TAVR volume affects hospital readmission risk | PCI mortality rate, LOS, costs higher on weekends | Incidental chest imaging findings keep patients hospitalized longer
May 16, 2017
CV Quality SmartBrief
Transforming Health Care from the Inside Out
First Focus
TAVR volume affects hospital readmission risk
Hospitals that had a high annual volume of transcatheter aortic valve replacements had a lower risk of patient readmissions, compared with medium-volume and lower-volume hospitals, according to a study presented at the Society for Cardiovascular Angiography and Interventions annual meeting and published online in JAMA Cardiology. Researchers said rates for length of stay and cost per readmission were stable among the hospitals in the study.
MedPage Today (free registration) (5/14) 
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PCI mortality rate, LOS, costs higher on weekends
The mortality rate for angioplasty patients admitted on a weekend day was about 2%, compared with 1% for patients admitted on a weekday, according to a study prepared for a Society for Cardiovascular Angiography and Interventions meeting. Data also linked weekend percutaneous coronary interventions to longer lengths of stay and higher costs.
HealthDay News (5/12) 
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Incidental chest imaging findings keep patients hospitalized longer
A study published in the Journal of Hospital Medicine reported that incidental findings were noted in more than half of patients who underwent imaging for chest pain, yet only 7% of the incidental findings were clinically significant. Follow-up in such cases contributed to longer hospitalization, which the authors note raises costs and exposes patients to hospital-acquired health problems.
DOTMed (5/15) 
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Unexplained stroke, explained.
Until an underlying cause is determined—and addressed—cryptogenic stroke patients may be at risk for recurrence. We can help you find the answers. Visit our resource page for the latest information on diagnosis, care management, patient education and more.
Practice & Hospital Management
Hospital creates cardiac critical care team to improve patient care
Sanger Heart & Vascular Institute at Carolinas HealthCare System was the first in its region to use electronic ICU technology to help develop a specialized cardiac critical care team, largely driven by advanced clinical practitioners, according to Dr. Kevin Lobdell, director of quality. He said the majority of team members say the initiative has allowed them to improve how they deliver care and also has helped with onboarding new colleagues.
Healio (free registration)/Cardiology Today (5/9) 
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Study: Patients happy with primary care telehealth visits
In-depth interviews with 19 adult patients show satisfaction with telehealth primary care visits and interest in continued use of the technology, researchers reported in the Annals of Family Medicine. Patients cited convenience and lower costs as the main benefits of telehealth visits.
Physician's Briefing/HealthDay News (5/11) 
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E-Health Watch
US agencies: Health care should exercise caution following global cyberattacks
The health care industry should be wary in their online activities after the WannaCry ransomware cyberattack against hospitals and health information systems across the world last week, according to HHS and other US agencies. HHS suggested several steps on how organizations could prevent ransomware attacks, and the US Computer Emergency Readiness Team said organizations should not pay a requested ransom.
Health IT Security (5/15) 
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Portal-linked decision aids helpful but rarely used, study finds
Attaching decision aids to patient portals can improve engagement and decision-making, but only if patients and their health care providers embrace the tools, according to a study in the Annals of Family Medicine. Many of the patients who used digital decision aids in a study found them useful, but few patients in the study utilized the aids, potentially because of technological barriers and skepticism on the part of patients and clinicians, researchers said.
Patient Engagement HIT (5/11) 
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Other News Highlights
Spotlight on Innovation
Sending lab results to a smartphone may speed ED discharge
Emergency department physicians who got lab results for troponin tests on their smartphones decided to discharge chest pain patients a median of 26 minutes faster than those who got results from an electronic patient record, according to a study in the Annals of Emergency Medicine. Researcher Aikta Verma said other key lab results also could be delivered to physicians using smartphone push-alert notifications.
United Press International (5/12) 
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Costs & Reimbursement
Heart failure specialists to get Medicare billing codes
The CMS on Oct. 1 plans to launch new Medicare billing codes for physicians who specialize in treating heart failure patients. The American College of Cardiology and the Heart Failure Society of America support the new codes because Medicare has denied payments to heart failure specialists when a general cardiologist in the practice also filed a claim for the same patient.
Modern Healthcare (tiered subscription model) (5/12) 
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CMS exempts over 800K physicians from evaluation under MIPS in 2017
The CMS has informed 806,879 clinicians they will not undergo evaluation under the Merit-based Incentive Payment System this year, up from October's estimate of as many as 780,000. Physicians who are new to Medicare this year and those who see fewer than 100 unique Medicare patients and have less than $30,000 in Medicare charges per year will not be required to comply with MIPS.
Modern Healthcare (tiered subscription model) (5/11) 
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ACC News
New Research Looks at Short- and Long-Term Trends in Diabetes Patients
New research exploring type 1 and type 2 diabetes diagnosis trends in youth and long-term incidence rates of cardiovascular disease and mortality in adults was published in The New England Journal of Medicine. Results from a study by Elizabeth J. Mayer-Davis, PhD, et al., found a significant increase in the number of youths diagnosed with type 1 and type 2 diabetes from 2002 to 2012. Meanwhile, a separate study by Aidin Rawshani, MD, et al., found that a combination of improvements in patient education, management of risk factors and advances in clinical decision-making support may have contributed to marked reductions in cardiovascular disease and mortality among Swedish adults with type 1 or type 2 diabetes. Read more on ACC.org. Take the new poll on reducing cardiovascular events in diabetic patients with cardiovascular disease from the Diabetes and Cardiometabolic Disease Clinical Topic Collection on ACC.org.
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Cardiology in the Changing Health Care Landscape
In a recent Fellows in Training/Early Career article published in the Journal of the American College of Cardiology, Joseph Ebinger, MD, discusses the unique set of skills and tools used to perform health services research, including the electronic medical record, clinical databases and patient registries. "To provide the highest value care for our patients, cardiologists, especially FITs and early career physicians, must embrace [health services research] as a unifying methodology, weaving through all aspects of cardiology," he writes. "ACC's leadership with such registries provides FITs with an incredible opportunity to gain experience, develop necessary skills, and improve population-based care through mentored research using these resources." In response, John A. Spertus, MD, MPH, FACC, explains, "It is incumbent upon our fellowship training programs and certification organizations to begin providing training in these skills and to ensure competency among practitioners. In so doing, we can meet the call for medicine to become more evidence-based, patient-centered, and value-focused, thereby improving the care and outcomes of our patients." Read more.
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There is a debt of service due from every man to his country, proportioned to the bounties which nature and fortune have measured to him.
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This news roundup is provided as a timely update to ACC members and partners interested in quality health care topics in the news media. Links to articles are provided for the convenience of the health care professionals who may find them of use in discussions with patients or colleagues. Opinions expressed in ACC Quality First SmartBrief are those of the identified authors and do not necessarily reflect the opinions or policies of the American College of Cardiology. On occasion, media articles may include or imply incorrect information about the ACC and its policies, positions, or relationships. For clarification on ACC positions and policies, we refer you to ACC.org.
External Resources are not a part of the ACC.org website. ACC is not responsible for the content of sites that are external to the ACC. Linking to a website does not constitute an endorsement by ACC of the sponsors or advertisers of the site or the information presented on the site.
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