On Monday I had the opportunity to speak on CBS Radio to respond to a Consumer Reports article on “The Business of Healing Hearts.” The article provides a critical look at how heart disease is treated across the country. The basic points of the article are as follows:

• People often get the wrong tests
• Angioplasty is overused
• Consumers don’t have enough information on cardiologists
• Heart disease is often misunderstood

The article discusses how financial incentives, such as direct-to-consumer advertising or fee-or-service payments, drive patients to seek care that is not necessary and drive physicians to subject patients to “fancy tests” and aggressive treatment that aren’t necessarily the best care. The report notes that PCI procedures are often overused in the nonemergency setting and that patients cannot find useful information about interventional cardiologists.

In general, the report underscores why reform of our current payment system is so needed. The current focus on volume and episodic care without regard to improved quality, better patient outcomes or patient satisfaction limits communication and creates hurdles to achieving the triple aim of better health care quality, better health and lower costs. It’s why the ACC is proactively advocating for a new payment system (or systems) that rewards improved coordination of care, team-based care delivery, appropriate use of tests and procedures and improved medication adherence to treatment therapies.

In my interview with CBS radio, I also noted the growing importance of “appropriate use criteria” (AUC) in helping allay some of the fears noted in the report. AUC are developed in partnership with key specialty societies to help define “when to do” and “how often to do” a given procedure in the context of scientific evidence, the health care environment, the patient’s profile and a physician’s judgment. Appropriate Use Criteria for Coronary Revascularization were developed in 2009 by the ACC using a combination of clinical science, knowledge and expert opinion to help understand when PCI is appropriate, not appropriate or uncertain. However, it can be challenging to implement AUC into practice. The ACC is looking at new ways to harness technology that can place the documents and other clinical documents like guidelines at the point of care.

Registries are also a key component of high-quality, cardiovascular care. The ACC strongly believes in the power of registries to improve the patient care experience. The Consumer Reports article notes that patients should ask their hospital if it participates in the NCDR because participation in the registry can help the hospital to monitor their performance and adopt quality improvement initiatives to optimize the care they deliver. Fred Masoudi, MD, FACC, is quoted in the article and says that NCDR is working to make NCDR metrics more accessible.

The majority of CV professionals are doing the right thing, but the ACC recognizes as with any industry, there are outliers and that there is always room for improvement. The ACC is proactively working to identify innovative ways – along with all the tools we already use, like NCDR registries, clinical documents and quality programs – to ensure high quality, cost-effective care for every patient.

I look forward to hearing your thoughts in the comments section below.

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