It is my pleasure to announce that Shalom “Shal” Jacobovitz has been selected as the ACC’s new chief executive officer (CEO).  Shal was chosen as CEO following a year-long nationwide search led by executive search firm, Korn/Ferry International. He will assume his new role in the coming weeks.

Shal comes to the ACC from Actelion Pharmaceuticals, U.S., a biopharmaceutical company specializing in cardio-pulmonary therapies, where he has served as president since 2004. Prior to Actelion, he held positions at F. Hoffmann La Roche, including serving as general manager for Central America and the Caribbean where he was responsible for the Pharmaceutical, OTC and Diagnostic division activities. He also served as the global lifecycle leader for cardiovascular products based in Basel, Switzerland. He has also held positions with Abbott Canada, Nordic Labs and Marion Merrill Dow (now known as Aventis) in Canada. Shal earned his Bachelor of Science degree in biology at the University of Western Ontario in Canada.

This is an exciting time for the College and we are excited about the skills and talents that Shal brings to the CEO position. With more than 25 years in the health care environment, he is a great choice to lead this strong organization and take it to the next level in this period of change in the health care environment. He is an innovative and proven leader, as well as a successful mentor. His clear commitment to quality, innovation and strategic management make him a great choice during a time when the College is ramping up to meet the ever-evolving needs of cardiovascular professionals domestically and around the globe.

I want to thank the members of the ACC’s CEO Search Committee, led by former ACC President William Zoghbi, MD, MACC, for their hard work over this past year. I’d also like to thank ACC’s chief operating officer and general counsel, Tom Arend, Jr, Esq., for his outstanding service as interim chief staff officer. I’d also be remiss if we didn’t recognize the amazing efforts of the College’s more than 350 staff members who kept the ship sailing forward. It is an honor and privilege to work with such a high-caliber group of people.

This *post is authored by Andrew M. Freeman, MD, FACC, chair of the ACC’s Early Career Professionals Section, and editor of the Patient-Centered Care CardioSource Clinical Community.

We’ve all been there – a busy clinic with a patient who has lots of questions and can’t quite make sense of your chicken-scratch, grade-school level coronary tree drawings. If you’re not in the medical field, it’s often very hard to wrap one’s head around the fact that someone is going to stick a balloon in the artery that supplies your heart. Of course, you’ve been working diligently to make sure that your patients are truly in the know, understand what’s going to be done to them, and that they are “captaining” their own health-ship. Being patient-centered in your delivery of care means involving your patients in their decisions about medications, intervention, and the overall disease processes. But, as we all have experienced, getting a patient up to speed quickly can be a daunting task.

This is where your ACC steps in. With the CardioSmart Explorer App for the iPad 2, you can select from many common health conditions and “bring to life” for patients what these conditions mean and what their treatments can look like. With a wave of your fingers, you can show a patient their heart muscle, its coronary anatomy, and the processes of a stent implantation. You can also mark up an anatomically and functionally correct digital model of the heart, and email this image directly to your patient. If your patient has atrial fibrillation, you can now show them how the electrical system of the heart works and how it can go awry.

The power of this application lies in its user friendliness, availability on the iOS (Apple) platform and its ability to show disease states and treatments with animations and pictures. Really, a picture is worth thousands of words. The concept of coronary disease and PCI with stenting can now be explained in 2 minutes instead of 20 – and can be instantly rewound, forwarded, and played in slow motion until all can grasp what this means.

Ultimately, this means your patient no longer comes to you with the “I don’t know what they did to me 5 years ago, but it involved a hole in my leg” phrase. Instead, you have a well-informed patient who understands exactly what has been done and why. Discussing procedures is now easier, and the risks and benefits of those procedures can be more clearly explained when the patient understands just how the procedure works.

As you can tell, the excitement behind this powerful application is tremendous – and for good reason. This kind of technology is the future of patient-centered medicine and no longer relies on “back-of-the-napkin” line drawings. Your ACC is proud to have brought this project to fruition, for you, our valued members.

This week is National Public Health Week, check out CardioSmart.org and the Patient-Centered Care CardioSource Clinical Community for additional tools and resources available to help prevent, treat and manage cardiovascular disease, while facilitating patient-centered care.

