Taking a Closer Look at Centralized Systems of Care

Kovacs headshotThis post is authored by Richard J. Kovacs, MD, FACC, chair of the ACC’s Clinical Quality Committee.

As a result of continued hospital and practice integration, as well as an ongoing evolution to a health care system focused on value, not volume, a trend towards more highly centralized and organized systems of care is emerging as a means of meeting the triple aim of improved outcomes, better care and lower costs.

As a concept, centralized care allows for common standards and goals across a system, making identifying problems or gaps in care, monitoring progress and achieving results more streamlined and arguably easier. However, moving from concept to reality does have its challenges given the need for alignment among a diverse group of stakeholders across the care continuum, as well as the need to overcome clinical, administrative and macroeconomic factors that differ from system to system.

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ACC.16 FIT Clinical Decision Making: The Importance of Revisiting the History and Physical Examination

CTP Photo 1This post was authored by Colin Phillips, MD, a fellow in the Division of Cardiovascular Disease at Beth Israel Deaconess Medical Center in Boston, MA.

As a fellow in training, the opportunity to spend a weekend with a community of great cardiology minds from around the world is a valuable and memorable experience.  Learning from the giants while reconnecting with old friends and professors made my first ACC meeting last year a blast. From the beginning of the conference, my enthusiasm built. It was impossible to walk through the convention center and not tap into the infectious energy. Every encounter carried the promise of new possibilities, new ideas and new relationships.

This year at ACC.16, I will present a poster in the FIT Clinical Decision Making: Congenital Heart Disease, Valvular Heart Disease, Pulmonary Hypertension session, titled “More Volume Lifts an Anchor: Severe Mitral Regurgitation in Hypovolemic Shock Masquerading as Mitral Valve Perforation.” Working with my mentor, Eli Gelfand, MD, FACC, we detail a case of mistaken identity. We report the story of a patient transferred to our home institution, Beth Israel Deaconess Medical Center in Boston, MA, for operative repair of a perforated mitral valve leaflet secondary to bacterial endocarditis. As we evaluated the patient, pieces of his story, including a dynamic systolic murmur and profound dehydration, did not fit the diagnosis as billed.  Continue reading

A Sister’s Love Uplifts Hearts

Robert Beekman HeadshotThis post was authored by Robert Beekman, III, MD, FACC, chair of ACC’s Adult Congenital and Pediatric Cardiology (ACPC) Section.

This year at ACC.16 several congenital heart disease (CHD)-focused sessions and events will take place, including an ACPC Section “CHD Community Day” focused on “Using Data to Improve CHD Care Across the Lifespan.” Other events include the 47th Annual Louis F. Bishop Lecture given by Carole A. Warnes, MD, FACC, on “Adult Congenital Heart Disease: The Challenges of a Lifetime” and the 2016 Dan G. McNamara Lecture on “Neurodevelopmental Outcomes in CHD: Where Have We Been and Where Are We Going?” given by Jane Newburger, MD, MPH, FACC. (Check out the Congenital Heart Disease Learning Pathway for more CHD sessions).

I am personally excited, however, to showcase the winner of ACC’s first “Design-a-Tie: Raise CHD Awareness” contest. The contest was open to anyone with a connection to CHD and a vision to share. The submissions we received from across the country were all amazing. However, one stood out from the rest. Continue reading

International Perspectives at ACC.16

Jose PineiroThis post was authored by Daniel José Piñeiro, MD, FACC, chair of the ACC Assembly of International Governors.

Cardiovascular disease is a global health issue that affects countries and communities around the world in myriad ways. As such, international viewpoints and experience are critical to the advancement of cardiovascular medicine everywhere. To this end, the College is continually working to expand its international reach. ACC’s 52,000-strong membership includes nearly 15,000 international members whose innovation and ingenuity make invaluable contributions to the College’s mission.

Nowhere is the importance of ACC’s international presence more evident than at the Annual Scientific Session. Last year during ACC.15, 40 percent of the attendees were international participants and we are continuing this trend this year as well. The International Perspectives Program at ACC.16 will provide a wide range of opportunities to learn more about cardiovascular disease concerns in other parts of the world and how cardiovascular professionals in those regions cope with those concerns. More than 18 sessions with representatives from 36 countries will offer insights into the latest research, as well as best practices and challenges associated with treating cardiovascular patients around the world. The International Perspectives Program will touch on each of ACC.16’s learning pathways.   Continue reading

Women’s History: Imaging, Quality and the Workforce

Douglas_PamelaThis post was written by Pamela S. Douglas, MD, MACC, a past president of the ACC and a member of ACC’s Women in Cardiology (WIC) Section.

I choose to specialize in cardiology because it combined a great mix of direct patient contact, therapeutic procedures, imaging and internal medicine. Medicine is a calling for me, and I love the breadth of cardiology and how all the components relate to each other and make each other richer.

I have spent much of my career focused on imaging. Our ability to see a heart beating in real time, watch valves opening and closing, is still awe inspiring and wonder-filled for me today. I’ve been a champion of quality in imaging and have worked to change the paradigm from quantity to quality in our guidelines and standards documents, regulatory processes and everyday practice. One of the important accomplishments of my ACC presidential year was to lead the College and the profession towards defining and adopting broad quality measures in imaging, developing appropriate use criteria and imaging outcomes metrics. The recent PROMISE randomized trial, the highlighted plenary presentation at ACC.15 and published in the New England Journal of Medicine, is an example of how this work is continuing and has been translated into real-world data regarding imaging outcomes. Further insights from the PROMISE trial will be presented at ACC.16 and will be published in a special issue of JACC: Cardiovascular Imaging focused on imaging in women on April 4.

