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HeartFlow scales with Zendesk to transform heart healthcare

Medical technology company HeartFlow is revolutionizing precision heart care. The company works with more than 500 hospitals globally to deliver personalized, non-invasive tests that help doctors better understand blood flow through a patient’s arteries. Zendesk is integrated across several teams at HeartFlow to ensure that all customer-related needs are documented and tracked through Zendesk. The results: a 98 percent customer retention rate and a 93 percent CSAT score across both new and existing customers.

“We capture things that we learn from our customers in Zendesk to pass on to our engineers for improvements. Our customers benefit from this feedback and improvement loop because we make numerous software improvements each year. We’re able to adapt regularly by truly understanding what our customers need.”

Tim Fonte

SVP of Upstream Marketing at HeartFlow

“The linkage between Zendesk and Jira allows for optimized escalation protocols, efficient prioritization of incoming tickets, and ensures that we provide really fast turnaround time when resolving issues.”

Christophe Lecas

SVP of Engineering at HeartFlow

Company Headquarters

Mountain View, California

Patients Served


Hospitals Served


Company founded



Customer retention



As the leading cause of death worldwide, heart disease touches nearly everyone in some way. Chances are good that each of us knows someone with heart disease or has lost someone to the disease. But new technology is making it possible to receive critical information about heart health, much earlier.

HeartFlow, Inc., founded in 2010 by two former Stanford University professors, has transformed the way doctors assess and diagnose coronary artery disease. Traditional non-invasive diagnostic tests do not show blood flow within specific arteries.

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. To date, the company’s solution has served more than 100,000 patients and partners with 90% of the top 50 U.S. heart hospitals.

Revolutionizing precision heart care: How HeartFlow works

HeartFlow operates as a service by securely receiving CT image data of a patient’s heart from a hospital through the cloud, analyzing the images 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 with information they could never have received non-invasively before,” says HeartFlow’s Senior Vice President of Upstream Marketing, 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 combining AI and 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.

Zendesk facilitates internal collaboration, extensibility, and security

Before Zendesk, teams within HeartFlow used multiple, disparate platforms for different support channels and internal service needs, which presented a challenge to 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,” says Fonte. “We looked at all the major competitors and narrowed it to Zendesk as the best fit for us.”

HeartFlow also provides proactive support, and creates tickets in Zendesk when a customer’s CT scan isn’t of sufficient quality to build a complete 3D model. This allows HeartFlow’s support team to quickly connect with the doctors and technicians, and then work with them to troubleshoot so they can get the image data they need to produce a model that will provide the most accurate information for the doctor and patient. HeartFlow created this proactive process to improve customer CT acceptance rates to over 90%.


Customer support continues to scale and improve as HeartFlow grows

HeartFlow’s customer base has grown rapidly over the last two years from 200 to more than 500 hospitals worldwide. And it’s grown in scope as well as size. While the company’s primary customer is still medical professionals based in a hospital or physician practice, there has been an increase in the number of patients reaching out to HeartFlow directly.

The company set up a phone number (877-HRT-FLOW) that allows a person to get a response quickly during times when they need to make an educated medical decision. Fonte adds, “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, with Zendesk, the team has a full view of each customer interaction.

Fonte initially 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, more 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,” Fonte says. “Everyone at HeartFlow is deeply aware of how we touch the customer. Whether it is 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 to the support teams — it’s all about the customer experience.”

The challenge for Fonte and his team is ensuring that HeartFlow continues to offer the same level of high-quality service as the customer base grows. Building a scalable, reliable system is a top priority for HeartFlow.

A seamless flow between Zendesk and Jira ensures exceptional customer experiences

“A big part of our continuous improvement comes from understanding what our customer needs are and collaboration between the customer-facing team and the engineering team to improve the product and customer experience towards that. We don’t want our customers to keep dealing with the same thing over and over again, so if something is showing up as a consistent pain point, we work to improve it. And that’s where the collaboration between the teams is really important,” explains Fonte. Underpinning that successful collaboration is the robust integration between Zendesk and Jira.

For HeartFlow’s SVP of Engineering, Christophe Lecas, the connection between Jira and Zendesk is critical. “The linkage between Zendesk and Jira allows for optimized escalation protocols, efficient triaging of incoming tickets, and ensures that we provide really fast turnaround time when resolving issues.”

This is particularly crucial in the healthcare sector where time matters greatly. “We know how busy it can be in a hospital, and we know how much our patients and clinicians want to receive an answer,” says Lecas. “So we’re always striving to work on their timelines. We’ve been able to reconfigure our forms and escalation paths within Zendesk to help achieve that.”

The same flow of information is used to collate customer feedback and inform product development. “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 through Jira for improvements,” Fonte says. “Our customers benefit from this feedback and improvement loop because we make numerous software improvements each year. They don’t need to purchase new hardware or software upgrades. We’re able to adapt regularly by truly understanding what our customers need.”

“The flow from Zendesk to a Jira ticket gives us visibility on what’s important for us to address for our customer,” says Fonte. “One of the top things that we learned from our clinical customers was that they wanted data presented with patient scans upfront rather than reviewing images first and then requesting an analysis.

So we’re building a new part of our product that will show an upfront anatomic assessment of CT scans making the physician’s entire workflow easier. That evolution really came from our customers. We learned from them what would make their lives easier. Many of the features of the new product are highly influenced by the feedback flowing through Zendesk.”


Multiple Zendesk integrations aid regulatory compliance

Fonte underscores 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. “What started as a way to manage traditional support issues has become a company-wide endeavor to ensure information flows to other teams to help make continuous improvements in the customer experience.”

Each HeartFlow team has its own communication channel or integration with Zendesk according to its needs, from PagerDuty to DataDog, as well as Slack. Zendesk has become the central hub of the company through which each team can track and respond to the needs of the customer. “There’s many channels of communication,” Fonte explains. “It’s a way of ensuring that all teams are aware of what they have to do to serve the customer. And that makes for a faster, more efficient customer experience.”

As a healthcare provider, HeartFlow is subject to stringent quality assurance regulations. Integrations between Zendesk and several other applications enable HeartFlow to fulfill its monitoring and feedback obligations and take any necessary actions. “In the healthcare industry, compliance with regulations and standards is crucial. So we need to be able to track customer feedback in a more rigorous way than you perhaps would in other industries. We have to link all feedback to our other systems for quality control to ensure that we are meeting those set standards,” Fonte explains.

All the work HeartFlow is doing to get its customers and patients the information they need isn’t about showing off the technology, Fonte says—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 says. “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.”

“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,” offers Fonte. HeartFlow’s use of Zendesk has evolved over time as it has grown and the company maintains exceptional customer retention (98 percent) and satisfaction (93 percent) rates across both new and existing customers.