Interview with Cara Santillo

March 2023

by Adam Kaufman, PhD

I had the good fortune to catch up with Cara Santillo of HeartFlow® after her presentation at the IPA Association of America's Annual Conference. The IPA Association of America (TIPAAA) is the leading trade association serving Independent/Integrated Physician Associations (IPAs/Affiliates). The association has nearly 677 IPAs chapters in 39 states (with more in development), and represents more than 303,000 Physicians affiliated with IPAs. HeartFlow is a leading AI-enabled diagnostic companies working at the cutting edge of computer vision and machine learning and the application within healthcare. Cara is HeartFlow’s Vice President of Market Access and Reimbursement.

Adam: Cara, many know HeartFlow and have cheered your pioneering work, but for those who do not could you tell us a little about HeartFlow?

Cara: At its core HeartFlow is a non-invasive diagnostic test for patients with known or suspected Coronary Artery Disease (CAD). We’re changing how clinicians diagnose patients with chest pain and other risk factors for CAD. The company was founded in 2010 based on research from Stanford University. We leverage CT Angiogram images, machine learning and computational models of fluid dynamics to create an incredibly accurate and granular view of coronary blood flow. We were one of the first AI-Enabled Diagostic products to receive FDA approval in 2014 and one of the first and still among the very few that has separate reimbursement from CMS for the Medicare and Medicare Advantage populations.

Adam: Why was it important for you to be at this conference?

Cara: HeartFlow is in over 500 sites including most major heart hospitals and increasingly physician offices and free-standing imaging centers. We’re very proud of the broad adoption enabled by the powerful technology, demonstrated outcomes, and reimbursement pathways. However, we’ve seen minimal adoption with IPAs in part because of their varied structure and reach. It’s been challenging to figure how and where to introduce HeartFlow to these types of clinical organizations. The TIPAAA conference was a good opportunity to introduce HeartFlow more broadly and get feedback on how we can better engage with these complex organizations.

Adam: What was the main content of your presentation?

Cara: While, of course I talked some about HeartFlow, the main point of my presentation was about the growing prevalence of AI-Enabled Diagnostic tools and how IPAs should think about partnering with these companies. There are now hundreds of these types of solutions almost each for a separate company, and several dozen have already received FDA approval.

At HeartFlow, we have been fortunate to help pioneer the category being one of the first to get FDA approval and establish broad reimbursement. We think we’ve learned some lessons that can help both other AI-Enabled Diagnostic vendors and IPAs be successful adopting and using these technologies. At the heart of that success is really the concept of a partnership. The focus of my presentation was on how to establish the goals and mechanics for these partners – really what needs to be explored and issued that need to be resolved for successful adoption.

Adam: What was the feedback?

Cara: We got  positive feedback on the presentation. Audience members that asked questions and provided feedback seemed very interested in the broader category, and also, in how to approach HeartFlow to discuss adoption for their IPA. As predicted and discussed during the presentation, one of the most common areas of feedback was that IPA management needed to take some time to work through their specific partnership structure, how to contract, and pull adoption through their complex organizations. They also need to work on how to rollout these kinds of technologies that often sit between primary care, cardiology, and radiology/imaging. Across those broad stakeholders there are of course diverse perspectives and often diverse or competing technologies for the same diagnostics.  I was surprised by the interest from IPAs to think about HeartFlow and these tools in the hands of their primary care docs directly in addition to the more traditional path of, in our case, just cardiologists.

Adam: Love that feedback. How can this audience learn more.

Cara: Would love to hear directly from anyone interested. Just share my email: csantillo@heartflow.com

Adam: Thank you Cara.

Cara: Of course, my pleasure.

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