What’s missing from National Heart Month?

National Heart Month

Last October, advocates of Breast Cancer Awareness Month encouraged women to get mammograms. The rationale: early detection saves lives. This past November marked the first time advocates of National Lung Cancer Awareness Month could encourage those at risk for lung cancer to request a low-dose CT scan of the lungs from their doctors. Since the CMS decision to cover lung screening for Medicare patients early in 2015, the test is now widely used to achieve—you guessed it—early detection of lung cancer.

But what test are the advocates of American Heart Month advising? The American Heart Association wants you to “learn the warning signs for heart attack and stroke.” Million Hearts® is “challenging men to start one new, heart-healthy behavior.” AHA’s Go Red For Women® wants you to “end heart disease and stroke in women” by wearing a red dress on February 5.

Do you honestly believe the actions of these non-profits during American Heart Month will have any effect on the rate of heart disease and heart attacks in the United States? Consider the fact that heart disease is a costly epidemic in America, currently responsible for 17% of national health expenditures and projected to triple in cost by the year 2030. Consider that by 2030, 40.5% of the U.S. population is projected to have some form of cardiovascular disease according to the American Heart Association’s own forecast.* Although some might point to a recent decline in heart disease deaths among seniors, mortality rates for women and those under 55 are not improving. What’s more, one-third of all first heart attacks are fatal.

Suspiciously absent from the dialog is the recommendation of any test that could achieve the early detection of heart disease. But one exists, and it’s been largely ignored by the greater medical community for more than two decades.

In 1993, San Francisco-based Imatron, Inc. made available to the public an ultrafast electron beam CT scanner capable of accurately imaging a beating heart, with a low radiation dose and a highly accurate picture of coronary artery calcification. Dr. Arthur Agatston—the cardiologist who would subsequently write the best-selling book The South Beach Diet—was instrumental in the early research on the coronary calcium score and developed the calculations assigned to the density of calcification in the coronary arteries.

In 2005, St. Francis Heart Hospital in Roslyn, New York, released the results of what became known as the St. Francis Heart Study in the July 5 edition of the Journal of the American College of Cardiology. The study of nearly 5,000 healthy patients demonstrated that the coronary calcium score predicted coronary “events” such as heart attack independently of, and more accurately than, conventional risk factors such as age, smoking, blood pressure, cholesterol and C-reactive protein.

Calcium ScoreIn August of 2012, a new study of intermediate risk patients lead by Dr. Joseph Yeboah, assistant professor of internal medicine-cardiology at Wake Forest Baptist Medical Center, found that widespread use of the coronary calcium score would have accurately “reclassified” 25% of individuals from intermediate to high risk, and another 40% would have been reclassified to low risk.

This meant that the current “gold standard” of coronary risk stratification—the Framingham score—was incorrect in its classification of more than half of people labeled as having intermediate risk.

Translated into English: The coronary calcium score works far better than the Framingham model at identifying those at risk of heart disease. These studies—and dozens more like them—proved that the coronary calcium score was the best non-invasive test for the early detection of heart disease in otherwise healthy individuals.

So why isn’t this test embraced and recommended by the medical establishment? Why doesn’t your primary care doctor recommend the heart scan to men over 40 and women over 45 every few years?

“CAC scoring is a poor bargain with high costs and real harms,” said Dr. Steven Nissen, chairman of cardiology at the Cleveland Clinic Foundation. “Calcium scoring has become a cult. It is widely advertised, and in Southern California there were once billboards encouraging people to go in and get their coronary arteries scanned, which can expose them to other risks, such as high levels of radiation. Yet there are absolutely no data [showing] that screening people for calcium with CT scanning affects their outcome in terms of survival.”

Calcium score naysayers like Nissen say that there are no randomized clinical trials that demonstrate that tests like the heart scan will ultimately reduce the number of heart attack deaths. He’s technically correct. However…there are also no randomized clinical trials that demonstrate the stress test will reduce the number of heart attack deaths—and that test is widely accepted as a “gold standard.” Nor are there such studies for many other lifesaving medical tests, such as breast MRI.

In fact, there is no randomized clinical trial that demonstrates jumping out of an airplane without a parachute causes death. But when we apply common sense, we see that we don’t really need such a study.

