In October 2019, Dr. Ryan Madder sat in front of a control panel in Waltham, MA, preparing for a robotic-assisted percutaneous coronary intervention (PCI) as he has done on countless occasions. Beyond the familiarity of the robotic controls and monitor with fluoroscopic images of the heart, this was anything but a typical procedure. While Dr. Madder sat outside Boston, he was about to attempt PCI on simulated patients located in New York and San Francisco.