You probably noticed that one of the studies presented at this year’s Annual Scientific Session showed sudden deaths occurred nearly twice as often in athletes participating in triathlons as in athletes participating in marathons: 1.5 per 100,000 versus 0.8 per 100,000. Investigators examined deaths that occurred in 2,846 triathlons featuring 922,810 participants. Nearly all the triathlon sudden deaths took place during the swimming portion of the event. 

Noting this unexpected differential, I've asked ACC Board members and officers to stick to marathons from now on.

*** Image from Flickr (Diamondduste). ***

Much has been made last week of relationships with industry. During ACC.09, reporters and other stakeholders took note that the ACC had decided not to pursue industry sponsorship of lanyards, portfolio bags and other high-value items (these would have produced nearly half a million dollars of revenue for the College). We did this in order to avoid the “NASCAR effect” of attendees as walking billboards and to visually reaffirm our commitment to responsibility and transparency in our partnerships with industry. But that doesn’t mean that well managed relationships with industry don't have real value for patients and society.

The ACC believes in responsibility and transparency in its relationships with industry, and we have taken many steps to eliminate historic practices that became acceptable to us (and are still in place with many other societies).

BUT we also believe partnerships with industry are absolutely critical to maintaining scientific progress in cardiology and other specialties. Right now, public funding for research and medical education is scarce. Cardiologists already pay for 90-95% of their own educational costs. Our attendees have to pay for everything on their own. Plus, leaving one’s office to attend a meeting like this in itself costs a lot of money in lost income! Digital education is valuable, but does not substitute for real discourse -- and folks would not go online and spend four 8-10 hour days staying up with what we presented.

Industry’s participation in our Exposition Hall (which is totally separated from any connection to educational programs or content), and some industry sponsored non-specific educational grants subsidize the meeting costs and therefore allow for reduced registration charges to the meeting (already over $800 or more for attendees). Also they create the ability to offer simulation, live cases, and innovative educational venues that attract people out of their offices to LEARN -- venues we could not otherwise afford to produce. More...

One of five Medicare beneficiaries discharged from the hospital is readmitted within 30 days, according to the Commonwealth Fund. Half of patients admitted for reasons other than surgery are readmitted without having seen a doctor in follow-up. The study appeared in the latest issue of the New England Journal of Medicine and shows these hospital readmissions cost Medicare $17.4 billion in 2004. Wow.

Heart failure readmissions account for the biggest chunk of that. Our new Hospital-to-Home (H2H) initiative with the Institute for Healthcare Improvement (IHI) could mean savings on a massive scale for heart failure and coronary artery disease. H2H aims to reduce preventable readmissions by 20 percent by 2012 for HF and CAD. We’ll give hospitals and physicians tools and strategies to help educate patients and ensure they follow up with physicians, adhere to medications and improve outcomes in the outpatient setting.

H2H got major media attention at ACC.09, resulting in great early coverage:

• Wall Street Journal: "Cardiologists Set Heart-Failure Treatment Program"
  
  
• MedPage Today: "ACC: Cardiologists Plan to Cut Heart Failure Hospital Readmits by 20%"

Well, we made it through another year. Despite the economic hard times, the cardiovascular world showed up in droves, making ACC.09 a true success. We’ve learned, we’ve networked, we’ve earned MOC or CME credits, we’ve done it all.

If you’ve been following ACC.09 on the blog and on Twitter, the fun doesn’t end with the conference. Keep reading The Lewin Report and adding your comments, and on Twitter, follow “Cardiology,” ACC’s more permanent Twitter account (available http://www.twitter.com/cardiology/). We’re going to keep looking for ways to harness this technology and other new technologies to improve the value we bring to members.

Thanks for a great conference, see you in Atlanta for ACC.10! 

Great overview of ACC Central on CVN!

Yesterday, the ACC said goodbye to one wonderful president, Douglas Weaver, M.D., M.A.C.C., and welcomed a new one, Alfred Bove, M.D., F.A.C.C. Dr. Weaver has contributed so much to the College, leading ACC health care reform efforts, representing the College at various events, including at the White House, and supporting the College’s mission. It is sad to see him go – but I am sure he will remain active, especially with national health care reform efforts moving full steam ahead.

