New Models of Cardiac Rehabilitation
Hybrid and virtual care models are expanding access and improving patient-centred cardiac care.
The COVID-19 pandemic transformed how cardiac care was delivered worldwide, highlighting the need to understand its impact on program delivery and care models.
Before the COVID-19 pandemic, cardiac rehabilitation programs were traditionally delivered in person. However, when the pandemic began, programs rapidly shifted to virtual formats to maintain patient care. In a new study from UHN’s KITE Research Institute (KITE), researchers examined how this transition reshaped cardiac rehabilitation across Canada, expanding access and supporting more patient-centred models of care.
The research team surveyed 108 representatives from 150 cardiac rehabilitation programs to understand the barriers and benefits of in-person, virtual, and hybrid program models. Compared to programming before the pandemic, they found a significant decline in in-person programming and an increase in virtual and hybrid models. Close to 50% of rehabilitation programs now offer two or three delivery models.
The integration of hybrid and virtual models helped programs reach more participants. Virtual programs require fewer operational resources than in-person programs, which allow programs to support more patients without exceeding capacity. At the same time, virtual programs reduce financial or logistic barriers for patients who face challenges attending in-person, such as transportation costs, limited mobility, or restrictive schedules.
By directing lower-risk patients to virtual or hybrid formats, programs can allocate limited in-person resources to high-risk patients who require more supervised, onsite care, addressing long-standing eligibility restrictions. Ultimately, program selection was based on patient preference and collaborative discussions between patients and clinicians, enabling more tailored, patient-centred decision making.
However, in-person models remain important for social connectedness and peer support. Participants noted that patients are generally less satisfied with fully virtual formats. Researchers also found that patients with language or communication barriers face challenges across all models, particularly in person, where translation services were not consistently available.
With continued improvements in technology and better translation services, these evolving models could strengthen Canada’s cardiac rehabilitation system and enable more equitable, patient-centred care.
Dr. Susan Marzolini, lead author of the study, is a Scientist at UHN’s KITE Research Institute. At the University of Toronto, Dr. Marzolini is an Associate Professor at the Rehabilitation Sciences Institute and an Assistant Professor in the Faculty of Kinesiology & Physical Education.
This work was supported by UHN Foundation.
Marzolini S, Ocampo G, Hébert AA, Barbieri R, Cotie L, Barry-Hickey D, Martinuzzi M, Konidis R, Oh P. The Evolution of Cardiac Rehabilitation Since COVID-19. Heart Lung Circ. 2026 Feb 5. doi: 10.1016/j.hlc.2025.09.006.