How At-Home Monitoring Empowers Patients and Improves Healthcare - Carol Lucarelli, Executive Director of Marketing and Ecommerce at OMRON Healthcare

Michael Carrese: Hi everybody, I'm Michael Carrese. One of our favorite themes here at Osmosis is how technology can help people become better informed about their own health, allowing them to participate more actively in maintaining and improving it. Well, today on Raise the Line, we're going to take a deeper look at that issue with the help of Carol Lucarelli, Executive Director of Marketing and E-Commerce at Omron Healthcare, the global leader in remote blood pressure monitoring and personal health technology. 

During her time at the company, Carol has led the marketing initiatives for numerous

product innovations, including VitalSight, which is Omron's first remote patient monitoring service. I'm looking forward to talking to her about the current healthcare landscape in terms of remote monitoring and what she sees coming down the road. Thanks very much for joining us today. 

Carol Lucarelli: It's a pleasure to join you, Michael, thanks for having me. 

Michael Carrese: So we always start with trying to find out more about how folks got where they are and get some career highlights. What eventually led you to your current role? 

Carol Lucarelli: Well, I've always been focused on marketing, so always in touch with pairing consumers with stuff in some way, shape, or form, and I spent a number of years earlier in my career in the office products industry. What I found is that I had a tremendous passion for whatever it was I was selling and marketing, and let's just say the same passion that I had for paperclips I'm able to build on that and landed at Omron and I'm really happy to be in the healthcare space because you can certainly see the difference that you make in the world. Omron is an organization guided by the Omron principles: we challenge ourselves; we want to contribute to society; we have respect for all. Those three pillars really speak to the organization and the good that we're doing in the world.

Michael Carrese: Can you help us understand more about Omron and the role that your company plays in this space? Remote monitoring is obviously a big piece of the healthcare story. 

Carol Lucarelli: Definitely. So this year, 2023, we're actually celebrating fifty years of leadership in the heart health space, and I think we're not just focused on heart health or healthcare in general. Omron Corporation, a much larger organization, is involved in sensors. What we do in the healthcare space is we take those sensors and we put them to use for patients and for healthcare practitioners, and really, we try to help physicians and their patients establish a great dialogue about how they can improve their health. 

So, we have a line of blood pressure monitors and scales that we group under heart health. We have products in other categories as well, like pain management, TENS devices, nebulizers for respiratory care. But our intention in being in this space is to really bring tools to the market, whether those are devices or services, supported by our knowledge in the space, our leadership in the space, and really create that great dialogue that allows patients and their clinicians to move things forward so that everyone is able to live their healthiest lives. 

Michael Carrese: Yeah, and obviously technological advances have made this kind of two-way communication much, much easier and more prevalent. So, help us understand what those advances have been and how you think it's impacting individuals and the healthcare system at large. I mean, there's a lot of talk about moving healthcare home and hospital in the home and all that sort of thing. Is that overstating it, do you think? 

Carol Lucarelli: I don't think so. I think there are individuals in this space that refer to us all as health citizens, and I think that is an incredible way to phrase things. We want individuals to take responsibility for understanding what ails them and be part of the care plan to get better.

It will benefit them certainly, but if you compare our healthcare system to those in other countries, we're fortunate that we've got access to clinicians. We're very fortunate that we don't have to wait, usually, eight, nine months to get to see a specialist. We have that ability within our system. And I think what we end up doing is because of the payer-clinician relationships and how everything gets paid for, one of the challenges that we've got is that clinicians have less and less time with patients. So if there's a way to bridge that by making sure that you have access to tools that allow you to get good data in that home setting, that allow you to have a way to communicate easily what you're seeing on those home devices or through those services, to share that with your clinicians, you've got that continuity of care, whether you're at their office, unfortunately in a hospital, or if you're at home, it's all connected.

I think that sharing that data through the likes of EMRs or whatever, but getting sound data, those statistics, the vitals that the clinicians depend upon and getting those into their hands with the things that we saw emerge as a result of the pandemic such as telehealth, remote patient monitoring, taking off, accelerating...all of that's going to be of benefit to not only the patients, but the care teams as well.

Michael Carrese: Yeah, and I think the word continuity is what jumps out at me in what you were just talking about because all the time between visits is really where things can either succeed or fail, and so if the providers are getting a more constant look at what's actually happening, they can probably tell, well, maybe they're not following the treatment plan or there's been some other hiccups and they can sort that out before the patient comes back to the next appointment and nothing's happened or there's been no improvement, right? 

Carol Lucarelli: Exactly, exactly. 

Michael Carrese: So one of the things that I really was interested in when I was reading up on the company is this campaign of “Going for Zero,” which refers to having no cardiovascular disease, respiratory issues, and life-limiting chronic pain. I'm sure I speak for everybody when I say, I hope you're successful with that. That's a great goal. (laughs)

Carol Lucarelli: (laughs)

Michael Carrese: So what's the idea behind that? I mean, to what extent do you folks think that all heart attacks, strokes, et cetera are preventable?

