HRS 2022 – It’s Time For Industry To Change Direction

Solutions Looking For Problems at HRS 2022

The Heart Rhythm Society’s Scientific Sessions is the annual meeting of electrophysiologists, technicians, managers, suppliers, and scientists in the electrophysiology (EP) space. This year, the conference was in San Francisco the last weekend of May. I have been going to this conference for years, and as Innovative Health rounds up clearances to reprocess virtually all major EP devices except for the ablation devices and extend our focus to interventional cardiology, I was curious about the supplier-dominated conference and the ability of Heart Rhythm Society (HRS) to ensure the current focus on cost reductions and sustainability in healthcare (including EP) was front and center.

Let me explain: The EP focused MedTech industry revolves around this annual conference. This is where they showcase their products, unveil their new technologies, and present the newest methodologies to improve EP procedures. As a result, providers show up to see what the industry can do for them this year. They leave their home theater and go to HRS to find solutions that are relevant in their EP labs. These EP labs are challenged with mandated budget reductions, staffing shortages, increased demand, and unsuccessful procedure rates that are just too high.

Instead of technologies that improve outcomes, reduce procedure time or cut costs, providers were met with aggressive (but very polished) salesmanship in oversized exhibits presenting new products that seemed to do little more than last year’s products. Yet, they were more expensive. New products are always more expensive. I recently suggested the analogy of a new car to represent the essence of new product development amongst the MedTech giants of the EP space: I own a car that does 110 miles an hour. It takes me 30 minutes to get to work. I am persuaded to buy a “better” car that does 150 miles an hour. I spend a lot of money on this new car, but it still takes me 30 minutes to get to work, since the speed limit on the freeway is 75 miles an hour, regardless what car I drive. This is what EP labs experience. The “better” technology is better in terms of its capabilities (number of electrodes on a mapping catheter, the dimensionality of an ultrasound image, the anatomy of the mapping catheter, etc.), but it makes no difference in terms of patient outcome. This is because, like my old car, the capabilities of the last generation device were less, but it did the same job. This was the case with the introduction of the 3D ultrasound catheter – and now the 4D ultrasound catheter. It was the case with the “advanced” introducer sheath from Biosense Webster. And it is the case with the displacement of the Pentaray mapping catheter with the Octaray mapping catheter. 8 legs to the octopus rather than 5. More electrodes. These products are solutions looking for a problem. The electrophysiologist is doing just as well with the last generation technology, yet the labs in which they operate are asked to adopt new technologies and accept price increases every year.  

These products are solutions looking for a problem.

It has been encouraging lately, and certainly at HRS this year, to witness how clinicians and EP lab management have gotten better at pushing back and remaining sober about the allure of the newest technology. New questions are being asked: Does it improve outcome? Does it reduce procedure time? Does it reduce total device costs in my ablation procedure? I heard these questions asked a lot, but the solution-providers revert to the capabilities issue: It can do more!

HRS 2022 wasn’t all bad. The electrophysiology community, after all, is populated by top-notch doctors and scientists and a whole lot of entrepreneurs who are focused on improving care and addressing healthcare economics in and around the EP lab. Our mission at HRS 2022, as in prior years, was to help EP labs across the country reduce costs by safely re-using single-use labeled EP devices. We are becoming more relevant as providers face the post-pandemic challenges of reducing costs without reducing care quality. We had great dialogue with clinicians, EP lab management – and suppliers - who are increasingly asking the question, “can this be reprocessed?”

We are becoming more relevant as providers face the post-pandemic challenges of reducing costs without reducing care quality.

What was lacking at HRS 2022, I think, was leadership on the part of HRS as a key institution in the EP space to actively set an agenda that reflects the current realities of the service line, the procedure area, however you want to put it. These realities are about caring for more patients with less money. They are not about buying a more expensive car that drives faster without getting to the destination any sooner.

Out of caution, HRS 2022 required everybody to be vaccinated and to be able to prove it. Otherwise access was denied and you didn’t get your wristband. For HRS 2023, I suggest a different rule in order to ensure HRS remains relevant: Unless you can prove your products or services reduce procedure costs, reduce procedure time, reduce environmental harm or enable better care for more patients at the same costs, you don’t get your wristband.