Welcome, everyone, to today's Heart Rhythm Society's Imagineers Showcase. My name is Amber Seiler. I'm a nurse practitioner at Cone Health in Greensboro, North Carolina. I'm honored today to be joined by Dr. Bobby Kurian, who's the co-founder and CMO of RFMX. Dr. Kurian is here today to talk with us about transforming atrial fibrillation management with value-based digital health solutions. Dr. Kurian? Thank you, Amber, for that introduction and for all the work of the HRS Imagineer team in putting this event together. My name is Bobby Kurian, and I am a practicing cardiac electrophysiologist. I'm also the CMO co-founder of RFMX, where we're focused on creating value that serve and connect patients, healthcare providers, and healthcare institutions with software-based solutions in the AFib space. So we have seen an evolution in how we manage patients with atrial fibrillation, with the development of pharmacological, surgical, and catheter-based tools developed to improve clinical outcomes. All of these innovations created in these categories are aimed towards meeting the expectations of reducing patients' risk of stroke, maintaining sinus rhythm, and reducing morbidity and mortality. We are now embarking in a new and exciting area of possibilities with the rapid development and explosion of digital health tools in the marketplace. Questions remain, however, in whether the digital health revolution is hope or hype, and if outcomes can be improved on AFib patients with the uptake and use of these technologies. Now, there are many wonderful digital health tools and technologies out there arriving on a regular basis for our AFib patients in the marketplace. The real challenge is the integration and connection of the data derived from these tools for our patients and healthcare providers, and integrated in a meaningful way. So what is RFMX, and how do we create value? We're a digital health company focused on using software-based solutions to help connect patients, providers, and healthcare institutions, identify relevant risk factors, stroke risk, and candidacy for catheter ablation AFib patients. Our digital ecosystem uses data from different sources, including EMRs and wearable devices, creating dashboards that lead to actual events, moving the needle forward in improving clinical outcomes, which can be tracked and show value for any organization. This connects patients, healthcare providers, and healthcare institutions in a meaningful, tangible, driven manner. So how do we do this? We have four modules of interconnected software. Our AFib population health module can take data from different sources, including disparate EMR data, which is cleaned, restructured, and reorganized to provide useful data that's relevant and tailored for management of AFib patients. This data can be connected and integrated with our digital AFib clinic, which allows for the management of AFib patients virtually with the patient-centered app, connecting the patients to the healthcare system DMR, and can be run by nurses and nurse practitioners. Telemedicine tools can be easily integrated into our ecosystem and connected via our patient-centered app. Our remote monitoring capabilities capitalize on the valuable biometric data that Bluetooth-enabled devices and wearable devices provide, and it's restructured to relay meaningful clinical data via monthly status reports that can be billed with CPT codes for Medicare. This digital ecosystem can integrate within a network of clinics at multiple sites, creating AFib patient databases within healthcare systems that can be tracked, allowing for transparency and visibility with respect to efficiency and clinical outcomes. So with the integration of these tools, we're able to easily identify, diagnose, and manage patients that lead to actual items that not only improve clinical outcomes, but are able to be tracked and show their value over time. Our clinical nurse and nurse practitioner dashboards are able to highlight those patients who are at risk in clinic in regards to modifiable risk factors and would benefit from lifestyle intervention. We also have the ability to identify stroke risk and need for appropriate blood thinners and ideal candidates for procedural interventions, including catheter ablation and left atrial appendage occluded devices. These can be quickly identified, allowing for upstream education that can be pushed prior to the clinic to the patient, and allowing for targeted guideline-directed interventions. Our IRIS AFib tool, which stands for Identification and Reduction of Stroke in AFib Patients, allows us to have a bird's eye view within the organization and search within our digital ecosystem and the EMR to identify patients who are at risk of stroke within a population and whether there are inappropriate therapies. This gives the healthcare provider and organization the opportunities for patient outreach, engagement, and education that can move the needle forward towards better outcomes. Nurse-led clinics that highlight risk factor modification and stroke prevention strategies have been shown to reduce mortality with patients with atrial fibrillation. We're excited as RFMx will provide the digital ecosystem and backbone that will allow providers to do this and scale at AFib centers in the U.S. in the digital age. This is the new model of outpatient care in the AFib space and the next evolution in how we'll manage patients clinically with AFib. For those who have modifiable risk factors that would benefit with lifestyle intervention, we offer digital health coaching that's tailored to the patient to meet them where they're at, that's centered along their patient-centered app. We're currently pursuing a pilot project at Texas Cardiac Arrhythmia and plan to have clinical data describing this experience over the