Bringing expert heart recovery support into patients' homes — and showing that it works.
Between 2021 and 2024, Baker Institute researchers partnered with Medibank to transform how Australians recover from heart disease hospitalisations. The Heart Health at Home study delivered personalised cardiac rehabilitation through digital technology and nurse support — making expert support accessible from patients' own homes rather than requiring to attend cardiac rehabilitation at a hospital or community centre.
This was Australia's first national, fully remote cardiac rehabilitation program, and the results demonstrate that digital delivery can be just as effective as traditional face-to-face programs — while being more convenient, cost-effective and accessible.
Why this matters
Cardiac rehabilitation — supervised exercise, education and lifestyle support following a heart event — is proven to save lives and prevent repeat hospitalisations. Yet fewer than 30% of eligible Australians complete traditional programs, often due to distance, transport challenges, work commitments or mobility limitations.
The question driving this research was simple but critical: could technology assist to bridge this gap without compromising patient outcomes?
What we tested
Following hospitalisation for heart disease, Medibank members were enrolled in a six-week digitally enabled cardiac rehabilitation program that included:
- A personalised digital app to track progress, access education and monitor health metrics.
- Weekly telehealth consultations with an experienced cardiac nurse.
- Individualised physical activity and lifestyle plans tailored to each patient's needs and recovery.
Researchers then investigated three key questions:
- Did it improve health outcomes?
The team measured whether participants showed improvements in cardiovascular risk factors — things like blood pressure, cholesterol, physical activity levels and medication adherence. - Did it reduce healthcare costs?
Researchers tracked whether participants had fewer rehospitalisations, spent fewer days in hospital and had better survival rates over 12 months compared to matched patients who completed face-to-face rehabilitation or received usual care. - What was the patient experience?
Through in-depth interviews, the team explored how both patients and nurses experienced the digital program — what worked, what didn't, and whether people felt supported throughout their recovery.
What we found
Health outcomes: digital delivery works
Patients who completed the Heart Health at Home program showed significant improvements in cardiovascular risk factors, comparable to traditional face-to-face rehabilitation. The personalised approach — combining app-based support with regular nurse consultations — effectively supported patients in making lasting lifestyle changes during a critical recovery period.
Healthcare impact: fewer hospitalisations, better survival
Over 12 months, participants in the digital program experienced reduced rehospitalisations and fewer days in hospital compared to matched controls. The study also demonstrated improved survival rates, suggesting that making cardiac rehabilitation more accessible leads to better long-term health outcomes.
Economic value: a cost-effective solution
The program showed to be not only clinically useful but also cost-effective compared to usual care. By reducing hospital readmissions and enabling care delivery without facility-based infrastructure, digital cardiac rehabilitation represents a sustainable model that could be scaled across the Australian healthcare system.
Patient experience: convenience meets quality care
Qualitative research revealed that both patients and nurses valued the flexibility and personalisation of the digital model. Patients appreciated receiving expert support without travel burdens, while nurses found they could build strong therapeutic relationships through telehealth and provide care tailored to each person's home environment and daily life.
Technical detail for researchers
Clinical outcomes
This prospective cohort study enrolled privately insured Medibank patients following cardiac hospitalisation into a digitally enabled cardiac rehabilitation (DeCR) program. The intervention comprised a mobile application integrated with wearable activity tracking, combined with six weekly telehealth consultations with cardiac nurses trained in motivational interviewing and behaviour change techniques.
Primary outcomes included changes in modifiable cardiovascular risk factors (blood pressure, lipid profiles, body mass index, physical activity levels) and medication adherence. Secondary outcomes examined rehospitalisation rates, hospital length of stay and 12-month mortality, with comparison to propensity-matched controls who received either centre-based cardiac rehabilitation or usual care.
Results demonstrated non-inferiority to traditional rehabilitation models across clinical endpoints, with significant improvements in risk factor modification sustained at 12-month follow-up.
Key publication
Braver JP, Marwick TH, Salim A, Hakamuwalekamlage D, Keating C, Yiallourou SR, Oldenburg B, Carrington MJ.
Effects of a digitally enabled cardiac rehabilitation intervention on risk factors, recurrent hospitalisation and mortality
Eur Heart J Digit Health 2025 6(4):688–703
Cost-effectiveness analysis
An incremental cost-effectiveness analysis compared the DeCR intervention to standard care from both healthcare system and societal perspectives over a 12-month time horizon. Analysis incorporated direct medical costs (hospitalisations, emergency presentations, primary care visits, medications), intervention delivery costs, and productivity losses.
The economic evaluation demonstrated that DeCR was cost-effective compared to usual care, driven primarily by reductions in unplanned hospitalisations and emergency department presentations. Quality-adjusted life years (QALYs) showed favourable incremental cost-effectiveness ratios well below accepted willingness-to-pay thresholds in the Australian context.
Sensitivity analyses confirmed robustness of findings across varied assumptions, supporting the economic viability of DeCR as a scalable intervention within Australian healthcare funding models.
Key publication
Braver JP, Marwick TH, Carrington MJ, Keating C, Oldenburg B, Scuffham P.
Cost-effectiveness of a digitally enabled cardiac rehabilitation program for patients with coronary heart disease
Eur J Prev Cardiol
Qualitative evaluation
Semi-structured interviews were conducted with program participants (n=20) and cardiac nurses (n=8) to explore experiences, perceptions and barriers/facilitators to engagement with the DeCR model. Thematic analysis identified key themes around program accessibility, therapeutic alliance formation in virtual settings, integration into daily life routines, and technical literacy requirements.
Participants valued the convenience and reduced burden of home-based delivery, though some expressed initial anxiety about technology use. Nurses reported that telehealth consultations enabled observation of patients' actual home environments, facilitating more contextually relevant advice. Both groups emphasised the importance of personalised support and human connection despite the digital medium.
Findings inform implementation considerations for broader rollout, including the need for technical onboarding support and strategies to maintain engagement throughout the program duration.
Key publication
Braver J, Tsindos T, Carrington MJ, Keating C, Ayton D.
Patients' and nurses' perceptions and experiences of a digitally enabled cardiac telerehabilitation program — a qualitative study
BMC Digital Health. 2025 3(18).
Research team
Lead researcher
- Justin Braver
Principal investigators
- Associate Professor Melinda Carrington
- Professor Tom Marwick
Collaborators
- Professor Brian Oldenburg
- Dr Catherine Keating
- Professor Paul Scuffham
- Dr Stephanie Yiallourou
- Professor Agus Salim
- Dr Dulari Hakamuwalekamlage
- Associate Professor Darshini Ayton
- Dr Tess Tsindos
What this means for the future
The Heart Health at Home study demonstrates that digital technology can break down longstanding barriers to cardiac rehabilitation without compromising the quality of care. By showing that remote delivery is clinically effective, cost-effective and valued by patients, this research opens the door to making life-saving cardiac rehabilitation accessible to thousands more Australians — particularly those in regional areas, with mobility challenges, or juggling work and family commitments.
As digital health infrastructure continues to evolve, the learnings from this study provide a roadmap for implementing scalable, patient-centred cardiac care across Australia and potentially other health systems worldwide. The future of heart disease recovery may not require leaving home at all — just the right combination of technology, expertise and personalised support.