Cardiac monitoring was an area of healthcare ripe for disruption because the standard tool for monitoring irregular heartbeats hadn’t changed much since it was developed in the 1960s. iRhythm, a medical device company, developed technology that has transformed this field. Its wearable biosensing device, the Zio monitoring patch, can better detect cardiac arrythmias. This device, as well as its end-to-end servicing offered by iRhythm, enables doctors to identify and diagnose irregular heartbeats more effectively and efficiently.
iRhythm is making an impact on the healthcare system through innovations that improve the quality of care that patients receive by enabling faster time to diagnosis and, therefore, treatment. It is also working to ensure that all patients, regardless of financial circumstances, have access to advanced diagnostic devices.
A Better Diagnostic Tool
The Holter monitor, developed eight decades ago, is still the technology that is the standard of care for cardiac monitoring. But this traditional technology can only be worn for two days, while the Zio monitoring patch is worn for 14. A study showed that the Holter device’s shorter wear period caused it to miss more than half of the arrythmia events that patients in the study experienced. Only 47% of arrythmias were detected by the Holter device, with its two-day wear period, versus 99 percent detection with the Zio patch worn for 14 days.1 The Holter device is also uncomfortable to wear because it has a bulky battery and includes dozens of wired electrodes.
Thirty-five peer-reviewed studies have validated that Zio is a better diagnostic tool and does not require the degree of repeat testing that Holter devices do. Zio also has three times the diagnostic yield of Holter monitors.2 That means more patients are getting diagnosed earlier and receiving necessary cardiac treatments.
Improved Quality of Care and Quality of Lives
iRhythm’s Zio monitoring patch helps patients to avoid serious medical events like strokes, of which arrythmias are a leading cause, while providing physicians with the timely information they need to develop effective treatment plans. The Zio is a small, light, and inconspicuous remote ambulatory cardiac monitor. The Zio monitoring patch can be applied at a clinic or at home by the patient after they have watched a video tutorial.
Since patients can use the wearable technology without the need for any further manipulation, it does not impose any lifestyle limitations. People can go about all their daily activities—showering, exercising, and sleeping comfortably—while wearing the device. The Zio monitor records every single heartbeat for analysis. During the monitoring process, patients are encouraged to document any symptoms and unexpected experiences, and that information helps provide context for the recorded data.
At the end of the prescribed period, the Zio monitor is returned to iRhythm for analysis. Much of this analysis is automated by iRhythm’s proprietary artificial intelligence (AI) algorithm—a 34-layer-deep neural network—and then reviewed by a technician, before any results are sent to the doctor. The algorithm assesses the large dataset for abnormalities and synthesizes key findings into an easy-to-read report. This information is used by a physician to assess the cardiac performance of the patient throughout the wear period, and it helps improve time to diagnosis and therefore treatment.
Today, there are approximately 6,000 healthcare locations that offer the Zio service. To date, there have been over 1 billion curated hours of heartbeat data and more than 4 million patients served.
Patients find the Zio device easy to use. The patch doesn’t force them to charge or replace batteries or adjust electrodes. As a result, a study found that 98 percent of the patients who wear it during the 14-day period can comply with the requirements for using it.3 In the same study, 88 percent of patients reported that they found the Zio device easy to use, and 83 percent said they would wear it again.
Saving Valuable Time and Costs
The Zio device and supporting service were designed to help physicians be more effective in the treatment of their patients. Healthcare systems across the country have used Zio to improve diagnostic accuracy, improve clinical outcomes, and reduce operating costs and expenses. The Zio patient report is accurate and succinct.
Healthcare systems using Zio can realize significant time and cost savings, enabling more time for value-add patient care. A good portion of the reductions come from the fact that medical professionals don’t have to spend time poring over pages of hard-to-read heart rhythm data because iRhythm’s AI system automates much of that analysis. iRhythm found that large healthcare systems (e.g., hospitals) that used the Zio patch and accompanying services as an alternative to the Holter device gained significant efficiencies. They experienced a 3-fold reduction in the time spent helping patients set up the device and a 50 percent reduction in the turnaround time for analyzing data from the devices. Overall, the Zio device enabled healthcare systems to increase the time spent with patients on more important activities—like determining treatment plans for irregular heartbeats—rather than having time and costs absorbed by lower-value activities like mining cardiac rhythm data.4
Making the Device More Accessible
The Zio patch itself makes high-quality healthcare more accessible to patients because it is easier to use and more likely to detect cardiac arrythmias than the traditional Holter device. But iRhythm also addresses the cost issue to ensure that more people can benefit from using the device. Currently, 93 percent of patients in the United States have access to the Zio service through government or commercial insurance payers. In instances when health insurance payment sources are unavailable, or coverage of costs may be only partial, iRhythm offers patients alternative payment options, such as interest-free payment plans.
Patients don’t have to figure any of this out on their own. iRhythm’s Patient Financial Navigator team is available to help people understand and gain the full benefits of any insurance coverage they have. The team can also review with patients what their out-of-pocket expense will be and what their payment options are. For patients experiencing a financial hardship, additional resources are available to help them manage their payment responsibility, including payment assistance programs. The company is dedicated to helping patients get the care they need. In 2019 and 2020, iRhythm provided direct financial assistance of $400,000 and $284,000, respectively.
A Commitment to the Environment
After data have been collected from the Zio patch, components of it are reused, recycled, or scrapped. The Zio patch and the associated packaging and labeling material do not incorporate hazardous chemicals. iRhythm also looks to minimize environmental impact through innovative design that enables the safe and effective reuse of printed circuit boards, by far the most environmentally impactful component of its devices.
Beyond its products, the firm’s remaining environmental footprint is limited to its five office locations in the United States and U.K., the largest of which is its headquarters office in San Francisco, which is in a LEED Gold-certified building.
Sustainable Development Goals
The Sands Capital six investment criteria tend to lead us to businesses that are innovators or vital facilitators of change in industries undergoing significant transformation. iRhythm is one of many portfolio businesses that create impact by addressing at least one major social or environmental challenge identified by the United Nations Sustainable Development Goals (SDGs). iRhythm’s efforts support SDG 3, Good Health and Well-Being; SDG 10, Reduced Inequalities; and SDG 13, Climate Action.
References: All data and information, unless otherwise noted, are from iRhythm’s 2020 Environmental, Social and Governance Report.
1 “Two Zio monitors: All the data you need,” on the iRhythm website, citing the following research paper, Turakhia, M., et al., “Diagnostic Utility of a Novel Leadless Arrhythmia Monitoring Device,” American Journal of Cardiology, 2013.
2 “Two Zio monitors: All the data you need,” on the iRhythm website, citing data on file. iRhythm Technologies, 2020, and Tsang, J.P. et al., “Benefits of monitoring patients with mobile cardiac telemetry (MCT) compared with the Event or Holter monitors,” Medical Devices: Evidence and Research, 2014.
3 “Two Zio monitors: All the data you need,” on the iRhythm website, citing data from the study reported in Barrett, P., et al., “Comparison of 24 hour Holter Monitoring vs. 14 Day Novel Adhesive Patch Electrocardiographic Monitoring,” American Journal of Medicine, 2014.
The business profiled was selected based on its reported alignment with one or more U.N. Sustainable Development Goals.
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