The 4th episode of the Perfect Care Podcast reviews the evolution of cardiac critical care @ the Sanger Heart & Vascular Institute. We think of these efforts, which began in 2004, in two eras: analog & digital. The later, digital era (built on the analog’s culture of data driven learning, teamwork and high-performance) includes tele-rounding and virtual critical care, which led to the more expansive and transformational remote perioperative monitoring initiative.