The Journal of cardiovascular management : the official journal of the American College of Cardiovascular Administrators最新文献

The use of noninvasive imaging modalities such as computerized tomography and magnetic resonance for coronary disease diagnosis will dramatically decrease the volume of diagnostic patients in the cardiac catheterization laboratory. Consideration must be given to what can be done to keep the cardiac catheterization laboratory a productive and cost-effective department once diagnostics are removed from the catheterization laboratory setting.

When diagnosis codes are reported and sequenced on an insurance claim, official guidelines are available to provide instructions for the correct assignment of ICD-9-CM codes. These instructions are intended to ensure that the correct reason for the diagnostic service is reported and that procedures are reimbursed when they are medically necessary.

The Centers for Medicare and Medicaid Services has made an important reimbursement decision regarding carotid artery stenting for patients at high risk for carotid endarterectomy surgery. This article will identify the carotid coverage questions and process as a case study of the issues that the Centers and stakeholders can face regarding complex new technologies, as well as the questions for carotid artery stenting and other new technologies that the process raises for your hospital.

Coding personnel should be aware of the new CPT guidelines for reporting carotid and vertebral stent placement. Payors' billing requirements for these procedures vary, and it is important to determine before billing whether the payor will accept the applicable CPT category I or III code or whether an unlisted code must be reported. Coding guidancefor these procedures will likely continue to evolve in thenear future.

Saint Vincent Health Center has adopted 2 strong tools--evidence-based practice and automated information technology--to significantly improve mortality in patients with acute myocardial infarction. Automated information technology drives real-time evidence-based clinical processes and has reduced mortality from 10% to 3% over a 1-year period.

Concord Hospital was able to use an existing electrocardiogram (ECG) data management system to greatly improve efficiency regarding the managing, interpreting, viewing, and reporting of ECGs. By taking advantage of the full capabilities of the current ECG data management system, Tracemaster, we were able to design a workflow process to allow any physician to view and interpret electronically any current or previous ECGs from any computer.

Yale-New Haven Hospital, in partnership with Voluntary Hospital Association (VHA Inc), launched the Women's Heart Advantage program in March 2001. Major program components implemented include (1) a comprehensive initial and ongoing internal communication program; (2) a health promotion initiative including a 24-hour, 7-days-a-week women's heart line staffed by nurses and an Internet health question-and-answer forum; (3) significant ongoing communication with nurses and physicians; (4) a community outreach effort to educate poor and minority women; and (5) an aggressive effort to secure financial partners to underwrite the cost of the program. Before launching the program, a telephone survey of 300 randomly selected New Haven County women ages 40 to 70 years was initiated in January 2001 and repeated in January 2002, 2003, and 2004. Findings include (1) the percentage of women who recognize heart disease as the number-one killer of women their age increased from 26% in 2001 to 59% in 2004, (2) the percentage of women who would call 9-1-1 or go directly to a hospital emergency department increased from 63% in 2002 to 83% in 2004, and (3) the percentage of women aware of recent Women's Heart Advantage program promotion grew from 33% in 2002 to 50% in 2004. Perhaps most importantly, the number of women with heart problems admitted through the hospital's emergency department increased from 1528 per year in 2001 to 1870 per year in 2004 (7.5% annual increase), whereas the number of men with heart problems admitted through the emergency department during the same time period has been relatively low (0.8% annual increase). By linking clinical, public health, and marketing expertise along with finding ways to partner with other organizations, the Women's Heart Advantage program has contributed to remarkable changes in women's awareness, knowledge, and behaviors, suggesting a model for approaching similar health-related problems.