next year. Thank you for your time, and I'm happy to entertain any questions at this point. Thanks so much, Dr. Currian, for that presentation. I think as providers that care for patients with atrial fibrillation, we clearly recognize now that risk factor modification is a huge part of our patient's care plan and have all been really trying to figure out ways to make this happen and make this happen well. We just have a few questions and wanted to touch base on some things that I'm sure everyone's wondering about. So this looks like a great platform and a wonderful way to help incorporate longitudinal care for our AFib patients, but what's your thoughts around cost modeling for this and who pays for it? Is it the patients, the practice, the insurance companies? Just wanted to get your thoughts around that. Great question, Amber, and costs are very important. From a modeling perspective, there's different sources in terms of revenue, in terms of who would pay for it. It depends on the system that you're dealing with. If you have an integrated system with your own insurance network as part of the system, then in that situation, the system would pay for it because they have incentive to keep patients out of the ER, keep patients out of the hospital, and improve their outcomes. We also have a model where patients themselves could pay for it with a monthly fee, similar to like new, where if, okay, you have this app, you need a little bit of support. A lot of patients that I've come across are willing to pay for it because they want to do better. They want to have better health and they just need that support system. So we're in the right timeframe with the tools that are available that allows us to provide that technology in a very unique, personalized way. Perfect. I absolutely agree. In our own health system, our ACO has been a huge proponent of helping to support us with our risk factor modification efforts. And so I do think that leaning on insurance companies is a great place to start for this. A second question, those of us who have been in EP for a long time, we've done device clinics and we've seen how much data can be generated from patients. And I do think that's a big concern. We all want to take really great care of patients and to do that in a streamlined way. One concern is data overload. And so with this app, how do you see that playing out and do you think that will be a concern for practices moving forward? I agree with you, Amber. There is an incredible amount of data that's out there. And I think as healthcare providers in general, we would want to avoid that as much as possible. I will say though, the way the market's working and how, with the watches and the Cardias of the world, no matter what, they're going to come to us. And so what that means is that we have to develop a structured approach to be able to integrate that data into a practical workload. And that's what we are actually doing. That is our goal, is to create that streamlined flow of data and to be able to utilize that in a meaningful way. And so part of this whole process in terms of us working with institution is us sitting down in the institution itself and help co-create workflows that work for the practice in regards to how the technology is utilized. There's lots of ways of building technology. One way is you just build a box and you give it to any organization and it may be a circle and no matter what, you stick it wherever it fits. And that's kind of a top-down approach, a little bottom-up approach. We'll show up at the organization and we'll work with you guys to figure out what the optimal workflow is in terms of how technology can be utilized. And so that's the stickiness and that's part of what would differentiate us, particularly from a large software company. Perfect. Perfect. And then just one final question. A lot of us are using the national registries that are available, like Get With The Guidelines AFib, to help make sure that our patients are appropriately anti-coagulated and that we're caring for them in guideline-directed ways. One of the things that those registries are missing is an outpatient component. And so some of us have created our own outpatient AFib databases to track those numbers and be sure that we're also meeting those guidelines. But would this product allow us to incorporate both our inpatient and our outpatient world to follow patients throughout their life journey? Absolutely. That is, from a software perspective, that is at the core of what we do. We go into any EMR or any database, frankly, and we're able to restructure that data so you know that data is accurate. Because as you know, a lot of these databases, there's a question of being accurate. So we actually go through, clean the data, restructure the data, and create a new database that we can believe and trust that everyone can see that provides for transparency and integrity of the data itself. Once we have that created, that allows us to be able to query the data in any, however you want to query it. Part of this ecosystem, which we created around a digital AFib clinic, is precisely to accomplish what you just described in terms of to say, okay, let's have transparency with how these clinics are run. Are we guideline-directed or not? And it's very easily, you know, we're able to show that now with the tools that we have. So to answer your question, absolutely. That's part of one of the goals of RFMx is to be able to show outcomes and to guidelines and so forth and make that connection. Perfect. Perfect. Well, thanks so much for sharing today and thanks everyone for tuning in and we hope you have a great day. Thank you, Amber. I appreciate the opportunity to present and discuss our technology.

AFib

digital health solutions

RFMX

clinical outcomes

patient-centered care