But, as the saying goes, when one door closes another opens ... I’m thrilled to have Fred Bove as our new president because he has so much to bring to the table on so many subjects.

As he said in his opening remarks last night, his presidency will be centered on bringing the focus back to the patient, as part of a very exciting initiative, dubbed “The Year of the Patient” (Watch a CVN interview with Dr. Bove on the initiative here). He said it best in his recent post to this blog, the emphasis of the Year of the Patient is "not only on respecting the cardiologist who provides continuous cardiac care to keep patients active and symptom free, but also in bringing patients into the care team and empowering them to participate in their care decisions."

The theme will resonate throughout national leadership and into our state chapters not only in 2009, but as a long-term theme for the College. Programming will be held that will strengthen the patient-physician relationship with both short- and long-term strategies, including greater promotion of our patient portal, CardioSmart.org. The College also will work with lawmakers to implement policies that encourage patient empowerment.

The College believes that the pathway to quality is through the patient. If we make sure that patients remain the focus during health care reform efforts, high-quality care will be the natural result.

Tomorrow in Room W101, ACC.09 will feature a “D2B: Sustain the Gain” symposium featuring experts in the field discussing current topics in STEMI care. If you’re asking yourself right now: I thought it was called “D2B: An Alliance for Quality?” – you’re right, it was. “D2B: Sustain the Gain” represents Phase 2 of the campaign. Since Phase 1 (An Alliance for Quality) was such a success [go to the Participant’s Workshop tomorrow morning, from 7 – 9 a.m. at the Rosen Centre Hotel, Salon 3, to hear why], the ACC is using D2B: Sustain the Gain to figure out how we can maintain those gains. It’s clear that there are many challenges inherent in sustaining D2B times of 90 minutes or less. We’ll be developing materials and support tools that hospitals need to continue their success.

Quality efforts like D2B are crucial in making a difference in health care reform efforts. The federal government doesn’t have to tell cardiologists to improve quality – cardiologists are working together to do it themselves. Through D2B, we’re making serious in-roads in improving quality – and I know from my visits to the Hill, lawmakers are taking notice.

Meanwhile, stay tuned this summer for the ACC’s newest national quality improvement initiative, Hospital to Home (H2H). With H2H, we’ve set a measurable goal of reducing the 30-day all-cause readmission rate for patients with heart failure or heart attack by December 2012. To register for this program in advance visit: www.acc.org/h2h/enrollment. This is an exciting opportunity to improve patient care and reduce preventable and costly readmissions. We have a great partner in IHI for this initiative as well.

The ACC is obsessed with quality. It’s the focus of everything we do, not only for science and education but also advocacy (I mean, our health care reform campaign is called QUALITY First). In fact, this blog was created so that the College could talk about quality.

Supporting this mission, ACC Annual Scientific Sessions are always overflowing with ways to improve quality. On Sunday, there was tons of fantastic programming, including the Simon Dack and Louis Bishop lectures, and sessions on bringing quality into practice and examining the value of pay-for-performance. Other “can’t be missed” events for this year include: 

• Delivering Cardiovascular Care in Different Health Care Systems, today, 12:15 p.m. – 1:45 p.m., Room W104
• Challenges in Health Communications: Meeting and Exceeding Patient Expectations, today, 2 p.m. – 3:30 p.m., Room W230
• The American College of Cardiology Door-to-Balloon: Sustain the Gain Symposium, tomorrow, 10:30 a.m. – 12 p.m., Room W101
• Evaluating and Improving Quality in Cardiovascular Imaging: Challenges and Opportunities, tomorrow, 12:15 p.m. – 1:45 p.m., Room W110B

Also, we’re trying to gage how members feel on health care reform through a survey that can be found in your portfolio bag. If you fill it out fast enough this morning and return it to ACC Central, booth 2062, there will be a free gift waiting for you (I’m not telling what it is, but it’s quite useful). For those of you a little slower in checking out ACC Central, there might not be any gifts left – except for the gift of helping ACC better understand its membership. That could be the best gift of all.

Check out this CVN interview with health care economist Len Nichols at ACC.09. Nichols gave the Bishop Lecture earlier today -- he said that ACC members should contribute to health care reform by participating in quality measurement, appropriately using technologies and engaging policy makers.