*A version of this article also ran in the CardioSmart Tech column on the Patient-Centered Care CardioSource Clinical Community.

Charles Darwin once stated: “It is not the strongest of the species that survive, nor the most intelligent that survives. It is the one that is the most adaptable to change.”

The field of cardiology is continuously changing, and exciting advancements made over the past few decades have led to the discovery of life-saving treatments and therapies.

A recently published article in the Journal of the American College of Cardiology by Robert Roberts, MD, MACC, and colleagues discusses one such advancement: genomics in cardiovascular disease. The authors explain the history of the development, but note the conundrum, “a major challenge to health care policy makers, physicians, care givers and end users are being created by the convergence of two major technologies: cost effective DNA sequencing of the whole genome and digitalization of patient data. The progress of DNA sequencing is said to have improved 10,000 fold in the past 8 years, while our ability to store, retrieve and analyze data has only improved 16 fold.”

They continue that “some claim that the convergence of these two technologies is the tipping point for personalized medicine. It could be costly not to realize we are at the cusp of the new era of personalized medicine.” They envision an “era of population medicine where ‘one drug fits all’ will be replaced by medicine based on one’s genetic composition, molecular makeup and how it affects the particular disease phenotype in that individual.”

The authors compare the “informational revolution” to the industrial revolution and quote Stuart Firestein, who noted, “from 5,000 years ago until 2003, humanity created a total of five exabytes (a billion gigabytes) of information. From 2003 to 2010, we created this amount every two days and in 2013 we created this amount every 10 minutes. Another way of stating this is to realize that every few hours we create more information than all of the information created by humanity since the start of civilization.”

Leave your thoughts about the advancement of genomics in cardiovascular disease below.

“It’s About Time!”, noted Ruben Navarrette, Jr., a CNN contributor and a columnist for the Washington Post, in an article announcing the election of Argentinian Cardinal Jorge Bergoglio as the “first Latino Pope.”  His article explained that it was “about time” that the Roman Catholic Church had recognized the “importance of Latinos” in the church and elected a Pope to represent them; further expounding in great detail that he is a “cafeteria Catholic,” a normally derogatory term meant to imply someone of the Roman Catholic tradition who picks and chooses which parts of Catholicism they wished to embrace a sort of moral relativism.  In practice, however, there is a core set of inviolate tenets which are not “pick and choose” just as most assuredly Bergoglio was not selected to cater to a subset of the Catholic demographic.

Here at the American College of Cardiology, we face a somewhat analogous situation. 

The inviolate tenet of the College is the unwavering commitment to continuously, unabashedly, and with zeal focus on providing the highest quality patient care.  Quite simply, our every effort to append, fix, modify or change our health care system must have as its central theme improving the care of our patients as well as the comfort of their families. 

In some instances, this is easy.  We have many tools and resources to help us accomplish this core mission, such as CardioSmart, which works to engage our patients via education and through endeavors that focus on shared decision making and patient-centered care. We have guidelines and appropriate use criteria that help define the appropriate use of therapies for the betterment of our patients.  
 
In other areas, we make changes to the system in order to improve our working situations, and in most instances these are business decisions which have a neutral effect on patient care.  Changes in affiliation within different medical centers, merging of practices, changes in services provided to patients, and changes in staff levels all come to mind. Sometimes, however, these system changes can inadvertently cause a negative impact on patient care.  An obvious example is a situation in which a practice integrates with a medical center and provider-based billing is initiated, which in return causes the patient’s expense to dramatically increase. Although this is certainly an acceptable business practice, it may reduce the access of those who are unable to afford treatment, and the patient might avoid receiving needed care or diagnostic evaluation due to such changes.  We must work to mitigate these detrimental effects.

In its most egregious manifestation, it takes the form of a decision by physician to ignore proven therapies and treatments, applying their own self-serving rules to an otherwise straightforward medical decision.  All of us have seen the patient who undergoes nuclear exercise testing every six months following an angioplasty, symptoms having been absent for five years, told by the physician that they are going to “prevent a heart attack” by testing them.  There are many other examples.
 
