Technology and cardiology

In a great article in his recent newsletter Bertalan Meskó, MD, PhD ( director of the medical Futurist Institute) raises the issue of technology and cardiology and in particular the impact of using digital technologies in the doctor patient relationship. His article spans a wide range of medical specialities but Cardiology is a part of the this portfolio (which ranges from general practice to dermatology to psychiatry and pathology)
The debate is set by categorizing the medical specialities in a quadrant which is defined by  2 axis: I) data based vs interaction based and II) repetitive vs creative. This leads to 4 quadrants, each with distinct differences:

  • A (repetitive-interaction): Medical Domains in which digital technologies will play a limited role and mainly as auxiliary tools
  • B (creative-interaction): Medical Domains in which digital technologies will have an impact but they will not change the patient-doctor interaction base of the process
  • C (repetitive-data based): Medical Domains in which a large group of repetitive activities will be replaced by digital technologies and thus create more space for creative tasks
  • D (creative-data based: Medical Domains in which the professionals will heavenly rely on digital technologies and will use them on a daily base
    Meskó categorizes Cardiology as a Medical Domain which has clear mix of repetitive tasks and creative thinking but with a data driven base and less with patient interaction.

Todays mix of technology and cardiology

If we focus on the current digital technologies which are used in Cardiology the main focus is still on capturing data (electrical, mechanical, invasive and non-invasive) to support diagnostics, support invasive interventions and monitor treatment effectiveness.
Within the digital data there’s a clear focus on digitization of diagnostic imaging from ECG, CT, MRI, X-Ray and Utrasound. Interestinglu these are most classic technologies which have been digitized over the years (ECG, CT, Ultrasound, X-Ray) and hardly technologies which have been digital from the start. And this transition from analog to digital has still impact on the data processing which probably results in the in-between position between repetitive and creative as chosen by Meskó.
Where heart performance could be expected to be both data driven and repetitive there’s still a significant part of the data handling which needs to be approached with creativity since the data lack accuracy and stability.

TMF grid cardiology
based on TMF grid february 2023

Which is of course a reflection of the daily challenge cardiologists and other physicians are facing in something as often used as making an ECG and interpretation of the ECG data. Today ECG waveform interpretation is still considered an art and a mastery.  Not a repetitive task which allows results in the same outcome. The same ECG data set can (and often does) results in different interpretation classifications (even by the same physician when the same data is presented again).

The future of technology and cardiology shows options for improved patient interaction based on accurate and consistent data.

From our perspective an ECG is not telling the whole patient story and patient interaction and a more holistic view are beneficial, but overall the medical domain of cardiology can benefit from increasing the quality and constancy of the data  to actually create more room for patient interaction and creative and patient specific solutions. When the data is more accurate and the (automated) data analysis provides consistent outcomes we can move away from spending time and efforts on more data capturing (over diagnosis) and spend more time on supporting patients in lifestyle changes and rehabilitation.
With CineECG we aim to move (at least a part of) Cardiology into the domain in which the base data is reliable, the physicians are supported by effective data processing applications so they can focus on therapy much sooner.

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