Carol Lucarelli: Well, if you listen to what the American Heart Association says, 80% are preventable and it all starts with knowing your numbers, and so I want to pause for just a second. Going for Zero, you referenced it as a campaign. For us, it is our mission. The elimination of heart attack and stroke is really what we're aiming to do. So, if you think that 80% of those cardiovascular events are truly preventable by looking at the signs, what do you need to make that happen? You need to monitor, not just to take a blood pressure reading every once in a while. It is truly a commitment to monitoring. So, the same way in my idyllic world that everybody's got a scale in their house and everyone should really have a toothbrush in their house, I want everyone to have a blood pressure monitor. I want everybody to get in this very regular habit of monitoring their blood pressure. Take your readings two to three times a day or whatever's recommended by your clinician. Understand what those numbers mean and be able to notice changes. 

We know that people who maintain a certain lifestyle -- whether they're active or sedentary; whether they have a history of heart disease or not; whether their diet is healthy or not -- all of those things impact your blood pressure readings. So, the idea that there is a normal range as identified by the American College of Cardiology and the American Heart Association, it's going to vary slightly from patient to patient. So if you know, based on conversations that you've had with your clinician, what your normal is and you can identify that ‘I'm seeing some things that are out of that range,’ you can pick up the phone, you can send a message through an app or whatever. You contact your healthcare team, and you say, “I'm noticing something out of the ordinary.” 

That's how we prevent 80%. The other twenty is going to be a little more interesting. It's going to require a little more work, certainly. All of those things that I just mentioned certainly factor into a person's risk. Other disease states and comorbidities certainly have an impact on that remaining 20%. But if you can attack 80% of those cardiovascular events and start to make it the exception rather than the rule, I think we're off to a fantastic start. 

Michael Carrese: Yeah, and talk about information being power...as you're saying, if you're consistent about it and you know your own apples to apples comparison, even a slight change can really be a good tip off.

Carol Lucarelli: Agreed. Definitely. 

Michael Carrese: So everybody wants to talk about AI all the time now. How is that being deployed in the remote monitoring space and in your situation at Omron? 

Carol Lucarelli: Well, about twenty-four months ago, we entered into an agreement with Kyoto University. Omron is headquartered in Japan, so we have many friends at Kyoto University across the variety of businesses that we’re in, but specifically in the healthcare space. They’ve embarked on a series of studies that will help us better understand how AI can play a role in this idea of preventing these cardiovascular events. Wouldn't it be wonderful if we got to a point five or ten years down the road where -- if a patient is engaged in daily monitoring of their blood pressure and understands all of the activities that impact their blood pressure on a daily basis -- we can see a concerning pattern and can send you an alert through your monitor, through the app, through whatever. I think that's where we see AI playing a tremendous role. 

It's already in place when you look at ECGs, EKGs in the U.S. There is AI at play there with some devices where they recognize we're seeing some irregular activity and we know this is the precursor to an event. So, it's working there. Can we get to that point with blood pressure? That's certainly what we're aiming to do. 

Michael Carrese: And is the AI benchmarking against like all of the patient information they've got or is it benchmarking against what's normal for the individual or some combination? 

Carol Lucarelli: Right now, in the early studies, it's taking a look at what those parameters need to be. We're just getting into it, trying to organize things. It's a series of studies, so we're taking one step at a time to figure out what really is going to be impactful, where we can garner those data points and then how we utilize them. But I think what's interesting from the Omron perspective is that we set these targets out every ten years for ourselves. We have these stretch targets, so by the time we get to 2030, we want to be at a point where we are working on identifying what those things can be, what those parameters are for something that is much more preventive in nature and not just caring for people who have already suffered an event or where something's already been identified. How do we get to the point where we see it coming? 

Michael Carrese: So, seeing as you're a marketing person, talk to me about adoption of these technologies and sort of penetration of the market, meaning physicians, but also what you can glean from that about consumer adoption of what you're doing? 

Carol Lucarelli: Well, let's start with the basics, maybe just home monitoring. We know that physicians are responsible for influencing about 70% of the purchases made for a home blood pressure monitor. For instance there is a high reading in the office and the care team said, “You know, we're seeing a trend here that we don't like. We think it's time for you to purchase a monitor.” We're fortunate in the U.S. that Omron is the number one doctor and pharmacist recommended brand of blood pressure monitors and Omron globally, if I go back to September of 2022, we sold our 300 millionth blood pressure monitor globally. Those numbers put us in the number one position globally as a provider of home blood pressure monitors. So, all sorts of great things working in our favor. 

