Candace Stuart, editor, Cardiovascular Business

Listen to your heart, and the heart, too.

In an interview, Michael Criley, MD, professor emeritus of medicine and radiological sciences at the University of California, Los Angeles’ David Geffen School of Medicine, argued that physicians now rely on imaging rather than bedside skills to evaluate a patient’s condition. The stethoscope can be a valuable tool, but physicians must be trained and skilled in its use for it to be effective.

Instead, many physicians make imaging their go-to resource for diagnostics, he said.

“If you are not thinking ahead and are just saying ‘I think I hear a murmur, maybe I should get an echo,’ that is a very wimpy way to go about it,” Criley said.

It also may be a wasteful use of healthcare resources. Scrutiny continues on overuse of many imaging modalities, including CT. In a study recently published in Stroke, researchers found that 95 percent of stroke patients who underwent MRI also had a CT scan, contributing to a 42 percent increase in the cost of inpatient stroke care from 1997 to 2007. That is an increase of $3,800 per case, the authors calculated.

Of course, CT and other imaging modalities offer many benefits and will continue to do so, when chosen judiciously. Multidetector CT 3D aortic annular dimensions were shown to be predictive of valve leakage and 3D CT imaging was shown to be superior to 2D transesophageal echocardiography for aortic annular evaluation before transcatheter aortic valve replacement in two separate studies recently published  in the Journal of the American College of Cardiology.

Private patient information, including imaging data, that is gathered and stored also is potentially vulnerable to a breach. Researchers at the American National Standards Institute raised the alarm in report on security threats, the potential cost of lost or stolen data and a process to gauge the effectiveness of security measures and measure the effects of a potential breach.

“Privacy and security programs would likely become a high priority if the healthcare industry more widely understood the increasing costs of class action lawsuits resulting from data breaches, not to mention the statistical probability that nearly all health organizations will experience an electronic data breach in the next few years,” according to the report.

That grabbed my attention, and I suspect it may have made a few hospital administrators’ hearts stop briefly as well. Are the authors exaggerating, or is this a timely reality check? Feel free to share your thoughts in an email.

Candace Stuart
Cardiovascular Business, editor
CStuart@cardiovascularbusiness.com