responsibly will remain a key issue, and transparency will be essential. None of us would be comfortable with our information going out into the world for an unspecified use and so the collation of data will continue to become more targeted. At HeartFlow, we recognise this and take great effort to illustrate the direct relation between adding data into our algorithms while adhering to strict patient privacy protocols, and the significant benefit this brings to patients and physicians.
Looking beyond Covid
Back in spring, when there were gaps in our knowledge of the coronavirus and its lethality, hospitals reallocated resources to prioritise Covid patients. As a result, many patients avoided seeking medical attention due to a perception that hospitals were rampant with outbreaks of the virus. Compounding this were concerns about a lack of PPE.
As a consequence, we saw outcomes for non-Covid patients take a hit, with many either missing out on vital procedures or seeking diagnosis at a later date when their condition had worsened. Fortunately, as we are armed with more specific information about the virus, who it affects most and how to treat it, balancing the treatment of Covid and non-Covid patients has become more manageable.
Thankfully, we are now seeing investment and research in other areas of health recommence. In the sphere of cardiac care, this means the NHS’s continued adoption of new CT scanners of greater image quality and efficiency. These also provide a richer diagnosis, including atherosclerosis plaque information. It also means that evidence-based medicine can continue to benefit from conducting large, international randomised controlled trials to improve methods of diagnosis and treatment.
Covid-19 will remain a key medical issue, but it will become more manageable throughout 2021 as greater accessibility to vaccines takes hold. It will mean the medical community can move beyond a pandemic discourse with a renewed focus on other conditions such as coronary heart disease, which remains the world’s biggest killer.