It is our professional responsibility to sight our way forward using a strict moral and ethical sextant focused on the prize of outstanding patient care and service to humanity rather than the “medical moral relativism” that allows us to pick and choose what we would like to do. 

Let us not be “cafeteria cardiologists” drifting in ethical relativism for our own gain, but let us embrace the highest standards of our profession, never losing our way amidst the difficulties of health care reform.

This post was authored by Payal Kohli, MD, fellow-in-training at the University of California, San Francisco (UCSF).

I don't even know where to begin about how great yesterday’s Fellows in Training (FIT) Mix 'n’ Mingle event was.  It started off with me spotting Dr. Deepak Bhatt, one of my all-time favorite mentors who I was hoping to catch a glimpse of to congratulate him on the presentation of the CHAMPION-PHOENIX trial.  I then saw Dr. Michael Landzberg, the most beloved adult congenital cardiologist of Boston, who taught me what a Fontaine was during my third week of my internship.

On my way to get a refill of my soda, I spotted Dr. Robert Harrington, who I am convinced will change the landscape of clinical trials on the west coast and who graciously invited me and my colleague Dr. Fatima Rodriguez to a Stanford Alumni event later that evening.  I'm only just getting started!  There were so many other amazing mentors in attendance, including Dr. Valentin Fuster, Dr. Lynne Stevenson, Dr. Pat O'Gara, Dr. Jeff Popma to name a few. The list was truly endless and I felt like I was in Hollywood with the stars, not knowing who to see next.

Next, I ran into Dr. Phil Green, who was my resident when I was an intern, and we recounted stories about practical jokes we used to play on each other, along with Dr. Tariq Ahmad and Dr. Nihar Desai.  I saw at least five generations of residents from my Brigham and Women's/Massachusetts General Hospital family, including Dr. Ehrin Armstrong who was my resident when I was a scared third-year medical student.

I think everything about academic medicine was perfectly crystallized into this one single event -- research, ideas, collaborations, networking, mentoring and education. This was truly a microcosm of the ACC meeting.

My only complaint?  I wish it was longer!

One of the most incredible aspects of the cardiovascular community is that despite distance, demographic, geographic or socioeconomic differences of our regions, practice types, or experience – we are connected. We share and are united in a mission to transform cardiovascular care and improve heart health. The work of this mission begins in the ACC State Chapters.

This past year the chapters have been busy doing a lot of work and there were some incredible wins in the states, including smoke-free legislation in states like West Virginia and Indiana, as well as an ongoing fight for tort reform in Michigan, Washington and Ohio. In many states like Pennsylvania, Delaware, DC, Maryland and Virginia, Chapters collaborated for their annual meetings – leading to a more connected regional ACC. Million Hearts meetings popped up around the country this year – with partnerships in Kentucky, Arkansas, Colorado, Mississippi and West Virginia and many others.

The Board of Governors (BOG) themselves accomplished quite a bit this year, including instigating the updated methodology around appropriate use criteria, assisting in the launch of the Million Hearts Campaign particularly at the state level and increasing opportunities for early career and fellows-in-training at ACC.13 and beyond. The BOG is gathered today in the city by the bay for a day-long meeting full of brainstorming and planning ahead of ACC.13’s kick off tomorrow.

However, the Chapters fun is just getting started at ACC.13. All Department of Defense, Veterans Affairs or Public Health cardiovascular professionals are invited to attend a special breakout session which includes free lunch this Sunday, March 10 from 12 – 2 p.m. Pacific Time (PT) in the San Francisco Marriott Marquis in room Golden Gate C1. RSVP here. Also, there is a ACC Political Action Committee sponsored reception for domestic Fellows-in-Training and the BOG that same day, March 10 from 6:30 – 7:30 p.m. PT in the Moscone Center West Building Faculty Lounge in the second floor lobby.

Winston Churchill said that “the farther backward you can look the farther forward you can see.” Looking back at the accomplishments of the states this year, I can see a very bright future ahead. Cheers to a great meeting and a wonderful new “ACC year” for ACC Chapters!

