CMMI Grant Recognizes Value of SMARTCare The Center for Medicare and Medicaid Innovation (CMMI) recently awarded the ACC a $15.8 million grant to support SMARTCare pilot projects in Florida and Wisconsin – one of the largest grants awarded by CMMI to date. The innovative pilots, developed by the ACC’s Florida and Wisconsin chapters, aim to reduce health care costs by providing tools to help doctors and patients communicate about options for their care while helping physicians apply the latest guidelines to the decision-making process. “We believe involving patients in an evidence-based decision-making process is the best way to improve outcomes while providing the highest value for the health care dollar,” said ACC President Patrick T. O’Gara, MD, FACC. “This grant will give us an opportunity to demonstrate how data from clinical registries can be leveraged to enhance physician/patient communication.” CMMI grants were established to foster health care transformation by identifying and supporting innovative models that establish new ways to pay for and deliver care that improve care while lowering costs. The SMARTCare model is expected to save 10 participating sites $42.2 million over the three-year pilot program, while also improving the decision-making process to benefit patients. “The overarching goals of SMARTCare are to increase the percentage of stable ischemic heart disease patients with optimal risk factor modification and to reduce imaging procedures and percutaneous coronary interventions not meeting appropriate use criteria while achieving high levels of patient engagement and lower rates of complications,” said Thomas Lewandowski, MD, FACC, SMARTCare project director and immediate past governor of the ACC’s Wisconsin Chapter. “These are big goals, but we have the right people at the table to make them a reality.” While SMARTCare is focused on the treatment of coronary artery disease, moving forward it has the potential to be a model that could be applied across medicine and across the country. “Our ability to utilize care patterns from separate states demonstrates how flexible and successful the program can be,” said ACC Florida Chapter Governor Juan M. Aranda, Jr., MD, FACC. “We are hopeful that someday, patients from all over the country will be able to take advantage of the tools included in the SMARTCare program.” New Registry Brings Together Diverse Partners Around Diabetes The ACC, in partnership with the American Diabetes Association, the American College of Physicians and Joslin Diabetes Center, have announced the development of a Diabetes Collaborative registry, the first clinical registry aimed at tracking and improving the quality of diabetes and cardiometabolic care across the primary and specialty care continuum. Made possible through support from founding sponsor AstraZeneca – a long-time proponent of efforts to improve diabetes care and reduce cardiovascular disease – the new diabetes registry will leverage the PINNACLE Registry’s already well-established technology platform to retrieve data from electronic medical records collected by participating primary care physicians, endocrinologists, cardiologists and other diabetes care providers. The data measures captured in the Diabetes Collaborative Registry will expand beyond those currently captured in PINNACLE to include additional measures relevant to a wider group of providers who are involved in the coordinated care and treatment of diabetes. Participation in the Registry is also expected to yield long-term benefits for practices, providers and patients. Physicians will be able to track adherence to performance measures at the provider and practice level, compare performance to national benchmarks, target quality improvement areas and ultimately transform the quality of care provided to patients. Researchers will also gain access to a repository of diabetes care data from various providers in outpatient settings. Patients will benefit from their physicians’ increased access to a central repository of diabetes data based on the latest science and research that can be used to tailor their care. “Cardiovascular disease is the leading cause of death among people with diabetes, and there is a clear need for cross-specialty management of diabetes patients,” said ACC President Patrick T. O’Gara, MD, FACC. “By consolidating patient data, this registry will allow primary care physicians and specialists who treat patients with diabetes to compare data and access real-time metrics on patients in all stages of the disease.” Vote for Your State’s BOG and Cardiovascular Team State Liaison Elections for the 2014 Board of Governors (BOG ) and Cardiovascular Team State Liaisons will be held Oct. 22 – Nov. 17. Elected representatives will bring local needs to national attention, create new initiatives, develop quality, advocacy, and educational opportunities, and expand the value of membership. To learn which states will be holding elections and for more information about the election process, visit CardioSource.org/Elections. Official results will be announced after the Board of Trustees meeting on Dec. 8. In Memoriam ACC’s First Woman President Suzanne B. Knoebel, MD, MACC ACC Past President Suzanne B. Knoebel, MD, MACC, passed away on July 2 in Indianapolis, IN. Knoebel joined the College as a member in 1970, and eventually became the first woman to serve as president, taking on the role from 1982 to 1983. She also served as editor-in-chief of ACC Current Journal Review. Knoebel received the Distinguished Fellow Award from the ACC in 1986 for her service to the College and actions as a