Design and Preliminary Testing of the CardioCare System in Health Checkup Centers: Implementation Report

Health checkup programs in China reach millions of older adults for cardiovascular risk screening, but few effective mechanisms exist to ensure high-risk individuals receive follow-up preventive care.

We developed the CardioCare system, a digital tool integrating a 10-year cardiovascular disease (CVD) risk prediction model with personalized health management features, to address this gap.

The CardioCare system was used in a hospital-based health checkup center. The system incorporates an established 10-year CVD risk model to estimate risk. We conducted preliminary usability testing at a health checkup center in Guangzhou. Older adults identified as high risk (≥10% 10-year CVD risk) were given personalized feedback and invited to a cardiovascular risk management clinic.

The CardioCare system was successfully implemented, automatically stratifying CVD risk for each checkup attendee and generating patient-specific recommendations. The CVD risk model integration functioned without major technical issues, although minor performance delays were identified and resolved, and physicians and nurses reported that the tool was user-friendly and fit smoothly into the clinic workflow. However, patient engagement was low: of the 2069 high-risk individuals invited for follow-up care, 181 (8.7%) attended at least 1 in-person visit at the clinic. Feedback from the patients who engaged was positive regarding the clarity of risk information and advice, but the low response rate indicated significant barriers to uptake.

This study demonstrated the technical feasibility of integrating a digital CVD risk assessment and management system into a health checkup setting. The system was successfully embedded into the clinical workflow and was acceptable to physicians and nurses. However, the low follow-up attendance among high-risk individuals highlights a major implementation limitation, indicating that risk identification alone is insufficient to ensure patient engagement in preventive care. Future development should focus on structured, multichannel engagement strategies and more convenient follow-up models.