AI-Enabled Commercialization.
Third Coast Dynamics builds AI that reads aortic hemodynamics from the CT and MR scans hospitals already take. 3Pillars runs its commercial and business operations: a Claude-enabled commercialization assessment that sequenced five revenue pathways and the health-system and provider-sponsored-plan targets behind them, and a set of Claude workflows that now run the back office week to week.
Company Profile
Third Coast Dynamics (TCD) was founded by physician-scientists at Northwestern University. Its product, TCDflow, derives hemodynamic insight for thoracic aortic disease from standard CT and MR angiography, the scans hospitals already take, instead of a specialized 4D flow MRI. About 1 in 25 US adults is at risk for thoracic aortic disease, which is silent and underdiagnosed.
The science is ahead of the commercial model: a 1,700+ patient feasibility study published in Radiology, a 4,000+ patient 4D flow validation dataset, a 20,000+ patient outcomes set, four pilot academic medical centers (Northwestern, Cleveland Clinic, UW-Madison and the University of Colorado), a Northwestern Medicine partnership, and an FDA pre-submission in October 2025 that confirmed the 510(k) pathway. TCD is STTR-funded and pre-revenue. 3Pillars holds an equity position and runs its sales and business operations as a fractional team.
The Challenge
A science-first founding team with no commercial function and no budget to hire one before a seed raise. The unknowns were the ones that decide a MedTech company’s first years: who the economic buyer is, what the product is worth and how it is priced, how heavy the implementation burden is inside a hospital, what the status quo and the alternatives look like, and how defensible the story is against incumbents.
The founders wanted a ranked view of where revenue comes from first, who to call, and what proof each buyer needs before the next milestone.
The Assessment
3Pillars applied the same top-down and bottom-up assessment it had run for a clinical data platform’s entry into the payer market, adapted for a pre-revenue imaging company selling into health systems and, later, the plans those systems sponsor. Claude did the research synthesis, the segmentation and the drafting; 3Pillars operators set the frame and made the calls.
Top-down: five revenue pathways, scored
Per-click CPT reimbursement, enterprise health-system contracts, platform-embedded distribution, value-based care and payvider contracting, and device-company co-development. Each was scored on near-term revenue, long-term ceiling, TCD’s readiness, the evidence gap, sales-motion complexity and strategic optionality, with HeartFlow’s nine-year path from FDA clearance to majority commercial coverage as the analog. The finding: no pathway produces near-term revenue without prior readiness, and only enterprise contracts have both today.
Bottom-up: the buyer universe, segmented and sequenced
Health systems were segmented by type and pilot fit: academic medical centers (about 100 to 120), multi-state non-profit systems, single-state non-profit systems (about 200 to 300, the best pilot targets) and the innovator systems with venture arms. On the plan side, 3Pillars profiled every provider-sponsored health plan in its Medicare Advantage lakehouse, 169 parent organizations, and scored each for TCD fit on size, cross-line breadth, star ratings, growth, academic affiliation and the payviders the pathway research had already named. Fifteen sit in Tier 1, including the integrated payviders where the value-based pathway lands and the pilot-linked systems that convert to enterprise contracts first. Buyer maps for each pathway named who signs, who champions and who blocks.
The sequence that came out of it: convert the four pilot academic medical centers into the first paid enterprise contracts in 2026 to 2027, then the top 50 academic medical centers with aortic programs; run per-click billing as the credibility and coverage track; explore platform partnerships without committing; and approach provider-sponsored plans and payviders from 2028 once the outcomes registry, cost-effectiveness analysis and utilization data exist. Pricing: a flat site subscription of $50K to $200K per academic medical center for the first five to ten contracts. With about 850,000 chest CT angiograms a year amenable to TCDflow (about 2,000 per center) and even a quarter of HeartFlow’s per-patient impact, the directional cost savings run about $700K a year per center, an implied buyer ROI of 3.5x to 14x.
The 3Pillars Solution Deployed
AI Imaging Intelligence Brief
A weekly market, competitor and regulatory monitor generated as a branded deck; nine issues from March 19 to May 20, 2026, each produced by Claude and reviewed by 3Pillars.
Investor newsletter skill
Leadership submissions triaged into four standing sections, loaded into a locked HTML and PDF template, and regenerated each quarter; the Q1 2026 issue shipped with a curated investor and KOL list.
60-month financial model
Six toggleable revenue layers, scenario-driven staffing triggers and three-statement output, with a user guide so leadership runs scenarios without 3Pillars.
Exit-strategy and capital-raise readiness
Commercial pathways, a scoring framework for four exit options, and the seed-round readiness plan for the 2026 raise.
Website and brand
A four-page site prototype built in Claude and handed to a developer; brand-asset and IP inventories for trademark filing.
Branded decks on a skill
Investor, marketing and working-session decks generated from a TCD deck-builder skill that holds the brand rules.
Results
Third Coast Dynamics is pre-revenue. The contract range and buyer ROI are engagement outputs. The $300K a year is the loaded cost of the commercial hire TCD did not make.
Functional Areas Touched
A fractional commercial and business operations team touches most of a pre-revenue company. Highlighted nodes are where this engagement created downstream impact.