With 1 in 4 people over the age of 40 likely to develop a heart rhythm disorder like atrial fibrillation (AF) in their lifetime, the risk of experiencing an AF-related stroke has never been higher. Health Tech World learns more about Fibricheck, a fast-growing international solution which can detect irregularities and deliver actionable life-saving results
Undetected and untreated AF is responsible for 20 to 30 per cent of all strokes, making it the single most important risk predictor for suffering a fatal or debilitating stroke.
Studies estimate that someone suffers an AF-related stroke every 15 seconds. One of these stroke cases was the father of FibriCheck co-founder and CEO, Lars Grieten.
Since the majority of these strokes are preventable with timely diagnosis and treatment, the idea for FibriCheck was simple – develop something that is easy to use, by anyone, at anytime, anywhere, and doesn’t require a costly device or a trip to the doctor.
Having started as a clinical research project in a Belgian academic teaching hospital in 2014, FibriCheck has gone from community bedside to the international stage with their clinically-validated and compliant smartphone app that enables people to remotely monitor their heart at home, whenever they choose over a selectable duration.
In as little as 60 seconds, users have validated real-time results and actionable findings they can share with their provider, improving timely detection and intervention for better health outcomes.
Now a CE-certified class lla medical device in Europe and the UK, with regulatory approvals from the FDA (US), TGA (Australia), Singapore’s HSA and the UAE’s Ministry of Health & Prevention, FibriCheck has garnered adoption worldwide since the pandemic through its ability to overcome many of the traditional access to care barriers – saving travel and appointment times for patients, redcuing diagnostic waitlists and backlogs and providing a scalable approach to population health management and continuity of usual care.
“The intermitten nature of AF, especially in the early stages makes it difficult to capture during scheduled appointments and annual checks,” says Felicia Vaz, who leads market access and business partnerships at FibriCheck to understand the company’s current global impact and how they’re working to transform care.
“This results in a lot of repeat visits, and to the frustration of patients and clinicians alike, yielding not a lot of evidence to explain what’s going on or how to proceed.
“While simple to undertake, routine testing for AF is not generally done before 65 owing to resource intensity, scarcity of diagnostic devices and long appointment waits.
“Despite knowing AF doesn’t discriminate, causing strokes and heart problems in people as young as 40, this balancing act of who and when to check and who should be prioritised is naturally challenging for the health system and providers, as many patients present with palpitation complaints year over year, without data or results to inform decision making.
“This ‘wait and see’ approach means patients often have to get worse before they can get better.”
FibriCheck’s first demonstration of its disruptive potential was proven in 2018 when the company screened approximately 65,000 people in a week, simply by placing a QR code in the local newspaper.
In addition to proving a tripling in detection rate by monitoring over the course of a week, compared to a single spot-check, the results also highlighted the significant impact large-scale detection programmes can have on population health outcomes improvement.
Importantly, the project also confirmed the feasibility and potential cost-effectiveness of supervised digital screening at scale.
The company is currently working with health system funders, clinical leaders and industry partners to implement targeted case-finding projects across the care continuum in countries around the world.
“Part of what motivates us at the company is the fact that our work helps empower and bring peace of mind to people,” says Felicia.
“More than the ‘thank yous’ we receive from our users that the solution helped save their life, it’s the feedback that the reports helped support a discussion with their provider, or the validation they feel when something is detected and the reassurance of knowing everything is ok when there isn’t.
“Likewise, we receive a lot of provider feedback that the application has helped to triage worried-well patients from serious ones, reducing appointment bookings and provider demand – freeing up more time for those that need it most. Or that they’ve been able to engage more of their hard to reach, at-risk patients with an at-home alternative to coming in.
“It’s the shared understanding that comes from both parties having been involved in the process. Ultimately leading to better medication adherence, treatment compliance and overall better outcomes.
“It’s user stories like this and knowing our work has an impact on people’s lives that pushes us to do what we do.
“For me personally, it’s about health system transformation, engaging people in their care and making things better for patients and providers, regardless of geography so that nobody, along with their loved ones, have to suffer through an unnecessary stroke and all that goes with a life-altering event.”
Prevention and health literacy hits especially close to home for Felicia, having watched her dad come back from a near-fatal and debilitating stroke at the age of 14.
“People don’t realise how much life changes, not just for the individual and how they see themselves, but their family, their community, and society more broadly – impacts like exit and re-entry to the workforce, returning to routine activities like driving and new features of daily life like regular specialist and doctor appointments,” says Felicia.
“Not to mention the costs associated with rehabilitation, modifications to your home to support temporary or permanent disability. The reminder is always there. The issue is so much broader than the event itself. That’s what makes stroke prevention so important.