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Hitting the Ground Running: Sports and Exercise on the Move at ACC.16

Hoffmeister 2This post was authored by Jana MH Goldberg, MD, cardiovascular disease fellow at the Hospital of the University of Pennsylvania, and a member of ACC’s Sports and Exercise Cardiology Section Leadership Council.

There is one thing that most members of ACC’s Sports and Exercise Cardiology Section have in common – a love for adrenaline. They are often themselves sports enthusiasts, putting in a few miles on the trail before sitting in the conference hall. This adrenaline carries through to the lectures as you can feel the excitement and interest in the room. This is sure to be the case at ACC.16 in Chicago.

We have been talking a lot about exercise prescription, but what about practical insight? Merle Myerson, MD, FACC, will be giving a talk entitled “Why Exercise is Real Medicine: Practical Tips for ‘Prescription’ in Clinical Practice,” during the Lifestyle Medicine intensive. Dr. Myerson, who was an exercise physiologist before becoming a cardiologist, will give a brief overview of the role of exercise in cardiovascular health, forms of exercise (aerobic and resistance), and will go over exercise as a diagnostic tool. She will review how best to give an exercise prescription in terms of duration, intensity and frequency, as well as who to screen prior to beginning exercise. The talk will even cover practical aspects such as whether or not you can code/reimburse for exercise counseling.  Continue reading

A History of Women’s Heart Health

NKWphoto2This post was authored by Nanette K. Wenger, MD, MACC, professor at the Emory University School of Medicine, director of the cardiac clinics at Grady Memorial Hospital and a member of ACC’s Women in Cardiology (WIC) Section.

As we celebrate the history of women in cardiology for women’s history month, it is important to emphasize women’s heart health as a part of that story. Although heart disease is the number one killer of women, cardiovascular disease was really thought of as a man’s disease until the last few decades.

Differing risk factors and symptoms for women weren’t really understood or recognized. Women who came in to the emergency room with chest pains were told they had a stomach problem or that they were imagining the pain and had emotional problems so they were sent home. Gender differences in heart disease remained unexplored and unacknowledged as women were underrepresented in or excluded from clinical trials and research and there were no guidelines to inform clinical decision-making. Continue reading

Health IT Innovation Showcased at HIMSS16

Photo for Publication or Presentation Purposes 2015This post was authored by Tyler J. Gluckman, MD, FACC, a presenter at HIMSS16.

Just weeks after the ACC was in Las Vegas for the 2016 Cardiovascular Summit, thousands of health information technology (IT) experts came together in the same city for the 2016 Healthcare Information and Management Systems Society Conference (HIMSS16). The conference focused on how technology is being used to improve health and was a stage for the U.S. Department of Health and Human Services (HHS) and other government agencies to announce policies that will shape the future of health IT.

At HIMSS16, the ACC took part in the HIMSS Interoperability Showcase, an area dedicated to innovations in interoperability. The ACC has been a longtime advocate for interoperability, which describes how effectively clinical data can move between different participants, both human and technological, in the care delivery chain. The College was able to highlight its work in this space – from Integrating the Healthcare Enterprise efforts to using NCDR registries to enable interoperability – during presentations by ACC members and staff in the Interoperability Showcase. Continue reading

And It’s Going, Going, Gone! ACC Knocks It Out of the Park at Big Sky

SK_headshotThis article was authored by Sandeep K. Krishnan, MD, a fellow in training (FIT) at Cedars-Sinai Medical Center in Los Angeles, CA.

The ACC has done it again! Another home run for the FIT team! I recently had the good fortune of attending the Teaching Tomorrow’s Teachers (3T’s) program embedded into ACC’s 38th Annual Cardiology at Big Sky conference. It was a conference like no other I have ever attended.

By itself, the ACC Big Sky conference is a unique entity. For five days starting every President’s Day weekend in mid-February, Kim Eagle, MD, MACC, and Patrick T. O’Gara, MD, MACC, host this highly-informative conference surrounded by the beautiful snow-capped peaks of Big Sky, MT, in and of itself a small, charming town located 1.5 hours away from the nearest airport. Continue reading

ACC’s WIC Section Celebrates Women’s History Month

Lewis headshotThis post was authored by Sandra Lewis, MD, FACC, chair of ACC’s Women in Cardiology (WIC) Section.

This March, ACC’s WIC Section is celebrating the achievements and history of female cardiologists. In a field typically dominated by men, pioneering women have brought diversity and innovation to cardiovascular medicine, enriching heart health and patient care.

Female cardiologists were once a rarity, with the first women physicians training during the 19th century. These early women physicians were determined to serve and broke down traditions and barriers to enter medical schools, crossing such hurdles as having their medical school admissions contingent on approval of their classmates. Their work created a strong model for us to build upon, setting the stage for the next generations to grow and thrive within the field. We continue to grow their accomplishments, and honor their contributions. Continue reading