Cardiovascular prevention, actively managed
Most prevention patients already have the data: lab values from several vendors, imaging read by several readers, years of medication start dates. What they do not have is anyone who has analyzed it. A membership harmonizes all of it into one comparable record and puts every treatment against the markers it was meant to move: whether it moved them, whether it is causing harm, and whether it is genuinely the reason, assessed against formal causal criteria by a cardiologist, on a schedule.
Levels of membership
Every level includes Trajectory, the practice's app, and keeps the logistics moving: prescriptions renewed before they lapse, tests followed until done, side effects recorded when they happen. Your cardiologist analyzes your record at every level, during visits. The paid levels carry advanced analytics between visits: data assembled and harmonized, updated actively, reviewed on a schedule, and available to you for interactive inquiries.
Both paid levels include everything clinically necessary and the same analysis. They differ in speed: how fast a question is answered, how soon a follow-up is booked, how often the analysis re-runs. Time is held on the schedule for members, so those hold however full the practice becomes. Anything urgent is scheduled by urgency at every level, including Free.
Free
Your care logistics, on time. Nothing waiting on a phone call.
Your tasks, tests, and refills kept moving, continuously
- Book from the live schedule yourself, without a phone call
- Testing ordered at a lab or imaging centre near you, then tracked until the result is back
- Refills flagged before you run out, so a medication never lapses while a request sits in a queue
- Side effects recorded when they happen, rather than half-remembered months later
- Visits that open with your record already assembled, so the time goes on decisions
Your trajectory is built from the start, and your cardiologist walks you through it during a visit. Seeing it yourself between visits, with the analysis and messaging your cardiologist from the app, begins at Base.
Base
Your cardiologist, reachable. Replies in 24 hours, follow-up appointments inside the week.
Your record collected, harmonized, and analyzed at least quarterly
- Everything in Free
- Unlimited messaging in the app: write as often as you need, and your cardiologist answers, within 24 hours
- Same week follow-up visits: hours held on the schedule for members, so a routine visit stays inside the same week however full the practice gets
- The Longitudinal Record: shown below, every treatment on one timeline with the markers it is meant to move, at the dose you actually took
- Overlay: pivot your whole record onto any one treatment and see what it did, and did not, move
- Focus: pin any markers to a shared axis and compare them directly
- Ask about this record: put a cause-and-effect question to your own record and get an answer back in seconds, graded criterion by criterion against the Bradford Hill criteria for causation
Premium
Your cardiologist, on demand. Replies in 12 hours, follow-ups inside one business day.
Your record collected, harmonized, and analyzed at least monthly
- Everything in Base
- Unlimited messaging in the app: write as often as you need, and your cardiologist answers, within 12 hours
- Follow-up visits within one business day: a routine visit inside one business day rather than inside the same week
- The harmonization and analysis runs monthly: what is missing, what needs updating, what is worth repeating, checked every month rather than every quarter, so a needed test is ordered in weeks rather than months
Month to month. Cancel any time. There is no minimum term and no cancellation fee. Cancelling stops the next charge; the level you have paid for runs to the end of that month and then steps down to Free, rather than closing. Your record is retained either way.
Visits are billed as visits at every level, including Free: $199 for a new patient and $149 for a follow-up, or billed to insurance. They are never bundled into a membership fee. A membership changes when a routine visit can be scheduled, never what it costs, and never who is seen first when something is urgent. Book a visit →
Nothing waiting on a phone call
Every test you have been asked to get, grouped by the place that will run it, with its address and its position on one track: ordered, scheduled, completed, results back. Every medication that needs a start date, asked once. This is the part of care that normally costs you three phone calls and a week of not knowing.
When did you start taking it?
Waiting on you: a scheduled date.
Waiting on you: a completed date.
Example view. Synthetic patient — not a real person.
Treatments and results, read together
A lab dashboard shows you values. A medical record stores them. Neither tells you whether the treatment you are taking is the reason a value moved, or whether it is the reason you feel worse. Answering that takes every marker a treatment could affect, on one timeline, against the dose you actually took, with what was expected of each recorded before the result came back.
