At heartMAP, we are obsessed with measurable impact. We project that our program will produce a 37% reduction in death and disability from stroke in our target population.
Affordability: We are focused on minimizing costs per patient without compromising on quality. Home-based testing eliminates transportation costs to obtain blood work, and a mandatory monthly clinic visit is replaced by a phone call, both of which eliminate the need to take time off work. A centralized virtual anticoagulation clinic answers calls from patients all over the country, allowing one agent to help up to 100 patients a day. Further, long-term patient tracking and embedded self-learning anticoagulation algorithm will produce improved adherence. Our cost-effectiveness analysis will help make a case to patients and providers of the exceptional value associated with this program.
Accessibility: The program is literacy-sensitive and culturally adapted. Further, home-based testing expands access to high-quality monitoring in rural areas without access to quality laboratories, and our virtual anticoagulation clinic can be accessed remotely by voice calls or texts.
Scalability: A centralized virtual anticoagulation clinic that can be accessed by voice calls or texts makes the program inherently scalable.
A core feature of the heartMAP program is that longitudinal patient follow-up with collection of process and outcome measures is embedded in the heartMAP matrix, providing continuous feedback on the success of the program. Our core performance measures are:
- Effectiveness Outcomes: Fatal and non-fatal strokes, quality-of-life
- Safety Outcomes: Fatal and non-fatal major bleeds
- Process Outcomes: Adherence, Time spent in therapeutic range (a strong surrogate marker for risk of stroke or bleeds)
- Economic Outcomes: Direct and indirect medical costs
Although the program is focused on anticoagulation, it will produce generalizable insights relevant to many chronic diseases requiring lifelong therapy such as hypertension, diabetes, and HIV.
It can also be adapted to other low-resource settings such as other countries in South Asia or Sub-Saharan Africa. The program will generate actionable data on adherence, patient behavior, and outcomes, with the power to inform important clinical and policy-level decisions.
heartMAP has the potential to change the paradigm of mobile phone-based delivery of outpatient specialty care and greatly alleviate the public health burden of chronic diseases in developing nations.