quality role model for others. Knoebel served as Herman C. and Ellnora D. Krannert Professor Emerita of Medicine at the Indiana University School of Medicine, to which she was appointed in 1977. She was also the original member of the Krannert Institute of Cardiology faculty and dedicated her life to research, education and patient care throughout her entire career at Indiana University. Kim Eagle Named Editor of ACC.org The ACC has named Kim A. Eagle, MD, MACC, as the editor of ACC.org, the college’s revamped web platform that will launch later this year. Eagle has served on the editorial board of CardioSource.org, the College’s current web portal, for the past six years as an associate editor of the Journal Scan database. “The College is extremely grateful to Dr. Eagle for agreeing to serve as the editor of ACC.org,” said Patrick T. O’Gara, MD, FACC, president of the ACC. “Dr. Eagle brings a unique blend of talents and experience to the position that will enable us to achieve our vision for the myriad ways that ACC.org will serve our members and the entire cardiovascular community. As a master clinician/educator, investigator, health advocate and mentor, Dr. Eagle will provide unique insights and foster a culture of continued digital innovation across ACC. We look forward to working with him, the editorial team and staff in this new role.” QI Meets Patient Engagement With CardioSmart.org Hospital Profiles This year, the ACC is taking quality improvement and patient engagement to the next level. Starting in August, all hospitals participating in the NCDR will have a hospital profile established on CardioSmart.org. Through these profiles, patients, caregivers and other stakeholders will be able to search hospitals based on specific criteria (location, hospital name and services provided) and learn about every participating hospital’s quality measurement efforts through the NCDR. Soon after the hospital profiles are established, voluntary hospital public reporting for select measures will be made available for the CathPCI Registry and ICD Registry. Eligible hospitals who voluntarily agree to report their data from these registries will have their measure results posted on their profile, demonstrating a further commitment to quality improvement. The ACC encourages participating hospitals to take advantage of this quality reporting opportunity. New Editor, New Look for JACC The first issue of the Journal of the American College of Cardiology (JACC) under the guidance of its new Editor-in-Chief Valentin Fuster, MD, PhD, MACC, debuted in July with several changes designed to better meet the changing ways cardiovascular professionals consume medical literature. “While the science has to maintain the highest quality to help the medical community, the educational manner by which we deliver that material has changed,” writes Fuster in his first Editor’s Page. Indeed, as long as I am editor-in-chief, I will strive, along with my fellow deputy and associate editors and section editors, to deliver highly impactful, highly meaningful, and deep content within a context of simplicity.” Among the changes, every original science paper, state-of-the-art review, or review topic will be accompanied by a central illustration summarizing the overarching theme or major section of the paper. Every original science paper will also end with a perspective summary outlining the core clinical competencies and translational outlook that were produced as a result of the research. Finally, each issue will be accompanied by an audio recording, available as a downloadable podcast, to describe the thrust of the overall issue. According to Fuster, readers should also expect to see two present and future sections every week in the form of a “State of the Art Review” that will be approached from a disease entity, as well as a “Review Topic of the Week” focused on a contemporary topic of basic, translational or clinical science. There will also be regular commentary and perspectives provided by ACC leaders at the national and international levels, Fellows in Training and early career professionals, and JACC editors. JACC recently received the #1 ranking for impact factor across all cardiovascular journals in the world. Update on MOC: Recalibrating the Process The ACC has continued to engage the American Board of Internal Medicine (ABIM) in advocating for modifications to the revised requirements for Maintenance of Certification (MOC). Recently ABIM President Richard Baron, MD, shared with the ACC and other professional societies the following preliminary process changes adopted by the ABIM Board during its June retreat: • Provide increased flexibility on deadlines; a one year grace period will be granted for those who have attempted but failed to pass the secure exam. The cost of the first exam retake will be reduced significantly. • Ensure transparency of information; ABIM will continue to update its governance and financial information on its website. • Ensure a broader range of continuing medical education (CME) options for medical knowledge/skills self-assessment (Part II); this will reduce redundancy and provide physicians with credit for relevant activities in which they are already engaged. ABIM will align its knowledge assessment standards with existing standards for certain types of CME products and providers. ABIM will also shorten the approval process for CME activities that include an assessment of the learner. • Provide more actionable feedback regarding individual test scores. • Evolve the “patient survey” requirement to a “patient voice” requirement and increase the number of