National Cardiometabolic Health Initiatives

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National Cardiometabolic Health Initiatives

• Laurence S. Sperling, M.D., FACC, FACP,FAHA
• Professor of Medicine (Cardiology)
• Director- Center for Heart Disease Prevention
• Emory University School of Medicine
• Chairman of ACC Cardiometabolic Working Group
• Chairman of The National Cardiometabolic Alliance
• President Elect, American Society for Preventive
  Cardiology

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Introducing the CardioMetabolic Health Alliance

• The CardioMetabolic Health Alliance (CMHA) is a
  partnership among American College of Cardiology
  (ACC), the National Minority Quality Forum (the
  Forum) the American Association of Clinical
  Endocrinologists (AACE) and the Association of
  Black Cardiologists (ABC).

Databases The Forum patient records that define
disease prevalence, costs and outcomes at the zip
code level ACCs NCDR patient records that define
clinical cardiac outcomes

• Professional Membership
• 42,500 cardiologist, cardiology care team members
  and members of the community
• 6,000 endocrinologists

• Other Resources
• Diverse publication and communication channels
• Research and quality improvement capabilities
• Educational programming infrastructure
• Experienced in public outreach work

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CMHA Began with a Registry

• Participants find QI Opportunities through
  Registries
• Comparison of practice and physician-level data
  to national benchmarks
• Measureable adherence to established clinical
  guidelines and performance measures
• Creation of registry-driven quality improvement
  programs

Registry Data
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ACCs National Cardiovascular Data Registry
NCDR A Generation of QualityThe premiere
source of clinical outcomes data
The NCDR is the most comprehensive,
outcomes-based quality improvement program in the
United States, encompassing both hospital-based
registries and a practice-based program.
The NCDR helps participating facilities and other
medical professionals identify and close gaps in
quality of care reduce wasteful and inefficient
care variations and implement effective,
continuous quality improvement processes.
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GAP Analysis of PINNACLE Data Suggested
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Prevalence of Obesity in U.S. Adults
1996
2006
2008
Percentage of State Obese (BMI gt 30)
No Data lt10 1014
1519 2024 25-29
gt30
CDC Overweight and Obesity
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Four Core Goals Operationalize Our Mission
Mission To reduce acute events associated with
cardiometabolic risk factors and disease,
particularly among minorities and at-risk
populations. Core Goal 1 Providers correctly
screen for and appropriately manage
cardiometabolic risk factors and disease. Core
Goal 2 Primary care providers and specialists
know when to referand/or coordinate with one
another. Core Goal 3 Providers knowledgeable
about racial and ethnic disparities. Core Goal
4 Patients self-activated to manage their own
risks and disease.
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Science and Quality Improvement

• Link CathPCI Registry and PINNACLE Registry
  datawith NMQFs National Health IndexFindings
  to design quality improvement interventions
  targeted for patients with greater risk for acute
  cardiovascular episode and providers who care for
  them planned for 2014
• Cardiometabolic Disease Clinical
  Communitylaunched Oct. 10, 2013
• Cardiometabolic Toolkitto launch 2014
• Cardiometabolic Think Tank June 20, 2014 at
  Heart House

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Online toolkit helping clinician assess and
manage cardiometabolic risk in cardiology
practices
Cardiometabolic Toolkit
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Cardiometabolic Toolkit - Development
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ACC and INTERVENT The Partnership
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CardioSmart _at_Work How We Help Employers

• Employers receive access to a variety of
  tools/services/programs, including
• Wellness coordinator manual
• Communications field guide
• Assistance with incentive design
• Branded portal landing page with access to an
  array of informational tools (including health
  topic search, videos, incentives, challenges,
  mobile apps, etc.)
• Health risk assessment (HRA) and reports
• Web portal for real-time tracking of HRA
  completion
• Online self-help lifestyle management programs
  (including, exercise training/physical activity,
  nutrition, weight management, stress management
  and tobacco cessation)
• Telephonic lifestyle health coaching
• Aggregate evaluation and reporting
• Other optional services (e.g., consulting,
  biometric screenings, device integration, onsite
  activities/interventions, custom programming,
  research)

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ACC and INTERVENT The Partnership

• Doctors are enthusiastic about prevention.
  However, they often dont have the time,
  resources or infrastructure for the provision of
  certain preventive services (especially lifestyle
  management).
• CardioSmart OnCall will allow doctors to provide
  their patients with credible, affordable,
  evidence-based lifestyle management programs
  without burdening them or their staff with
  significant additional work or overhead.

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CardioSmart OnCall Mobile Patient Referral and
Tracking App
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Think Tank Integrating to Synergize and
Optimize Cardiometabolic Care June 20, 2014

• Problem
• Treating cardiometabolic disease requires
  integrated, coordinated and interdisciplinary
  approach to patient care that is largely
  unprecedented.
• Purpose
• To engage expert stakeholders from cardiology
  to primary care to endocrinology, and from
  physicians, advanced practice nurses, physician
  assistants, dieticians, patient educators and
  pharmacists in a facilitated, action-driven,
  discussion of how to best coordinate care for
  patients with cardiometabolic risk factors or
  disease.
• Convene panel of 12-20 experts for a facilitated
  discussion, followed by publication of
  proceedings
• Face-to-face discussion of 4-6 hours
• Experts representatives from cardiology,
  endocrinologyor diabetes, and primary care
• Full care team representatives such as
  advancedpractice nurses, physician assistants
  and diabeticeducators
• Broad range of stakeholders to sit in on
  proceedings

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Additional Resources

• CardioMetabolic Health Alliance Website
  www.cardiometaboliccha.org
• CardioSmart Website www.cardiosmart.org
• Cardiometabolic Disease Clinical Community
  http//www.cardiometabolic.cardiosource.org
• Current ACC Toolkits can be found at
  http//www.cardiosource.org/Science-And-Quality/Cl
  inical-Tools.aspx

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CMHA Partnering Organizations

• American College of Cardiology
• www.cardiosource.org
• American Association of Clinical Endocrinology
• www.aace.com
• National Minority Quality Forum
• www.nmqf.org
• Association of Black Cardiologists
• www.abcardio.org