As a young cardiologist, Jeffrey Wessler knew most of his time would be spent treating patients with full-blown heart disease. It was a depressing realization.
So he began researching ways to help at-risk people avoid getting sick through lifestyle changes and other interventions, and came up with a new specialty he calls preventative cardiology.
"I wanted to figure out whether we could go from a reactive to proactive state," said Wessler, a cardiology fellow at Columbia University Medical Center and the founder of a digital health company called Heartbeat. "To me, that's really the next wave of where health care is going."
In late 2016, Wessler started Heartbeat with a group of Columbia-trained cardiologists, as well as engineers, data scientists and patient experience specialists. The idea was to open health clinics and attract patients who are at risk of heart disease and other chronic ailments. Heart attacks and strokes are leading causes of death in the U.S., and roughly one in three Americans have high blood pressure.
The Heartbeat team started testing its approach in January of this year with a cohort of more than 2,000 people, and has now opened its clinics to the public. The company has two clinics in New York so far with two more slated to open in the coming months.
Heartbeat is operating under the premise that apps alone can't fix health care. While many start-ups have formed in recent years to connect consumers with a doctor via smartphone, or screen for medical conditions using algorithms, there's a more popular view in the medical sphere that even millennials and the most digitally-savvy patients need face-to-face appointments with physicians. Like Heartbeat, Forward and One Medical have taken the hybrid approach.
"We really needed the doctor's eyes and touch" to change behavior, said Wessler, explaining why he opted to open physical clinics despite the added costs over pure software-based operations.
Heartbeat uses some digital components like online tests, which can be submitted before the visit to assess cardiovascular risk. The tests are often a motivator for people to come in to the clinics in person.
"Everything that can be treated virtually, will be," said Bill Evans, managing director for Rock Health, a venture fund dedicated to digital health.
The Heartbeat clinics look like a cross between a doctor's office, a start-up work space, and a gym, all with the intention of making the experience less intimidating and more comfortable. On the wall is a sign that reads, "NOT JUST A DOCTOR'S OFFICE."
Patients get the usual tests like blood pressure, blood oxygen, heart rate and body mass index. They also get an EKG to look for heart rhythm abnormalities, as well as a cardiac ultrasound. And they're asked to run on a treadmill while being closely monitored to figure out exercise capacity, as well as root out signs of blockages.
Heartbeat, which has raised $2.5 million in venture funding, has a care team, including a nutritionist and exercise therapist, to help patients develop sustainable plans. Customers can review that plan online at any time by logging into the Heartbeat system. While there, they can sign up to go for a run with a doctor in Central Park.
Heartbeat's clinics accept Medicare, as well as most of the major health insurers. For those who opt to pay out of pocket, a single visit costs $200 or an annual membership is $299.
The company is hoping that in five or 10 years it will gather compelling evidence to show a reduction in heart attacks and strokes among its patients. That would save insurers from paying for expensive hospitalizations and emergency room visits, and put Heartbeat in the position of improving patient outcomes and moving away from the fee-for-service model.
Wessler said that one of the most memorable aspects of the visit for many patients is the ultrasound that shows their heart beating.
"It's an out-of-body experience for some people," said Wessler. "A lot of them will say that they need to take better care of their heart."