For over 60 years, the hospital has been the epicenter of cardiac care. It made sense: The technology and equipment required to test, treat, and manage patients could only be found within the walls of a clinic, due to both cost and logistical complexity. For decades, the “gold standard” was tethered to the zip code of the nearest medical center.
The disruption of this model over the last five-plus years has enabled clinically valid, medical-grade technology to transition from the hospital hallway or doctor’s clinic to the patient’s living room. This shift is being propelled by the convergence of necessity and capability in three key ways: the ongoing decline of physician supply, specifically cardiologists; innovation gains bringing medical-grade tools into the home; and a shift from sick care to preventive care to reduce cost and resource burden. The convergence of these shifts suggests that the transition of the home to become the primary clinical setting is no longer a distant vision, but an imminent reality and a viable path forward. Moving from care in the clinic to the home is propelled by leveraging innovative technology and tools that are high fidelity, and this enables better access to and quality of care, particularly in specialties like cardiology.
The catalyst for change
First, we are facing a demographic inevitability. By 2030, one in six people globally will be aged 60 or over. In the U.S., the challenge is even more acute: 90 percent of adults over 65 manage at least one chronic condition, and nearly 80 percent manage two or more, according to data from the Centers for Disease Control and Prevention (CDC). We are becoming a nation of chronic patients exactly at a time when our clinical resources are strained.
Second, we are navigating a shrinking workforce. The Association of American Medical Colleges (AAMC) projects a physician shortage of up to 86,000 by 2036, with specialized fields like cardiology and vascular surgery seeing the lowest “supply adequacy.” In addition, nearly half of active cardiologists are aged 65 or older, leading to high retirement rates. We do not have the capacity to manage the incoming wave of cardiac needs.
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Third, the maturation of medical-grade digital health tools has hit an exponential curve. In 2025 alone, the U.S. Food and Drug Administration (FDA) cleared nearly 300 AI/ML-enabled medical devices, a 50-fold increase in annual volume over the last decade.
The friction of legacy standards
To understand the gap we must bridge, look at the 12-lead electrocardiogram (ECG). Standardized in 1954, the 12-lead ECG remains the “gold standard” for a rapid, comprehensive view of the heart’s electrical activity. However, the process has remained largely unchanged for seven decades. It utilizes 10 electrodes to generate 12 distinct angles of the heart, and requires patients to disrobe, often in high-traffic environments, and relies on specialized clinicians to interpret the report. The device itself is often expensive and cumbersome to transport and utilize. A breakthrough in 1954 has now become a resource-heavy bottleneck in 2026.
Today, FDA-cleared, medical-grade ECG technology is available to patients at their local drugstores, brand-name retailers or for purchase online. These devices vary in comprehensive data and information, ranging from single-lead wearables to portable six-lead devices which can detect atrial fibrillation (AFib), bradycardia, and other common arrhythmias. While these devices don’t replace a 12-lead ECG, they enable patients to monitor conditions at home and provide medical-grade data to their physicians to increase opportunity to catch changes earlier that can lead to more serious conditions. Many physicians use these tools actively to engage on a regular basis with their patients to avoid the cost and hassle, for both the patient and provider, of bringing the patient into the office, and enable peace of mind for the patient and family that they can now track ongoing changes at home. However, as we transition from episodic sick care to a focus on preventive care leveraging innovative tools that provide more robust clinical encounters with actionable medical data, our clinical standards and protocols are struggling to keep up.
Beyond the data deluge: the quality mandate
As digital health adoption grows and the volume of data collected grows, the industry must ensure that health data generated at home from digital health tools meets the highest standards, particularly when powered by clinically validated AI. The digital health market is projected to surpass $697 billion this year, but this growth is a dual-edged sword. We’re drowning in “wellness” data while starving for “clinical insights.” The primary challenge facing clinicians today isn’t a lack of data, but a surplus of “noise” that fails to provide the medical-grade insights needed for clinical intervention. For the home to become a true clinical extension, we must ensure that remote systems and tools are rigorously vetted, clinically validated, and trusted by providers.
If we power intervention and diagnostic tools with AI, the input and processing of data must be of the highest clinical integrity. AI is only as good as the signal it consumes; if the home-generated data is fragmented or unverified, the resulting AI insight cannot be trusted.
From reactive detection to proactive prediction
The ultimate promise of moving cardiac care to the home is the transition from reactive detection to proactive prediction and timely intervention. Historically, cardiology has been a “wait and see” specialty. We wait for the palpitations or symptoms to occur before we intervene, and due to the lack of availability of specialty providers, we also wait to see one when needed. Global mass screenings have rarely been cost-effective, because the “gold standard” tools were too expensive to deploy at scale. By moving medical-grade tools into the home, we can finally implement targeted screening.
We can use data to pinpoint high-risk individuals based on genetics, lifestyle, or existing comorbidities and monitor them with the same intensity as an inpatient. By targeting conditions like AFib, the primary driver of stroke, we can deploy resources where they are most likely to save lives and reduce long-term costs. We are no longer looking for a needle in a haystack; we are putting a sensor on the needle.
Geography should not define care
Perhaps the most profound impact of this shift is the democratization of care. As the location of care shifts, geography loses its power over patient outcomes. Clinically valid AI can bring the expertise of elite medical centers to every home, whether in a remote town or a major metropolis, making “too late” a thing of the past. However, this future depends on our ability to implement disruptive technologies and to differentiate between wellness technology, designed to help healthy people optimize, and medical-grade tools, designed to help people and their providers make informed care decisions.
The move from the hospital to the home as the primary clinic is at a tipping point. To tip in the right direction, our industry must stop treating “remote monitoring” as a secondary data source and demand that home-based tools meet the highest rigors of evidence-based medicine. Only then can we ensure that as care moves home, quality and access doesn’t just keep pace with the clinic, it sets a new standard.
Ben Green is a physician executive.
