Dedicated outdoor air systems (DOAS) are a proven solution for reducing energy consumption as they optimize the control and functionality of ventilation and thermal comfort independently. A very high efficiency approach to DOAS pairs a high efficiency heat/energy recovery ventilator (HRV/ERV) with a high efficiency heat pump, while following design principles that optimize performance. This paper builds on a 2018 Summer Study paper (Love et al. 2018) that presented initial results from three demonstration projects. The expanded data set discussed herein includes results from the energy monitoring of 14 demonstration projects, including eight pilots completed between 2015-2018, and six additional sites supported by NEEA since 2019. These combined results, along with five years of market and technical analysis, have enabled NEEA to develop a market transformation program in support of this high-performance HVAC strategy.