. 2022 Aug 26;17(1):61.

doi: 10.5334/gh.1141. eCollection 2022.

World Heart Federation Roadmap for Digital Health in Cardiology

Jasper Tromp^#¹, Devraj Jindal^#², Julie Redfern³, Ami Bhatt⁴, Tania Séverin⁵, Amitava Banerjee⁶, Junbo Ge⁷, Dipti Itchhaporia⁸, Tiny Jaarsma⁹, Fernando Lanas¹⁰, Francisco Lopez-Jimenez¹¹, Awad Mohamed¹², Pablo Perel^{5

13}, Gonzalo Emanuel Perez¹⁴, Fausto Pinto¹⁵, Rajesh Vedanthan¹⁶, Axel Verstrael¹⁷, Khung Keong Yeo¹⁸, Kim Zulfiya¹⁹, Dorairaj Prabhakaran^{2

13

20}, Carolyn S P Lam²¹, Martin R Cowie²²

Affiliations

¹ Saw Swee Hock School of Public Health, National University of Singapore, The National University Health System Singapore, and Duke-NUS Medical school, Singapore.
² Centre for Chronic Disease Control, New Delhi, IN.
³ School of Health Sciences, Faculty of Medicine and Health, University of Sydney, AU.
⁴ Massachusetts General Hospital, Boston, US.
⁵ World Heart Federation, Geneva, CH.
⁶ Institute of Health Informatics, University College London, London, GB.
⁷ Fudan University Zhongshan Hospital, CN.
⁸ Hoag Hospital, University of California, Irvine, Newport Beach, US.
⁹ Dpt of Medicine, Health and Caring Sciences, Linköping University, Linköping, SE.
¹⁰ Universidad de La Frontera, Temuco, CL.
¹¹ Dpt of cardiovascular medicine, Mayo Clinic, Rochester, US.
¹² Dpt of Medicine, University of Khartoum, Khartoum, SD.
¹³ London School of Hygiene & Tropical Medicine, London, UK.
¹⁴ Dpt of Cardiology, Clínica Olivos, Buenos Aires, AR.
¹⁵ University Hospital CHULN, CAML, CCUL@RISE, Faculty of Medicine of the University of Lisbon, Lisbon, PT.
¹⁶ Department of Population Health/Institute for Excellence in Health Equity, New York University Grossman School of Medicine, New York, US.
¹⁷ Hasselt University, Antwerp, BE.
¹⁸ Dpt of cardiology, National Heart Centre Singapore, SG.
¹⁹ Dpt of internal medicine, City Clinical Hospital No. 7, Kazan medical state university, Kazan, RU.
²⁰ Public Health Foundation of India, Gurugram, IN.
²¹ National Heart Centre Singapore, Duke-National University of Singapore, SG.
²² Royal Brompton Hospital & School of Cardiovascular Medicine, Faculty of Life-sciences and Medicine, King's College London, London, GB.

^# Contributed equally.

PMID: 36051317
PMCID: PMC9414868
DOI: 10.5334/gh.1141

World Heart Federation Roadmap for Digital Health in Cardiology

Jasper Tromp et al. Glob Heart. 2022.

. 2022 Aug 26;17(1):61.

doi: 10.5334/gh.1141. eCollection 2022.

Authors

Affiliations

¹ Saw Swee Hock School of Public Health, National University of Singapore, The National University Health System Singapore, and Duke-NUS Medical school, Singapore.
² Centre for Chronic Disease Control, New Delhi, IN.
³ School of Health Sciences, Faculty of Medicine and Health, University of Sydney, AU.
⁴ Massachusetts General Hospital, Boston, US.
⁵ World Heart Federation, Geneva, CH.
⁶ Institute of Health Informatics, University College London, London, GB.
⁷ Fudan University Zhongshan Hospital, CN.
⁸ Hoag Hospital, University of California, Irvine, Newport Beach, US.
⁹ Dpt of Medicine, Health and Caring Sciences, Linköping University, Linköping, SE.
¹⁰ Universidad de La Frontera, Temuco, CL.
¹¹ Dpt of cardiovascular medicine, Mayo Clinic, Rochester, US.
¹² Dpt of Medicine, University of Khartoum, Khartoum, SD.
¹³ London School of Hygiene & Tropical Medicine, London, UK.
¹⁴ Dpt of Cardiology, Clínica Olivos, Buenos Aires, AR.
¹⁵ University Hospital CHULN, CAML, CCUL@RISE, Faculty of Medicine of the University of Lisbon, Lisbon, PT.
¹⁶ Department of Population Health/Institute for Excellence in Health Equity, New York University Grossman School of Medicine, New York, US.
¹⁷ Hasselt University, Antwerp, BE.
¹⁸ Dpt of cardiology, National Heart Centre Singapore, SG.
¹⁹ Dpt of internal medicine, City Clinical Hospital No. 7, Kazan medical state university, Kazan, RU.
²⁰ Public Health Foundation of India, Gurugram, IN.
²¹ National Heart Centre Singapore, Duke-National University of Singapore, SG.
²² Royal Brompton Hospital & School of Cardiovascular Medicine, Faculty of Life-sciences and Medicine, King's College London, London, GB.

^# Contributed equally.

PMID: 36051317
PMCID: PMC9414868
DOI: 10.5334/gh.1141

Abstract

More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service delivery. Digital health technologies can help address these challenges. They may be a tool to reach Sustainable Development Goal 3.4 and reduce premature mortality from non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation. World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.