“For so long we’ve been doing it wrong,” says Matt Budoff, M.D., a cardiologist affiliated with UCLA Medical Center and one of the nation’s leading advocates of the calcium score. “There’s a very famous Chinese saying from the very first medical text that says that superior doctors prevent the disease, inferior doctors treat the full blown disease. I think we have been inferior doctors in cardiology for quite a long time. We have been waiting for heart attacks, we’ve been waiting for chest pain, we have been waiting for patients literally to suffer sudden death to jump in there with guns blazing and catheters interacting and trying to save them rather than getting to them earlier before the first event.”

Budoff’s research was instrumental in helping to achieve new American College of Cardiology (ACC) guidelines—released in 2013—that call for the use of calcium scoring to help better stratify risk in patients.

“The studies suggest that we may have been underestimating the value of calcium scoring for detecting and managing patients with known or suspected coronary disease,” says Kima Allan Williams Sr., M.D., vice president of the ACC and chief of cardiology at Rush University Medical Center in Chicago.

So, if the calcium score is a far better test to achieve early detection of heart disease than any other available test—cholesterol, blood pressure, etc—or risk stratification model, such as Framingham, why are organizations like the ACC so late to the game in advocating it?

Ironically, Dr. Steven Nissen was heavily involved with the ACC throughout the last decade, even serving as president of the organization. In 2007, Time magazine named him one of the 100 Most Influential People in the World. With that kind of clout and respect from the establishment, it’s safe to say that his opposition to the test—despite its clinical viability—has had an effect.

Still, you’ll find that many hospitals, diagnostic imaging centers and large cardiology practices offer the coronary calcium score test—usually at a cost of about $100.

My advice to you during American Heart Month is to pony up that C-note and get yourself screened so that you can achieve early detection if you have heart disease. Isn’t that the whole point of an awareness month anyway?

 


 

*Forecasting the Future of Cardiovascular Disease in the United States. A Policy Statement From the American Heart Association

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A Highly Personalized New Year

personalized medicineWith a predicted annual growth rate of 4.8 percent, the health and wellness industry is, in a word, healthy. However, one of the segments within health care expected to grow at more than twice the rate of the industry as a whole is a specialty known as “personalized medicine.”

 

The simple definition of personalized medicine is “the right treatment for the right person at the right time.” According to The Institute for Systems Biology co-founder Dr. Leroy Hood, there are four attributes of personalized medicine:

 

It is personalized, because it takes into account an individual’s genetic profile;

It is predictive, because it anticipates health problems and drug reactions;

It is preventive, focusing on wellness and not on disease;

It is participatory, empowering patients to take more responsibility for their health care decisions.

Personalized medicine is made possible by advances in genomic testing and proteomic science that have resulted in more highly targeted diagnostics and treatment options. Supporters of this approach cite increased efficiency of treatments, reduced instances of adverse drug reactions, elimination of unnecessary treatments and improved outcomes. As individuals become more aware of their individual risk, low-tech approaches like functional foods and nutraceuticals will also play an important role in personalized medicine.

 

In a report entitled “The new science of personalized medicine: Translating the promise into practice,” PricewaterhouseCoopers predicts:

The U.S. personalized medicine market is estimated at about $232 billion and is projected to grow 11% annually, nearly doubling in size by 2015 to over $450 billion. The core diagnostic and therapeutic segment of the market—comprised primarily of pharmaceutical, medical device and diagnostics companies—is estimated at $24 billion, and is expected to grow by 10% annually, reaching $42 billion by 2015. The personalized medical care portion of the market—including telemedicine, health information technology, and disease management services offered by traditional health and technology companies—is estimated at $4-12 billion and could grow tenfold to over $100 billion by 2015. And the related nutrition and wellness market—including retail, complementary and alternative medicine offered by consumer products, food and beverage, leisure and retail companies—is estimated at $196 billion and projected to grow by 7% annually to over $290 billion by 2015.

 

By all accounts, personalized medicine is a disruptive innovation, taking place at a time when the U.S. health care system is already undergoing many changes. As a result, there are several exciting opportunities for companies within the core B2B medical industry sector, which includes pharmaceutical, biotech and medical device companies:

  • A reduction in the time, cost, size and failure rate of clinical trials
  • The ability to command premium pricing for drugs and therapies of proven effectiveness
  • Reduced number of drugs or devices recalled due to safety concerns

 

Healthcare providers who embrace this approach will benefit as well. According to the report, “the biggest opportunity in personalized medicine may lie in identifying new products, services and information targeted directly to consumers. Success in this space will require new approaches, new relationships and new ways of thinking.”

 

How does this relate to Armada clients and their marketing challenges in 2015 and beyond?

