Executive Spotlight: Interview with Dan Balda, MD, Medicomp’s President and CEO

Interview by Jodie Elrod
Interview by Jodie Elrod

Get to know Medicomp’s President and CEO, Dan Balda, MD. Medicomp develops, manufactures, and provides service with the most reliable and sophisticated ambulatory heart-monitoring systems in the world.

Please describe your background in EP and how it prepared you for your current position as Medicomp’s President and CEO.

I received my electrical engineering degree from Cornell University and my medical degree from the University of Florida College of Medicine. At the University of Florida I was privileged to be mentored by Dr. Carl Pepine, past president of The American College of Cardiology. Carl had a strong influence on my career, and we still work together today. I also spent a year performing clinical research and setting up a non-invasive electrophysiology lab at Alexian Brother’s Hospital outside of Chicago prior to attending medical school. My medical experience and training has helped me a great deal as the leader of Medicomp. As a physician, I was trained to put the patient’s needs first, and when we do that, everything seems to fall into place. Products are easier to develop, customers are easier to find, and our contribution to medicine is more significant when our goal is to serve the patient first and foremost. Patient care is something I am passionate about, and that has prepared me well for this role. In fact, that passion drove me to accept the position at Medicomp — I can now help far more patients than if I wore a stethoscope around my neck. Not many medical companies are led by physicians, which isn’t a bad thing, but I believe my medical background, training and clinical mindset positions Medicomp to serve our patients and customers in a way that is different than other medical device and service organizations.

What do you feel our readers should know first and foremost about your company?

We are clinicians first. Not only is our clinical staff trained as clinicians, but our management team and sales force all become Certified Cardiac Technicians. Our products and staff are all geared to diagnosing faster so physicians can treat sooner. As a medical monitoring company we have four main areas of responsibility, and the areas are an ordered set with the patient first, closely followed by the physician, then the practice and the technician. First, we are responsible to the patient. If we make our monitors convenient and as transparent as possible, the patient will be compliant, which is the first step to a faster diagnosis. Next, we are responsible to the physician, the shepherd of all things medical. For the physician we deliver clinically significant results faster. The algorithm that lives on-board of every one of our monitors automatically captures clinically significant ECG based on rate, rhythm, morphology and p-wave information independent of a patient’s symptoms or their ability to activate the monitor. As a physician, it is hard for me to diagnose what I can’t see. If it’s there, our algorithm will capture it. Our next area of responsibility is to the practice, the financial entity that allows doctors to continue to serve patients. Medicomp services have to be cost effective, and they are. By delivering accurate results faster, we allow the physician to treat the patient much more quickly. This in turn fuels the practice’s financial engine. Finally, we are also responsible to the technician at the practice who enrolls the patient and trains them to use our equipment. For the technician, we drive convenience. They are among the busiest members of the practice, and it is our goal to make the enrollment and training process faster and easier than any other. 

Tell us about the launch of the SAVI Wireless in 2010. What are some of the unique features of this product? How does use of the smartphone with this product benefit patients?

The SAVI Wireless was highly anticipated by our customers. Like its predecessors, it uses our proprietary Diogenes algorithm, which is the only algorithm on the market that looks at and analyzes all aspects of the ECG. Diogenes automatically captures clinically significant ECG based on rate, rhythm, morphology and p-wave information independent of patient’s symptoms or their ability to activate the monitor. The main benefit with any of our monitors is the algorithm…if you don’t catch it on film, the physician can’t document it and move to definitive treatment. The smartphone is more convenient for the patient because they do not have to initiate a call to the Medicomp Cardiac Monitoring Center and push the data to us. The smartphone automatically pushes the data for them. It allows us to see significant arrhythmias in near real time. Additionally, the smartphone allows Medicomp bidirectional communication with the device; we can send the device information as well as receive information from it. This affords us with a host of features previously unavailable on ambulatory cardiac devices, such as the ability to retrieve additional data, push the patient a message, locate the patient with GPS, call the patient, or even open up the speakerphone and ask passersby for assistance if we suspect the patient has collapsed.

In addition, describe Medicomp’s Arrhythmia Access™ iPhone app, approved by Apple in 2010 and launched on the app store.

Medicomp is a certified iPhone app developer. Our expanding app platform allows customers to check reports, receive notification alerts (a pushed alert to the iPhone to inform the MD that their patient has had a significant arrhythmia), and even enroll a patient by snapping a few photos. Again, our goal is to help diagnose faster, and the Arrhythmia Access iPhone app is a great tool and platform to help us achieve this goal.

Is Medicomp currently involved in any clinical trials? Discuss Medicomp’s comprehensive ECG clinical trial monitoring services, which extends your ECG monitoring service to industry partners such as medical device companies and pharmaceutical and biotechnology companies.

Medicomp has multiple clinical studies involving over 8,300 patients that are underway or in the planning stages. Our scientific commitment is unmatched. Our largest study is the CABANA trial, a 3,000-patient, 140-center, NIH-sponsored trial that will last six years and enroll patients from over a dozen countries across five continents.

What are some of Medicomp’s ‘industry firsts’ that you’re most proud of?

