A new research initiative, CARDIO-India, has been launched to reimagine cardiovascular care delivery in India through a community-first, technology-enabled approach, moving beyond traditional telemedicine models. The programme is a collaboration between the University of Leicester and the Centre for Chronic Disease Control (CCDC).
The initiative aims to address critical gaps in cardiovascular disease (CVD) care, particularly among ageing populations in low- and middle-income countries (LMICs), by bringing healthcare services closer to communities.
Community-first model to bridge care gaps
According to Kamlesh Khunti, Professor of Primary Care and Diabetes and Vascular Medicine at the University of Leicester, the programme adopts a community-based approach instead of relying solely on remote consultations.
“Traditional telemedicine assumes patients can independently access digital consultations. Our assisted telemedicine model supports those who cannot, by delivering services directly to their doorstep through mobile health units,” he said.
The programme will standardise cardiovascular risk assessment and management using digital decision-support systems based on evidence-based guidelines. This approach is expected to bridge gaps between primary, secondary, and tertiary care, especially for older adults facing multiple long-term conditions, social isolation, and financial constraints.
Nationwide trial to test real-world impact
CARDIO-India will be evaluated through a large-scale cluster randomised controlled trial spanning 10 states across India. While ambitious, researchers acknowledge both scientific and operational challenges.
Khunti noted that variations in population risk profiles, healthcare-seeking behaviour, provider capacity, and existing infrastructure could affect outcomes. To address this, the study design includes stratified sampling to ensure comparability across regions.
Operational challenges such as reaching remote areas, training healthcare workers, maintaining digital infrastructure, and engaging diverse communities are also anticipated. However, the team expressed confidence in overcoming these barriers based on prior experience with similar trials.
Global relevance for emerging economies
The programme is designed as a bi-directional learning model, with insights expected to benefit both India and the UK. Lessons from managing high CVD risk in Indian populations—characterised by early onset and multiple comorbidities—could inform care strategies for South Asian populations in UK cities like Leicester, Birmingham, and London.
Additionally, the model’s emphasis on community health workers and assisted telemedicine could help address workforce shortages in healthcare systems globally.
Addressing gaps in existing mobile health services
CARDIO-India builds on the Mobile Medical Units (MMUs) under the National Health Mission, aiming to strengthen their capabilities.
Dorairaj Prabhakaran, Executive Director of CCDC, highlighted existing gaps in MMUs, including the lack of cardiovascular risk screening, follow-up care, and electronic health records.
“Older adults often require integrated management of multiple physical and mental health conditions. CARDIO-India addresses this through electronic decision support, assisted telemedicine, and patient-facing digital tools,” he said.
Digital health to improve continuity of care
The programme integrates AI-enabled diagnostics and digital health records under the Ayushman Bharat Digital Health Mission.
These tools are expected to enhance early detection, risk stratification, and guideline-based treatment of cardiovascular diseases. Digital systems will also enable continuity of care by allowing healthcare providers to access patient records across different locations.
Features such as medication reminders, follow-up alerts, and personalised self-management guidance are expected to improve long-term disease management.
Policy shifts needed for ageing population
With India’s elderly population projected to grow significantly, experts emphasise the need for systemic healthcare reforms.
Prabhakaran called for a shift from episodic, acute care models to long-term management of chronic diseases, particularly CVDs. He stressed the importance of strengthening workforce capacity by training doctors, nurses, and frontline health workers in geriatric care and multi-morbidity management.
He also advocated for policy changes that prioritise continuous care, including insurance models that cover medications, monitoring, and rehabilitation, rather than focusing primarily on hospital-based interventions.
Finally, he underscored the need for cross-sector collaboration, noting that cardiovascular health outcomes are influenced by broader factors such as nutrition, transportation, and social support systems.
The CARDIO-India programme represents a significant step towards building scalable, inclusive, and technology-driven healthcare models for managing cardiovascular diseases in India and other emerging economies.