ARPA-H named the first ADVOCATE contracts on September 11. The program, Agentic AI-Enabled Cardiovascular Care Transformation, runs $62.7 million over four years with $33.7 million in year one. It funds an AI agent that manages heart failure patients between clinic visits, medication titration included.
Three companies build the patient-facing system. Tempus AI has up to $9.5 million to extend its Olivia app with continuous monitoring. UpDoc has up to $9.2 million for an autonomous reasoning system under physician oversight. Atman Health has up to $7.7 million for a voice-first agent that pairs a language model with a deterministic engine holding more than 9,000 clinical criteria and 6,900 titration profiles.
Stanford holds the supervisory safety contract at up to $15 million. Duke has up to $15.5 million for validation across five health systems. Kaiser Permanente has up to $16.3 million and will enroll about 2,500 patients across 21 medical centers. The 39-month pathway includes benchmarking the agent against cardiologists and a randomized trial.
Every team owes FDA an authorization package within 24 months. Atman says it will file an IDE at month 12 and target a De Novo at month 24. Nobody has taken a generative AI agent that changes drug doses through a device pathway before, and whatever framework comes out of this will set the terms for the companies that try next.