October/November 2007

Door-to-balloon time (D2B) is a critical cardiac quality indicator. As a whole, U.S. hospitals are doing fairly well with other quality indicators, says Betsy Bradley, PhD, professor of public health at Yale University in New Haven, Conn., but D2B time is a challenge for many sites. Here are some prescriptions to break the 90-minute barrier.

Thanks to new, more intelligent interfacing capabilities based on new open software protocols, next-generation contrast injectors support more complex injection protocols and integrate with information systems, while keeping pace with increasing CT scanner speeds.

As the quest for more data in cardiac care grows with its link to reimbursement and quality of care measures, the number of national registries is sure to blossom. Last year, at the urging of the Centers for Medicare & Medicaid Services (CMS), the National ICD Registry was developed through a partnership of the American College of Cardiology Foundation (ACCF) and the Heart Rhythm Society (HRS).

According to the Centers for Disease Control and Prevention (CDC), heart disease has been the leading cause of death in the United States for the past 80 years and is a major cause of disability. The CDC estimates that approximately 61 million people in the United States have heart disease, and approximately 950,000 people die from the condition each year. Overall, heart disease contributes to approximately 40 percent of all deaths.

Cardiac catheterization labs across the country are evolving. Changes in types and volumes of procedures combined with an increasingly competitive environment and reimbursement cuts are forcing cath labs to adapt and fine-tune their management strategies. What brings success? Diversifying into EP and peripheral vascular procedures, tightly managing and even consigning pricey inventory such as drug-eluting stents, cross-training staff, and ensuring high flexibility.

In 50 years, echocardiography has gone from a single dimensional view of the heart to a 3D and even 4D real-time technique. Adding to echo’s sophistication are quantitative analysis, greater portability, better workflow and efficient information management.

Advanced visualization has shot from the realm of experimental, futuristic technology to almost routine practice in just a few short years. While the reliance by physicians on 3D varies, clinicians can often determine the presence and extent of heart disease without an invasive procedure. On the horizon, 3D users see further improvements that will reduce radiation exposure and speedier interpretation times.

Welcome to the first issue of Cardiovascular Business—the business magazine for cardiovascular medicine. So why a business magazine for cardiovascular health? Because excellent cardiac care depends on the fiscal health and business intelligence of your cardiovascular practice.

Insurers and the government may not be on board, but the medical community sure is: when it comes to improving patient care, cardiac CT is a must-have technology. But depending on the size and scope of your practice, department or hospital, the business case is a little less clear. Clouding the picture are uneven reimbursement rates across the country, the steep learning curve toward reading proficiency and the expense of the equipment and third-party advanced visualization software.