The Electronic Health Record: 4 Years Later

This post was authored by Alfred A. Bove, MD, PhD, MACC, and was originally published in the August 2014 issue of CardioSource WorldNews.

Like many of you, I have been immersed in the world of the electronic health record (EHR) for the past four years. I am reminded daily to digitally close an encounter, to be sure electronic prescriptions are signed, to click on a box to swear that I reviewed a lab or imaging report, and to be sure to give the patient a summary of their visit before he or she leaves the office. I receive constant reminders of drug interactions, the need for flu shots, and whether I am at par with my peers in e-prescribing, closing encounters, etc.

Our EHR is available through a secure web browser, so I can access the information from home or when traveling to keep up with my patients and clear the never-ending new items from my inbox.  Continue reading

ACC Members Hit the Hill to Advocate for CV Professionals and Patients

Nearly 400 cardiovascular professionals stormed Capitol Hill this week to meet directly with their legislators. In their meetings, ACC members shared examples of how the College is leading the transformation of care and urged Congress to work with the ACC to develop a quality driven health care system, ensure practice stability and secure the future of cardiovascular care. With a plethora of challenges facing health care providers, ACC Members were able to provide first-hand perspectives of how decisions made in Washington impact practices and patients across the country. Hot topics on the Hill included Sustainable Growth Rate repeal, In-Office Ancillary Services Exception preservation, increased research and graduate medical education funding, incentivizing the use of clinical data registries, and improving access for Medicaid children with complex medical problems. Take a look at the full set of messages that members took to congressional offices. Continue reading

Provider Perspectives on EHR Benefits and Interoperability

Over the last few years, the percentage of practices using electronic health records (EHRs) and the number of cardiologists participating in the federal EHR Incentive Program has grown tremendously. With these developments, clinicians are recognizing some real benefits from their EHRs, however, according to a recent CardioSurve survey, much room for improvement still exists for this technology particularly in the areas of interoperability and closing gaps in treatment and care.

Nearly eight out of 10 cardiologists (78 percent) indicated they have been using EHRs for at least two years or more. More importantly, nine out of 10 cardiologists said they have a fully functioning EHR program or are in the process of implementing one. Popular CV practice EHRs continue to be Epic, Allscripts, NextGen, Cerner, GE Centricity, e-Clinical Works, Athena Clinicals, GEMMS, and Greenway. Continue reading

Reducing Radiation Risk For Our CHD Patients

This post was authored by Aimee K. Armstrong, MD, FACC, co-director of the ACC’s Reducing Radiation Risk Quality Improvement Initiative

The treatment of congenital heart disease (CHD) often includes multiple diagnostic and interventional cardiac catheterizations, which give repeated patient exposure to ionizing radiation. There is growing concern regarding the adverse effects of the cumulative radiation exposure, particularly in children, whose organs are still developing. Developing organs are more sensitive than mature organs to the induction of certain cancers from radiation exposure. In addition, children have a longer life span than adults, during which to manifest the possible detrimental effects of the exposure. The long-term effects (stochastic injuries) are not the only concern, as large skin doses can also lead to radiation burns (deterministic effects). In fact, the Joint Commission has deemed a peak skin dose of >1500 rads a sentinel event. With interventional catheterizations for CHD becoming more complex and lengthy, particularly with the introduction of transcatheter valve therapy, there is a need to pay particular attention to the cumulative radiation dose that our patients receive and we need to seek ways to decrease this dose whenever possible. Continue reading

Legislative Conference Day 1 Provides Members With Important Views From the Hill

Following an entertaining evening with political power couple Mary Matalin and James Carville courtesy of the ACC Political Action Committee (PAC), the College kicked off its 2014 Legislative Conference early Monday morning with a record number of cardiovascular professionals (nearly 400, including approximately 100 Fellows in Training and 80 CV Team members) in attendance. Continue reading

Tiny Steps to Implement Pulse Ox Screening

This post was authored by John Gordon Harold, MD, MACC, immediate past president of the ACC.

On a yearly basis critical congenital heart conditions affect three out of every 1,000 live births, accounting for nearly 30 percent of all infant fatalities in the U.S. As physicians we have come a long way in our ability to treat these conditions in a timely manner, often using prenatal sonograms to identify structural heart disease. However, the sensitivity of congenital heart disease (CHD) is highly fickle, with operator expertise, fetal position, gestational age, and defect type causing prenatal sonography to entirely miss many newborns with CHD, let alone critical conditions that need immediate intervention. Continue reading

ACC Board of Governors Come Together to Move College’s Strategic Vision Forward

I have often said the men and women who make up ACC’s Board of Governors (BOG) are the College’s feet on the ground – meeting the needs of cardiovascular professionals where they live and work. As such, the BOG plays a critical role in the success of ACC programs and tools. This weekend’s BOG meeting underscored the importance of this role as member leaders engaged in discussions around how best to move the College’s strategic vision forward. In particular, leaders addressed shared decision making tools, educational programs and products, involvement in hospital and outpatient-based clinical data registries, increasing member value, top cardiovascular advocacy issues, potential partnerships and more. Continue reading

Leading the Transformation of Care

This post was authored by Kim Allan Williams, Sr., MD, FACC, president-elect of the ACC. – See more at:

This post was authored by Kim Allan Williams, Sr., MD, FACC, president-elect of the ACC.

Over the past 40 years, the world has seen significant advances in cardiovascular care including a 50 percent decline in cardiovascular-related deaths. A study published in Circulation last month further demonstrated the progress that has been made. The study found that hospitalizations for acute cardiovascular disease and stroke showed rapid decline from 1999 through 2011, compared to other cardiac-related conditions. Additionally, patients achieved improved mortality and readmission outcomes. Continue reading

Working Collaboratively to Help Patients and Clinicians Address LDL Risks

This post was authored by Kim Birtcher, MS, PharmD, AACC, chair of the ACC’s LDL: Address the Risk Oversight Workgroup.

High low-density lipoprotein (LDL) cholesterol is a modifiable risk factor for cardiovascular disease and stroke, yet many patients aren’t taking the medications or making the lifestyle changes needed to lower their risk.  On the provider front, the number of published clinical guidelines with substantially different recommendations also poses confusion for patients and clinicians alike. In an effort to address the significant gaps in care, the ACC launched its LDL: Address the Risk initiative to improve patient outcomes by increasing awareness of the gaps in lipid management, along with the importance of managing LDL-related risks. Continue reading

A Look at Trends in Cardiovascular Hospitalizations and Outcomes

This post was authored by Harlan M. Krumholz, MD, SM, FACC, member of the ACC Board of Trustees.

In cardiology we need to measure our achievements by what we have done for patients and populations. It is not enough to brag about new programs provided or treatments delivered. In the end we need to know the results we have achieved.

Such information, however, is not easy to obtain. We do not have the type of integrated national data that would provide a surveillance system. However, the Medicare Fee-for-Service system does have records stretching back more than a decade that can be accessed and analyzed to determine trends in hospitalization rates and outcomes. Continue reading