How HeartFlow is using deep learning and data—and very human support—to help save lives

HeartFlow reduces its reply time by 70% while serving 30,000 patients using Zendesk Support and Talk

“The world of CT imaging is very technical and complicated, so we’re trying to help and be proactive with customers, so that they can optimize what they’re doing with HeartFlow, patient-by-patient. That’s been one of the bigger initiatives and why we chose Zendesk: it lets us track and respond to customers around every single need they have.”

Tim Fonte

Vice President of Customer Success at HeartFlow

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As of 2019, nearly half of all adults in America have some kind of heart disease, and it accounts for 31 percent of all deaths worldwide, making it the #1 cause of death. These numbers mean that heart disease touches nearly everyone in some way, as the odds are that each of us knows someone with or has lost someone to the disease.

Physicians need to assess patients with chest pain or related symptoms to determine if patients have narrowings in their coronary arteries, and whether these narrowings restrict blood flow and require interventional or surgical treatment.

New technology is making it possible to receive critical information about heart health, earlier. HeartFlow, Inc., founded in 2007 by two former Stanford University professors, is transforming the way doctors assess and diagnose coronary artery disease. Traditional non-invasive diagnostic tests do not show blood flow within specific arteries, and invasive tests are needed to provide artery-specific blood flow information. The HeartFlow Analysis is a personalized cardiac test that creates a 3D model of a patient’s coronary arteries, giving doctors a new and non-invasive way of understanding blood flow through the arteries. No catheters are involved, and to date, the company’s solution has served over 30,000 patients. HeartFlow operates as a service by securely receiving CT image data of a patient’s heart from a hospital, analyzing the images in the cloud with deep learning, providing human quality control, and delivering back the HeartFlow Analysis through web and mobile apps.

“We want our customers to be delighted by receiving information they could never have received non-invasively before,” said HeartFlow’s Vice President of Customer Success, Tim Fonte. HeartFlow’s solution provides the most accurate non-invasive data at a fraction of what traditional invasive methods cost. This is a novel solution of SaaS in the diagnostic cardiology world. HeartFlow is the first of its kind to be cleared by the FDA and reimbursed by Medicare and commercial insurers.

Fifteen years ago, Fonte worked as a researcher for HeartFlow’s founders at Stanford and has witnessed firsthand the clinical trials and success stories along the way. This gives him a personal connection to, and deep belief in, what the company is trying to accomplish for doctors—and, importantly, for the patients they help treat.

“We want our clinician customers to have that moment where suddenly everything they’ve been trying to understand about a patient becomes clear,” he said. “Everyone at HeartFlow is really aware of how we touch the customer. From our sales team meeting customers, to the engineering team building and improving the product, to the production and quality teams analyzing the data, all the way down to the support teams — it’s all about the customer experience.”

Until 2016, the teams within HeartFlow used multiple, disparate platforms for different support channels and internal service needs, which presented a challenge when scaling. The teams needed a solution that would help facilitate an increased level of internal collaboration, that was flexible enough to integrate with other systems, and allow for maximum, secure data storage.

“We are a very data-driven company with tens of thousands of data sets within our product. We need a way to track all our customer feedback and service needs related to the use of this data,” Fonte said. “We looked at all the major competitors and narrowed it to Zendesk as the best fit for us.”

HeartFlow’s Customer Success team is structured a little differently than other SaaS companies, given the software’s deep integration into hospitals and adherence to FDA regulations. In-person training, integration with hospital image storage and health record systems, and troubleshooting in the field may involve engineers, CT experts, and implementation specialists to handle the most technical issues. “We do a lot of work with customers that goes beyond software. We help them establish high quality CT programs, setup ordering and billing workflows, and ensure the customers understand the clinical nuances of the HeartFlow Analysis,” said Fonte.

Under the Customer Success umbrella, Chris Manuel leads a customer support team connected with more than 100 agents, located in California, Texas, and a few locations outside the U.S. This team handles questions and issues from doctors and hospital staff, as well as inquiries from hospitals or even patients who are interested in learning more about HeartFlow. It happens fairly often, Manuel explained, that someone is researching cardiac procedures for themselves or on behalf of elderly parents and contacts HeartFlow—often in an emotional state—hoping to learn more about what the HeartFlow Analysis is, how it works, and where they can get it.

