WHF Roadmap for digital health interventions in cardiology

WHF Roadmap
Recommendations by the World Heart Federation for successful development and implementation of digital health interventions1

Cardiovascular diseases (CVD) account for a significant, and growing, global healthcare burden with more than 500 million people affected worldwide.2 There are many options in managing CVD, however the delivery of optimal care is complicated due to constraints in healthcare workforce, financing, availability and affordability of CVD medicine and service delivery.

Digital health interventions examples



Remote monitoring

Remote monitoring

Mobile apps

Mobile health apps

Digital tools

Digital decision support tools

Such DHIs have the potential to improve healthcare for cardiovascular diseases, by empowering patients and healthcare organisations, improving long-term patient outcomes, improving patient care experience and reducing healthcare costs.3

The potential and benefits of digital health interventions

Patient doctor

Improve patient experience and long-term outcomes to care


Empower patients and HCPs/HCOs

Reduce costs

Reduce healthcare costs and improve resource usage

Health coverage

Enable universal health coverage

HCOs: Healthcare organisations; HCPs: Healthcare professionals.

However, due to poor context-specific design and a lack of proper evaluation standards, DHIs are often perceived as ineffective and lack recommendation in current guidelines. Robust qualitative, quantitative and economic evaluation and development of implementation strategies, especially for complex DHIs, are essential for their success. 

The main barriers for the successful implementation of DHIs can be divided into different categories:

  1. healthcare system, including a lack of national privacy regulations and regulatory approval standards, inadequate digital infrastructure and insufficient reimbursement frameworks, 
  2. healthcare provider, in terms of both a lack of digital literacy and misperception of the effectiveness of DHIs, 
  3. patient-related, including their age, local gender norms, socioeconomic factors, lack of digital and health literacy, misperception of effectiveness of DHIs and limited user-specific design adaptations and 
  4. technological factors, such as no context-specific adaptation of technology, lack of interoperability, insufficient usability and design and limited national and institutional infrastructure.

Roadblocks for implementation of digital health interventions


Insufficient DHI standardisation and interoperability


Insufficient DHI clinical testing and reduced perceived effectiveness

Data privacy

Data privacy and storage

Additional roadblocks

  • Lack of digital literacy
  • Lack of national guidelines and digital infrastructure
  • Lack of regulatory standards
  • Reimbursement and long-term investments

DHI: Digital health interventions.

During the design process of digital health interventions, it is therefore important that the content and functionality of a DHI is aligned with the goal of the intervention. Digital applications also need to be optimised for their intended use and their implementation environment, therefore national strategies, reimbursement policies and digital infrastructure are key factors for long term success of DHIs. See World Health Organisation Guideline Recommendations4 and European Society of Cardiology e-Cardiology Working Group Position Paper2 for further information.  

Successful implementation of DHIs also relies on good leadership and governance, high-quality legislation and policies, a clear investment and reimbursement strategy, a supportive digital healthcare infrastructure, clear interoperability and data standards, and a healthcare workforce educated on digital technologies (as suggested in the National eHealth Strategy Toolkit from the World Health Organisation and International Telecommunication Union 2012).5

Solutions for improved implementation of digital health interventions


(Co-)Design of user-centered applications


Robust quantitative, qualitative and economic evaluation of DHI


Development of mechanisms and guidelines on data privacy and storage

Additional solutions

  • Digital technology education
  • Implementation of national guidelines and digital infrastructure
  • Implementation regulatory standards/frameworks
  • Development of reimbursement strategies
  • Design of context-specific applications

DHI: Digital health interventions.

The World Health Federation Roadmap for Digital Health in Cardiology1 analyses each of these barriers in detail and provides context-specific solutions as well as DHI examples that have been successfully implemented in real world settings.

Key facts
  • Delivery of optimal care for cardiovascular diseases is often complicated due to constraints in healthcare workforce, financing and service delivery
  • Digital health interventions have the potential to improve healthcare for cardiovascular diseases, e.g. by empowering patients and healthcare organisations, improving patient care experience and reducing healthcare costs
  • Robust qualitative, quantitative and economic evaluation and development of implementation strategies are essential for the success of digital health interventions

CarDiaLogue unites the passion for cardiology and diagnostics in an engaging dialogue

Join the #CarDiaLogue today and sign up for updates.

CarDiaLogue brings you the latest insights and valuable perspectives from some of the sharpest minds in cardiology to complement your specialist skills.

Form Successfully Submitted!
Thank you for your submission!


  1. Tromp J, Jindal D, Redfern J, Bhatt A, Séverin T, Banerjee A, et al. World Heart Federation Roadmap for Digital Health in Cardiology. Glob Heart. 2022;17(1):61. 
  2. Roth GA, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020;76(25):2982-3021.
  3. Frederix I, et al. ESC e-Cardiology Working Group Position Paper: Overcoming challenges in digital health implementation in cardiovascular medicine. Eur J Prev Cardiol. 2019;26(11):1166-77.
  4. WHO guideline Recommendations on Digital Interventions for Health System Strengthening. World Health Organization; 2019. Available from:
  5. National eHealth Strategy Toolkit: World Health Organization and International Telecommunication Union (2012). Available from: