March 4, 2016

Robert Shor, MD, FACC

This BOG Update is brought to you by Robert Shor, MD, FACC, Chair of the Board of Governors.

Many thanks for a great meeting and many thanks for keeping the listserv active with your thoughtful comments. We will have time to engage the BOT at the ACC.16 town hall meeting where the topic will be Maintaining the Relevance of the ACC for members.

We covered a number of topics related to quality and process improvement at our recent meeting. These included a wide variety of projects including collaborative population health initiatives, statewide projects (NCDR and PCI) as well as tools to enhance chapter effectiveness. Drs. Garwood Gee and Norman Lepor gave a fantastic talk on the California Chapter's Leader Report Card, and Drs. Anuj Gupta of Maryland, Akshay Khandelwal of Michigan and I (Virginia) covered statewide PCI review programs in our respective states – all with the idea of sharing best practices and leveraging our strengths. One of my key themes this past year has been optimizing chapter effectiveness. Our collective high tide has raised all boats, and in turn, the bar for each of us. I was particularly excited to recognize the Alabama, Michigan, New Jersey, North Carolina and Texas Chapters for their work in advancing the College's Strategic Plan. Congrats again!

I have you all to thank for participating in the fantastic real time polling system, which we'll employ at selected future BOG meetings. Your responses helped guide the discussion and determine our focus on strategic initiatives moving forward. I hope they were as enjoyable and useful as I felt they were. I've highlighted some of our salient discussions and action items for the near term below.

Advocacy and Population Health Efforts
As mentioned during the meeting, I had the opportunity to connect with Dr. Janet Wright, former senior vice president of science and quality at the ACC and executive director of Million Hearts, as well as Dr. Gerard Martin, chair of the Population Health Policy and Health Promotion Committee. The College is planning to partner with Million Hearts on population health efforts, and at the BOG meeting, we heard that you are most interested in focusing on smoking cessation (47%) and hypertension (44%). We will be working with Gerard and Janet and the ACC staff to create the toolkits for the Chapters to help implementation of these initiatives. This will take time to develop and implement, so we need to keep at it.

We also learned that 64% of you are not participating in PINNACLE. What can the College do to bring BOG participation to 100%? I believe the PINNACLE Registry will be very important as we move from volume to value. To paraphrase from the recent CV Summit, "What you do not measure, you cannot know" or improve. I hope each of you go to your health system requesting PINNACLE participation and encourage you members to do the same.

Continuing our ongoing discussions around insurance denials and test substitutions, we learned that 90% of the BOG meeting respondents would like to replace pre-authorization with FOCUS or similar tool. More on this topic to follow, in a forthcoming survey and following a meeting with the Chairs of the BOG, FOCUS Task Force, Health Affairs Committee and Science and Quality Committees. We will have the survey ready to send out shortly and ask that you send and supply the link through the Chapters and mention it in your Chapter newsletter. Hopefully this will, like our prior surveys, emphasize the importance of this issue to the ACC leadership.


  • College developing a 25x25 toolkit for chapters, partnering with Million Hearts on smoking cessation and hypertension toolkit development.
  • Meeting with the Chairs of the BOG, FOCUS Task Force, Health Affairs Committee and Science and Quality Committees, as well as member survey, to assess interest and appetite in addressing insurance denials and test substitutions.

Statewide PCI Review Programs
Drs. Gupta, Khandelwal and I shared information from statewide PCI programs in our respective states. 51% of BOG respondents are interested in possibly developing such a program in their states, and 83% of those individuals are interested in a more focused discussion. Staff will arrange a call for interested participants – stay tuned.


  • Staff will arrange a call for interested BOG members to discuss statewide PCI review program development.
  • Staff will arrange a call with NCDR to discuss using blinded data in statewide reviews.

I remain energized from our productive meeting last month at Leadership Forum and I look forward to seeing you all in a few weeks at ACC.16 in Chicago.