Reimbursement changes, healthcare reform, comparative-effectiveness research, conflicts of interest, accountable care organizations and a workforce shortagethese are some of the topics that our Leadership Forum participants put forth as challengeswith perhaps some hidden opportunitiesfor the coming year.
While an ambulatory EMR may help a practice reach financial incentives and streamline patient information, the initial rollout may be costly and negatively impact productivity.
Triage methods for low-risk chest pain lack consensus. However, a recent scientific statement and appropriate use criteria (AUC) have recommended best practices, paying particular attention to coronary CT angiography (CCTA) as a triage tool.
Successful system-wide protocols to address the care of STEMI patients have spurred facilities like Clarian Cardiovascular at Methodist Hospital in Indianapolis to develop similar programs of facilitated care to treat other time-sensitive vascular emergencies such as aortic aneurysms and dissections. As a result, Clarian has reduced its time to treatment and mortality rates, while expanding its referral base.
At the recent American Heart Association (AHA) meeting, several reported trial results will most likely inform practice in the coming years. These include RAFT, which found that CRT-D devices benefit less severe heart failure patients; GRAVITAS, which found that high doses of clopidogrel hold no benefit for low responders; and PARTNER quality-of-life trial, which found a significant positive quality of life for patients receiving transcatheter valve implants.
Patient advocatesoften suffering from incurable diseaseshave become increasingly influential in pushing for the development of new therapies, and that influence has been multiplied by the internets ability to quickly spread information and connect like-minded individuals.