2009 marks the 25th anniversary of ACC/AHA clinical practice guidelines ... a milestone worthy of celebration! The creation of guidelines has been a joint activity between the ACC and AHA since the 1980s, advancing the missions of both organizations by providing clinical recommendations to improve cardiovascular health. Well-developed guidelines have the potential to enhance the appropriateness of clinical practice, improve the quality of cardiovascular care, lead to better patient outcomes, improve cost-effectiveness, and identify areas of further research needs. Past President Jim Dove, M.D., M.A.C.C., has addressed the challenges we’ve faced over past years, and the future of guidelines as he sees it, in a post on this blog in February.

If you visit ACC Central at booth 2062 (and you really should!) you’ll see our clinical materials all marked with the symbol on the right. We’re giving away free CDs of interactive versions of the guidelines and other tools that will work on your PDA and desktop. We also have the very popular pocket guides: 53 percent of you said that pocket guides are your favorite tool to implement guidelines, in a Lewin Report poll last month.

This is it, folks. The event you’ve been waiting for all year -- ACC.09, of course. The science is at an all-time groundbreaking level, attendance is high and the education simply can’t be beat. This year’s meeting will focus on quality, quality and more quality in cardiovascular practice.

We started this morning with the the ACC.09 Scientific Showcase, featuring the Simon Dack Lecture by Princeton University economics professor Uwe Reinhardt, a presidential address by ACC President Doug Weaver, M.D., F.A.C.C., and a JUPITER trial presentation. Reinhardt discussed the challenges facing the health care system and its stakeholders, while Dr. Weaver discussed the challenges facing the cardiology profession.

Starting a little after noon, noted health care economist Len Nichols will present the 48^th Annual Louis Bishop lecture on “What Health Care Reform Will Cost Us: And Why Doing Nothing Will Cost Us Even More.”  Nichols, who spoke at our 2009 Health System Reform Summit, will discuss the problems with the health care system and its payment structure. The health care system can’t afford “business as usual” and something must change. Following his presentation, president-elect Fred Bove, M.D., F.A.C.C., immediate past president, Jim Dove, M.D., M.A.C.C., and past president Tim Garson, M.D., M.A.C.C., and I will discuss the implications of and chances for health care reform.

Reform isn’t going to be easy, but we’ve got to do it. If we can just implement some of the ideas from Reinhardt and Nichols, we’ll be well on our way.

*** Image from Flickr (Stacy Young) ***

Check out the CVN video of ACC President Doug Weaver from ACC.09. He discusses his most recent meeting at the White House (this is his second trip to the White House recently), previews ACC.09 and discusses the imperative for health care reform.

In a mere three days, the cardiology world will head to Orlando for ACC.09 – the best place to find the latest and most innovative findings in CV science. If you’re a cardiovascular practitioner, the conference will provide opportunities to interact with experts from around the world and discuss approaches to clinical dilemmas. Our motto – “Helping Cardiovascular Professionals Learn. Advance. Heal.” – is something we take very seriously around here, and ACC.09 is just one way in which we fulfill it. Check out the ACC.09 Web site for a great video about the meeting: http://acc09.acc.org. 

Science isn’t the only thing that’s going to be new in Orlando – the ACC is launching its most robust foray into social media ever, by combining the blog with other social media like Twitter and Flickr, to connect and share at ACC.09.

Here’s how you can get connected (Feel a bit old and out of it? I’ve included links to FAQs so you can figure out exactly what I’m talking about): 

• Continue to follow the blog – this should go without saying!
• Sign up for Twitter, a real-time messaging service (first FAQ here). ACC has two accounts for members, ACC_09 and Cardiology, available here and here. If you become a follower of ACC_09 on Twitter, you’ll be kept up-to-date on breaking news, events and interesting tidbits about the meeting. You’ll also be able to connect with other ACC_09 followers and discuss meeting highlights.
• Upload your photos to the ACC09 group on Flickr, a photo sharing Web site (second FAQ here), available at http://www.flickr.com/groups/acc_09, or by searching ACC09.

As you can see, ACC.09 is an event not to be missed. We hope to see you at ACC.09 – online and off!