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Turning the Corner on Heart Failure Care

Heart Failure (HF) affects an estimated 6 million people worldwide and remains the leading cause of hospitalization for individuals over 65, with an approximately 50% mortality rate within five years. Despite technological advancements in many areas of medicine, HF management has been slower to evolve, underscoring the urgent need for innovation.

Dr. Ries Robinson, CEO of Rodin Scientific and a member of the DocGo Medical Advisory Board, is a leading voice on both the barriers to progress and the solutions needed to elevate the standard of HF care.

Dr. Robinson highlights three primary obstacles: a reliance on lagging indicators and reactive monitoring, capacity constraints in cardiology practices, and structural and regulatory hurdles that slow the adoption of better models. Yet he remains optimistic. Rather than viewing the field as trapped in dysfunction, he sees it as primed for transformation with digital HF monitoring and remote care representing “a promising pathway forward.”

Let’s dive deeper.

1. Lagging Indicators and Reactive HF Monitoring

Managing heart failure demands early, individualized insight. Yet most current HF monitoring tools depend on the abnormal accumulation of fluid, a lagging indicator of decompensation. Even seemingly direct measures like weight gain only signal trouble once congestion is already advanced. These markers are both late-stage and low sensitivity (with weight gain detecting worsening heart failure in only 10–20% of cases). A patient’s condition can deteriorate significantly without any observable change in weight.

A more proactive approach involves continuous remote monitoring of pulmonary artery pressure (PAP) using CardioMEMS, a small wireless sensor implanted in the pulmonary artery. After implantation, patients are sent home with a bedside device resembling a pillow, which they lie on once a day to take pressure readings. Over the first couple of weeks, the care team monitors these readings to understand what’s normal for that patient. Unlike traditional measures, CardioMEMS detects subtle rises in pressure up to 30 days before symptoms of fluid buildup become clinically evident (i.e. before weight gain, swollen ankles, or shortness of breath). 

If the pressure starts trending outside the expected range for a few days in a row, the heart failure team can step in and adjust treatment, often before any symptoms appear. In parallel, cardiovascular implantable electronic devices (CIEDs), such as pacemakers and defibrillators, offer an additional layer of remote insight by continuously transmitting heart rate and rhythm data to the patient’s care team.

As Dr. Robinson notes: “The future of HF care must shift from symptom management to proactive, remote monitoring of heart health indicators. This shift would enable physicians to catch evidence of a worsening condition before the patient even notices a change.”

2. Capacity Gaps in Existing Programs

Heart failure specialists are primarily trained and incentivized for late-stage procedures, not  continuous monitoring of chronic conditions. In addition, cardiology practices at full capacity allocate resources to later-stage patients, limiting bandwidth for proactive care. As a result, clinics and hospitals face challenges in delivering more remote care, requiring a shift in mindset, not to mention additional funding, availability, and the time to reorient their model towards earlier-stage patients. 

3. Regulatory Barriers to Integrated Care

Beyond the operational constraints on providers, medical device manufacturers, with the technology to drive significant innovation, face regulatory obstacles and misaligned incentives. Specifically, manufacturers are unable to bill health insurance providers for monitoring services unless formally classified and licensed as care providers. Even when breakthrough devices exist, manufacturers lack incentive to build truly integrated solutions because success is often judged by device sales, not by patient outcomes like reduced readmissions. Without financial alignment around metrics such as fewer 30-day hospitalizations, there’s little reward for developing smarter, more proactive systems.

Because existing care providers are too strained to implement new systems or analyze monitoring data, manufacturers primarily sell standalone devices, which are less effective without integrated data analysis. Instead of encouraging continuous improvement, today’s model favors standalone products over end-to-end solutions, creating structural barriers that disincentivize companies from developing comprehensive care systems and limiting innovation and widespread adoption of proactive monitoring.

“A Clear Path to Progress”

Heart failure treatment remains in urgent need of improved clinical workflows and smarter monitoring systems. Fortunately, Dr. Robinson sees “a clear path to progress” with companies like Cardiac RMS by DocGo leading the way by adopting innovative tools and care models.

“DocGo is demonstrating real leadership by building care models around the needs of heart failure patients. The team is focused on improving remote care outcomes through best-in-class monitoring, expanding access to cardiology expertise, and closing care gaps with smarter, scalable solutions.”

Cardiac RMS by DocGo enhances existing cardiology practices with a more attentive, data-driven approach to heart failure management. Through its virtual care management program, Cardiac RMS supports the use of CardioMEMS and CIEDs, enabling continuous, predictive monitoring of key indicators (including pulmonary artery pressure and arrhythmias) with data transmitted directly from patients’ homes to their care teams. This empowers physicians to detect deterioration early and intervene well before symptoms escalate.

At the same time, DocGo extends the reach and efficiency of cardiology teams, allowing clinics to prioritize acute cases while maintaining support for patients in earlier stages of care. Lastly, by operating within existing regulatory and reimbursement frameworks, Cardiac RMS also creates space for testing and scaling new care models, helping advance innovation without disrupting day-to-day care.

Companies like Cardiac RMS directly address the three barriers Dr. Robinson identified, helping reduce hospitalizations and enabling a more scalable, cost-effective model of care. As Dr. Robinson put it, “Widespread adoption of remote monitoring supported by clinical teams that can read and quickly respond to the data is the first step to an era where heart failure management resembles proactive care rather than reactive crisis management.”