Atrial fibrillation (AFib) is an irregular heart rhythm typically affecting people over 65 that can lead to serious complications, such as strokes, heart failure, and dementia. The CDC estimates that 12M people in the US alone will have AFib by 2030 , while a study funded by the Italian Ministry of Health predicts around 14.4M people in the EU will be diagnosed with it by 2060 . According to Harvard Medical School, more than 1 in 6 ischemic strokes are caused by AFib with the number jumping to 1 in 3 for people ages 80 and older . Strokes caused by AFib complications tend to be more severe than strokes caused by other conditions . Although AFib is extremely prevalent, there are surprisingly few products readily available for detecting and monitoring the disease. This was the driving force for our team to uncover and create solutions that could be accessible to millions of people.
My Heart Lab is a research study app that allows users to detect and monitor for possible AFib and share comprehensive reports with their doctors — enabling users and doctors to monitor heart rhythms actively and passively. My Heart Lab is a complete ecosystem that includes watch and phone apps for users and comprehensive reports for clinicians. Notably, it is the world's first watch app to combine PPG technology for continuous AFib monitoring with a verification ECG and the world's first to feature an AFib burden assessment.
My Heart Lab was designed and developed by Samsung Research America's Digital Health Lab in close collaboration with cardiologists at the University of California San Francisco. Working alongside leading cardiologists, we were able to uncover valuable insights and address constraints and criteria that would make the product successful in both consumer and healthcare environments to ultimately aid in clinical decision making.
Precision and world-class design play a pivotal role in healthcare applications where lives can be saved or harmed based on intricate design decisions. We applied sound User-Centered & Inclusive Design principles, providing a revolutionary solution that could allow millions of people worldwide to start detecting a serious disease and monitoring their heart health today.
Throughout the design process, we observed various aging populations using smart phones and smartwatches in the field, along with conducting usability testing with people over the age of 65. These insights informed our design decisions, specifically regarding inclusivity, by accounting for users with varying degrees of digital literacy, cognitive abilities, vision, and motor skills — all without compromising modern user expectations for digital products.
The Digital Health Lab welcomes you to explore how our solutions are helping define the future of healthcare.
References:  CDC: https://www.cdc.gov/heartdisease/atrial_fibrillation.htm  EU study: https://academic.oup.com/europace/article/21/10/1468/5498762  Harvard Medical School: https://www.health.harvard.edu/heart-health/stroke-risk-when-you-have-atrial-fibrillation
Approximately 1/3 of AFib patients will have a stroke within their lifetime, making AFib responsible for 15-20% of strokes in the US . The chance of developing AFib increases as people age, with 9% of those over 65 in the US diagnosed with the condition . Along with stroke, AFib increases the risk of dementia, heart failure, and death . A recent data analysis of the multigenerational Framingham Heart Study found that participants with AFib lived on average two years less than participants without AFib . With AFib being so prevalent, it ultimately costs the US healthcare system around $26 billion per year .
AFib can cause heart palpitations, fainting, lightheadedness, shortness of breath, and/or chest pain . Surprisingly, AFib is often associated with no symptoms at all , allowing this serious condition to possibly go undetected among millions of people throughout the world. This means they do not get proper treatment in time before AFib progresses into more significant health issues. For this reason, our research initiative, My Heart Lab, has the potential to become a lifesaving tool for millions.
My Heart Lab is an AFib research study app that makes the process of detecting and monitoring AFib extremely simple. Samsung Research America and The University of California San Francisco have collaborated to detect possible AFib using Samsung smartwatch technology. The app monitors users' heart rates and heart rhythms through Samsung's smartwatch PPG and Electrocardiogram (ECG / EKG) technology. Our design team set forth to create an ecosystem of products for users that translate the PPG and ECG technology into intuitive interfaces that alert users when they should take an ECG without causing unnecessary alarm. Previous AFib clinical studies had negatively impacted healthcare utilization, creating patient safety concerns. Taking this into account, we considered user-centered perspectives for both patients and clinicians from the very beginning.
Throughout our design process, we went to great lengths to fully understand both AFib and our users. We started out by clearly defining our target users based on a clinical diagnosis & treatment decision tree, informing us to design the applications primarily for users over 65. From there we dove deeper into researching AFib by conducting a competitive landscape analysis of products used by cardiologists in the field and testing leading devices. We immersed ourselves in understanding our users through interviews with cardiologists in the field and observing older populations using smart phones & wearables in real-world settings. We regularly tested our designs, concepts and iterations in a collaborative effort — conducting weekly feedback sessions and usability tests with cardiologists and patients throughout our design process.
Through our research and testing, we set out to design an accessible yet powerful system that makes it easy for users to understand AFib, review their results, and relay detected information to their doctors.
Active & Passive ECG Monitoring & Results My Heart Lab is the world's first watch app to passively combine PPG technology for continuous AFib monitoring with a verification ECG and the world's first to feature an AFib burden assessment to determine length and frequency of AFib episodes. Users can also actively take an ECG at any time and report their symptoms.
