HeartSense, a nonprofit community organization, is using digital stethoscopes and AI to screen for pathologic murmurs in patients who do not have easy access to a primary care physician, leading to earlier detection and improved outcomes.
Antoine Keller, MD, the founder of HeartSense and a cardiothoracic surgeon at Ochsner Lafayette (La.) General Hospital, recently connected with Becker’s to talk about the impact the program, AI and new technology has had on bringing care to historically underserved communities.
Note: Responses were lightly edited for clarity and length.
Question: How are you using AI and technology in cardiology to improve patient outcomes?
Dr. Antoine Keller: One of the things I think that is really important for us to really develop a new perspective on is how we can use technology in places that don’t really have access to technology, or have historically been underserved by all of the wonderful technological advancements that we have in medicine. Our HeartSense program has really evolved out of an understanding that there are large groups of people in the United States that don’t have access to medical care, not because they don’t live in proximity to the medical care, but because they don’t have a mechanism to be able to interact with the medical community.
We have to find innovative ways to reach people and to allow them to get the care that almost everybody else in the country can afford, not necessarily in a financial sense. We feel that taking digital technology into the community is a really good way to be able to understand where people are lacking in their access to medical care, and a way to introduce them to a pathway for them to be able to get the medical care that they deserve. We take this digital technology into underserved communities and we give the technology to the existing healthcare infrastructure. Our main goal is to be able to capitalize on existing infrastructure, because it is a way to be able to reach people with limited resources and then allow them to develop a pathway to be able to have the same expectation of a favorable outcome for whatever they have as anybody else in the country.
Q: How has the delivery and quality of care changed in underserved communities since starting HeartSense?
AK: The most obvious way that it has changed from what we can see is that we identify people who have structural heart disease that didn’t know they had structural heart disease, would not have known they had structural heart disease had they not come to our screening program and would likely have ended up in the emergency department with heart failure. We identified a little more than 20% of the people over age 60 that we screen have some sort of pathologic structural heart disease. More than half of these people don’t have a primary doctor or a cardiologist. So to me, that means the majority of people in these underserved communities don’t see doctors on a regular basis, and when they do have pathology, it goes unrecognized for longer, so that they present later in the disease process, oftentimes with irreversible heart damage.
That does a number of things for the patients and for the physicians too. For patients, that gives them the confidence that they actually do have something wrong. They can take a day off work, because it takes a whole day to see the doctor these days and or get transportation. They can find somebody to watch their kids. They can take off work because every day counts if they want to feed their families. So it gives them the confidence that it is important for me to go because I know that something’s wrong, they’re not just going to find out if something might be wrong or not. It’s good for the doctors too, because we have a shortage of doctors, and certainly a dearth of experienced clinicians who have expertise in cardiovascular medicine in these underserved communities. If their clinics are populated by people who may or may not have disease, then it is a much less efficient system than if we know we can populate their clinic with people who actually have a problem, so it makes the workflow and the matriculation through to treatment much more efficient.
Q: What capabilities do you think that AI might have in the future when it comes to the cardiology field?
AK: The possibilities are endless. I think they’re only constricted or confined by the number of people that we have to be able to think about these things and the support we have from industry to be able to make them happen. I think robotic placement of transcatheter heart valves is coming. More precise placement of devices, more precise design of devices that are specifically designed for specific individual patients because of all the volumes of data that we have access to now, it really does only limit us by what our imaginations can concede. It really is an exciting time to be doing this cardiovascular in the cardiovascular space right now.
