Heart care has been communicated largely through lifestyle advice such as eating better, exercising more, stopping smoking, and managing stress for decades. The American Heart Association guidelines include these behaviours in terms of prevention of future heart attacks and to assist in recovering from a heart attack. In recent years, heart disease has become more complex, which means that our lifestyles and lifestyle modifications will no longer be sufficient. Cardiac care must now be individualised based on continuous, data-driven metrics rather than ‘one size fits all’ approaches.
The limitation of lifestyle-only guidance
Lifestyle changes are mostly theoretical; adherence to lifestyle modifications is inconsistent, symptoms are frequently ignored, and risk accumulates without notice. More cardiac events occur not because people were unaware of advice, but rather because they fail to monitor or detect the symptoms of the disease.
The progression of heart disease has many causes, such as family history of heart disease, concurrent diseases, diabetes and high blood pressure. Addressing the complexity of heart disease will require more than simply seeing a physician annually for preventive care.
Continuous monitoring, not episodic care
In traditional cardiac care, there are gaps in providing continuous care, especially for patients at risk for negative outcomes due to their cardiac condition. In the modern healthcare setting, a key component of care is continuous monitoring of patients and their cardiac function. Using remote ECG monitoring, wearable devices, and IoT-enabled cardiac health care solutions, physicians can get real-time data to be alerted in emergency situations like arrhythmias, sudden elevations in blood pressure, and irregular changes in heart rate; this will enable the patient to prevent cardiac events.
The use of technology does not intend to replace a physician; rather, it is meant to offer an extension of the physician’s visibility into day-to-day life, which is where most of the risk builds up.
Data integration and predictive insight
Heart care today generates an astounding amount of information from diagnostic tests, imaging, laboratory results, and wearable devices to medication history data. Access and collection of this data with safety is a real challenge.
Effective analysis of cardiac data enables a better understanding of the patient’s condition. Additionally, integrated cardiac data can provide guidance on how to be more effective with a patient's medications and rehabilitation plan in real time. For instance, having a single point of access to a patient’s cardiac data allows care teams and providers to determine whether any changes to current treatments are necessary to create coordinated plans.
What modern heart care must focus on
To scale effective heart care, especially in India, we need to rapidly achieve a few practical goals that improve results on the ground. These include:
* Early detection at the primary care level: Early identification of patients at high risk of cardiac events through the use of modern IoT-enabled diagnostic devices for treatment by primary care physicians before symptoms develop.
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* Connected care between GPs and cardiologists: Coordination of health services between physicians and Cardiology Specialists allows Cardiology Specialists to review test results, patient history, etc., and make timely, well-informed decisions without having to wait for referral.
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* Continuous monitoring: Continuous monitoring of key cardiac parameters via remote monitoring allows for timely detection of potential declines in patients' cardiac health, particularly for patients living in urban and semi-urban locations with limited access to specialists.
* Patient education: Continuous awareness and patient education are significant. Accurate information about their condition will result in the patient becoming more responsible for their health, leading to lifestyle changes and providing an earlier opportunity for recovery.
Lifestyle modifications still form the base of our heart health, but the way we approach modern heart care must be preventative, predictive and most importantly personalised. Heart care will need to combine the knowledge of physicians, the latest technology available, with the data of patients. The future of cardiac care will no longer be defined by guidelines but by our ability to link our daily lives to our clinical understanding. That is how we will truly make an impact on decreasing the incidence of heart disease.
(Arindam Sen is the CEO & Director, Heartnet India)
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.