Cardiovascular disease remains the leading cause of death in both the United Kingdom (UK) and worldwide1. For several coronary and valvular conditions, timely surgical or catheter-based interventions improve survival and quality of life2,3. Yet the UK National Health Service (NHS) faces an unprecedented backlog of over 370,000 patients (in a population of 67 million) awaiting critical cardiac procedures, leading to over 30,000 excess deaths4. In this Comment, we describe a novel strategy for digitally-supported prioritization for critical cardiovascular procedures. We then examine potential ethical concerns in this new clinical and population health pathway and evaluate programmatic features that may address these hazards while promoting effective technology adoption within the service provision for these most vulnerable patients.