Boston Heart Diagnostics CEO Pushes for More Holistic Role for Labs

Susan Hertzberg, the chief executive officer of Boston Heart Diagnostics, opened her presentation at this year's G2 Intelligence Laboratory Institute with a statistic that is often cited by sector leaders: Testing drives about 70 percent of the clinical decision-making process but consumes only about 2 percent of the health care dollars.

But Hertzberg—a blunt-talker in a sector where mild politesse tends to be the rule—all but rolled her eyes when she cited those stats in a weary, singsong manner. She noted that it's so-often repeated that many seem to miss the point: Labs should be getting paid more for their work, and they should probably secure a bigger role in how they serve patients.

"We're cheap. And that's the wrong message," she said. "The right message is that we do drive clinical decisionmaking, and we could drive better clinical decision making if you would pay for the tests that we want to bring to market that would do better than the tests we introduced 40 years ago."

However, Hertzberg noted that the sector's biggest players have been overly reliant on trading volume for advances, a quandary that could take a long time to exit.

In the meantime, she suggested that labs push more aggressively into personalized medicine (she noted that population medicine has not yet worked, and this could be a new approach). The demand is enormous: Most Americans lead sedentary lives with little exercise, and often eat processed foodstuffs to the exclusion of all else. At the same time, food scientists are creating more products that are addictive to eat. Those are among the reasons heart disease is the leading cause of death.

While drugs can be effective, they only show demonstrable changes about 30 percent of the time—and nearly a quarter of those patients prescribed statins never obtain their medicine to begin with, and 60 percent stop taking the drug after the first year a prescription has been ordered. And if a patient has a heart attack, each year of their life moving forward can cost about $50,000 a year due to the far more intensive case management and monitoring that is involved.

"This is the case for doing more earlier. This is the case for using diagnostic insights to drive better treatment and intervention in patient management," Hertzberg said.

Boston Heart focuses on identifying at-risk patients and using the diagnostic data to better individualize treatment. The lab focuses on four factors: Their lipid levels, metabolic issues, the presence of inflammation and any genetic factors.

Last year, Boston Heart introduced a test that focuses on levels of myeloperoxidase (MPO), an enzyme generated in conjunction with cardiac inflammation. Elevated levels of MPO in conjunction with a patient complaining of chest pain is considered a reliable predictor of a heart attack or stroke within one to six months.

Earlier this year, the lab introduced a graphically intensive, 25-page report for each patient who undergoes testing. It provides specific information as to whether they are at risk for a heart attack or another cardiac event. Hertzberg believes that it cuts through the jumble of data that many patients have to navigate when they receive their test results from the doctor.

"We have now contextualized for them the treatment the doctor wants them to provide," said Hertzberg, who noted that improving patient healthcare literacy is a key to improving their health.

After the exam and test results, patients can visit the Boston Heart portal and answer a survey regarding their diet, exercise habits and other information about their background. That and their lab data help create another report regarding how they should tweak their diet. No foods are prohibited, although cutbacks may be recommended. Boston Heart also provides thousands of recipes keyed to each specific diet recommendation.

"It is a very deep and rich support system that supports how the patients live their lives," she said, quipping that "if you're a lactose intolerant vegan, we have a diet for you."

The lab also encourages patients to keep a food journal, because academic studies indicate those who do lose twice as much weight as those who do not. And Boston Heart also has nutritionists on staff to provide coaching to patients to help improve their eating habits and health.

"We want to get patients on the right path and keep them there," Hertzberg said.

Takeaway: The lab sector could probably fare better in the marketplace with new genomic tests if it focused more on improving the health of individual patients.