EMS stroke triage platform edges out fellow digital cardiac care startups at AHA Scientific Sessions 2019 pitch contest

Forest Devices' system, which employs disposable EEG caps and AI to streamline stroke care, was highlighted by judges and audience members over the cardiac offerings of fellow finalists Welldoc, PhysIQ, Happify Health, Qura and VUNO.
By Dave Muoio

A half dozen digital health startups went head to head this weekend in a pitch contest hosted by the American Heart Association.

The competition’s cohort ranged from well-known heavy hitters like Welldoc to Korean hospital spinout Vuno, but in the end it was Pittsburgh-based Forest Devices that claimed top honors from both the contest’s eight judges and its audience.

“Our solution is AlphaSTROKE, a portable, noninvasive device designed to provide EMS with fast, objective and accurate stroke identification and severity information,” Andrew Maza, VP of clinical affairs at Forest Devices, said on stage during his presentation.

Comprised of head-worn EEG caps and connected artificial intelligence technology, the system can identify whether the patient has experienced a stroke within one minute, he said. In less than five minutes, it provides a binary output on the patient’s condition that helps medics direct that patient to the most appropriate healthcare facilities.

By helping to cut down the number of patients arriving at hospitals only to require transportation to yet another location, the tool cuts down the long-term brain damage that often occurs when stroke treatment is delayed, Maza explained. Notably, the system also represents a more concrete triage workflow than the imprecise tests EMS teams are employing while en route to the hospital.

“Currently, the only alternatives to the AlphaSTROKE are subjective and quite frankly less accurate clinical exams — things like ‘hold out your arms,’ ‘squeeze my finger,’ ‘smile for me,’” he said. “But none of these exams, despite the wide number that have been tested, have shown a high degree of sensitivity and specificity, as was recently confirmed by an AHA systematic review. The AlphaSTROKE, on the other hand, has shown an accuracy of nearly 90% in its clinical trials, the results of which we’ve begun to publish in conferences and different journals.”

Forest Devices’ system is still in the premarket stages, and Maza said that the company is targeting a sales and distribution model consisting of a single, sub-$1,000 purchase for the unit’s core and $100 to $200 purchases to replace each single-use EEG electrocap.

The technology is currently seeing some deployment thanks to a partnership between the startup and Alberta Health Services, and the startup has consulted with a handful of EMS groups to better inform its design and implementation.

“We actually met with a few different EMS agencies around the country, and we thought about making it smaller … but EMS actually said that they wouldn’t prefer something smaller because they’re afraid that they might lose it or misplace it,” Maza said. “So we’re pretty confident with the size that we have. We don’t think it would take up too much real estate in the ambulance, but we are working to fully ruggedize it so that even if you throw it off the back of the truck it’ll work the same.”

While Maza’s pitch earned Forest Devices the highest scores from judges and audience members, five other cardiovascular-focused digital health startups earned their finalist positions over hundreds of other startups considered by the AHA. These consisted of:

Welldoc — Best known for BlueStar, the first mobile health product to secure reimbursement as a diabetes therapy, Welldoc's BPStar product takes a similar chronic disease coaching approach for hypertension management. Through the prescribed app, patients receive targeted guidance encouraging healthy lifestyle changes and regular self-monitoring, all while clinicians receive updates on their patients’ conditions through a provider dashboard.

PhysIQ — This startup’s platform specializes in extracting raw readings from a variety of sensors and other patient monitoring hardware, which it then centralizes as a single output for clinical teams. By applying machine learning to these collected readings, the company says it’s able to more quickly identify or even anticipate cardiac events.

Qura — Qura builds wireless implantable sensors that are so small, 100 device could be placed within the area of a 12-point period, President Doug Adams said during his presentation. These sensors can communicate with an in-home wireless device to be upload and eventually send readings to a data center for analysis without any prompting from the user. While the technology is still in the animal trial stage (with early work in humans slated for roughly a year from now), the company envisions these sensors fitting within an inserted stent to monitor cardiovascular health metrics.

Happify Health — This digital platform is looking to improve cardiovascular health by addressing a patient’s underlying mental health and encourage lasting behavior change, much in the same way a cardiac rehab program might. The app-based tool includes a range of evidence-based and gamified therapies to drive user engagement.

VUNO — The Korean startup has built a deep learning algorithm that relies on sensors to provide a more immediate alert system for in-hospital cardiac arrest. Integrated into EHRs and active in a small handful of systems, VUNO is looking to sell its DeepEWS tool to hospital administrators and, at least in South Korea, anticipates some reimbursement through rapid response team funds.