Digital readiness for cardiovascular care in high-burden US communities with cardiology workforce constraints.

November 5, 2026| Source: Nature medicine

Digital health may extend cardiovascular care in communities with limited specialist access, but its effectiveness depends on whether communities have the infrastructure, devices, affordability, and capacity needed to use digital services. We linked national data on cardiometabolic disease burden, cardiology workforce, and digital readiness across 82,999 US census tracts. Among high-burden tracts in counties with no cardiologist or declining per-capita cardiologist supply, 4,765 (18.0%) tracts representing 19.9 million residents had higher digital readiness and were thus classified as deployment-priority tracts, whereas 21,752 (82.0%) tracts representing 74.1 million residents had lower readiness and were investment-priority tracts. Investment-priority tracts were spread across the urban-rural continuum and faced different barriers (adoption versus infrastructure). Contrasting classifications frequently occurred among neighboring census tracts within the same metropolitan area, highlighting geographic variation not captured by county-level targeting. Findings were broadly consistent across nine additional analyses with varying measures of readiness, workforce access, and classification thresholds. These findings provide a national framework for distinguishing communities where digital cardiovascular care may be deployed from those where infrastructure and adoption support may first be needed to enable equitable implementation.

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