This hosted by MTPConnect’s Andrew Bowskill and facilitated by Dr Lissette Pregelj (The University of Queensland). Helen Souris (CEO Cardihab) along with Tracey Duffy (Therapeutic Goods Administration), Dr Rob Grenfell (CSIRO) and Bronwyn Le Grice (ANDHealth) were invited to discuss the benefits and challenges of embracing Australia’s adaptive regulation process when developing digital health technologies. They discuss the pitfalls and plans digital health innovators need to consider as well as tips for navigating the TGA processes.
Tasmanians living with heart disease will soon be able to rehabilitate from cardiac episodes virtually in an Australian-first deal with a state government.
Digital health group Cardihab has struck an agreement with Tasmania's health department and the Royal Flying Doctor Service to roll out its platform in public hospitals across the state.
Heart disease is the leading cause of death in Tasmania, with the fatality rate for the condition higher than the national average by 9.8 deaths per 100,000 people.
In 2019, Royal Flying Doctor Service researchers found remote Australians are also 1.6 times more likely to be hospitalised for coronary heart disease than city dwellers, and 1.3 times more likely to die.
The RFDS posits that four out of five premature cardiac disease deaths could be avoided if cardiac rehabilitation services were made available in the bush.
With thousands living in rural and remote areas on the Apple Isle, the technology will give Tasmanians recovering from cardiac events the option to carry out their treatment from home.
"It is an ideal solution for people whose busy lives prohibit them from attending traditional face-to-face clinics, people living in remote areas, patients who are less mobile and throughout COVID-19," Cardihab chief executive Helen Souris said.
The health service is delivered through the Cardihab app under clinical supervision and includes weekly phone or video consultations.
Doctors are concerned the high number of patients they're seeing with cardiovascular issues is just the tip of the iceberg.
But they hope a new app might help them reach more Tasmanians, allowing them to prevent potentially deadly conditions.
Watch the interview on Win News Tasmania featuring John Kirwan CEO Royal Flying Doctors, Helen Souris CEO Cardihab and Dr Paul MacIntyre Clinical Director Acute Medical Services.
Cardihab is pleased to announce a state-wide agreement with the Tasmanian Department of Health and Royal Flying Doctor Service Tasmania to provide digital cardiac rehabilitation services in public hospitals across the state.
Cardihab is a landmark Australian digital health platform that facilitates the virtual delivery of cardiac rehabilitation services for patients recovering from cardiac events and living with heart disease.
Cardihab Chief Executive Officer Helen Souris said Cardihab presented a solution that could improve access to critical cardiac rehabilitation programs for patients recovering from cardiac events and living with heart disease in Tasmania, particularly those in regional and remote areas.
Patients complete the virtual program using the Cardihab app remotely while under clinical supervision by qualified healthcare professionals. Supported by weekly phone or video consultations from their clinician, patients can benefit from the convenience of technology enabled care from their home.
“Using the Cardihab platform to manage their cardiovascular disease and complete their rehabilitation program patients under the care of clinical staff can continue to receive high-quality support virtually from the convenience of their home,” Ms Souris said.
“It is an ideal solution for people whose busy lives prohibit them from attending traditional face-to-face clinics, people living in remote areas, patients who are less mobile and throughout COVID-19.”
Ms Souris said Cardihab’s clinically validated platform provided an important solution to managing heart disease, the leading cause of death in Tasmania.
“Cardihab increases patient care delivery options, enables clinical professionals to deliver service efficiently and supports both patients and clinicians growing demand for proven digital health programs that are personalised, convenient and flexible,” she said.
Royal Flying Doctor Service Tasmania Chief Executive Officer John Kirwan said that Cardihab will build on the success of its Prime Mover Phase III heart/lung rehabilitation service – also supported by funding from Primary Health Tasmania under the Australian Government’s Primary Health Networks Program - and reinforce its primary health care team’s focus on evidence-based e-health.
“We measure success in many ways, such as reducing unplanned re-admissions to hospital, increased life expectancy for patients, reduced burden on paramedics and emergency departments and enabling people to continue working and contributing economically to their family and society,” Mr Kirwan said.
“But it’s mainly about an individual’s quality of life when they undertake successful rehabilitation – the reduction in stress and fear of triggering another life-threatening event and the positive path back to good health.
“Cardihab will allow our staff to assist our clients in the most remote and rural areas by creating increased access and options for those who would ignore rehab due to barriers of time, cost and distance.”