ways this requirement can be met, particularly by using tools already in use (shared decision-making, active participation in patient/ family advisory panels, training programs in patient communication, etc.). ABIM recognizes that their initial statements regarding this requirement were vague and will work to roll out new processes over the next two years. • Reduce the data collection burden for the practice assessment requirement; utilize practice improvement activities already in place and minimize the time and complexity of data input. • Investigate changes to the secure exam to increase relevance with specific attention to exploring applications for practice focus areas (“modular exams”) and open book exams. The College was also invited by ABIM to attend an Internal Medicine Summit in Philadelphia on July 15 to share member feedback in an open forum with 25 other professional societies affected by the MOC process. Patrick T. O’Gara, MD, FACC, president of the ACC, William J. Oetgen, MD, MBA, FACC, executive vice president of Science, Education and Quality of the ACC, and Debra Ness, MS, member of the ACC Board of Trustees, represented the ACC. During the time allotted, O’Gara made the following recommendations for ABIM’s consideration: 1. Creation of dual pathways for recertification, one involving a 10-year secure exam with annual completion of CME activities as currently required for licensing/ credentialing; and the other consisting of completing MOC Part II activities for 10 years. This recommendation has been strongly endorsed by the ACC’s Board of Governors. 2. Harmonization of CME with MOC credits. 3. Recognition of ongoing, hospital-based quality improvement and patient surveys as qualifying for MOC accreditation. 4. Elimination of the “double jeopardy” faced by interventional, electrophysiology and heart failure colleagues who currently have to pass both the general cardiology and sub-specialty boards. 5. Reduction of fees. 6. Improvement in the ease with which accurate and understandable information can be retrieved from the ABIM web site. 7. Research into the value of MOC, as measured by physician competency and patient outcomes. O’Gara further emphasized the urgency of the situation and the need for action. Many of these points were shared by the other participants and additional recommendations were made concerning enhanced communication, partnerships, ways to improve self-assessment products/modules, and formative feedback from the secure exam. There was further discussion about the desirability of changing the manner in which some diplomats are listed on the ABIM website as “not meeting MOC requirements.” More MOC information and resources are available at CardioSource.org/MOC. Regular updates are also posted to the ACC in Touch Blog at blog.cardiosource.org. UN Hearings Continue Critical Discussion Around NCDs Over the last several months, the ACC has participated in United Nations’ (UN) hearings on the prevention and control of non-communicable diseases (NCDs). The first hearing attended by ACC Past President John Gordon Harold, MD, MACC, addressed a ‘Zero Draft’ Outcomes Document that the World Health Organization (WHO) released. The report provided a benchmark of the progress to date since the UN Summit on NCDs in 2011. It noted that the progress of reaching a 25 percent global reduction of premature deaths from NCDs by the year 2025 (25 by 25), “has been insufficient and highly uneven, [and] continued efforts are essential for achieving a world free of the avoidable burden of NCDs.” The second hearing, attended by Harold and ACC President Patrick O’Gara, MD, FACC, continued the discussions. “Coming out of the hearings, I am optimistic that priorities will soon be set,” said O’Gara. “No issue is greater in regards to NCDs than the current under-resourcing of the global efforts.” According to both Harold and O’Gara, the final Outcomes Document must address this issue head on with strong language regarding the inclusion of NCDs in the post-2015 development agenda with a specific reference to a dedicated NCD target or targets. They also note it should include strong monitoring mechanisms in order to be successful. ACC in Touch Follow @ACCinTouch on Twitter for breaking news from all of the top cardiovascular meetings this fall, including #ESCCongress2014, #TCT2014 and #AHA14. Also use the hashtag #ACCLegConf during the ACC’s 2014 Legislative Conference from Sept. 14 – 16.CardioSource. Look out for central illustration summaries from papers published in the Journal of the American College of Cardiology posted to the ACC’s Facebook page each week. Visit Facebook.com/AmericanCollegeofCardiology to learn more.CardioSource.org/ACCinTouch Recent posts on the ACC in Touch Blog include ACC President Patrick T. O’Gara, MD, FACC, on the latest update from the American Board of Internal Medicine on Maintenance of Certification requirements, and Michael Mansour, MD, FACC, chair of ACC’s Board of Governors, who describes notable updates to the tables and figures in the cholesterol guidelines. Recent guest posts include William J. Oetgen, MD, MBA, FACC, ACC’s executive vice president of Science, Education and Quality of the ACC, who discusses the Cardiometabolic Think Tank, and Dipti Itchhaporia, MD, FACC, a past chair of ACC’s Board of Governors, on six lessons for success for female cardiologists. Correction: The Spring 2014 issue of Cardiology (page 44) contained an incorrect photo of Thomas T. Tsai, MD, MsC, FACC. Please note the correct photo of Tsai here. Cardiology regrets the error.
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