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Heart disease is responsible for one death every eight minutes in the United Kingdom
Cardiovascular disease is the leading cause of death worldwide, killing nearly 18.6 million people in 2019, and the problem is only getting worse, as deaths have increased by 17.1% over the past decade and cases increased 26.6%, leading to 523.2 million cases of cardiovascular disease in 2019.
In the United Kingdom alone, coronary heart disease is responsible for around 64,000 deaths annually, which is an average of 175 people each day, or one death around every eight minutes.
It's those statistics that led Dr. Ross Upton to found Ultromics: the Oxford, England-based company provides an AI-enabled cardiovascular imaging solution with the goal of reducing time to diagnosis, and improving patient outcomes. Earlier this week, Ultromics announced a $33 million Series B funding round, led by the Blue Venture Fund with participation from Optum Ventures, GV, and existing investor Oxford Sciences Innovation. This brings its total funding to $52 million.
"I set out to find a solution with my then PhD supervisor, Dr. Paul Leeson, a Professor of Cardiovascular Medicine at the University of Oxford and Ultromics’ Chief Medical Officer. I originally started my academic career studying zoology, but during my second masters in cardiovascular imaging, I trained as a sonographer and got inspired when performing heart ultrasounds, or echocardiograms, analyzing images and studying data science," he told me.
"We set out in 2017 to find a way to reduce the number of lives lost to cardiovascular disease by allowing clinicians to make more accurate diagnoses, more quickly with one of the most convenient and accessible tools, ultrasound."
Ultromics' solution is called the EchoGo platform, which uploads echocardiograms to the cloud and analyzes them quickly and with greater accuracy than the human eye alone. It consists of two FDA-cleared products, the first being the EchoGo Core, which provides fully automated analysis of resting echos.
"We are rapidly adding features and capabilities to EchoGo core, but we started with the advanced measurements most commonly useful for assisting physicians in detecting heart failure. this includes Left Ventricle Ejection Fraction (LVEF), Left Ventricle Global Longitudinal Strain (LV GLS), and Left Ventricle Volumes," Upton explained.
"These measurements help physicians more accurately diagnose heart failure including Heart Failure with Reduced Ejection Fraction (HFrEF), Heart Failure with Preserved Ejection Fraction (HFpEF), cardio-toxicity in cancer patients, and various forms of cardiomyopathy and amyloidosis."
The second product is the EchoGo Pro, which increases the sensitivity and specificity of detecting coronary artery disease on a stress echo.
"Combining EchoGo Pro with stress echo allows for accurate detection of CAD that surpasses much more expensive, invasive, and uncomfortable modalities such as a nuclear stress test."
Ultromics’ typical customers are the cardiology service lines within hospitals, integrated delivery networks, and private practice cardiology groups. The company also works with several diagnostic imaging centers that perform echocardiograms. It is currently rolling out across the U.K.’s NHS and is also scaling its U.S. commercial operations. Both EchoGo Core and EchoGo Pro are already being used and validated by several organizations, including Mayo Clinic and the Oregon Health and Science University.
In terms of the ROI for its customers, that is nearly instantaneous, Upton told me.
"First, embedding EchoGo into diagnostics reduces opportunities for human error and allows all health systems, hospitals, cardiology practices, and imaging centers to provide their patients with precise, accurate, and timely heart disease diagnostics. This leads to better outcomes, and better outcomes is not only our primary focus, but what drives the providers that adopt our technology," he said.
The company is also solving for some of the major issues that exist in cardiology and the echocardiography sub-specialty right now, including the increase in cardiac disease patients. It also helping to alleviate the rapidly approaching shortage of cardiologists and cardiac sonographers, which was starting to lead to massive burnout in cardiologists and sonographers, something that has only gotten worse over the last 18 months due to COVID.
"When we are able to come in and say we can automate 15 minutes of a 60-minute echo procedure using AI analysis in the cloud, that’s a huge qualitative return on investment. That 25% efficiency gain can allow hospitals and clinics to keep up with growing demand, or mitigate the risk of turnover because the staff is just burnt out."
There are other companies that use AI for diagnosing heart disease, including Hello Heart and Cleerly, both of which raised funding rounds within the last few months, but the difference for Ultromics is that no other company has succeeded in automating every step in such a way that eliminates the variability and lack of reproducibility in echo analysis, Upton said.
"Also, we go a step further and produce diagnostic recommendations. Much of AI’s success depends on the data used to train the algorithms, and we have benefited from having exclusive access to a massive dataset of echocardiograms with known patient outcomes there were ethically sourced with patient consent through Oxford and the NHS," he explained.
"This data set combined with the scientific rigor and leading minds in AI and echocardiography from across the world has allowed us to succeed in fully automating the entire echo analysis pathway and produce disease classifiers and automated measurements with never-before-achieved precision and accuracy."
The company plans to use its new funding to accelerate its growth, specifically in the U.S. market, and to drive product innovation into EchoGo Core and EchoGo Pro. This includes research collaboration with organizations like Mayo Clinic, University of Chicago and many others, including the necessary clinical trials that prove the efficacy of our AI in disease detection.
There are still a lot of limitations to echocardiograms, including the time it takes to conduct a study, the limited technology, tools, and software becoming outdated and obsolete, as well as the cost and time it takes to find and retain or train sonographers. There's also high variability and low reproducibility that result from manual and subjective analysis, Upton told me, noting that these limitations are major contributors to the fact that as many as 1 in 5 patients are misdiagnosed, millions of dollars are spent unnecessarily treating and managing heart disease, and huge inequities in outcomes across socio-economic cohorts.
Those are the problems the company has been working for a decade to solve, and now it believe it finally has the solution.
"Ultromics’ ultimate goal is to enable truly effective and preventative cardiac care. If we can provide the right patients with the right interventions earlier, and reduce the volume of unnecessary procedures associated with poor heart health, we will be increasing efficiencies and quality of life across the board."
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