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BOT Discussion Topics

ACC Board of Governors Business Meeting Thad F. Waites, M.D., F.A.C.C., Chair Sunday, September 11, 2011. ACC Board of Governors Business Meeting Dipti Itchhaporia, M.D., F.A.C.C., Chair-elect BOT Update Sunday, September 11, 2011.

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BOT Discussion Topics

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  1. ACC Board of Governors Business MeetingThad F. Waites, M.D., F.A.C.C., ChairSunday, September 11, 2011

  2. ACC Board of Governors Business MeetingDipti Itchhaporia, M.D., F.A.C.C., Chair-electBOT Update Sunday, September 11, 2011

  3. American College of CardiologyBoard of Trustees UpdateDipti Itchhaporia, MD, F.A.C.C.Chair-Elect, Board of Governors

  4. BOT Discussion Topics • Review of the Environmental Scan Report-Dr Laslett. • Financial Perspective-Dr Chazal, Mr. Fitzpatrick-Kiosk-Wallmart, leveraging our resources-(database/Registries) • Patient Centered Care, CardioSmart- DR Walsh and Dr Foody • Healthcare Reform topics and the Wisconsin Project

  5. International Strategy • Jeff Kindler, former CEO of Pfizer, spoke on Globalization Trends in Healthcare. • Dr Huon Gray, Chair of the International Committee discussed ACC’s international strategy. International membership has been trending upwards- ACC-3902 members in 2008 and 4,366in 2010. The percent of total revenue generated by international attendees has remained a driver of success for the Annual Scientific Sessions. • ACC currently has 11 international chapters

  6. Education, Maintenance of Certification .Evolution of knowledge Systems and Life-Long Learning. Dr Nishimura discussed long and short range vision to support members in maintaining certification and adopting life-long learning behaviors through Lifelong Learning Portfolio. The entire learning agenda is undergoing a transformation to address proficiency gaps, linked to outcomes and performance data from actual practice.

  7. Important Voices in Cardiology • Dr. Braunwald-Cardiology is a scholarly profession based on science. The Four flags that are in front of the heart house- signify respect for community, education, science and advocacy. • Dr. Califf- We are at the helm of the #1 cause of death and disability. It is a global issue. ACC’s role is to guide the cardiologists and take the lead to professionalism. • Dr Fuster-Science and education have to be integral to what we do.

  8. BOT Prioritization of Initiatives • Develop a Competency-Based Curriculum • Affirm the International Strategy and Examine Governance Structure • Facilitate Value-Based Purchasing by Accelerating NCDR Business Intelligence Capabilities (ICD and ACTION-GWTG Registries) • Invest in Improving the CardioSource User Interface including Mobility and Device Specific Capabilities & Establishment of Oversight Group

  9. BOT Prioritization of Initiatives • Invest in the Capability to Move NCDR Registry Data into the LLP and Facilitate MOC- look at individual report cards . Translate guidelines to clinical practice (NCDR is an example) • Affirm Current CardioSmart Direction and Examine Potential Expansion of Patient Engagement Efforts • Affirm Wisconsin SmartCARE Project and Explore Other Potential Localities • Develop In-House Data Analytics Capabilities

  10. BOT Initiatives In Motion • Build NCDR TAVI/TAVR module and Advance ACC’s Capabilities and Credibility in FDA, CMS Post Market Surveillance • Work with ABIM in “Choosing Wisely: The Five Things Campaign”- Kickoff is 2012 • ACC Participation in Coalition Addressing Fundamental Tort Reform • Work on Payment Reform models • Improve Co-sponsored CME Approach • Continue to launch and Early Work of Educational Quality Review Board (EQRB)

  11. Things are moving fast but we the BOG can be the drivers…

  12. ACC Board of Governors Business MeetingSearching and Learning at the Point of CareDino Damalas, CIO ACCSunday, September 11, 2011

  13. Staying Current “Suppose a truly diligent and hard-working physician goes home after work every night, 365 days a year, and reads 10 journal articles.  By any standard, this would be a prodigious and laudable effort, warranting admiration and respect.  But by reading a mere 3,650 articles each year, for the biomedical literature published last year alone, he or she would already be 160 years behind.” ~ Don Lindberg, director of the National Library of Medicine

  14. Staying Current • The body of medical knowledge will triple over the next 10 years • How does a Cardiologist stay on top of latest medical advancements, best practices, and engage in continuous learning? • Journals • Guidelines • Appropriate Use • Self Assessment Programs • Clinical Trials • Expert Consensus • MOC / MOL (quagmire of testing and recertifying)

  15. Staying Current • How do you stay current? • How much time do you spend per week learning and keeping up-to-date? • How maintain your certification and licensure?

