Establishing Foundations on Both Sides of the Bridge: Exploring Contextual Barriers to Cardiac Rehabilitation Uptake to Inform Digital Health Technology Design

Cardiac rehabilitation (CR) is crucial for secondary prevention of cardiovascular diseases. Yet, many patients with a clear indication of CR do not participate in such programs. To build a more nuanced foundation for developing digital health technologies supporting patients’ CR uptake, we explored the practiced CR referral process to identify context-specific barriers in Austria. We conducted a contextual inquiry including four observations in both out- and inpatient settings and 13 stakeholder interviews. The results indicate a lack of a defined referral process, limited intersectoral communication, doctors’ unawareness and knowledge gaps, and patients missing clear information about CR. Thus, digital health technologies that aim to support patient-centered cardiovascular care pathways should be designed for timely patient information and engagement, automated referral support, and enhanced intersectoral communication.