***SPOILER ALERT: The following includes some solutions to our 2023 Cardiology Crossword Challenge***
Cardiology, like the world as a whole, had more headspace for introspection and growth in 2023 as the COVID-19 pandemic officially ended, allowing for shifts in practice and public policy.
Perhaps most on the minds of cardiologists is the momentum to create a new, independent medical board. The move comes after years of friction over the American Board of Internal Medicine (ABIM; 6 Down) mandate that midcareer physicians must pursue Maintenance of Certification (MOC) to show their competencya process that many cardiologists have argued is time-consuming and expensive. Application for the new board to the American Board of Medical Specialties is imminent, TCTMD reported this month.
Also gaining steam in 2023 have been debates over what constitutes the right credentials for managing patients with heart disease. Highlighting the tensions over scope of practice was the furor kicked off when Glenfield Hospitals cardiology X (formerly Twitter) account congratulated an advanced nurse practitioner (ANP; 44 Down) for performing a TAVI case as first operator. The resulting firestorm focused on safety concerns as well as worries that physician trainees might be missing out on chances to learn structural heart skills.
TCTMD spoke with Cathleen Biga, MSN, RN, president and CEO of Cardiovascular Management of Illinois and president-elect of the American College of Cardiology (CATHLEEN; 30 Down), who observed that its been a year of evolutions in team-based care and scope of practice that are important to both applaud and watch carefully.
This year marked the second for in-person meetings in the postpandemic era, with many dropping the option of live remote attendance, which in turn led to more discussion about how to balance work and life commitments against the fear of missing out (FOMO; 5 Down). For years, Twitter has been the place to keep up with live meeting updates, but many cardiologists have soured on the new X platform and a few have quit altogether.
But if some are pushing pause on some digital interactions, they may yet be turning to other online tools, including artificial intelligence (AI) and large language models. ChatGPT (19 Across) became one of the most talked-about technologies of the year and left journal editors scrambling to create rules around how to acknowledge AI authorship on submitted articles.
On the regulatory front, major US Food and Drug Administration decisions on drugs and devices made headlines. These include the approval of the first pulsed-field ablation catheter, two renal denervation (RDN; 54 Down) systems for treating high blood pressure, the first extravascular ICD (EVICD; 16 Across), the LimFlow (20 Down) device, and colchicine (2 Down), an old drug made new in CAD prevention, among others.
Lastly, two evolving approaches may help with the chronic shortage of hearts for transplantation. Leading the way is research supporting the safety and efficacy of hearts donated after circulatory death (DCD; 52 Down), while much more preliminary steps continue in the realm of genetically modified porcine hearts (PIG; 37 Down).
What Did We Miss?
Our Cardiology Crossword Challenge inevitably missed plenty of important developments this year.
Biga pointed out that the US Centers for Medicare & Medicaid Services physician fee schedule issued in late 2023, set to go into effect January 1, 2024, has elements that will impact the delivery of CV care: community health integration services, social determinants of health risk assessment, caregiver training, and principal illness navigation services. The latter two help overcome some limitations of existing chronic care codes, which have been hard for practices to implement, she explained. If we can really teach the family members to prevent readmissions and hospitalizations and ED visits, such caregivers would be a valuable focal point.
The endorsement for social determinants of health, noted Biga, will make it easier for clinicians to do their part in addressing equity.
Also pivotal, from a financial perspective, is the American Medical Associations ongoing Physician Practice Information Survey. Responses to the survey will help policymakers understand the costs involved in running a medical practice, Biga stressed: if these numbers arent accurate, Medicare physician payments could suffer.
The other thing that I think is critical that weve got to watch next year [is] how we do shared services, said Biga. The goal is to help maximize the skill sets of everyone on the teamphysicians, advanced practice nurses, registered nurses, pharmacists, etcto get that patient where they need to go . . . and still get paid for that whole embracing of the team.
And finally, US cardiologists should expect Medicare to continue the trajectory toward quality as a metric that factors into reimbursement, Biga highlighted. Within the agencys Quality Payment Program (QPP), theres now not only the Merit-Based Incentive Payment System (MIPS) but also, as of 2023, the MIPS Value Pathways (MPVs) reporting option. In 2024, she predicted the concept of value will become even more important.
As to the stewing controversies over scope of practice and shifting roles in cardiology, she herself has faced pushback over being the first nonphysician to lead the ACC. In her view, this expertise brings a unique perspective.