“Having the ability to help those potential patients is extremely rewarding,” Manuel said. It’s a situation he’s been in himself, and he knows the value of feeling heard. “My career has been exclusively in the software as a service market, but I come from a family of physicians and healthcare professionals. My father has heart issues and so this is near and dear to me. The ability for people to quickly speak to a person, or email and get a response, is truly meaningful.”

So much so that Manuel set up a phone number (877-HRT-FLOW) that lets a person get a response quickly during times when they need to make an educated decision. Fonte added, “We don’t directly sell anything to a patient because physicians order the HeartFlow Analysis, but we help patients find a physician they can work with, who can best assess them, and potentially get a HeartFlow Analysis.” Whether inquiries come in via the phone, through the website, email, or other marketing channels, the goal is to have a full view of each patient or customer interaction.

Most tickets are handled by email through Zendesk Support, but the team is rolling out Zendesk Talk to connect with doctors and technicians by quickly texting when the data in a CT scan isn’t of sufficient quality to build a complete 3D model. That allows HeartFlow’s support team to quickly intervene, open a ticket for help, and then work with the hospital to troubleshoot so they can get the data they need to produce a scan that will yield the most accurate information for the doctor and patient. HeartFlow created this proactive process to improve customer CT acceptance rates to over 90%.

Manuel appreciates the flexibility of Zendesk and the ecosystem of available apps and integrations. The team created a specific app to identify HeartFlow Employees vs customers in addition to using conditional fields and distinct forms to aid easy reporting, Myndbend to add approvers to tickets, a ticket redaction app, Read Receipts, and uses the Zendesk API to pull critical data from Zendesk to help with data analysis and to track trends in customer feedback that can be used by engineering and other internal teams.

“Given that we use deep learning, our algorithms can be improved over time and so we try to capture and collect things that we learn from our customers in Zendesk to pass on to our engineers for improvements,” Fonte said. “Our customers benefit from this feedback and improvement loop because we make numerous software improvements per year. They don’t need to purchase new hardware or software upgrades. We’re able to adapt regularly by really understanding what our customers are doing.”

From a support perspective, HeartFlow monitors KPIs, such as the volume of tickets compared to the rate of response. Since using Zendesk, the team’s ticket volume has risen 600% with a growing customer base, while reply time has decreased 70%. In fact, customers are blown away when they hear back within an average of 30 minutes.

Fonte underscored that customer support isn’t the only team at HeartFlow using Zendesk; it’s been integrated across several teams, so that all customer-related needs are documented and tracked through Zendesk. This helps bridge the gaps between working with customers in the field and across the company’s digital scape.

“We have to fit the world that we work in, especially dealing with imaging, how training is done, and how data is acquired and sent from a hospital,” Fonte said. “Even though we’re a software-based company, there’s still a lot of in-person and hands-on work. We’re straddling the boundary of SaaS and traditional healthcare technology, and that’s part of what makes us unique in the cardiology world.”

The team aims to remain at the forefront of customer experience as it works to make the HeartFlow Analysis available to all patients. Next steps are to look at implementing Zendesk Explore and Sunshine. “Some of the features of Sunshine could be incredibly valuable as we grow by allowing more integration with other HeartFlow data,” Manuel said, like having the ability to see more comprehensive information of a customer’s usage of the HeartFlow Analysis. All the work HeartFlow is doing to get its customers and patients the information they need isn’t about showing off the technology, Fonte said—the team knows the solution works and wants to allow doctors the freedom to help patients.

“You can’t just build a neat technology and throw it out in the medical world and expect people to like it because it’s new and interesting,” Fonte said. “We’ve shown now through thousands of patients in clinical studies that the HeartFlow Analysis is effective, and the evidence is published and peer reviewed. Now physicians can assess it in clinical practice and make their decision.”