Heart Decide makes complex discussions with patients more effective

Review of the Heart Decide app for iPhone and iPad”

An important step in combating cardiovascular disease is educating patients about the underlying disease process, their own cardiovascular history, and steps they can take to reduce future risk. Unfortunately, it’s well recognized that educating and communicating complex health information to our patients is not something clinicians do well.

Heart Decide by OrcaMD is an app that aims to change that. It includes a variety of tools to facilitate discussions about cardiac disease between patients and physicians. Some features of the app are free while others, such as sharing, require a subscription fee of $20/month or $200/year.

On opening the app, we are taken to the Home Screen where the content is divided into three categories. The first is an animated 3D heart model that can be sliced both horizontally and vertically to reveal internal anatomy like valves and septae. You can also see the major epicardial vessels on the surface. The model can be rotated in all directions and moved around on the screen.

You can also draw or write on the heart; for example, you could circle the left circumflex to show a patient where the stent was placed or draw an arrow through the mitral valve as you explain regurgitant flow. A surgeon could draw in where bypass grafts were plugged in to the epicardial vessels.

Pressing save adds the annotation to an email “prescription” of information (see below, requires subscription).

The second section on the home screen is a series of well done, short narrated videos on a variety of cardiac conditions. Like our annotated drawings, these can be shared with your patient as well provided you have a subscription.

Finally, the third section includes several short animations, generally a few seconds, showing procedures like placement of an annuloplasty ring on the mitral valve, passing of catheters through the femoral artery, and more. These videos are really designed to be playing as the physician is explaining the procedure to their patient. A nice feature here would be to allow more control of progression through the animation so it can be timed to the discussion being had with the patient. Like the narrated videos, these can also be shared.

You can also import your images or videos into the app for inclusion in your information “prescription”. For example, lets say your patient had a femoral artery aneurysm that had to be intervened on. You may doodle that, take a picture, and then include in the “prescription” shared with them after their visit. These captured images & videos don’t however save for later use.

The app includes a “prescription” functionality that’s really designed to collect the resources used during the discussion and share them with the patient via email. For example, if I’m explaining a PCI to the left circumflex to my patient, I may share the annotated drawing on the 3D heart where I marked the stent position, videos on coronary disease, and the animation of a PCI. The emails are sent from Orca rather than from your registered email address.

Evidence Behind the App

While the the information in the app is pretty basic, it’s worth recalling that the content was originally developed in partnership with cardiologists from Harvard Medical School. Otherwise, the level of medical information is