 

I believe the trend toward personalized medicine presents excellent marketing opportunities across the spectrum of healthcare businesses:

 

Device manufacturers are able to position their technologies to specialists for greater utilization within at-risk populations. For example, an individual at risk for stroke could benefit from enhanced cerebral perfusion monitoring on everything from complex cardiovascular surgical procedures to less invasive interventional radiology or orthopedic procedures. Marketing strategies include surgical team education, pre-op patient education and payer initiatives.

Biomedical testing companies can work with primary care physicians to better identify personal risk within broader patient risk categories. For example, a test that determines the effect of aspirin resistance can lead to a more personalized approach to reducing cardiovascular risk that may result in adjusted aspirin doses or alternate medications to achieve therapeutic goals. Marketing can capitalize on this with increased physician education through direct marketing and public relations targeting print and online media read by PCPs, as well as strategic partnerships with pharmaceutical companies.

Genetic testing improves the identification of cancer risk, and genomic tumor profiling results in more targeted and potentially less toxic cancer treatment with fewer side effects. For example, a hospital or diagnostic center specializing in breast health can embrace these technologies and differentiate itself from other providers in both referring physician and direct-to-consumer marketing, such as television, print, radio and digital advertising in order to attract and maintain loyal customers.

 

These examples represent the proverbial “tip of the iceberg” in marketing opportunity, and as history has shown, adoption can be accelerated through direct-to-consumer marketing approaches—even for companies that have previously focused exclusively on provider marketing.

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Five Insights: Capitalize on a LinkedIn Company Page

Insights on Capitalizing on LinkedIn Company PagesWe recently attended the Social Media Breakfast Minneapolis-Saint Paul event (SMBMSP) and got to thinking about LinkedIn and its hidden opportunities to promote your medical device company, outpatient clinic, hospital or health care product line.

LinkedIn is a social network with over 116 million users and its offerings for the health care industry is growing at an exponential pace. And a company page allows your brand to reach your target clients, future employees, potential business partners and even consumers. Share your brand messages, specialties and services, and latest news through a successfully built LinkedIn company page. With a few simple steps you can capitalize on a LinkedIn page’s ability to promote product awareness and expand company reach. Our team compiled a handful of tactics to get you started:

1) Images are Powerful

LinkedIn recently upgraded its visual options and now allows panoramic images for your company page — similar to the banner photos on Facebook pages. Since it is the first thing a person sees when visiting your company page, choose this image wisely. Highlight an event, health awareness month, service, physician or product, and create a visually appealing cover photo that best represents the work environment. Paul DeBettignies, an IT recruiter who blogs at Minnesota Headhunter, suggests changing the banner image quarterly to gain exposure and to show up in your followers’ news feeds more often. You’ll start to see more people taking notice of your page and your brand.

Armada Medical Marketing’s LinkedIn cover photo promotes each of our social media channels and provides a “call to action” to encourage viewers to connect and follow.

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Q: Need a Strategy for Wear Red Day?

A: Here at Armada we’re promoting National Wear Red Day on our own behalf and raising awareness of women and heart disease for our clients. Showing a strong internal effort to back this cause is a great strategy for gaining social buzz. Capitalize on your company or medical practice’s participation by sharing your updates and photos and engaging with other relevant organizations online.

Go Red for Women created National Wear Red Day, every first Friday of February (this year it’s Feb. 1, 2013), exactly a decade ago to shine a spotlight on a serious health issue and the No. 1 killer of women.

According to recent statistics, 21 percent fewer women are dying from heart disease! Now that’s awareness in action!

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Q: What is the New Timeline on Facebook?

A: Last week Facebook announced that brand pages will take on a new format as the Timeline layout. Page admins have until March 30 to adapt their brand pages, and then it’s a mandatory switch-over. This new layout offers a refreshed outlook to your brand strategy on Facebook.

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Thanks for Subscribing, Liking and Retweeting

Oftentimes in this profession we take for granted the public’s knowledge for marketing buzzwords, promotional messaging and social media navigation. It’s always good to take a step back and provide you, our Periscope Blog followers and clients, with some simple How-Tos.

And in this season of giving thanks, we’re thanking you for subscribing to our blog as well as liking Armada Medical Marketing on Facebook and following us on Twitter. Not sure how to do all that? Here’s our first How-To:

Facebook: “Like” Us

Step 1: Visit facebook.com/ArmadaMedicalMarketing

Step 2: Log into your Facebook Account (if you do not have an account setup on Facebook, no worries, we have a step-by-step guide below)

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