Virtually modelling surgery in real-time: a Q&A with HeartFlow

We first started working with NHS England when we successfully received funding from the NHS’ Innovation and Technology Payment (ITP) programme in 2018. The ITP seeks to fast-track the uptake of cutting-edge technology within the health service to improve patient care and help reduce costs. 

The funding meant that we could begin working with individual hospitals and NHS Trusts across England without impacting their annual budgets. We were awarded ITP funding again in 2019 which has allowed us to work with nearly 50 hospitals across England, with plans to be in over 70 by 2020. 

The HeartFlow Analysis is helping doctors formulate treatment plans and reduce the number of patients sent for invasive diagnostic testing. It’s also helping to save the NHS money. The National Institute for Health and Care Excellence (NICE) estimates that it could save £9.1 million a year through a reduction in costly invasive procedures and time saved in the catheterisation lab. 

The HeartFlow Planner allows clinicians to plan procedures before a patient gets to the catheterisation lab. The technology helps physicians to identify blockages, virtually model different treatment scenarios before the procedure, and enable them to understand the potential impact of the modelled treatment in real time. 

We believe this tool will help to streamline the treatment planning for patients and give doctors the ability to review their plans with colleagues and ensure everyone has a clear picture of the initial treatment plan before entering into the catheterisation lab. Planner has just received FDA clearance in the United States, and is currently under review for CE-marking. 

The pace of technological development has accelerated rapidly in recent years but there’s still so much opportunity to go further. AI is helping to make the diagnostic process more accurate and efficient. The relationships between those who develop these tools and the NHS is vitally important in improving patient care and delivering much-needed cost savings. 

Continued support from the government to introduce cutting edge technology to the NHS is key. This has been the focus of a number of announcements this year, such as Baroness Nicola Blackwood’s speech, in which she outlined the government’s ambition for the UK to become the world’s leading health tech ecosystem. She also pointed to HeartFlow as an example of new technology already benefitting the NHS. This support has been important in helping to raise the profile of innovative products and accelerating adoption across the country. 

The NHS considers innovation and advances in technology to be key to helping it enhance the patient experience, save money, and ultimately improve patients’ lives. Right now, the organisation is using technology to help patients access urgent care online, and perhaps most famously, increase the use of apps to help people manage their own health by speaking with GPs over video calls. 

Further to this, 400,000 more patients will benefit from new tests and procedures as announced by Simon Stevens, NHS England’s CEO in June this year. This announcement referred to the AI and machine learning technologies that the NHS is adopting, with the HeartFlow Analysis being a part of this. There was also a new blood test announced which has the potential to cut the time it takes to rule-out a heart attack by 75%. The blood test can detect changes of protein levels in the blood, which allows doctors to rule out a heart attack in three hours. 

Looking ahead, medical devices will increasingly be able to offer doctors more accurate insight into the potential outcomes of their recommended treatment plans. They’ll be able to help doctors understand how their patient might fare if they choose to pursue one course of action versus another. This will be transformational in terms of patient care and the efficient use of resources in the areas where they’re most needed. This is where HeartFlow’s Planner technology could make a real difference. 

HeartFlow has had a huge impact in hospitals across NHS England by reducing the waiting times for treatment. Traditionally, when diagnosing Coronary Heart Disease (CHD), many hospitals had to rely on access to stress testing which often involves multiple tests to assess a single patient. This adds strain on cardiac resources with long waiting times, and is not always accurate.

Portsmouth Hospitals NHS Trust serves a population of approximately one million. For example, since rolling out HeartFlow’s technology in 2018 it has helped clinicians at the hospital reduce waiting times in the cathetirisation lab from several months to just six weeks. Furthermore, many patients who have had the HeartFlow Analysis don’t need further testing for CHD – as cardiologists’ desire for more information have been satisfied by the analysis that the technology has produced.

HeartFlow is also beginning to level the playing field between genders when it comes to heart health and the diagnosis of CHD. Last year, research published by the European Society of Cardiology found that women wait, on average, 37 minutes longer than men to seek medical help when experiencing heart attack symptoms which may result in worse outcomes for women.

Symptoms of coronary artery disease often differ between sexes and can often manifest in more subtle ways than chest pain – for example, if a woman experiences an ache in her jaw or back, or has nausea, then it could be a symptom of heart disease. Thanks to HeartFlow technology, doctors can see exactly what’s going on in a patient’s coronary arteries, no matter how nonspecific the symptoms they’re experiencing may be.

With innovations like the HeartFlow Analysis increasingly available to people within the UK, doctors are able to detect disease earlier, improving the chances of positive patient outcomes. 

Engineers and scientists play critical roles in the advancement of medical technology, but, if they do not have a medical background must develop a strong partnership with a medical professional to be effective. I co-founded HeartFlow with a vascular surgeon, Dr. Christopher Zarins, and a cardiac surgeon, Dr. John Stevens, both colleagues I had met at Stanford University. So, although I didn’t have a medical background specifically, it was critical to test my ideas with a colleague who had experience in the field. 

I’d been studying computational fluid dynamics for years – using algorithms and data analysis to understand how fluid moves in a specific space. I’d been considering how this could be applied to medicine for many years while on the faculty in the Medical school and the Engineering school at Stanford University; specifically, combining computer simulation methods with medical imaging data. The HeartFlow Analysis came from this, with the aim of helping clinicians to understand the severity of coronary heart disease (CHD) in a patient’s arteries. 

Many sector innovations are derived from learning about another industry’s best-practice as you can test their ways of problem solving that often produce more effective ways of doing something. I’m always excited to see what other companies and ideas are founded when cross-disciplinary expertise comes together to help improve the diagnosis of diseases and patient care.