  16. JIT Clinical Knowledge • In short, you must • Read volumes of clinical information • Retain that knowledge in memory • Apply knowledge at the point of care • All while juggling 30 or more patients per day • Knowing everything at the POC is just not possible • What will you do? • Google it? • Best Guess? • Research after work and on weekends? • Ask a colleague? • What do you do now?

  17. The Problem • Knowledge exists in a vast library of clinical documents! Getting to it a timely fashion is next to impossible. • Physicians need answers to clinical questions while working with patients (the episode of care). • Answers to these questions are often deeply embedded in large documents. • Traditional search engines are effective at locating the document, but offer little help in locating the answer within the document.

  18. The Solution (Point of Care Searching) • Perform semantic analysis on trusted documents. • Analyze the clinical question, then locate documents with candidate answers. • Perform relevance evaluation of candidate documents to locate the most probable answer. • Present the most relevant parts of the document

  19. Trusted Documents • Clinical Guidelines (43) • Consensus Documents (121) • SAP Learning Modules (12)

  20. Analyzing the Clinical Question

  21. Search Term Significance

  22. Relevance • Information that is closely related to the clinical question • Appropriate source (Trusted) • Must have the necessary and appropriate parts (Complete) • Comprehensive without superfluous detail (Concise)

  23. Assessment • Four clinical scenarios were randomly given to a group of 19 cardiology fellows using actual cases of ACHD. • Fellows developed 68 clinical questions based on review of the cases. • Fellows were asked to use Google and CardioCompass to locate answers to questions.

  24. Assessment • For questions where users were able to find answers with both tools, they were asked to rank answers based on completeness, conciseness, and relevance. • Responses regarding their preferred tool were captured using a Likert scale (1=Strongly prefer standard, 2=Prefer standard, 3=Neutral, 4=Prefer semantic; 5=Strongly prefer semantic).

  25. Assessment Results – Site Preference

  26. Assessment Results – Completeness

  27. Assessment Results – Relevance

  28. Application in the real world • Use a computer or mobile device to ask a clinical question • Most relevant resources returned and highlighted for review • Optimal memory performance occurs when relevant information is available at the point-of-need. (Yerkes-Dodson law) • Integrate the searching into a continual learning and certification process (MOC)

  29. Maintenance of Certification

  30. Maintenance of Certification

  31. Enhanced / POC Search - Vision • Provide Point of Care (POC) tools through CardioSource • Semantic search (ask a question) • Find specific answer within trusted clinical documents • Opportunities for MOC • Provide broader search of entire cardiovascular body of knowledge Annual Meeting 2012

  32. Enhanced / POC Search – Current Status • Phase I: Replace Current CardioSource.org search engine • Requirements Completed: March 2011 • Development Completed: April 2011 • Testing Completed May 2011 • Implementation: June 2011 • Phase II: POC Search (CardioCompass) • Requirements: In Progress • Development Complete: August 2011 • Testing Complete: September 2011 • POC Advisory Group Feedback • Implementation: Q4, 2011 • Phase III: POC Learning (Integration with Learning Portfolio) • Preliminary Target: March 2012

  33. Enhanced / POC Search – Expectations • By Annual Meeting 2012 • Enhanced general site search (available now) • Integration of CardioCompass to search trusted clinical documents • Pilot mobile version for use with iPhone, iPads, and other smart phone devices • Not included for Annual Meeting 2012 launch • MOC • Initially slated for delivery, but requires additional business processes • Need to tie in competencies and build refine process • Should be delivered in 2012

  34. The Future • Integrate Maintenance of Certification • Evaluate other clinical document and sources to incorporate into search • User feedback and sharing • Tighter work-flow integration (Mashups) • Personalization • Change notification at appropriate time • Patient context from EMR

  35. Demonstration

  36. ACC Board of Governors Business Meeting Cardiology Landscape in Canada: A Health Policy and Practice ReviewChristopher Simpson, M.D., F.A.C.C., John Mancini, M.D., F.A.C.C., Rodney Zimmermann, M.D., F.A.C.C. Sunday, September 11, 2011

  37. Why should ACC be International? (based on presentation to the ACC Board of Trustees, August 2011)Huon Gray, MD, FACCChair, ACC International CouncilJohn BournasSenior Director, International, ACC

  38. Summary of International Strategy (1) ACC will always remain, first & foremost, a US professional society and will never lose sight of the importance of the needs of its domestic membership, which represents 88% of total membership.

  39. Summary of International Strategy (2) • ACC has high prestige abroad and many want to be part of its mission • FACCs present in over 100 countries • Overseas membership growing around 6% per annum recently • Particularly from economically emerging countries

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