The penetration rate in U.S. households is less than 50%. But oddly enough, that is the number of U.S. adults who suffer hypertension. We've got 116 million US. adults that are hypertensive -- and there's a fair number of them that don't even know it -- and there's 37% of that 116 million that don't have it under control. So, sheer measuring of blood pressure is one of the things that helps keep patients under control. We have heard when we've done research with physicians that the number one complaint they have about people that are under their care is that they're not taking medication as prescribed. I take this opportunity anytime I have a chance to talk to people like you, Michael, or others...oftentimes we're asked about who our competition is, and I will tell you it's not another manufacturer or brand of blood pressure monitors. It's ignorance and apathy. So the opportunity to speak to you, to have a booth at the Consumer Electronics Show like we did just a month ago, to talk to the media, to get our story out, to tell people that they need to be monitoring -- it's all part of the mission of Going for Zero that we just talked about. But I think the idea of the adoption rate, the household penetration of blood pressure monitors falls well short of the number of people who really need them. 

Michael Carrese: Yeah, you have 50%. You want to make sure it's the right 50%. 

Carol Lucarelli: Exactly. 

Michael Carrese: So, what's next with all of this, particularly because we just seem to have this acceleration of technology and the massive impact that it's having on providers -- some of whom are feeling overwhelmed, frankly, in terms of the ones that we've talked to -- but what do you see happening next in remote monitoring technology and at-home care? 

Carol Lucarelli: I think right now, one of the things that we're really happy to talk about is VitalSight. It is our remote patient monitoring service focused on hypertension management. The great thing is that it integrates directly into the patient's EMR, so we work within the existing workflow of the care team. That, to me, is of benefit and I think whatever the technology is in the future, it has to work into the existing workflow. It’s got to be supported by the likes of Medicare or the private insurance payers, because that's how our health system works. We can't go rogue and develop a technology that's going to be outside of those parameters and have adoption, and I think that's really critical. So, we make it a point to address not only what are the patient needs at home -- because that’s where the majority of our blood pressure monitors are -- but I think looking more broadly, it's making sure that there is a dialogue that can continue between patient and care team and work within the existing parameters. 

But I think from a pure technology perspective, we're focused on AFib and other arrhythmias. ECG technology is something that we've got built into one of our blood pressure monitors. Three and a half years ago, we launched Complete. It is a combination ECG and upper arm blood pressure monitor in one. It utilizes Omron Connect, an app that we've invested more into. It's free. It works with any one of our connected blood pressure monitors today and our connected scales and all sorts of other stuff. But what that does is it kind of works within the patient's workflow. I'm never without my phone. Before we started, you asked me to make sure it was silenced because that thing goes off all the time. I think working with physicians in their workflow and patients within their workflow is key. How do we make it easier for people to gather the data, share the data? 

We know that with AFib, it's estimated there's about six million U.S. adults that have AFib and a bunch of them don't know it because it's an irregular heartbeat, right? So, how do we put the technology into the hands of the people so that when they're feeling off, they've got this available to them as a tool to help identify things as opposed to having to make that trip to the doctor's office or the hospital for an ECG and get it read and that sort of thing? This is something that's easily available to people today and I think if you look at what we know is happening with Covid hospitalizations, I think it's 5% of the people coming out of the hospital after being there as a result of Covid are diagnosed with AFib. 

Michael Carrese: Wow. 

Carol Lucarelli: Wow. And so now we've got all sorts of other things, Long Covid, et cetera. We don't know how some of these things are impacting our systems. Think back three years ago, what did we know about Covid? Everyone thought it was purely a respiratory disease. We knew nothing, and then the early indications were it was a respiratory disease. And now it's, you know, it's...

Michael Carrese: Multi-system. 

Carol Lucarelli: Multi-system, you know, playing havoc with all sorts of stuff. So, I think the technology that we've got today will continue to evolve. We want to try to support the consumer population because they are the health citizens. What can we do to arm them with better information to continue those all-important conversations with their care teams? And so we view that as, you know, close in. It's getting the word out that you really need a blood pressure monitor because if 50% of the U.S. adult population has hypertension...I look at the two of us, it's one of us, statistically speaking. 

Michael Carrese: More likely me. 

Carol Lucarelli: (laughs) You never know. But I think then following that, certainly from a close-in standpoint, it's AFib and other arrhythmias that we know go hand in hand with heart health, where we are focused, but then preventive. What is it going to be that kind of tips the scales and says, this is something that is allowing us to predict those things? Because we want to be of assistance. We know that clinicians are suffering from burnout. There's a shortage. There are all sorts of things. So, how do we make it easier for those that are in the field today to do what it is they do so well? We're not going to make decisions for them, we want to support the decision-making that they are making on behalf of their patients.

Michael Carrese: Well, it is such an interesting and expanding area and I'm sure if we talked a year from now, there'd be more news about what's happening with the tech, and I hope adoption of it. I'm feeling that most of us are going to end up with some kind of monitoring technology in our homes. We have it on our phones already, right? 

Unfortunately, we're out of time. I have to leave it there. But I want to thank you so much, Carol, for being with us today and giving us a peek into this really interesting space. 

Carol Lucarelli: I appreciate the opportunity, Michael. Thanks so much.

Michael Carrese: I’m Michael Carrese, thanks for checking out today's show, and remember to do your part to raise the line and strengthen the healthcare system. We're all in this together.