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The role of some cardiac device makers is evolving in the cath lab as they expand from selling products to providing services and solutions. It's a trend that is likely to continue globally.

Physicians in fields like cardiology have traditionally looked to clinical practice guidelines to help articulate the best evidence-based care for patients. The rapidly growing movement to value-based care is prompting clinicians—including echocardiographers—to carefully weigh a more focused and integrative approach to delivering consistent, quality medicine: care pathways.

The vision was clear. The experienced heart and vascular team at the Northwestern Medicine Bluhm Cardiovascular Institute in Chicago needed a cardiovascular information system (CVIS) to stretch across its seven hospitals and 100 ambulatory care centers, physician offices and clinics. 

A plan for increasing use of cardiac rehabilitation (cardiac rehab, or CR) was a few months short of launch when the Centers for Medicare and Medicaid Services (CMS) tapped the brakes.  

The need for permanent pacemakers in patients with severe aortic stenosis who undergo transcatheter aortic valve replacement (TAVR) remains a complication, even as TAVR expands into lower-risk groups. That may prove to be a limitation, especially with younger patients who may have decades of life ahead of them.

Among sweeping changes underway in U.S. healthcare is a brighter spotlight on patients' transitions from hospital to home. What can be done to reduce readmissions during these vulnerable periods and possibly save billions of dollars in the process? Increasingly, an answer lies with mobile integrated teams of providers, often led by paramedics, who take healthcare right into patients' homes.

Data are an essential support for administrators and clinicians working together in healthcare. Choose datasets that reflect the practice’s goals and priorities, help you maintain a pulse on the health of the practice and spark the conversations that you and your leadership partner(s) must have to function at your combined best.

As a growing body of evidence links palliative care to improved quality of life and better healthcare utilization for patients with heart failure, some in the medical community are advocating a shift from the traditionalist, acute care model to one more in tune with the psychological and physical needs of people with advanced cardiovascular disease.

 Bundling is premised on viewing healthcare as a continuum, but most of today’s healthcare systems use electronic medical records (EMRs) developed for episodic fee-for-service billing. While many in the cardiovascular community are at the beginning of this experiment, some health systems participated in the earlier Bundled Payments for Care Improvement (BPCI) Initiative and have insights to share.    

Policymakers from the FDA and CMS have been invited to participate in ACC.17, says Jeffrey T. Kuvin, MD, ACC.17 chair and chief of Cardiovascular Medicine at the Heart & Vascular Center of Dartmouth-Hitchcock Medical Center in Lebanon, N.H. “This year, we’ll be able to draw on local  expertise, which also happens to be our nation’s expertise—people who can help us understand important, timely issues in cardiovascular medicine and in the world of medicine,” he says.

Don’t underestimate the importance of scheduling in running a successful cardiovascular practice. 

 Effective patient education leads to improved informed consent, decreased preoperative anxiety and better postoperative pain management. Whether allocating office and hospital resources for patient education results in more cost-effective medicine is a more complicated issue.  

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