Want to monitor congestive heart failure patients? There’s an app for that.

How smartphones can help doctors detect fluid accumulation via a patient’s voice.
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· 4 min read

Monitoring patients with congestive heart failure for costly and dangerous complications, like fluid accumulation, could soon be as easy as asking Apple’s Siri for directions or ordering your outfit for the Eras tour via Amazon’s Alexa.

Israel-based health technology company Cordio Medical, along with AstraZeneca and Spain’s Bellvitge University Hospital, are piloting HearO, a smartphone application that uses artificial intelligence to detect heart failure warning signs in a patient’s speech patterns and notify their doctor weeks before a cardiac event occurs.

“We took this known clinical phenomenon and just turned it into something that can be measured objectively [by] looking at electrical signals created by speech, captured by microphones on off-the-shelf mobile devices,” Cordio CEO Tamir Tal told Healthcare Brew.

The pilot will examine patient compliance with HearO and the software’s notification of potential heart failure events over six to nine months.

The medical-grade software, which is undergoing FDA review, seeks to improve the quality of life for congestive heart failure patients and expand their symptom monitoring options—which can cost around $20,000 for more invasive devices, as well as have varied result accuracy and compliance among users.

The app, which Tal said would cost patients about $80 a month, might prevent some of the 1+ million congestive heart failure-related hospitalizations that take place each year in the US—and cost the healthcare system an estimated $11 billion annually, he noted—if doctors can intervene sooner.

Patients with chronic heart failure—a condition that affects more than 6 million US adults—can experience fluid buildup in the lungs (known as pulmonary edema). The condition often requires hospitalization and diuretic treatment as well as maintenance medications, Tal said. But giving too much diuretic medication to patients can trigger eventual kidney failure.

“The cardiologists are trying to find a balance: to give them enough diuretic to be stable and not have a heart failure episode, but on the other side not too much for them not to get into dialysis,” he said. “The problem with that is that there’s a very thin line between [them].”

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Congestive heart failure patients prescribed the HearO app must repeat about five sentences into their smartphone each day. Those samples are then uploaded to a cloud-based server (currently Amazon Web Services) where they are analyzed in near-real time. Clinicians can view the results (and any alerts) via a shared web portal and determine if they need to intervene with diuretics to prevent a potential hospitalization.

Tal said the technology—which is similar to that used by voice recognition features, like Siri and Alexa—doesn’t care about the patient’s tone or what they’re saying, but rather the “electrical signals of the speech and the differentiation between a stable condition and a potentially deteriorating condition.”

Beyond fluid accumulation, the technology can also detect things like a Covid-19 infection or chronic pulmonary obstructive disease, which may also require immediate medical interventions in heart failure patients. But it doesn’t flag all conditions that could cause head or lung congestion (including respiratory infections or the flu) since they don’t affect the mechanics of speaking in the same way, Tal said.

The software has an 82% success rate in “predicting a heart decompensation event up to 22 days before” it occurs, according to past and ongoing studies from the US and Israel validating the HearO technology.

Compliance has not been an issue among its early users, Tal said. That is likely because the software is downloaded onto a patient’s existing smartphone—which most patients are already using multiple times throughout the day—and not a separate device.

“There’s a lot of FDA-approved devices out there that are wearable and did not succeed because of [insufficient] compliance,” he said, adding that accuracy issues and the lack of a “gold standard” for monitoring heart failure complications have hurt those efforts.

Tal expects HearO to garner FDA approval in the next year.

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Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.