In the phone app, users can view daily, weekly, or monthly summaries of ECG results. For users diagnosed with AFib by a doctor, they can also monitor their AFib burden. Users can always share fully detailed clinical reports with their physicians right from the app. Reports are automatically generated weekly, instantaneously when significant events occur, or on-demand. When My Heart Lab confirms possible AFib with an ECG, users are notified that they have a newly created report ready to share with their doctor, facilitating an informed dialog with their physician. Reports are automatically and invisibly generated, updated, and managed, creating a seamless experience for the user.
Accessible Information Understanding AFib is complex. We made the information more accessible by creating a clear distinction in user groups, appropriately providing concise summary interfaces for users and comprehensive reports for physicians. Throughout the phone and watch apps, we purposely defined three key states for heart rhythm — Possible AFib, Normal Rhythm, and Undetermined. This allowed us to keep explanations simple while providing users with crucial information. These carefully considered terms enabled us to create messaging that could alert users when necessary without causing undue anxiety. In addition to making critical information accessible, we provide educational content created by leading cardiologists within the app.
Insights for Clinicians Along with revealing health insights to users, we designed a system that enables physicians to broaden their visibility, increase detection, and surface clinically significant information in their patients. These three aspects substantially help in making a clinical decision for AFib diagnosis.
Critical information is surfaced and brought to light in our comprehensive reports that contain ECG results, symptoms reported, the past three weeks of heart rate change, activity levels, and the duration of AFib episodes. This is accomplished by superimposing relevant information in a logical order to provide a global picture of what was happening when possible AFib was detected. From the first page, doctors can get an understanding of the patient's history and current condition and then dive in more in subsequent detail pages. The reports are dynamic and efficient, expanding or reducing the number of pages based on an individual's health data. They are also optimized for digital & print formats and colorblindness. The reports were designed and iterated on with sustained input from our partnering cardiologists and ultimately tested for usability & validated with a panel of cardiologists at UCSF.
"Consumer health devices have done a good job of creating an interface for users to use the device effectively. However, very often the data from these devices are given to healthcare providers as part of the compilation of data used for healthcare decisions. To date, the data presentation has largely focused on engagement of users and a user-centric approach. The reports designed for My Heart Lab are designed to bridge this gap and provide data to a healthcare provider in a way that is easy to understand, actionable and with all relevant data presented in a clear and upfront way. At the same time, the user-experience for the user (patient) is clear and easy to understand. The smartwatch interface, robust algorithms and easy to use doctor reports should provide a really useful tool for screening, diagnosing and managing AFib." — Dr. Jeffrey Olgin, Cardiologist & Cardiac Electrophysiologist at UCSF Medical Center
"The atrial fibrillation reports generated using My Heart Lab allow health care professionals to get a weekly highlight of a patient meaningful heart data, such as the presence of atrial fibrillation, the quantity of atrial fibrillation (AFib burden), the heart rate trends in context of the user's physical activity and their ECG results. This will help millions of people around the world get a rapid diagnosis of atrial fibrillation. Furthermore, by making the smartwatch derived atrial fibrillation burden readily available for clinical decision-making, health care providers will be able to better manage atrial fibrillation and have a meaningful impact on the heart health of patients. " - Dr. Robert Avram, Cardiac Specialist at UCSF Medical Center
My Heart Lab offers an innovative, balanced, and comprehensive approach to healthcare design. The watch app unobtrusively and passively runs in the background — cautious to alert users only when attention is needed, while the phone app is always accessible to monitor results or learn more about AFib. In the event that possible AFib is detected, comprehensive reports facilitate the conversation with a physician by surfacing insights and revealing critical health information. The last few years have seen rapid growth in mobile and wearable sales, and smartwatches featuring health monitoring have become increasingly more common as consumers realize their vast capabilities. My Heart Lab has the potential to provide early detection of AFib for millions of people around the world. Facilitating early detection and treatment could lead to a significant reduction in the incidence of strokes, heart failure, and dementia. Considering the predictions on AFib occurrence in the coming decades, it's imperative to use tools like My Heart Lab to make early detection & monitoring simple, safe, and mainstream.
References:  StopAfib.org: www.stopafib.org/stroke.cfm  healthline: www.healthline.com/health/living-with-atrial-fibrillation/facts-statistics-infographic  The Journal of Innovations in Cardiac Rhythm Management: www.innovationsincrm.com/cardiac-rhythm-management/2011/april/70-atrial-fibrillation-and-congestive-heart-failure  PhillyVoice: www.phillyvoice.com/life-expectancy-atrial-fibrillation-prevention-early-detection-research/  Gray, David (2010). Chamberlain's Symptoms and Signs in Clinical Medicine: An Introduction to Medical Diagnosis (13th ed.). London: Hodder Arnold. pp. 70–71. ISBN 9780340974254.  Munger, TM; Wu, LQ; Shen, WK (January 2014). "Atrial fibrillation". Journal of Biomedical Research. 28 (1): 1–17. doi:10.7555/JBR.28.20130191. PMC 3904170. PMID 24474959.