An initiative at the intersection of health care and digital technology, University of Iowa Health Care has launched a pilot program designed to improve heart failure treatment through personalized, virtual care. The program was spearheaded by Colten Stewart, MD, a fellow in the cardiovascular disease program, who had previously explored opportunities to bring medical expertise and technology together to address gaps in heart failure management.

From his first days in health care as a nurse, Stewart recognized the urgent need for more effective ways to ensure heart failure patients received guideline-directed medical therapy (GDMT). As the mean age of the population increases, heart failure is becoming one of the fastest-growing diagnosis-related groups. Despite the unambiguous effectiveness of the available treatments, only 10 to 20 percent of heart failure patients are on GDMT and less than 5 percent receive the optimal dosage.

Stewart saw an opportunity to use virtual tools to bridge this gap. It was during his internal medicine residency at Iowa, he was introduced to HekaHeart, a digital health company specializing in virtual cardiology solutions. Stewart began to look for ways to offer their services to people with heart failure at Iowa. “I wish I could take credit, but it was actually Colten’s idea,” said Linda Cadaret, MD, Stewart’s mentor and a clinical professor in Cardiovascular Medicine.

HekaHeart had already developed an advanced prototype of a virtual heart failure clinic focused on GDMT optimization, making it an ideal partner for Stewart’s initiative. Their care platform was built to enable personalized GDMT initiation & optimization, volume management, patient engagement, and remote monitoring. Alongside the platform, remote providers actively manage treatment regimens with HF-specialist oversight and a dedicated RN team provides access support, education, and care coordination.

Patients are referred into the platform either after discharge, during a clinic visit, or proactively identified through scans of the electronic medical record. Within 72 hours of enrollment, a “smart” scale and blood pressure cuff are shipped to their home, a treatment plan is generated, and patients meet virtually with their care team to begin treatment. A multidisciplinary team, overseen by Cadaret, uses the platform’s care algorithms to monitor vitals and labs, conduct virtual check-ins, and optimize medications.

Beyond increasing access to GDMT, a key element of follow-up care for heart failure, the initiative promotes health care equity by reaching underserved patients in rural areas or who may have other barriers to access specialists. It also allows the multidisciplinary health team—including residents, pharmacists, and nurse practitioners—to apply their expertise within the platform’s software and clinical program.

Enthusiasm for the initiative led to the launch of a 100-patient pilot at Iowa, and early results from the first cohort have been promising. The percentage of patients on GDMT has increased nearly 200%, with patients submitting daily vital readings more than 80% of the time. Not only does this save clinicians hours, but patients have also embraced the platform, valuing the direct access to a heart failure team, which consistently responds within 30 minutes.

“We are excited!” Cadaret said. “It’s rare for us to partner with digital health companies and collaborate on new technology. The whole team is unified in its excitement.”

This fusion of technology and health care promises to set a new standard in heart failure management. James Blum, MD, Associate Professor of Anesthesia and UI Health Care’s Chief Health Information Officer, emphasized the potential impact of this clinician-tech collaboration. The expectation is for the program to scale and serve a broader population, revolutionizing heart failure care across the state and beyond.

“We know our ability to manage these patients is a significant challenge; we don’t have the resources to do this internally. Working with HekaHeart will help us provide much better care, reduce the risk of readmission, and improve patients’ quality of life,” said Blum.

As the program progresses, it serves as a model for how digital health solutions can transform patient care and address pressing health care challenges. With its focus on improving outcomes for heart failure patients, the initiative could soon be adopted by other health systems seeking to enhance and scale care through technology.

UPDATE: We have removed the link for patient referrals to this program, which is no longer accepting new patients.