The reality is we have a physician workforce shortage [and] a nurse workforce shortage, so its necessary to find solutions, Biga commented. There are changes afoot, such as HR 2583, a bill specifying physicians arent the only ones able to prescribe cardiac rehabilitation, which will bring changes in this regard.
Team-based care, to be done right, requires balance, she stressed. It involves making sure everyone is working at the top of their license and not over their license, making sure people are working in their lane, said Biga. What we need within CV care delivery is a mechanism that weaves. . . . Medicine is an art as well as a science. This weaving together of everybodys skill sets comes out into a beautiful brocade, but only if its woven with the strengths of each individual aligned in the right way.
As cardiology becomes ever more specializedand subspecializedevery team member offers their own expertise, she added.
See the rest here:
Top Policy and Practice News for Cardiologists in 2023 - TCTMD
- Applications of Nanotechnology in the Field of Cardiology - Cureus - April 15th, 2024 [April 15th, 2024]
- Tri-City Cardiology's Ambulatory Surgical Center (ASC) Leads the Way in Revolutionizing Heart Failure Management - PR Newswire - April 15th, 2024 [April 15th, 2024]
- Watchdog group calls out risks associated with private equity in cardiology, other specialties - Cardiovascular Business - April 15th, 2024 [April 15th, 2024]
- Heart health: Cardiologist shares impact of advanced wearable technology on patient monitoring - News9 LIVE - April 15th, 2024 [April 15th, 2024]
- Apr 12 2024 This Week in Cardiology - Medscape - April 15th, 2024 [April 15th, 2024]
- TAVR Found Non-Inferior to SAVR for Low-Risk Patients - Diagnostic and Interventional Cardiology - April 15th, 2024 [April 15th, 2024]
- Telemedicine Strategy After MI Scores a Win in TELE-ACS - TCTMD - April 15th, 2024 [April 15th, 2024]
- Global Interventional Cardiology Devices Market Projected to Reach $21.9 Billion by 2030 - GlobeNewswire - April 15th, 2024 [April 15th, 2024]
- Impact of Interatrial Shunt May Vary by Heart Failure Type - Diagnostic and Interventional Cardiology - April 7th, 2024 [April 7th, 2024]
- SGLT-2 Inhibitors Show Mixed Results After Heart Attack - Diagnostic and Interventional Cardiology - April 7th, 2024 [April 7th, 2024]
- No Reduction in 90-Day Deaths, Heart Attacks With Human Apo/A1, A Building Block of HDL Cholesterol - Diagnostic and Interventional Cardiology - April 7th, 2024 [April 7th, 2024]
- Association of Black Cardiologists' "We Are The Faces" Campaign Unveils New Videos for Black Maternal Health Week - PR Newswire - April 7th, 2024 [April 7th, 2024]
- UNC Hospitals Performs First Transcatheter Tricuspid Valve Replacement in North Carolina | Newsroom - UNC Health and UNC School of Medicine - April 7th, 2024 [April 7th, 2024]
- Cardiawave is Presenting the 30-day Follow-up Results from its Valvosoft Pivotal Study on the Teatment of Severe ... - Diagnostic and Interventional... - April 7th, 2024 [April 7th, 2024]
- Real-world Evidence at the American College of Cardiology Scientific Session ACC.24 to Demonstrate Positive Impact ... - Diagnostic and Interventional... - April 7th, 2024 [April 7th, 2024]
- American College of Cardiology Sets Full Range of Education Sessions and Meetings ACC Scientific Session, ACC.24 - Diagnostic and Interventional... - April 7th, 2024 [April 7th, 2024]
- ACC.24: Smidt Heart Institute Experts to Share Research Findings, Clinical Knowledge - Diagnostic and Interventional Cardiology - April 7th, 2024 [April 7th, 2024]
- Cardiovascular Research Foundation, CRF, Introduces New York Valves: The Structural Heart Summit - Diagnostic and Interventional Cardiology - April 7th, 2024 [April 7th, 2024]
- Medicare drops AUC requirement for advanced imaging, ASNC celebrates - Cardiovascular Business - April 7th, 2024 [April 7th, 2024]
- Yale Faculty Present Groundbreaking Clinical Research at the 2024 American College of Cardiology Scientific Sessions - Yale School of Medicine - April 7th, 2024 [April 7th, 2024]