This post was authored by Icilma Fergus, MD, FACC, president elect of the Association of Black Cardiologists.

Teaming up with the ACC on the Spirit of the Heart (SOTH) community events has been an easy partnership for the Association of Black Cardiologists (ABC). Heart disease remains the number one health threat in America, and underserved and minority communities tend to be hit the hardest, with lower health literacy levels and greater cardiovascular risk.  Through the SOTH events, ACC and ABC have come together to increase awareness of heart disease and promote better heart health in high-risk communities.

Tomorrow is the first SOTH community event for 2013, with the goal of raising awareness in underserved communities in the San Francisco area. A community leaders’ forum breakfast will feature discussions by local health care, city and political leaders on heart disease prevention and community strategies, and will be immediately followed by a full day of free health screenings, a “Living with AFib” educational program and activities for the public where individuals can learn about their risk for heart disease and receive free counseling.  Be sure to check out CardioSmart’s Facebook page for photos from the event.

Our other joint ACC/ABC SOTH events last fall held in Houston, TX, Dallas, TX, Austin, TX and Harlem, NY were tremendously successful, and we’ll be continuing these community events throughout the year.

Personally, I have always had an interest in spreading awareness of prevention of heart disease to populations who are most seriously affected, especially women and communities of color. I chose to become a cardiologist partly because when I was doing a work study as a pre-med student, I saw sick dogs with weak hearts being studied at Columbia Presbyterian Hospital, and I immediately knew that I wanted to work with the heart.  I wasn't sure about whether I wanted to work in invasive or non-invasive until I met Dr. Thierry LeJemtel during my residency. Dr. LeJemtel is a brilliant French cardiologist who is famous for his work in heart failure. He quickly became my mentor and someone who I looked up to. I remember these beautiful, intelligent nurse practitioners he worked with, affectionately known as “Charlie's Angels.” I knew that one day I wanted to be half as smart as Dr. LeJemtel, and work hard and still look as poised and polished as his nurse practitioners.

If you have not yet gotten involved in the SOTH events, I urge you to get involved. For some, it is a great reminder as to why we got involved in cardiology in the first place.

With the increase in use of technologies such as Smartphones, tablets and e-readers, mobile devices are now a part of our everyday lives. These technologies have become increasingly popular over the past few years and have the ability to be truly transformative in our work flow as well as the way we communicate with one another other globally. To that end, the ACC has developed several mobile resources for you and your patients that hopefully you will find helpful.

The CardioSmart Explorer App is the first medical app by the ACC, was previously available exclusively to members of the ACC for free, but is now also available to the general public for a nominal fee (to download the App click here). The app is available for the iPad 2 and is designed to help you explain medical conditions and procedures to patients and thus enhance the clinician/patient relationship at the point of care. (Watch the demo video below or click here). Physicians and health care professionals can review and discuss common heart problems and treatment options by utilizing the app’s high-resolution cardiac graphics and animation, as well as walk step-by-step through the structure of an animated 3-D beating heart by swiping up or down through seven basic layers of normal cardiac anatomy.

In the works is the AnticoagEvaluator App, an ACC risk assessment tool that will launch at ACC.13. This tool is an easy and fast way for clinicians to assess stroke and bleeding risk and the benefits and risks of antithrombotic therapy in patients with chronic atrial fibrillation. The app will be free for ACC members and will be available for use on iPhone, iPad, and Android devices starting in early March.

In addition, the ACC has created a new ACC Connect App for members. The App is available for both iOS (iPhone, iPad, and iTouch) and Android devices, and allows cardiovascular professionals to stay connected through their electronic devices. Features include a searchable member and ACC staff directory, the ability to update individual contact information, news feeds from the ACC, and access to important ACC phone numbers. As a member, I encourage you to check your own profile for accuracy. To download on an iOS device, click here. For Android devices, click here.

For those attending ACC.13 in San Francisco, meeting attendees should download the ACC.13 eMeeting Planner App. This easy-to-use App allows you to personalize your meeting by searching for sessions by specialty, interest area, and role in the cardiovascular care team. Plus, get access to Expo info, animated maps, Twitter feeds and more (to download the App click here).  There will also be several sessions at ACC.13 targeted at mobile technologies and social media. Watch these tutorials on "How to Create and Export Your Schedule" and "How to Use Filters" for a more detailed look at using the ACC.13 eMeeting Planner App.

