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Cardiology · Observational pilot
The Pritikin Cardiac Rehab pilot: patients who opened their orbit started rehab at more than twice the rate
Over nine months at a leading Midwest health system, 187 patients referred to Pritikin Intensive Cardiac Rehabilitation were invited to a cardiac rehab orbit. Of those who activated it, 52% went on to start the program. Of those who never activated, 24% did.
One number carried the pilot: the gap in rehab start rate between patients who activated their orbit and patients who never did.
52%
Activated, then started ICR
26 of the 50 patients who activated their orbit started the program.
24%
Never activated, then started
34 of the 141 who did not activate. Less than half the activated rate.
32%
Combined, all invited
The overall start rate across all 187 invited patients, well below the activated cohort.
9
Months of pilot data
Pilot months 1 through 9 at one outlet, reported December 2023.
Cohorts as reported by Pritikin ICR, December 2023. Observational pilot, not a randomized trial.
The two cohorts
Same invitation, different journeys
All 187 patients were referred to the program and invited to an orbit. What separated them was whether they activated it.
Activated their orbit
Opened and used the orbit they were invited to
Half of these patients went on to start Intensive Cardiac Rehabilitation.
52%
of this cohort started ICR
187
invited to an orbit
50
activated their orbit
26
started ICR
1,302
ICR sessions completed
Did not activate
Invited to an orbit but never activated it
Fewer than one in four of these patients started the program.
24%
of this cohort started ICR
187
invited to an orbit
141
did not activate
34
started ICR
1,402
ICR sessions completed
This was an observational pilot, not a randomized trial: patients chose whether to activate, so activation and program start may share underlying causes such as motivation or staff contact. The pilot's own recommendation is a randomized design next.
Honest scorekeeping
Against the pilot's own goals
Three KPIs were set before the pilot began. Two could not be evaluated, and one fell short of its target. We report all three.
Inconclusive
Growth in new Pritikin ICR enrollments
Target: 10% year-over-year increase
26 enrollments in the pilot period, with no prior-year figures at this site to compare against.
Inconclusive
Share of eligible patients invited to an orbit
Target: 90% of eligible patients
187 patients were invited, but the site could not report how many were eligible overall.
Below target
Share of invited patients who activate
Target: 75% activation
27% activated. Only 27% of new ICR candidates received the extended engagement emails, which we treat as the primary cause.
What we learned
Obstacles, and what we changed
A pilot exists to surface problems before full deployment. These are the five that mattered, each with the fix it produced.
01
No historical ICR start data at the site, so year-over-year comparison was impossible.
Run the next pilot as a true randomized A/B test: every other eligible patient receives an orbit.
02
Year-to-year changes in insurer ICR reimbursement policy and provider coverage skewed any year-over-year read.
Same fix. A randomized concurrent design removes payer-policy drift from the comparison.
03
Staffing changes and shortages made orbit invitation and onboarding inconsistent. Only 27% of new ICR candidates received the engagement pathway emails.
Shorter pilot window plus Epic integration, so invitation and engagement fire automatically rather than depending on staff availability.
04
Orbit activation reached 27% against a 75% goal.
Rebuilt engagement pathway emails aimed at a 50 to 75% activation range.
05
Site staff could not see or manage the status of patients they had invited.
Shipped. Patient invitation status is now visible and editable by site staff in the platform.
Go deeper
Get the pilot results, or talk it through
Download a summary of the nine-month pilot results, including cohort detail, the KPI scorecard, and the obstacles as we reported them. Or bring your own rehab enrollment numbers and we will walk through what an orbit could change.
