My first experience with virtual care came during the early months of the COVID pandemic—and, to be honest, I hated it. Six years later, I have changed my mind. Virtual care is reaching an inflection point. The future is less about video visits and more about continuous care. Just as EPs interrogate devices to guide care between visits, general and heart failure cardiologists can now use EMR-integrated cardiac platforms to transform connected cardiac data into clinical action. Imagine the workflow: Home BP + wearables + implanted-device data + labs → EMR-integrated platform + AI-supported clinical decision support → cardiologist/PharmD/APP review → medication optimization and patient outreach between visits. Two observations changed my thinking. First, much of the most important work in cardiology already happens between visits—often without compensation. Second, an electrophysiology colleague recently told me that, for many follow-up visits, all she needs is a device interrogation or a Zio patch and a brief video conversation. It made me realize this model shouldn’t be unique to electrophysiology. This is the model we’re building at @Cedars-Sinai. I believe it represents the next evolution of cardiovascular care. Thanks to @TCTMD for highlighting this emerging approach. My latest perspective is in the article below.

The reality is—scheduling an in-person visit just to increase a beta-blocker dose or add an SGLT2 inhibitor is a waste of time and resources. Cardiologists don’t have the capacity to see patients every 1–2 weeks to uptitrate GDMT, and most health systems lack the infrastructure to do it for them. The result: both clinical inertia and administrative inertia. That’s why we need new solutions. I’m excited to partner with @rhythmsci and CEO/founder @shawnkumar1000 to bring HF-AI to market. HF-AI is a comprehensive heart failure solution that uses home blood pressure readings to remotely titrate guideline-directed therapy. In TURING-HF (JACC: Heart Failure, 2025), cardiologists accepted 90.8% of HF-AI recommendations. It doubled GDMT use, enabled 80% of medication changes remotely, and reduced hospitalizations by 74%. Building HF-AI was step one. Validating it in a clinical trial was step two. Getting it into the hands of clinicians through RhythmScience is how we change outcomes. By integrating HF-AI into Rhythm360—alongside implantables and home BP data—we can personalize heart failure care at scale. And ultimately—save lives. @HanCardiomd @DrMarthaGulati @gcfmd @MKIttlesonMD