About cardiovascular disease and cardiac rehabilitation
- According to the Australian Bureau of Statistics heart disease is the leading cause of death in Tasmania;
- According to the Heart Foundation the death rate for heart disease in Tasmania is 75.3 per 100,000 people, above the national average of 65.5 deaths per 100,000 people;
- According to research by the Royal Flying Doctor Service, cardiac rehabilitation services, if made available in the bush, could prevent as many as 80 per cent of premature deaths from cardiac disease. Remote Australians are 1.6 times more likely to be hospitalised for coronary heart disease than people in major cities, and 1.3 times more likely to die.
- Throughout Australia one in five emergency flights by the Royal Flying Doctor Service are for heart attack and stroke. An average of 112 patients per-week are retrieved by the RFDS from country areas for heart treatment.
- According to the Australian Bureau of Statistics cardiovascular disease remains Australia’s biggest killer, accounting for 44,000 deaths in 2017 and 1.1 million hospitalisations a year;
- The Australian Institute of Health and Welfare forecasts cardiovascular disease to remain the most expensive disease group, rising to more than $22 billion in 2032-33;
- A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology recently recognised cardiac rehabilitation as one of the most cost-effective interventions to ensure favourable patient outcomes across many cardiovascular diseases, reducing cardiovascular mortality, morbidity and disability, and increasing quality of life;
- A study in the Journal of the American College of Cardiology showed that cardiac rehabilitation achieved a 26 per cent reduction in mortality and an 18 per cent reduction in readmissions, as well as quality of life benefits.
About Royal Flying Doctor Service Tasmania
Based at Launceston Airport, Western Junction, RFDS Tasmania was officially formed on September 12, 1960, and has steadily grown over the past 60 years from a solely aeromedical service into a holistic health care provider servicing almost every municipality in the state.
With the aim of tackling chronic disease and reducing the rate of hospital admissions RFDS Tasmania delivers a range of primary health care services and community projects to benefit all Tasmanians, including an award-winning dental outreach program and mental health and physical health programs that are all provided free of charge thanks to a combination of Federal and State Government funding.
Mobile and visiting dental care services are currently operating on King and Flinders Islands, in northern, north-eastern and north-western Tasmania plus more recently in the Fingal Valley. Its primary health services are delivered in 11 local government areas and includes youth mental health services and recently introduced mobile health hub buses to reach more rural communities.
RFDS Tasmania is accredited against the National Safety and Quality in Health Care Standards and certified against the National Mental Health Standards
It also runs an education program that involves primary and secondary schools and a suite of online education resources for teachers and students, and it offers a variety of scholarships for those training in medicine, nursing and dentistry.
What is the Prime Mover Program?
Prime Mover is an exercise and educational based therapy program developed by RFDS Tasmania's primary health care team.
It is designed for people living in rural and remote areas with stable heart and lung conditions.
The aim of the program is for participants to return to an active and satisfying life, and help prevent the occurrence of cardiac and pulmonary events.
It involves a team of physical health workers, exercise physiologists and physiotherapists, often employed from the area in which they work, conducting one-on-one consultations, group exercise sessions and education to support individuals living with chronic conditions.
Not only does the RFDS provide exercise therapy and lifestyle management support, but it identifies any potential limitations to physical activity and explores appropriate referral pathways.
We are pleased to announce that Helen Souris was among the women interviewed by Information Age who spoke to five female founders across their innovation labs in Sydney and Melbourne about the hurdles they’ve overcome and the best business advice they’ve been given.
The women are:
Carli Johnston, co-founder of Virtual Method – based at Harbour City Labs in Sydney
Virtual Method is an AR/VR specialist production agency.
Helen Souris, CEO of Cardihab – based at River City Labs in Brisbane
Cardihab is a digital health company that helps patients reach optimal health when at risk of, or living with, heart disease.
Kate Abrahams, Mantle – based at Harbour City Labs in Sydney
Mantle Corporate Affairs Technology is developing an augmented AI platform to reinvent organisational communications.
Trish Mackie-Smith, Inndox – based at River City Labs in Brisbane
Inndox is a digital property logbook that passes from one owner to the next.
Tanya Hyams-Young, CPO / COO Sourse – based at Harbour City Labs in Sydney
Sourse is an AI platform for media, telecoms and the subscription economy.
In a year best described as ‘challenging’, innovation has become much more than a buzzword. In fact, it has become a critical factor in the successful delivery of services across all industries, particularly healthcare.
2020 has provided a distinctly unusual environment for the delivery of healthcare, particularly for people who have been reluctant, or unable, to access traditional clinical services in both metro and regional areas. Health care providers have been required to accelerate innovation and adopt delivery models reliant on digital technologies to ensure care continuity, and that the quality of care has been maintained and accessible for all.
Even before 2020, the availability of over 40,000 healthcare apps on Android and IOS demonstrated the global consumer demand for apps and other digital technologies to independently manage their health. However, very few of these are evidence-based or designed to be incorporated into the mainstream delivery of specialised health services.
