Heart health for all: how we can improve access to cardiac care around the globe

Heart health for all: how we can improve access to cardiac care around the globe

Sep 24, 2024 | 5 minute read

In the effort to achieve better health for all, tackling cardiovascular disease stands out as the biggest challenge and opportunity worldwide [1]. For patients in rural or underserved communities, accessing timely cardiac care can be especially difficult, putting them at risk of delayed diagnosis and poorer health outcomes. Fortunately, with the advent of artificial intelligence (AI), virtual care, and other digital technologies, we can now bridge these gaps to bring better cardiac care to more people. Here's how - and why it matters.

Starting my medical career in Brazil - a country of contrasts - I saw firsthand the stark differences in access to care. I did my residency at a basic public health facility in São Paulo, where we were able to provide essential care despite limited resources. But just 40 miles away, patients faced a very different reality, with far fewer medical options. Where we live should not determine the quality of healthcare we receive. Yet too often, it does.

Nowhere is this more evident than in cardiac care, where timely diagnosis and intervention can mean the difference between life and death. At least three-quarters of the world's deaths from cardiovascular diseases occur in low- and middle-income countries [2]. But even in developed regions like the US and Europe, access to cardiac care is challenging for many. A lack of qualified healthcare professionals, along with growing demand, is one of the main reasons why. For example, a recent study published in the Journal of the American College of Cardiology showed that nearly half of all counties in the US do not have a single practicing cardiologist [3]. Similarly, the 2024 Philips Future Health Index report found 75% of cardiology leaders worldwide say staff shortages are impacting patient care at their organizations.

As an industry, we must do more to bridge these gaps. By harnessing the power of AI, virtual care, and remote patient monitoring, we can bring cardiac care to more patients. Let's explore how each of these innovations can help:

1. Empowering healthcare professionals through AI

Many aspects of cardiac care - such as performing an ultrasound exam or a CT scan of the heart - require substantial expertise. But what happens when that expertise is in short supply? I still remember how daunting performing my first ultrasound exam was and how helpful it was to have support from a more experienced physician. Today, AI can play a huge role in simplifying complex diagnostics, so that even less experienced healthcare professionals can deliver high-quality care with confidence.

For example, recent advances in AI have made cardiac CT more accessible to a wider range of facilities, simplifying its use for routine exams. Less experienced technicians can also call on remote consultation and expert training, giving them the support and reassurance they need. Similarly, integrating AI in ultrasound systems can help physicians detect, diagnose, and monitor cardiac conditions with greater confidence and efficiency.

Personally, I don't believe AI will ever substitute human skills. But it can certainly help us use those skills more effectively. Given the widespread shortages of specialized healthcare professionals, AI can assist in triaging patients who need expert attention, ensuring they receive specialized care in a timely manner. For instance, AI-enabled ultrasound technologies can now help detect early warning signs of heart disease in patients with cancer, who often have a higher risk of developing heart disease due to treatment side-effects. By identifying these issues sooner, patients can receive interventions earlier, which can result in better health outcomes and improved quality of life.

2. Expanding the reach of cardiac care through telehealth

Telehealth has emerged as another powerful tool to increase access to cardiac care, especially in remote and rural areas. Coupled with investments in basic community healthcare facilities, telehealth can bring care closer to patients who would otherwise have to travel long distances to reach medical services.

In Brazil, for example, Philips Foundation and local Philips teams partnered with SAS Brasil to set up four specialized telehealth centers to deliver quality healthcare to remote areas. These centers, initially aimed to handle 19,000 appointments, exceeded expectations by providing 29,000 exams and consultations, both online and in person. More recently, the partnership has been extended to launch a first-of-its kind innovation lab in Brazil dedicated to digital health education. By empowering local health workers with technology and training, such initiatives help ensure sustainable, long-term improvements in community health. Watch the short BBC film below to hear how it got heart patient Dona the support she needed:

In other parts of the world, telehealth is bringing medical expertise directly to patients' living rooms. However, to ensure no patient is left behind, investments in telehealth must be complemented by broader policy interventions to expand broadband access and improve digital literacy. Even in developed countries, the COVID-19 pandemic revealed major inequities in digital health access, contributing to disparities in health outcomes. For example, in the US, over 21 million individuals - including up to one-third of households in New York City - lack broadband internet, limiting access to telehealth [4].

Crucially, financial incentives for physicians should also support adoption of telehealth. This could involve reimbursement models that adequately compensate for virtual consultations, as well as funding for training and resources that enable healthcare providers to effectively integrate telehealth.

3. Enabling continuous patient care with remote cardiac monitoring

As hospitals around the globe face a critical shortage of beds, finding safe and effective solutions to discharge patients earlier has become increasingly important. This is especially crucial in cardiovascular care, where continuous monitoring and timely intervention can significantly impact patient outcomes.

Remote cardiac monitoring technology can track a patient's vital signs, such as blood pressure and heart rate, to help manage their conditions after discharge. This can reduce the risk of readmissions and allow patients to recover close to their loved ones. It can also improve access to care by allowing healthcare providers to monitor and support more patients, regardless of their geographic location.

Numerous studies have shown how remote cardiac monitoring can play a powerful role in supporting early detection of adverse cardiac events and enabling potentially life-saving interventions for patients. We are just beginning to untap its possibilities. When enhanced with AI, remote monitoring technology can analyze large volumes of data to predict potential issues, thereby allowing timely responses. It's no wonder cardiology leaders in the 2024 Future Health Index report identify remote patient monitoring as their biggest area of planned investment for AI clinical decision support in the next three years.

Partnering for impact at scale

As these examples show, the potential of technologies like AI, telehealth, and remote monitoring to help deliver better cardiac care to more people is profound. However, we must also recognize that patients in different communities and parts of the world face unique barriers to accessing care. These barriers are not limited to geographical distance but also include socioeconomic factors, cultural differences, and technological infrastructure. There is no one-size-fits-all solution.

That is why public-private partnerships at a country or regional level, in collaboration with other stakeholders such as regulators, are crucial for developing and testing tailored approaches to improving heart health, which can then be scaled to benefit more patients. By uniting our efforts, we can have more impact. At Philips, we are taking a similar collaborative approach to related disease areas such as stroke. For instance, in a recently published joint policy paper with the World Stroke Organization, we call for a coordinated approach to expand access to life-saving stroke care.

Investments in prevention are equally important, as many cardiovascular diseases can be mitigated through early intervention and proactive health management. Education can play a crucial role in this by helping patients recognize symptoms, understand treatment options, and adopt healthier lifestyles. This is especially important for patients who may experience atypical symptoms, such as women, whose cardiovascular health issues are often underdiagnosed and undertreated [5].

By focusing on technological innovation, partnerships, and comprehensive education, we can deliver more effective and inclusive cardiac care that addresses the diverse needs of patients worldwide. Together, we can ensure that every heart gets the care it deserves.

Sources

[1] https://www.who.int/health-topics/cardiovascular-diseases

[2] https://www.who.int/health-topics/cardiovascular-diseases

[3] https://www.acc.org/latest-in-cardiology/articles/2024/07/08/11/54/no-practicing-cardiologist-in-nearly-half-of-us-counties

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816740/

[5] https://www.heart.org/en/news/2024/02/09/the-slowly-evolving-truth-about-heart-disease-and-women

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