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Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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A prescription for the ‘blockbuster drug of the century’: AHA outlines patient engagement strategies

August 30, 2013

Megan Tooley, Cardiovascular Roundtable

Patient engagement.

As you have likely noticed, this concept has been garnering increased attention lately, and not just in the medical community. A 2012 study in Nursing Research and Practice found the focus on patient engagement in academic research has increased significantly, from just 74 journal publications on the topic in 2002, to over 950 in 2011. Patient engagement has also found a place in mainstream media, heralded by one journalist as the “blockbuster drug of the century.”

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Build your multidisciplinary CV care team with these resources

August 19, 2013

Megan Tooley, Cardiovascular Roundtable

Recently, many of our members have asked us how to elevate multidisciplinary collaboration for complex patients, whether by implementing multidisciplinary rounding, convening multidisciplinary high-risk patient committees, or even developing polycondition clinics to address longitudinal needs of poly-chronic patients.

In truth, this comes as little surprise: as we discussed in our recent study, Blueprint for Cardiovascular Disease Centers, an increasingly comorbid and complex CV population is making it difficult for a single provider or service line to adequately address all of a patient’s needs. To create and carry out comprehensive, high-value care plans for these patients, programs need to ensure multidisciplinary collaboration between relevant providers and non-clinical support staff.

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What you need to know about aortic disease centers

July 19, 2013

Carly Anderson, Cardiovascular Roundtable

You’d like to develop a cardiovascular disease center—but where should you begin? At our 2012-13 national meeting, we discussed seven imperatives for developing any type of CV disease-centric program, and delved deeper into three areas of particular interest: heart failure, valve, and atrial fibrillation centers. But other disease-center programs also have substantial growth potential, such as aortic disease centers.

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Specialists get a shot at patient-centered medical home model

March 29, 2013  | Comments (1)

Megan Tooley, Cardiovascular Roundtable

This week, the National Committee for Quality Assurance (NCQA) launched a recognition program that aims to extend its successful Patient-Centered Medical Home (PCMH) model beyond primary care to specialty practices. The new Patient-Centered Specialty Practice (PCSP) designation program provides clear guidelines for specialists looking to establish a role in patient-centered “medical neighborhoods,” and will recognize practices committed to providing team-based, coordinated care and enhancing communication with providers and patients across the continuum.

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How to advance palliative care at your institution

January 11, 2013

Brian Maher, Cardiovascular Roundtable

As providers seek to promote patient-centeredness in a value-based delivery system, palliative care will be a critical offering that has far-reaching implications across multiple service lines.

For CV services especially, palliative care is an integral component of the care continuum, often with focus on preventing readmissions for susceptible patients, such as those with heart failure. For example, Parkview Heart Institute leverages a home health coordinator to ensure heart failure patients discharged home are receiving the correct post-acute strategy, including palliative care, based upon their risks. Like Parkview, Lehigh Valley’s outpatient palliative care service has led to substantial reductions in hospitalizations and variable costs per hospitalization.

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TAVR outcomes remain strong at three years

October 31, 2012

Megan Tooley, Cardiovascular Roundtable

The latest results of the PARTNER Cohort B trial, recently presented at the 2012 Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium in Miami, demonstrate that the mortality benefits of transcatheter aortic valve replacement (TAVR) in inoperable patients are maintained out to at least three years.

Furthermore, the data provide insight into the impact of comorbidities at the time of implant on outcomes, further emphasizing the importance of careful patient selection for TAVR.

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Risk stratification methods to reduce heart failure readmissions

September 21, 2012

Nicole MacMillan, Cardiovascular Roundtable

The Roundtable frequently receives questions related to stratifying heart failure patients by risk of readmission, and about the various models and methods of implementation we have come across.

In light of impending HF readmission penalties beginning in October of this year, there is a clear focus among providers on lowering heart failure readmission rates to avoid paying fines of up to 1% of their base Medicare reimbursements. We have previously discussed the readmission penalty program.

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ROMICAT II: CCTA is safe and efficient in the ED, but not a cost cutter

July 31, 2012

Megan Tooley, Cardiovascular Roundtable

As previously discussed in Cardiovascular Rounds, a number of recent studies have evaluated the overall costs and downstream impact of coronary CT angiography (CCTA) in various patient populations.

Adding to this list is the ROMICAT II (Rule Out Myocardial Infarction Using Computer Assisted Tomography) trial. The study assessed if using CCTA as a first diagnostic test in the emergency department (ED) to rule out acute coronary syndrome (ACS) in low-to-intermediate risk patients is more effective than standard evaluation.

The trial results, published in the New England Journal of Medicine on July 26, further validate the utility of CCTA as a safe alternative to nuclear imaging for certain patients presenting to the ED with chest pain. While overall costs, including all subsequent downstream services, were modestly higher in the CCTA group on average, the efficiency gains from a CCTA-based diagnostic strategy are promising. 

Overall, more patients were discharged from the ED with fewer admissions to an observation unit among those receiving CCTA compared to standard evaluation.

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Rating: | Brian Maher | March 30, 2012

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