Keywords: digital health interventions for CVD; e-health; health system governance.

PubMed Disclaimer

Conflict of interest statement

Dr Jasper Tromp is supported by the National University of Singapore Start-up grant, the tier 1 grant from the ministry of education and the CS-IRG New Investigator Grant from the National Medical Research Council; has received consulting or speaker fees from Daiichi-Sankyo, Boehringer Ingelheim, Roche diagnostics and Us2.ai, owns patent US-10702247-B2 related to artificial intelligence and echocardiography. Dr Devraj Jindal holds a copyright for the CARDIOMETCARE-M software which is a clinical decision support system. Dr Julie Redfern owns a portion of the IP for the TEXTCARE software that was developed following the TEXTME study. She is also funded by a NHMRC Investigator Grant Leadership Level 2 [GNT2007946]. Dr Khung Keong Yeo has received research funding from Amgen, Astra Zeneca, Abbott Vascular, Bayer, Boston Scientific, Shockwave Medical, Nestle, Novartis (all significant, via institution); Consulting or honoraria feeds (all modest) from Abbott Vascular, Boston Scientific, Medtronic, Amgen, Bayer, Novartis, Astra Zeneca, Peijia Medical; Speaker or Proctor fees from Shockwave Medical, Abbott Vascular, Boston Scientific, Medtronic, Philips, Alvimedica, Bayer, Biotronik, Orbus Neich, Shockwave Medical, Amgen, Novartis, Astra Zeneca, Microport, Terumo. Dr. Lopez-Jimenez is co-inventor of several AI algorithms that have been licensed to digital health companies and may receive financial compensation in the future. He is member of the advisory board for Anumana, an AI-based technology company. He has co-developed digital health technology to use 3D volumes to assess cardiometabolic risk with Selected Research Inc, and may receive financial benefit in the future. Dr Dorairaj Prabhakaran holds a copyright for the CARDIOMETCARE-M software which is a clinical decision support system. Prof Carolyn SP Lam is supported by a Clinician Scientist Award from the National Medical Research Council of Singapore; has received research support from Bayer and Roche Diagnostics; has served as consultant or on the Advisory Board/Steering Committee/Executive Committee for Abbott, Actelion, Alleviant Medical, Allysta Pharma, Amgen, AnaCardio AB, Applied Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Cytokinetics, Darma Inc., EchoNous Inc, Impulse Dynamics, Ionis Pharmaceutical, Janssen Research & Development LLC, Medscape/WebMD Global LLC, Merck, Novartis, Novo Nordisk, Prosciento Inc, Radcliffe Group Ltd., Roche Diagnostics, Sanofi, Siemens Healthcare Diagnostics and Us2.ai; and serves as co-founder & non-executive director of Us2.ai. Dr Martin R Cowie has provided consultancy advice to Medtronic, Boston Scientific, Abbott and AstraZeneca, related to aspects of digital health. As from 1 August 2022 he has been employed by AstraZeneca as Clinical Vice-President in Late Stage Research (Biopharmaceuticals).

Figures

The potential of digital health interventions for CVD. © World Heart Federation — **Figure 1**
The potential of digital health interventions for CVD. *© World Heart Federation*.

Selected roadblocks and solutions to implement digital health interventions, based on the WHO/ITU framework. © World Heart Federation — **Figure 2**
Selected roadblocks and solutions to implement digital health interventions, based on the WHO/ITU framework. *© World Heart Federation*.

**Figure 3**
NCD nurse using mPower Health CDSS in a government health facility, reproduced with permission from the Centre for Chronic Disease Control (CCDC), New Delhi, India.

CONNECT smartphone application. Reproduced from NPJ Digit Med. 2020; 3. Redfern J, Coorey G, Mulley J, et al., A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial — **Figure 4**
**CONNECT smartphone application.** Reproduced from NPJ Digit Med. 2020; 3. Redfern J, Coorey G, Mulley J, et al., A digital health intervention for cardiovascular disease management in primary care (CONNECT) randomized controlled trial.

See this image and copyright information in PMC

References

1. Burden G, Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020; 76: 2982–3021. - PMC - PubMed
1. Abbafati C, Abbas KM, Abbasi-Kangevari M, Abd-Allah F, Abdelalim A, Abdollahi M, et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396: 1223–1249. DOI: 10.1016/S0140-6736(20)30752-2 - DOI - PMC - PubMed
1. Barber RM, Fullman N, Sorensen RJD, Bollyky T, McKee M, Nolte E, et al. Healthcare access and quality index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: A novel analysis from the global burden of disease study 2015. Lancet. 2017; 390: 231–266. DOI: 10.1016/S0140-6736(17)30818-8 - DOI - PMC - PubMed
1. Manne-Goehler J, Geldsetzer P, Agoudavi K, Andall-Brereton G, Aryal KK, Bicaba BW, et al. Health system performance for people withdiabetes in 28 low-and middle-incomecountries: A cross-sectional study of nationallyrepresentative surveys. PLoS Med. 2019; 16. DOI: 10.1371/journal.pmed.1002751 - DOI - PMC - PubMed
1. Zhou B, Danaei G, Stevens GA, Bixby H, Taddei C, Carrillo-Larco RM, et al. Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys. Lancet. 2019; 394: 639–651. DOI: 10.1016/S0140-6736(19)31145-6 - DOI - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

World Heart Federation Roadmap for Digital Health in Cardiology

Affiliations

World Heart Federation Roadmap for Digital Health in Cardiology

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources