Top Things to Know: Role of Telemedicine in Congenital Heart Disease Care Models in Low-and Middle-Income Countries
Updated: October 05, 2026
Prepared by Barbara Entl, MD Science and Medicine Advisor American Heart Association
- Telemedicine has emerged as a promising strategy to improve healthcare access and expand specialist capacity across low- and middle-income countries (LMICs), which represent most nations globally.
- This scientific statement reviews current telecardiology applications, implementation strategies, and barriers, while outlining pathways for sustainable integration into LMIC health systems.
- Many LMICs continue to face severe shortages of pediatric cardiologists, cardiac surgeons, and cardiac imaging resources, contributing to delayed diagnosis, limited treatment access, and higher congenital heart disease (CHD)-related mortality.
- By enabling remote consultation, imaging review, and specialist decision support, telemedicine can strengthen local clinical capacity, reduce unnecessary travel, improve access to specialist expertise, and foster collaboration between tertiary and peripheral centers.
- Across the CHD care continuum, telecardiology can support diagnosis, inpatient management, follow-up, multidisciplinary care, and fetal cardiac assessment.
- Remote echocardiographic interpretation using real-time, asynchronous, or hybrid care models may expand diagnostic capacity in underserved regions while improving access to expert imaging support.
- Emerging technologies, including mobile health (mHealth), artificial intelligence (AI), and tele-ICU programs, may enhance screening, image quality, clinical decision support, emergency consultation, and postoperative management.
- Despite these advances, the scalability of telecardiology programs remains constrained by limited digital infrastructure, unreliable connectivity, workforce shortages, equipment costs, and the absence of standardized reimbursement and regulatory frameworks.
- Assisted telemedicine models, in which frontline providers perform standardized data acquisition with remote specialist support, may help optimize specialist capacity and improve scalability in resource-constrained settings.
- Sustainable implementation of telecardiology requires coordinated engagement among policymakers, health systems, regulatory bodies, global health organizations, and frontline clinicians. Telecardiology should therefore be viewed not only as a technological solution, but as a socio-technical intervention integrating digital systems, clinical workflows, and local healthcare infrastructure.
Citation
Mattos SS, Vervoort D, Moshin S, Sholler G, Sethi Y, Maheshwari S, Sun K, Bennett DA, Zühlke LJ, Staveski S; on behalf of the American Heart Association on behalf of the American Heart Association Council on Lifelong Congenital Heart Disease and Heart Health in the Young, Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee; Council on Clinical Cardiology; and the Council on Cardiovascular and Stroke Nursing. The role of telemedicine in congenital heart disease care models in low-and middle-income countries: a scientific statement from the American Heart Association. Journal American Heart Assoc. 2026;15:e054084. doi: 10.1161/JAHA.126.054084