Community heart failure screening, run by nurses under cardiologist oversight

Breathlessness in an underserved community

Breathlessness affects 10% of the adult population and over 25% of those aged 70 and above, but diagnostic delays are common, particularly in socioeconomically deprived communities where specialist services are hardest to reach. Heart failure and COPD together account for more than two-thirds of breathlessness cases. Delays in diagnosis lead to worse outcomes, more hospital admissions, and higher cost of care.

North Liverpool is one of the most deprived parts of England. The Everton BEAT Breathlessness Project, funded by the British Heart Foundation Healthcare Implementation Fund, was designed to close the diagnostic gap by bringing the assessment to the community rather than asking the community to navigate the assessment.

AI echo where there is no on-site echocardiographer

Us2.ai sits at the centre of the clinical pathway as the AI-assisted echocardiography platform. The software performs fully automated analysis on standard DICOM 2D echocardiograms, producing a structured report with chamber quantification, valve assessment, strain, and diagnostic flags. Because the platform handles the measurement work end-to-end, the program does not require an echocardiographer physically in the room.

That makes guideline-directed diagnostic quality achievable in a community setting that could not otherwise host a hospital-grade echo service. Heart failure specialist nurses and general practitioners acquire the study and use the report to guide the next step in the pathway. Cardiologist oversight remains in place for clinical decisions.

"It could save your life."

Gina, 75, from Liverpool, had been living with breathlessness, facing lengthy hospital waiting lists and repeated appointment cancellations. While attending a social support session at Everton in the Community, she took up the offer of a free BEAT Breathlessness screening. A point-of-care finger-prick NT-proBNP test came back elevated, triggering an AI-assisted echocardiogram on the same visit. The study was reviewed remotely by consultant cardiologist Dr Rajiv Sankaranarayanan and confirmed heart failure with reduced ejection fraction. Guideline-directed treatment began the same day, bypassing the usual GP-referral and hospital-waiting-list pathway.

"If I hadn't got the screening done, I'd still be waiting for a hospital appointment. One day it would have been too late. Everton — they've saved my life."

Gina's case illustrates the operational point the program is built around: in a community with high prevalence and constrained access, moving from symptom to confirmed diagnosis and treatment in a single visit changes outcomes.

A blueprint for reducing health inequalities

The Everton BEAT Breathlessness project demonstrates that Us2.ai can be deployed effectively beyond the hospital, enabling high-quality cardiac diagnostics in community environments operated by non-specialists. For health systems looking to expand access while controlling cost, it offers a real-world implementation model: a community venue, trained non-specialist operators, AI-assisted echocardiography for the technical work, and cardiologist oversight for clinical decisions.