Challenges, Crises & Creativity

Challenges is a word we hear all too often in healthcare. In this issue, challenge unites our articles. For example, how frustrating is it to access in a meaningful way the data troves contained in patients’ electronic health records and hospital IT systems? How difficult is it to analyze and employ those data to improve patient care and reduce costs? In another story, we note how challenging it can be for cardiologists to evaluate patients with stable chest pain while the field is still in what Journal of the American College of Cardiology Editor-in-Chief Valentin Fuster, MD, PhD, calls “a primitive age of evidence.”

Alarmists might perceive some of the topics we report on as crises. After all, some of our stories focus on life-and-death issues such as heart transplantation. People are dying because there are too few donor hearts for the patients who need them. Further, healthcare’s latest hot topic, the lack of interoperability across healthcare communication platforms, may be to blame for a portion of the large number of deaths attributed to preventable medication errors each year (BMJ 2016;353:i2139).

So, is it a challenge, a crisis or something in the center? The CVB team approached this month’s topics the same way we try to tackle all of our stories—offering solutions. We talked with physicians, nurses, administrators, advocates and health informaticists, among others, about models of collaboration or coordination they are using to address daunting tasks. Our cover story looks at how TAVR pioneers successfully managed mostly uncharted terrain by empowering nurses to perform the critical role of coordinator. Our story on stable chest pain is complemented by a contribution by Jeffrey Schussler, MD, who shares his enthusiasm about new technologies that could make evaluation much more precise. As you’ll see in our health IT–focused stories, innovators are turning data headaches into opportunities. The secret sauce is creativity.

Is your team testing a creative solution to a vexing problem in cardiovascular care? Would our readers find your experience helpful for improving their practice? I hope you’ll share your ideas with us.