It is also necessary to recognise that with an aging population and the rise of chronic conditions such as heart disease, the availability of clinically validated digital health programs and apps to help patients manage their health is critical in reducing the impact on already stretched health services across Australia.
The need for evidence-based digital health resources is not just being recognised by tech entrepreneurs, biotech and pharma companies. Front line practitioners have long been aware of the disconnect between the needs of patients and the availability and accessibility of evidence-based digital health solutions.
An article by Jen Hummelshoj (RN) published in 2019 on the Australian College of Nursing website notes, “As Nurses, we know the importance of evidence-based practice. The widespread adoption of mobile phones presents a significant opportunity to improve health behaviour, particularly in relation to prevention and management of chronic disease, but the evidence base for these interventions is currently lacking.”
The pandemic has been a strongly motivating factor for the government’s investment in digital health innovation, not just to address short term needs, but also, as stated by Health Minister Greg Hunt “to support our efforts to become a leading digital economy by 2030.”
There is no doubting the potential positive impact of evidence-based digital health innovations that bring together clinical oversight and the tech-enabled delivery of structured care plans via apps. At Cardihab, we strongly believe that as an industry we need to focus on the crucial interdependencies of telehealth infrastructure and validated virtual programs that deliver clinical outcomes. Removing barriers to uptake, clinical integration and improving funding pathways will enable better delivery of person-centered care and efficiencies in healthcare utilisation.
As an industry we also need to consider what additional standards digital health programs should incorporate as best practice. For example, the inclusion of data from technologies that are registered on the Australian Registry of Therapeutic Goods ( ARTG) to ensure governance, quality frameworks and demonstrable clinical outcomes.
We also believe that context is important – making sure that the technology we use and the data we collect is clinically relevant and/or validated. Quite simply, clinical evidence is critical in differentiating patient centred, clinically led digital health programs from the multitude of solely tech driven consumer apps that source data from the Internet of Things (IoT).
Last, but not least, we are staunch advocates for the unequivocal protection of the health data that is collected during the use of digital health programs, ensuring privacy for both patients and clinicians.
Bertalan Meskó (The Medical Futurist) notes that “Digital health is nothing else but the cultural transformation healthcare has been going through in the 21st century.”
Further on he opines that “The reason why (digital health) hasn’t been implemented yet is purely human. It’s the 3Rs of healthcare gatekeeping: Rejection by individual medical professionals, good Regulations that are lacking, and the Resistance within the existing healthcare system, which is rooted in the belief that change can be stopped. Well, 2020 made it obvious that it can’t.”
Constantly incorporating feedback from patients and clinicians about the usability of developing digital health platforms, and extracting the best possible data from them, results in clinicians consistently delivering high quality and effective care to their patients, irrespective of whether that care is delivered via a digital health platform or face-to-face.
At Cardihab, we have focussed on patient-centered outcomes from the beginning and acknowledge the benefits of having a pandemic forcing a shift in thinking right across the health industry to embrace digital health solutions. The future for us is exciting and filled with opportunity to establish clinically validated technologies as core components to how healthcare is delivered either in the clinic, at home or in blended models that meet the needs of the patient and the care providers.
What are some of the things you believe the health care industry should be prioritising within the digital health scope as we shift towards a future where patients access healthcare in ways that work for them?
One of the key benefits of the CardihabTM program of Digital Cardiac Rehabilitation (DCR) is the ability to improve participation in Cardiac Rehabilitation (CR) compared to traditional models of care. This was demonstrated in the Varnfield Randomised Control Trial that showed DCR significantly improved uptake, completion and adherence to DCR programs when compared to traditional models of care.
In a subsequent study led by cardiologist Dr John Rivers from the Queensland Cardiovascular Group, it was demonstrated that these significant improvements in participation are repeatable in the real world context. The study evaluated the impact on CR participation that was associated with the introduction of a smartphone enabled app (CardihabTM) for patients declining conventional CR. Information on barriers to CR participation were also collected.
The results of this study were shared in late October at the Virtual Canadian Cardiovascular Conference. The study showed that patients who initially declined traditional CR were able to be re-engaged and initiated into CR programs when offered Cardihab. Offering Cardihab to patients that declined traditional models of care significantly increased participation from 21% to 63%.
Cardihab would like to congratulate Associate Professor Melinda Carrington from Baker Heart and Diabetes Institute who was recently awarded the Heart Foundation Vanguard Grant for ‘Improving secondary prevention and survivorship after a coronary event through enhanced disease management in higher risk individuals’.
Coronary heart disease (CHD) remains the number one killer of Australians and places a burden on the healthcare system as it is the costliest disease group to treat due to hospital readmissions.
