March 2010

In December 2009, CMS released a proposed rule that aims to change the practice of medicine. This rule, if finalized, will codify a $17.2 billion dollar program that provides large financial incentives to practices that adopt EHRs. The finalization of this program represents an unprecedented commitment to health IT and to transitioning physician practices from paper to EHRs.

Now that continuous-flow left ventricular assist devices (LVAD) are available as a destination therapy, rather than just a bridge-to-transplant therapy, options for late-stage heart failure patients have expanded. The new indication is welcome news, but the debate has begun regarding which patients are the best candidates, and when in their care cycle to implant LVADs.

U.S. cardiologists are experiencing a 36 percent cut in SPECT imaging reimbursement as part of the 2010 Medicare Physician Fee Schedule (MPFS). As a result, cardiology practices nationwide are trying to survive, while hoping that cardiology advocacy groups can persuade CMS that the dramatic cuts will potentially hurt patient care and increase healthcare costs in the long term.

With a more sophisticated understanding of sudden cardiac arrest (SCA) and improved technology, the field of resuscitative medicine is moving forward at a rapid clip. The missing piece to the puzzle, however, is getting more automated external defibrillators (AEDs) into more public spaces, coupled with education and training.

Cardiology departments are learning that their cardiovascular information systems (CVIS) are the perfect conduit to produce actionable and quantifiable data that can drive quality process improvement and cost savings.

Practice-based protocols and teamwork combine to provide a recipe for top-notch patient care at Mount Sinai Medical Center, located in Upper Manhattan.

In todays healthcare environment, its imperative to keep an eye on cost effectiveness while providing evidence-based care. In the cath lab, hemostasis patches are emerging as a low-cost alternative to closure devices and a complement to manual pressure.

Cardiologists might grumble about reimbursement and other healthcare challenges (and with good reason), but they certainly know where their hearts are. The devastation in Haiti following the earthquake on Jan. 12 produced an outpouring of help from the cardiology community that should be recognized. While we cant list everyone, a few examples will show the spirit in action.

While no recent studies have been conducted to identify the number and type of physicians going into concierge, or retainer, medicine, from most published accounts there has been an increase in the number of internists exploring or converting to this type of practice. In addition, the concierge medicine practice model is likely to pique the interest of certain specialists such as cardiologists and nephrologists, who tend to establish long-term relationships with their patients.