- Getting Too Little Sleep Linked to High Blood Pressure - Diagnostic and Interventional Cardiology - April 7th, 2024 [April 7th, 2024]
- What's Going to Be Hot at ACC 2024 - TCTMD - April 7th, 2024 [April 7th, 2024]
- E-cigarette use linked to increased risk of heart failure, large study finds - News-Medical.Net - April 7th, 2024 [April 7th, 2024]
- Osso VR and ACC to Develop Cardiac Procedure Training with VR - HIT Consultant - April 7th, 2024 [April 7th, 2024]
- Kapil Yadav, M.D., Joins UAMS to Lead Nuclear Cardiology and Vascular Medicine Program - UAMS News - March 19th, 2024 [March 19th, 2024]
- Doctors form new coalition focused on reducing private equity's role in cardiology, other healthcare specialties - Cardiovascular Business - March 19th, 2024 [March 19th, 2024]
- Beth Israel Deaconess Medical Center cardiologist to be honored by American Heart Association - American Heart Association - March 19th, 2024 [March 19th, 2024]
- March 19 Doctors on Call Will Focus on Cardiology - KRSL - March 19th, 2024 [March 19th, 2024]
- Cardiologist shares his long journey from Libya to United States - Cardiovascular Business - March 19th, 2024 [March 19th, 2024]
- Cardiologists share historic research that led to FDA's long-awaited approval of coronary DCB - Cardiovascular Business - March 19th, 2024 [March 19th, 2024]
- Most physicians think private equity is bad for healthcare - Cardiovascular Business - March 19th, 2024 [March 19th, 2024]
- Meth-Related Cardiomyopathy: Where the Biggest Clusters Are - Medpage Today - March 19th, 2024 [March 19th, 2024]
- Gilbert H. L. Tang Appointed Editor-in-Chief of JACC: Case Reports - Diagnostic and Interventional Cardiology - March 19th, 2024 [March 19th, 2024]
- SS Innovations' SSi Mantra Surgical Robotic System used to perform Mitral Valve Replacement - Diagnostic and Interventional Cardiology - March 19th, 2024 [March 19th, 2024]
- Intravascular imaging during PCI in heart disease patients improves survival, reduces adverse outcomes - News-Medical.Net - March 19th, 2024 [March 19th, 2024]
- PA Martine Altieri Brings an Obesity Medicine Clinic to Her Cardiology Patients - AAPA - March 11th, 2024 [March 11th, 2024]
- WEGOVY APPROVED FOR HEART RISK: U-Mich cardiology, obesity medicine experts available for interview - Newswise - March 11th, 2024 [March 11th, 2024]
- AHA Sums Up AI's Potential in Cardiology, but Also the Hurdles Ahead - TCTMD - March 11th, 2024 [March 11th, 2024]
- Houston cardiology-focused tech platform exits to private equity, plans to scale - InnovationMap - March 11th, 2024 [March 11th, 2024]
- The Daylight Saving Time Health Effects You Might Not Be Expecting, According to a Cardiology Specialist (Exclusive) - PEOPLE - March 11th, 2024 [March 11th, 2024]
- How a big CMS update on carotid stenting could impact interventional cardiology - Cardiovascular Business - March 11th, 2024 [March 11th, 2024]
- Global Cardiology Medical Imaging Informatics Market - Cloud-powered Telecardiology to Improve Access to Healthcare - PR Newswire - March 11th, 2024 [March 11th, 2024]
- Valley Health cardiologist talks regional heart health | Nvdaily | nvdaily.com - Northern Virginia Daily - March 11th, 2024 [March 11th, 2024]
- With the correct research, AI in pediatric cardiology has great potential - Contemporary Pediatrics - March 11th, 2024 [March 11th, 2024]
- Top in cardiology: Cannabis use, heat exposure associated with higher stroke risk - Healio - March 11th, 2024 [March 11th, 2024]
- Researcher promotes subsidies to bring cardiac care closer to home in rural areas - Montana Right Now - March 11th, 2024 [March 11th, 2024]
- Cardiologist aims to improve care, reduce costly air transport - The Taos News - March 11th, 2024 [March 11th, 2024]
- Long-term Survivors of Childhood Cancer at Higher Risk of Death Following Heart Issues; Threshold for Treating Risk ... - Diagnostic and... - February 29th, 2024 [February 29th, 2024]
- Even Modest Lp(a) Elevations Bode Poorly for Cardiovascular Health - Medpage Today - February 29th, 2024 [February 29th, 2024]
- Bojangles surprises CMC cardiology team with heart-shaped biscuits for Heart Month - wpde.com - February 29th, 2024 [February 29th, 2024]
