Cardiology Practice Recognition program endorsed by the American College of Cardiology

Bridges to Excellence (BTE) has supported the American College of Cardiology (ACC) in the development of the Cardiology Practice Recognition program, a practice-level recognition program designed specifically to identify quality in cardiovascular practice. As the value-based approach to health care delivery continues to evolve, it is important to identify cardiovascular practices that demonstrate a commitment to the delivery of quality care while providing clear direction about opportunities for improvement for practices that may not.

Cardiology Practice Recognition Process:
The Cardiology Practice Recognition data flow process is similar to that of the standard BTE programs:

1. Data is submitted through a portal housed on ACC CardioSource website:
   • Practices submit practice and physician level data for all applicable structural and professional elements within the Cardiology Practice Recognition program.
   • Practices submit medical record data for defined samples of their patients with Hypertension, Coronary Artery Disease, Heart Failure, and/or Atrial Fibrillation/Atrial Flutter.
2. Practice data are aggregated and sent to one of the independent Performance Assessment Organizations (PAOs) with which BTE has a relationship.
3. The PAO applies the scoring rules and evaluates whether established recognition thresholds are achieved. 
4. As part of BTE’s mission to identify and promote quality, PAOs report results to the following: 
   • To the Practice: Practices receive notice of their recognition pass/fail status with a scorecard of their results. The practice may use their scorecard to facilitate quality improvement. 
   • To BTE: Only Recognized practices and the individual cardiologists within the practice are reported to BTE for display on BTE’s consumer portal for recognition information hosted by HealthGrades, ACC CardioSource website, and transmission to BTE-licensed health plans for associated incentives. No clinical data is shared with BTE at any point in the process. BTE Cardiology Practice Recognition status lasts two years from the date on which the PAO awards recognition. 

Cardiology Practice Recognition Goals:
The Cardiology Practice Recognition is a tool for cardiovascular practitioners and healthcare purchasers to understand and evaluate quality cardiovascular care. The purpose of the Cardiology Practice Recognition program is threefold:

• Establish legitimate goals and targets for cardiovascular specialists and their practices to achieve in their clinical processes, operational infrastructure, and professional development. 
• Provide a road map to guide performance improvement. 
• Bring consistency to market by standardizing the methodology for how cardiovascular practices are assessed and recognized. 

The program was beta tested during the 1st and 2nd quarter of 2010; the next phase of the program is slotted to be launched in the 2nd quarter of 2011. The quality indicators are organized within three domains and listed below:

Clinical Measures (as developed and specified by ACC/AHA/PCPI)

HYPERTENSION:

• Plan of Care
• Blood Pressure Control

CORONARY ARTERY DISEASE:

• Blood Pressure Control
• Lipid Control
• Symptom and Activity Assessment
• Tobacco Cessation and Intervention
• Antiplatelet Therapy
• Beta Blocker Therapy (with prior MI or LVSD)
• ACE-I/ARB Therapy (with DM or LVSD)

HEART FAILURE:

• Left Ventricular Ejection Fraction Assessment (Outpatient Setting)
• Symptom and Activity Assessment
• Patient Self-Care Education
• Beta Blocker Therapy (with LVSD)
• ACE-I/ARB Therapy (with LVSD)

ATRIAL FIBRILLATION AND ATRIAL FLUTTER

• Assessment of Thromboembolic Risk Factors
• Chronic Anticoagulation Therapy
• Monthly International Normalized Ratio (INR) Measurement for Patients on Warfarin

Structural Elements and Criteria

1. Use of Accredited Lab for Non-Invasive Diagnostic Imaging: Echocardiography
2. Use of Accredited Lab for Non-Invasive Diagnostic Imaging: Nuclear
3. Use of an Electronic Prescribing System
4. Use of a Patient Satisfaction Survey
5. Use of a CCHIT-approved EMR
6. Active Participation in a Recognized Cath and PCI Registry AND/OR Active Quality Improvement Process for Cath and PCI Procedures
7. Active Participation in a Recognized ICD Registry AND/OR Active Quality Improvement Process for ICD Procedures
8. Successful Participation in CMS PQRI

Professional Elements and Criteria:

1. CV Board (ABIM or ABP) Certification
2. CV Subspecialty Board (ABIM) Certification: Electrophysiology
3. CV Subspecialty Board (ABIM) Certification: Intervention
4. Documentation of Continuing Medical Education
5. Current FACC or FAHA Designation
6. Cardiovascular Subspecialty Designation
7. Certification: Board of Nuclear Cardiology (CBNC)
8. Certification: International Board of Heart Rhythm Examiners (IBHRE)
9. Certification: Board of Cardiovascular Computed Tomography (CBCCT)
10. Certification: National Board of Echocardiography (NBE)

Practice Testimonial:
Demonstrating Practice Quality with the Cardiovascular Practice Improvement Pathway - David May, MD, PhD, FACC; September/October 2011

Practices interested in applying for Cardiology Practice Recognition may visit www.cardiosource.org/cpip or email [email protected].