After a person has a CHD event, they are recommended to attend Disease Management Programs (DMP) such as Cardiac Rehabilitation programs. Attendance to Cardiac rehabilitation programs demonstrate benefit on patient mortality, re-hospitalisations, psychological wellbeing, quality of life and CVD risk factors Many are unable to attend due to work or family commitments and geographical locations. Innovative concepts such as incorporating e-health and telehealth can overcome barriers by providing more flexible options.
We are honoured that we will be collaborating in this two-year study to improve the access and quality of secondary prevention and prolong survivorship after a CHD event in patients deemed to be at highest risk of a recurrent ischaemic event. This will be assessed by comparing 90-day hospital readmissions (primary endpoint) in patients receiving an intensive Disease Management Programs (DMP) utilising e-Health (SmartCR app) and telehealth strategies (intervention group) versus patients receiving Usual Care (control group). Extended 12-month follow-up and usage of the SmartCR cardiac rehabilitation platform app will be comprehensively evaluated.
Below is detailed bio of Melinda from Baker website
Great news this week with Melinda Carrington - Head of our Preclinical Disease & Prevention lab awarded a @heartfoundation Vangaurd Grant for a her work to improve secondary prevention of coronary #heartdisease in high risk patients with better disease management. @WomenSciAUST pic.twitter.com/BPRdGTcj2g— Baker Institute (@BakerResearchAu) October 23, 2020
Associate Professor Melinda Carrington is a Health Services Researcher and a Future Leader Fellow of the National Heart Foundation. She received prior NHMRC Career Development and Early Career Training Fellowships in Health Services Research. After completing her PhD in sleep research at The University of Melbourne, she undertook post-doctoral training in cardiovascular clinical trials at the Baker Institute before leaving to establish the Mary MacKillop Institute for Health Research at ACU. Melinda returned to the Baker Institute in 2017 with her team to head the Preclinical Disease and Prevention Unit.
Associate Professor Carrington has over a decade of experience in conducting community intervention trials in cardiovascular and metabolic disease prevention and chronic disease management. Together with her team, Melinda specialises in comprehensive risk assessment and nurse-led interventions to prevent cardiovascular disease and diabetes, particularly in settings where there is disadvantage, such as regional communities, lower socio-economic groups and amongst Indigenous Australians. The group have been integral in discovering clear benefits for eHealth resources with the provision for optimal care of patients with chronic conditions in the community, primary care and hospital settings.
Melinda is an Honorary (Principal Fellow) within the newly established Baker Department of Cardiometabolic Health at The University of Melbourne, Adjunct Senior Research Fellow at Monash University and an Adjunct Professor at Torrens University.
- European Society of Cardiology Heart Failure, Late breaking science award (2017)
- European Society of Cardiology, Late breaking science award (2015)
- European Society of Cardiology Heart Failure, Late breaking science award (2014)
- American Heart Association, Late breaking trial (2014)
- American Heart Association, Best research paper (2013)
- European Society of Cardiology, Best abstract from ESC affiliated cardiac societies (2012)
- American Heart Association, Best abstract from Australia (2012)
- National Heart Foundation Future Leader Fellowship (2016–2020)
- NHMRC Career Development Fellowship (2012–2015)
- Cardiac Society of Australia & New Zealand, McCredie/Wilcken Travelling Fellowship (2012)
Helen Souris presented at the Innovate Health #innov8health Pitchfest 2020 event to showcase our platform and share our story of how we are helping clinicians and patients recover from cardiac events. We also shared our vision for a future where clinically validated digital health platforms assume a prominent role in standards of care. There were 5 other innovative start-up companies pitching at this event and we are incredibly proud to have won that pitch event.
This is a significant moment for us to all celebrate but one that could not be achieved without the support and collaboration of our customers both present and future. A very special and heartfelt thank you must also go to the amazing Cardihab team that work tirelessly on our platform and our strategic partners.
We are driven by helping as many clinicians and patients get access to Cardihab so that patients continue to have access to essential care despite geographical and/or COVID-19 related social distancing challenges, and look forward to celebrating more great outcomes with you. READ MORE
Helping patients stay motivated and engaged in their recovery programs is important in the early stages post-acute cardiac event or procedure, but also in the longer term. Completing the Cardihab program through Medibank Heart Health at Home service improved Neil's compliance to prescribed exercise after his heart valve replacement and bypass operation.
"Not only filling it in encouraged me to do the exercise, and do the check in. I might not have done it [the exercise] otherwise, I would have got a bit lazy."
The 84 year old accessed the program on his iPad to help track his blood pressure, medications and other risk factors as well as having a weekly phone call with a cardiac nurse to discuss his progress and any concerns.
Read the full story: Keep Healthy with a heart health App By Ilsa Cunningham - 14 August 2020