- Health Beat: Local cardiologists raise awareness about heart disease prevention - Iredell Free News - February 29th, 2024 [February 29th, 2024]
- Miami Valves 2024 Showcases Innovations in Structural Heart and Cardiovascular Care - InventUM - University of Miami - February 29th, 2024 [February 29th, 2024]
- Cardiology Specialists Keep a Pulse on Adults Born with Heart Defects - Checkup Newsroom - February 29th, 2024 [February 29th, 2024]
- A Living Legend of Health Equity in Stroke and Heart Disease - Penn Medicine - February 29th, 2024 [February 29th, 2024]
- Cardiologist at heart of TAVR controversy loses hospital privileges due to 'disruptive,' 'inexplicable' behavior - Cardiovascular Business - February 29th, 2024 [February 29th, 2024]
- Integration of pharmacist-led pharmacogenomics testing in cardiology clinical practice - Healio - February 29th, 2024 [February 29th, 2024]
- Foiled Theft of Medicines at Punjab Institute of Cardiology Highlights Organized Crime Concerns - BNN Breaking - February 29th, 2024 [February 29th, 2024]
- Feb 23 2024 This Week in Cardiology - Medscape - February 29th, 2024 [February 29th, 2024]
- Hospital doesnt miss a beat when it comes to cardiac care - Martha's Vineyard Times - February 29th, 2024 [February 29th, 2024]
- Cardiologist on the beat for healthy hearts | News, Sports, Jobs - Marietta Times - February 29th, 2024 [February 29th, 2024]
- One of few females in her field, Dr. Sheth focuses on educating women about heart health - Chicago Tribune - February 29th, 2024 [February 29th, 2024]
- URMC Hosts 'Heartbeat of Upson' Celebration | Lifestyle | upsonbeacon.com - upsonbeacon.com - February 29th, 2024 [February 29th, 2024]
- WVU, Valley Health offer pediatric cardiology in Tri-State | Special Sections | loganbanner.com - The Logan Banner - February 29th, 2024 [February 29th, 2024]
- First patient treated using A-Flux Reducer interventional system for angina - Cardiac Rhythm News - February 29th, 2024 [February 29th, 2024]
- Happy Holidays from the Diagnostic and Interventional Cardiology Team - Diagnostic and Interventional Cardiology - December 31st, 2023 [December 31st, 2023]
- 7 New Year's Resolutions for Heart Health From Cardiologists - Livestrong - December 31st, 2023 [December 31st, 2023]
- Pulse Biosciences Announces First-in-Human Procedures with its Novel CellFX Nanosecond Pulsed Field Ablation ... - Diagnostic and Interventional... - December 31st, 2023 [December 31st, 2023]
- Smidt Heart Institute at Cedars-Sinai opens Aortic Surveillance Clinic for patients with enlarged aortas - News-Medical.Net - December 31st, 2023 [December 31st, 2023]
- Creatinine and Cystatin C-based GFR Estimation in HF Mortality - Physician's Weekly - December 31st, 2023 [December 31st, 2023]
- Holidays linked to surge in heart attacks, warns cardiology chief ahead of Christmas - WTOV Steubenville - December 22nd, 2023 [December 22nd, 2023]
- 5 trends in cardiology to watch - Harvard Health - December 22nd, 2023 [December 22nd, 2023]
- Colchicine Not the Answer for Recurring Arrhythmias After Ablation - Medpage Today - December 22nd, 2023 [December 22nd, 2023]
- Chamber Cardio Launches Innovative Value-Based Cardiology Care Platform with Early Success - PR Newswire - December 22nd, 2023 [December 22nd, 2023]
- Drinking in moderation can help avoid 'holiday heart syndrome' - UT Southwestern - December 22nd, 2023 [December 22nd, 2023]
- Top Cardiology Trials and Studies of 2023: Insights and Breakthroughs - Medriva - December 22nd, 2023 [December 22nd, 2023]
- Overview of Major Cardiology Trials in 2023 - Medriva - December 22nd, 2023 [December 22nd, 2023]
- New drugs, updated treatment strategies: 5 important trends in cardiology from an eventful 2023 - Cardiovascular Business - December 22nd, 2023 [December 22nd, 2023]
- The Top Cardiology Trials of 2023 - Medscape - December 22nd, 2023 [December 22nd, 2023]
- Cardiologists' Holiday Wish: Medicare Pay Cuts Roasting on an Open Fire - TCTMD - December 22nd, 2023 [December 22nd, 2023]
- Dec 15 2023 This Week in Cardiology - Medscape - December 22nd, 2023 [December 22nd, 2023]