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Customer Case Study

16x Growth in 3 Years.
Virtual Cardiac Rehab at National Scale.

A leading virtual cardiac and pulmonary rehabilitation provider went live on Canvas and scaled note volume 16x in three years. When a major national payer partnered with the company to expand cardiac rehab access nationwide, Canvas was already running at scale underneath.

16xNote Growth
27Appointments per Patient
92%Patients Feel Better
53%Avg. Aerobic Gain
The Customer

Closing the 90% Gap in Cardiac Rehabilitation

This virtual cardiac and pulmonary rehabilitation provider delivers structured rehab programs staffed by a multi-disciplinary clinical team. Patients receive a monitoring kit - heart rate monitor, blood pressure cuff - and participate in live-monitored exercise sessions, nutrition coaching, and stress management from home. The result: 92% of patients report feeling significantly better after 12 weeks, with a 53% average gain in aerobic capacity.

The Care Model

Virtual cardiac and pulmonary rehabilitation with live clinician monitoring. Patients recovering from cardiac events, COPD, heart failure, long COVID, and general shortness of breath participate in structured rehab programs from home. Every session captures vitals in real time - roughly 20 vitals per patient on average. The company addresses a massive access gap: 90% of eligible cardiac rehab patients miss out due to transportation, scheduling, and geographic barriers. By going virtual, this provider eliminates all three. A multi-disciplinary clinical team delivers care nationwide.

Growth Trajectory

Venture-backed by leading venture capital firms. A major national payer announced a first-of-its-kind nationwide partnership with the company to improve cardiac rehab access - a validation of the virtual model at payer scale. The provider also partners with multiple top-five national insurers and major health systems across the country. Monthly note volume grew 16x in three years.

Platform at Scale

16x Note Growth. ~27 Appointments per Patient. One Programmable EMR.

This practice is one of the highest-volume operations running on Canvas. Their clinical workflows - live-monitored rehab sessions, RPM data collection, chronic care management, and e-prescribing - generate more data per month than most practices generate in a year. Canvas scales with them: auto-scaling infrastructure, a read replica for analytics, and API-driven workflows that keep the entire team moving.

16xNote Growth in 3 YearsOne of the highest-volume operations on the Canvas platform - and still growing.
~27Appointments per PatientLive-monitored rehab sessions, follow-ups, and chronic care management visits.
~20Vitals per PatientHeart rate, blood pressure, and oxygen saturation captured every session.
0.13Rx per PatientA rehab and monitoring practice, not a primary prescribing one - medication management as needed.
64%Coverage RateMajority of patients with insurance coverage on file - supporting payer-billed rehab across major nationals.
92%Patients Feel BetterAfter 12-week structured rehab programs, with a 53% average gain in aerobic capacity.
Clinical Profile

Cardiac, Pulmonary, and Chronic Disease - the Conditions That Drive Healthcare Costs

The clinical profile reflects a complex, chronically ill patient population where every condition is a cost driver. COPD, hypertension, atherosclerotic heart disease, atrial fibrillation, and diabetes - these are the diagnoses that generate the highest downstream spending in healthcare. Virtual rehab addresses them head-on, with structured clinical encounters, vitals monitoring, and medication management.

Top Conditions

COPD leads at 87.5% of patients, followed by essential hypertension (49.7%), hyperlipidemia (28.9%), shortness of breath (18.5%), GERD (17.6%), obstructive sleep apnea (15.6%), atherosclerotic heart disease (15.5%), and type 2 diabetes (13.9%). The diagnosis mix spans both the cardiac/pulmonary conditions that drive the core rehab program and the chronic comorbidities where early intervention generates downstream savings for payer partners.

Prescribing & Monitoring

0.13 prescriptions per patient on average - this is a rehab and monitoring practice, not a primary prescribing one. When clinicians do prescribe, the medication profile is classic cardiology: diuretics (furosemide), beta-blockers (metoprolol, carvedilol), ARBs (losartan), and heart failure medications. Remote patient monitoring codes (99457, 99458, 99454) confirm active device-based monitoring, while chronic care management codes (99490, 99439) represent a growing secondary revenue stream.

Plugin Architecture

API-Driven Integration at High-Volume Scale

The engineering team built a tight integration between their clinical platform and Canvas, using webhooks, APIs, and the read replica to keep systems in sync at high volume. Their plugin layer is purpose-built for scale - every note state change fires a real-time notification to the company's backend, and bulk operations handle the volume that comes with a large distributed clinical team.

API & Integration
Workflow
Webhook ForwarderFires real-time payloads to the company's backend on every note state change
Bulk Note SigningBatch sign operations for high-volume clinical documentation workflows

Real-Time Event Streaming

The primary plugin sends a webhook request to the company's backend every time a note is created or signed in Canvas. At this volume, this is a high-throughput event stream that keeps the clinical platform, analytics, and operational dashboards synchronized with Canvas in real time. A dedicated engineering team builds integrations against both the webhook events and a read replica for analytics and reporting.

Built for Volume

At this note volume, the practice needed bulk operations that traditional EMR workflows cannot support. The bulk note signing plugin lets providers sign large batches of clinical documentation efficiently - critical for a practice where clinicians each manage large patient panels. Canvas's auto-scaling infrastructure handles the load, and health data network integration enables clinical data exchange across payer and health system partnerships.

From First Patient to National Scale.
Canvas Grows with Your Mission.

Canvas Medical's programmable EMR runs API-first and at scale - so whether you're serving your first patients or scaling nationwide, your care model stays in the driver's seat.

Learn More About Canvas Medical