The ACC also offers ways to review CardioSource.org content on your iPhone, iPod touch, iPad, Android and Blackberry through the CardioSource Mobile App. Further, several of ACC’s print publications feature apps including the JACC iPad edition App (which was named one of the top medical education apps, and one of Apple’s top 80 medical apps); the Cardiology magazine App available for the iPad, iPhone and iPod touch; and the CardioSource World News App for the iPad. Other mobile resources include heart songs and ACCEL.

Further, CardioSmart offers several mobile resources for patients. The free CardioSmart Med Reminder app is designed to help patients take their medications as prescribed in addition to serving as a personal medication record (PMR) to help patients communicate to their health care providers about medications. Other mobile resources include free SMS text messaging services for patients in the U.S. looking for tips to prevent cardiovascular disease or to quit smoking.

There are so many tools and different ways we can impact health care. I do hope you find these tools useful in your daily work, providing you with content and tools at your fingertips for improved efficiency and effectiveness in providing health care.  Under Incoming President John Harold, MD, MACC’s direction next year, I am confident the ACC will take its digital strategy to the next level, with even more mobile offerings and tools to help the cardiac care team and their patients achieve their goals.

Decision making has evolved over time. Many years ago, when options were limited to either medical or surgical, clinical decisions were relatively simpler and the “Heart Team” was smaller and more cohesive. However, with the introduction of catheter-based approaches in addition to surgery, specialties became more siloed. Today, with choices and treatments more complex than ever, it’s critical that we rekindle the Heart Team approach. Collective input and wisdom from a complement of medical, surgical and interventional experts is needed for optimal decision making.

This team approach, inclusive of shared-decision making with patients, is at the crux of patient-centered care. It is also the crux of a State-of-the-Art paper published on Feb. 25 in the JACC by myself and other cardiovascular and surgeon leaders. The paper highlights the many ways that managing care for patients with complex cardiovascular disease has changed substantially over the last decade with the advent of appropriate use criteria, advances in information technology, and an increasing amount of evidence-based data. As such, it points out that “failure to implement a Heart Team is increasingly not an option.”

Over the last three years, the Heart Team concept has been included as class 1 recommendations in European guidelines for coronary revascularization, as well as played a headlining role in the 2012 Appropriate Use Criteria for Coronary Revascularization Focused Update, as well as the 2012 ACCF/AATS/SCAI/STS Expert Consensus Document on Transcatheter Aortic Valve Replacement. In the case of coronary revascularization, AUC and Guidelines recommend that Heart Teams consist of cardiovascular surgeons, interventional cardiologists and primary cardiologists. More recently, in the case of transcatheter aortic valve replacement, Heart Teams will need to consist of surgeons, interventionalists, and general cardiologists, as well as imaging specialists, neurologists, cardiac anesthesiologists and others vital to patient selection and optimal procedural performance.

The paper highlights the balanced and complementary approach to patient care offered by the Heart Team as a result of joint and shared decision making among multi-disciplinary stakeholders. While specific strategies for implementation of Heart Teams will vary as a result of things like institutional structure or facility limitations, it is critical that the broad concept evolve to become the standard of cardiovascular care moving forward. “By exploring the multiple options available and sharing them with patients and their families where applicable, more optimal shared decision making is achieved, along with a tailored recommendation for therapy for a more informed and engaged patient,” the paper states. “From a professional team point of view, subsequent joint participation in procedures can not only improve the skill sets of all involved medical and surgical personnel but also elevate the cognitive interchange that occurs among the specialties.”

At the end of the day, dialogue among patients, their families and the various medical professionals involved in providing care is key to ensuring the most appropriate treatment. Ultimately our goal as physicians is to ensure our patients are not only equipped to take greater responsibility for managing their cardiovascular health, but to work collaboratively with us to achieve common goals. The Heart Team, in my mind, is the pathway to achieving this goal.

Read more about the Heart Team Approach on CardioSource.org.