Longitudinal record
Statin uptitration · 8 wk ago387 measurements · 27 constructs
Statin uptitration
expected vs observedWe increased your statin dose. We'll recheck your cholesterol in about 8 weeks to see how much it moved.
- ApoB is predominantly Lp(a)-carried, so the 40 mg step buys less than the LDL-C drop suggests — read from Lp(a)
- Cholesterol is absorption-dominant, so a statin alone will plateau — read from campesterol, absolute, beta-sitosterol, absolute
Example view. Synthetic patient and synthetic values — not a real person, and not medical advice.
One intervention, every consequence it could have
A plan names the treatment and the readouts that would show whether it is working and whether it is causing harm. Selecting the treatment lines every one of those readouts up against the dose actually taken — and against everything else being taken at the same time, which is what makes an alternative explanation visible instead of assumed. Each readout carries what was expected of it before the result arrived, so a value that did not move is as informative as one that did.
Pin any markers and compare them directly
The tracked set is not a fixed panel. Any marker in your record can be overlaid onto any treatment, and any group of them pinned to one axis and compared side by side. Markers are organised by what they actually measure — atherogenic burden, particle quality, cholesterol absorption — rather than by which laboratory panel happened to contain them, so a question can be asked in the terms it occurs to you in.
When a value moves the wrong way, ask the record why
A repeat calcium score that comes back higher reads like bad news, and most patients are told exactly that. Ask the record instead and the answer arrives in seconds, assessed criterion by criterion against the Bradford Hill tests for causation: timing, dose-response, size, reversibility, known mechanism, and what else could explain it. Every figure is read from your own data, and where the data cannot settle a question the answer says so rather than filling the gap.
“Could the worsening of my calcium score be explained by my statin?”
Your score most likely rose because of the statin — and that is the drug working, not failing. Statins convert soft plaque into calcified plaque, which is more stable and also more visible to the scan. A rising Agatston score on treatment is the expected consequence, which is why it is read here as an intended effect rather than a warning.
| Criterion | Finding | From your record |
|---|---|---|
| Timing computed | Met | moved from 34 to 52 after the change |
| Dose–response computed | Met | the marker tracks the dose ladder (10 MG: 22, 20 MG: 34, 40 MG: 52). |
| Size of the change computed | Large | a 53% change from baseline |
| Stopping and restarting curated | Not applicable | stopping is not expected to reverse this, so a gap off the drug would not settle it. |
| Known mechanism curated | Met | curated intended effect: rosuvastatin is expected to increase Coronary calcium score over ~180–730 days. |
| Other explanations computed | None found | no other treatment on this marker overlaps the window. |
Example answer, computed from a synthetic patient — not a real person, and not medical advice.
Common questions about the membership
Does a higher level mean better care?
No. Whatever management is clinically necessary is delivered in full at every level, and anything urgent is scheduled by urgency rather than by level. Medically warranted encounters are billed as visits at every level and are never bundled into the fee.
What happens if I stop the membership?
You keep the level you have paid for until the end of that month, and then move to Free.
How do I join if I have already been seen by the practice?
Sign up with the email address already on file and the membership connects to your existing record. If it does not match, the practice sends an invitation to the address on file, so access to an existing record is never granted on an unverified claim.
Does the membership replace my primary care physician?
No. This is specialty cardiovascular prevention for patients managing risk deliberately. It does not provide primary care, urgent care, or emergency care, and members are expected to keep a primary care physician.
Is the membership billed to insurance?
No. The membership fee is self-pay and is never billed to insurance. Insurance is used only for traditional medically necessary encounters: a visit is billed the way any specialist visit is billed, at every level including Free. The two are separate: the fee buys the harmonizing and the analysis, and it buys no visit time.
Ask about the membership
Signup is not open yet. Membership will be month to month, cancel any time, and available in the states where the practice is licensed.
Membership terms and the consents collected at signup will be published before signup opens. This membership does not provide emergency care. If you are having a medical emergency, call 911.