Our list of industry firsts includes many accomplishments from the 1980s to the present day:

In 1983, Medicomp introduced the first solid-state (digital) Holter monitor; this device had artificial intelligence capable of analyzing, automatically selecting and storing normal and abnormal two-channel ECG strips. In 1986, through the use of innovative data compression techniques, Medicomp introduced the first system capable of storing an entire 24 hours of ECG data in solid-state memory. In 1988, with the introduction of the Epicardia 1250 system, Medicomp pioneered the first low-cost digital Holter monitoring system that provided sophisticated clinical reports with full disclosure data.

In 1990, Medicomp introduced the Epicardia 3500 and 4000, which were the first to use hyper-link technology, even preceding its use in the Internet; both systems allowed full editing using hyper-link technology, so if you clicked on the statement or statistic of interest, the system would hyper-link the user to the supporting ECG in full disclosure. In 1994, Medicomp launched the first Holter monitor into space; Medicomp was selected to provide Holter monitoring for the Mir Space Station because of the durability of its Holter monitors and its unique ability to transmit full disclosure data from Mir back to Earth. In 1996, Medicomp delivered the first digital Holter monitoring network to Kaiser Permanente of northern California, which allowed three main locations to scan Holter records for over 30 facilities across normal telephone lines. In 1997, Medicomp opened its Cardiac Monitoring Center and became the first Holter equipment manufacturer to deliver Holter monitoring services to physicians remotely across the country, guaranteeing 24-hour turnaround time with STAT reports available in one hour (when the industry average was 5–7 days). In 1999, Medicomp introduced the CardioPAL Event Monitor, which was the first event monitor capable of both real-time (accepting ECG from the fingertips) and continuous looping (accepting ECG from patch-style electrodes) ECG monitoring.

In 2000, Medicomp became the first and only to provide Holter monitoring equipment to the International Space Station. In 2002, Medicomp introduced the first event monitor with a full-fledged Holter algorithm on-board, the CardioPAL AI; the artificial intelligence was capable of automatically capturing clinically significant ECG based on rate, rhythm and morphology. In 2005, CardioPAL SAVI was the first event monitor with p-wave analysis for the detection of atrial arrhythmias; SAVI automatically captures clinically significant ECG based on rate, rhythm, morphology and p-wave abnormalities.

In 2006, Medicomp developed the Validator, the first device that allowed head-to-head comparison of event monitoring algorithms. We have found dozens of examples of clinically significant arrhythmias from the “Gold Standard” MIT and Beth Israel databases that competitive monitors miss and Medicomp’s SAVI automatically analyzes and captures.

In 2007, Medicomp introduced the first true AF Burden monitor reporting. In 2008, Medicomp was the first to offer event-type reports with true AF Burden statistics for implantable loop recorder (ILR) patients. In 2009, Medicomp introduced the first iPhone application for ambulatory cardiac monitoring services. Finally, in 2010, Medicomp offered the first wireless monitoring platform offering an algorithm that analyzes rate, rhythm, morphology and p-wave for every beat.

The above list incorporates a number of firsts for Medicomp, and a few of my favorites include the first digital Holter monitor, the first and second monitor in space, the first rate, rhythm, morphology and p-wave analysis, the first to report true atrial fibrillation (AF) burden, and the first iPhone app.

What strides is Medicomp making in the fight against atrial fibrillation?

I used to tell my patients AF is like the prostate cancer of the heart. If you live long enough, you will get it. New advances in ablation technologies have come far, but diligently mining the data for post-procedure AF has been difficult. With the addition of p-wave analysis to our Diogenes algorithm in 2005, Medicomp completed a project that took over 12 years of development. This addition allows us to diagnose AF more accurately than any other ambulatory monitor. When we released this monitor, physicians didn’t know what to make of asymptomatic AF. Medicomp pioneered AF Burden monitoring to help study these questions and assess the amount of time a patient spent in AF before and after intervention. At Heart Rhythm 2007 we released our AF Burden monitor, which was selected as the device of the month in Cardiology Today just three months later. Now, thanks to some of the newest studies performed using our technology, it is very clear that AF does not discriminate. It does not care if you can feel it or not; it will cause a stroke just the same. Our advanced ambulatory AF diagnostic platform is precisely the reason we have been selected over all others to assess the many AF-related endpoints in multinational, NIH-sponsored trials such as CABANA.

Looking ahead, what types of things will take place in order for Medicomp to continually grow in the EP market?

All we need to continue to grow in this market and continue to positively impact more patients is five minutes; if I had five focused minutes with each EP, they would understand that all algorithms are not created equal and all patient monitors and monitoring companies are not vanilla. I think five minutes is all it would take for Medicomp to earn their trust to care for their patients. Medicomp is simply an extension of the practice. Most cardiologists strive for world-class staff and facilities; we extend a world-class image outside their walls.

What announcements will Medicomp be making at Heart Rhythm 2011? What are you looking forward to at this year’s meeting?

At this year’s Heart Rhythm we will continue promoting the clinical value of our algorithm that analyzes all aspects of the ECG as well as our Arrhythmia Access iPhone app with easy enrollment options. The expanded app will allow technicians at our customers to enroll a patient in a quarter of the time; just snap two pictures, key in a minimal amount of information, and the enrollment is complete. This development effort really addresses our responsibility to our customer’s technicians and makes their jobs easier each day so they can better focus on patient care.

Is there anything else you’d like to add?

On March 31, 2011, I led an investment group made up of current and past Medicomp management to acquire Medicomp. This new ownership will allow the new Medicomp organization to focus on growing the Medicomp brand and business to become the medical monitoring center to the world. I had another chance to bet on the Medicomp team, and I went all in!