iRhythm and Verily announced a partnership last month to “co-develop solutions intended to provide early warning, diagnosis and management for patients, particularly for those with silent or undiagnosed AF.” We spoke with iRhythm CEO Kevin King to understand how the two companies complement each other and how they can solve the problem together.
Ben Ouyang, Medgadget: Tell us about yourself.
Medgadget: Can you tell us about atrial fibrillation?
King: Cardiac arrhythmias are abnormal heart rate and heart rhythm activities that can form in patients and lead to severe heart-related complications. The market for testing these patients is largely centered on a category of what we would call symptomatic patients: these patients present to their physician or to the emergency room with symptoms of dizziness, palpitations, loss of consciousness, anxiety – a whole variety of things. A physician needs to sort out whether or not the underlying cause of those symptoms is associated with heart rate or heart rhythm abnormality – often called an arrhythmia. That’s a fairly large market.
We’ve been disrupting that market with our Zio service for the past seven years. We emerged as the leader in that field and have about 32 peer reviewed publications that demonstrate the superiority of our service. Furthermore, there’s another segment which is the asymptomatic population of patients. These are patients that have risk factors like age, diabetes, hypertension, and sleep apnea, but they don’t present to the physician with any particular symptom other than the risk factor. What we’re trying to figure out here is “do these risk factors confer atrial fibrillation?”, which is 1 of the 14 different arrhythmia classes that we diagnose. The importance of this in the marketplace is that if atrial fibrillation is left untreated, a patient’s risk of stroke is five times greater. There are well established treatments, namely oral anticoagulation therapy, that can lower the risk of a patient by as much as 80%.
Medgadget: What’s the problem that you hope to achieve by partnering with Verily?
King: The real problem here is how do you find these patients that are asymptomatic, but are at risk? How do you diagnose them and manage them? And that in essence is what the iRhythm-Verily relationship is about.
Medgadget: What’s been done so far for this problem of asymptomatic patients?
King: We conducted an independent study in iRhythm and Scripps Clinic about a year ago called mSToPS (mHealth screening to prevent strokes). We looked at patients that were asymptomatic with risk factors. We found an increased rate in atrial fibrillation in that population compared to a control population. This is the pioneering study that’s part of the impetus for giving us confidence that there’s a market to be developed.
Medgadget: What’s the current need of iRhythm right now?
King: The iRhythm solution has to be focused on diagnosing as many as 14 to 16 different types of arrhythmias, but a solution that we envision here is focused only on atrial fibrillation. So there’s somewhat of a trade-off between the complexity of what you need to do and the duration of what you can monitor in people.
Medgadget: What will you work on with Verily?
King: We’re going to be working together on developing next generation atrial fibrillation products that combine both of our companies’ technologies, with the hopes of creating what we would call an end-to-end system. What we need to do together is improve the identification of patients at risk, the diagnosis of those patients, and their management. The flow here is around identifying at risk patients, protecting or diagnosing them early, and then enabling some type of medical management so that we can either lower the cost or improve the outcome of the patient.
The fundamental value proposition is that you want people to look longer. If you look longer, a likelihood of capturing arrhythmia is greater, mostly because these atrial fibrillation patients will go in and out of atrial fibrillation in a random pattern. Verily brings a wealth of technology to the collaboration, including wearable technologies that are capable of longer-term monitoring than what iRhythm currently does. They also have the ability to identify at risk populations of patients in conjunction with the methodology that we use. They have built a number of technologies that help to mine data about patient populations and infer information about them. We need to look inside of healthcare data repositories with a more inquisitive eye about trying to uncover new sources of information or new insights that might lead us to find a more enriched target population. We think about Verily and think about Google and think about search. There’s an underlying competency there that we’re looking to rely on.
Medgadget: What about business advantages with Verily?
King: Verily has a track record of partnering with companies that have strong channels in leading positions in vertical markets. The way that they monetize their technology is through their partners in a vertical. You’ve probably heard about Verily and ResMed and sleep apnea, or Verily and DEXCOM and diabetes. Now you’re hearing about Verily and iRhythm and cardiac arrhythmias. This is this is a business model that we like and believe is complementary, and allows us to bring our technologies together to still be recognized as a market leader.
Medgadget: What are you working on right now?
King: We’re in the process of calculating the cost of utilization of service. The outcomes will be reported sometime next year. We’re really happy with the platform that we have. This is in addition to try to develop the market, either faster or more robustly than what we have.
At the end of the day, we’re really trying to effect change. We believe that the odds of effecting change are increased through this partnership.
Flashbacks: Medgadget Exclusive Interview with iRhythm’s CEO Kevin King; ZIO Wireless Patch May Be Better Option Than Holter Monitors for Cardiac Arrhythmia Diagnosis; New Software Diagnoses Cardiac Arrhytmias from ECGs Better Than Cardiologists
Related announcement: iRhythm Announces Collaboration with Verily to Develop Health Management Solutions for Atrial Fibrillation Patients
JAMA 2018 study: Effect of a Home-Based Wearable Continuous ECG Monitoring Patch on Detection of Undiagnosed Atrial Fibrillation
Link: iRhythm homepage…