“It’s more than just a company mission statement for us, we’re driven to remove the barriers around accessible stroke prevention and transform the way care is delivered.”
The app itself was designed by and continues to be informed by users and clinicians to ensure it is fit for purpose and continues to evolve with care needs.
“Unlike a lot of tech developers who build solutions – often in a vacuum – to answer a problem, I’d like to think we put our users at the heart of everything we do because you can’t bring about lasting change without bringing people along,” says Felicia.
“And for that we have an amazing team whose unique lenses bring diversity to our work as widespread as our customers”
Having partnered with both Fitbit and Samsung pre-pandemic to help make its technology accessible to mass consumer audiences, the trend in people self-monitoring and managing their health via apps only continues to grow. Since Fibricheck’s first appearance in the UK in late 2019 through its partnership with Fitbit, it has seen adoption by over 30 NHS organisations, and over 150,000 patient users nationally, since March 2020.
And ith the rise of digital health during the past 18 months, Fibricheck’s adoption is ongoing.
”Digital health’s impact is better realise when we stop looking at health as a seperate thing, but rather embeded in daily life the way online banking or the shared economy has evolved,” says Felicia.
“It’s really exciting to be apart of the movement that is advancing and transforming the way we operate as a society.”
Pre-COVID, the company’s focus was primarily around case finding and detection. While remote monitoring post-treatment intervention was always a feature of solution, the prevalence of face-to-face consultations never necessitated a need by providers.
However, once COVID hit, the demand for FibriCheck grew exponentially, with the company being part of the physician-initiated and led TeleCheck-AF, which enabled thousands of people to access cardiac care at home.
Onboarding 40 leading hospitals and centres of excellence across 14 European countries in less than two months at the start of the pandemic, FibriCheck enabled remote AF management post-intervention via specialist prescription.
Telecheck-AF quickly became a pan-European response to the crisis, breaking new ground in the monitoring and provision of care continuity. And as the return to business as usual remains in flux, many clinics involved in Telecheck-AF are now adopting remote monitoring as standard practice, despite the return of face-to-face appointments.
“Through TeleCheck-AF, clinicans were able to replace 95 per cent of face to face visits,” says Felicia.
“We know AF detection rates dropped last year as non-COVID related care took a back seat with redeployment efforts and resources strained at the front lines.
“People were told not come in and consequently continue to be apprehensive about engaging with the system. Unsurprisingly, many high-risk and at-risk individuals continue to fall between the cracks while the system tries to recover and deal with the backlog of missed appointments and procedures, causing delays in life saving intervention.
“There are so many digital pathways that were created, and continue to be created. By working to deliver these things together, we can streamline and simplify the process for patients and providers.”
Felicia is a big proponent that the conversation needs to shift from digital inclusion/exclusion to digitally enabled/ supported if health equity is to be meaningfully achieved.
“In one of our recent implementations where FibriCheck was aligned to vaccine delivery, replacing annual in-practice pulse checks, our oldest female patient was 92 and our oldest male 83, which goes to show using technology isn’t hard, it’s just about making it easy for people and supporting them to do so,” she says.
“Many older people prefer using our app to attending appointments in person; as it supports their independence and reduces reliance on caregivers and family to facilitate their care. It also provides them with a sense of security by not having to go into the hospital.
“People are quick to say older generations can’t use technology and end the conversation there. This viewpoint is both ageist and limiting. Not only have more people embraced mobile technology during the pandemic, but for many it was their only connection to the outside world and their family and friends during lockdown.
“Reaching people where they are is one of the biggest advantages of digital health and where it can bring the most value to the system in engaging and informing the people they’re trying to help.”
Felicia and the Fibricheck team are part of the DigitalHealth.London Accelerator programme 2020-21, a 12-month programme for digital health companies whose products or services have been selected as having high potential to meet NHS and social care challenges.
“I think the Accelerator programme is the perfect space to test and learn,” she says.
“In our application, rather than saying we are great choose us, I was honest about our gaps and unknowns and where I thought we could benefit most from help via the programme.
“I think our openness and willingness to adapt made us relatable and worthy of help in many ways. Just as digital has the ability to connect and bring people together, successfully implementing digital transformation is about bringing people together around what you want to accomplish – anyone can get on board with someone else’s mission when you’re aligned on a shared purpose.
“DigitalHealth.London have really helped us in achieving what we wanted to do during our time in programme, and in many ways went beyond what we thought we needed, thanks in part to the openness we fostered.”
- Applications for the DigitalHealth.London Accelerator programme 2021-22 close on Sunday. To apply or for more information, visit here