September 2010

Due to the current economic recession and decreasing reimbursement to cardiology, cath labs across the U.S. are being pressured to implement cost-control strategies to remain solvent.  Five cath lab practitioners and administrators came together to discuss their institutions tactics for maintaining economic viability, including competitive bidding and reducing the number of vendor products, while providing superior patient care.

Heart failure and complex coronary artery disease are persistent problems in the U.S. and a significant beneficiary of healthcare dollars. A model of care emerging for these patients is a strategy that focuses on the continuum of care. At Ochsner Medical Centers Heart and Vascular Institute in New Orleans, physicians have taken a multidisciplinary approach to treating these high-risk patient populations. Percutaneous left ventricular assist devices (LVADs) are an integral part of Ochsners strategy to improve care for these very sick patients.

Todays cath labs are repositories of much information that will determine hospital standings in terms of quality, physician performance, and profits and losses. All of this informationfrom images to inventory to hemodynamic datamust be available in real time withinand outsidethe  enterprise. Cardiovascular Business asked two health systemsone best-of-breed, one single-sourceto discuss their cath lab IT strategy.

While most physicians agree that transparency is an integral aspect of contemporary cardiology practice, a fundamental disagreement is brewing about the potential benefits and harms of new state and federal regulations that seek to further limit interactions between industry and providers via gift bans and restrictions on continuing medical education (CME) funding. One camp asserts this trend could inhibit innovation, while the other camp contends that stricter divisions are necessary to prevent potential conflicts of interest.

Both PET and CT are excellent cardiac imaging modalities, but does their individual value hold up when combined in a hybrid scanner? The tentative answer seems to be no, with a few exceptions.

While a plethora of research has reinforced the clinical benefits of performing catheter-based proceduresdiagnostic and PCIvia the radial artery compared with the femoral artery, some hospital executives question whether the fiscal and workflow benefits of employing this technique will be equally beneficial. Four providers speak to their reasons for adopting a transradial program, along with the economic and practice management considerations.

The debate whether industry support of academic activity is appropriate and can be managed effectively has increased over the last several years. While most agree that industry support has been vital to the development of new therapies to treat diseases, there also have been reports of egregious conflicts of interest from all sidesindustry and academia.

MUSE

Sharp HealthCare is a not-for-profit, integrated regional healthcare delivery system that includes four acute-care hospitals, three specialty hospitals and two medical groups and multiple clinics in the San Diego area.

Since CMS began publicly reporting hospital readmission rates for heart failure in 2009, a greater emphasis has been placed on quality initiatives that can help curb them. But are readmission rates the best metric by which to judge hospital quality?

MRI provides excellent soft-tissue contrast, but the drawback is its temporal resolution. Whereas CT scanning of the coronary arteries takes mere seconds, MRI can take up to 20 minutes or even longer. The latest innovation to increase the speed of MRI, however, is to employ multi-channel radiofrequency (RF) coils with parallel acquisition techniques.

If you turn to the back of this months issue, there are two articles in our News & Views section that speak to the state of cardiovascular medicine and its practitioners. The first, More patients seen, but less reimbursement, details the results of a survey that indicate a rise in the number of patient visits with a concomitant decrease in overall profits. Thats not really surprising, given the challenges handed to cardiovascular practices in the last several years.

As people age, their stem cells also age, diminishing their functionality. Many studies conducted to determine the efficacy of cardiac stem cell therapy have used donor cells from younger patients. These cells are healthy and readily adopt the cardiogenic phenotype in which researchers are interested. The problem with that approach, however, is that in clinical trials, researchers want to use patients stem cells, but they cant expect to have similar results as with younger donor cells. The answer is to find a way to manipulate autologous cells so they regain their youthful function.

Select an Issue
""