Solutions / Physicians & NPs

Most of your heart-failure patients will never see a cardiologist. The science still has to treat them.

The Institute studies how a physician, nurse practitioner, or physician assistant can hold a specialist standard in the room they already have.

The Institute's operating observation is that only 17% of heart-failure patients ever see a cardiologist. The other 83% stay with PCP, NP, and PA teams. 46.3% of U.S. counties have no cardiologist; 86.2% of rural counties have none (Kim et al., JACC 2024). That is the care model, not a referral-queue inconvenience.

Cardiothoracic Field Science puts a continuous multisensor chest recording next to the medication plan so the visit is not a single blood pressure and a guess. Guideline-directed therapy only works if someone moves the dose. CHAMP-HF found that fewer than 1% of eligible HFrEF patients were simultaneously on target doses of ACEI/ARB/ARNI, a beta-blocker, and an MRA. Computer-assisted decision support in this work proposes a next step. The treating clinician remains the authority. It does not diagnose or treat on its own.

This is the setting the published field evidence came from. At Prevail Heart Clinics, a rural U.S. site, 394 consecutive patients were enrolled from October 2014 through May 2016. Care was delivered predominantly by a physician assistant. All-cause 30-day readmission was 6.1%, against a 24.7% contemporaneous Medicare CHF benchmark. Heart-failure hospitalizations fell 71.4% in the first year. In a companion published post-acute deployment, guideline-directed medical therapy improved 92.3% within 30 days. Papers: 27th European Cardiology Conference (Rome, October 2018) and Journal of Clinical & Experimental Cardiology, Volume 9, authored by Dr. Kevin A. Courville, MD, FACC, FHFSA. They are not 2026 multi-site results. A larger outcomes refresh is underway.

2026 performance research (61-patient 12-lead comparison; 52-subject Holter-referenced arrhythmia analysis) is about whether the chest recording is clinically usable. Atrial fibrillation in that long-term file met the study bar on only 24 events in 7 patients and is not a powered AF claim.

The Institute is not replacing the cardiologist. It is building the science the non-specialist uses until the cardiologist is actually needed, and the model the cardiologist uses on the complex patient.