Hypoplastic Left Heart Syndrome (HLHS) is a serious health condition affecting infants. Since 1981, when procedures were first developed to address HLHS, the mortality rate has been declining, and by 2015, the procedures were very successful. But once patients were sent home, there was still a devastating 20% mortality rate, and parents were tasked with medical responsibilities and decisions that they weren’t prepared or trained for. In 2016, Jeff Vergales, a pediatric cardiologist at the University of Virginia, and his team developed an iPad-based remote monitoring system, called Healthy Outcomes through Patient Engagement (HOPE), which connected to the electronic medical record. This case offers a brief history of HLHS and treatment advances up to the app prototype. Students must consider the following: Does the major outlay of funds and personnel necessary for the app justify the few patients it serves? Are there other conditions that might benefit from this technology? How could insurers be involved?