National Cardiometabolic Health Initiatives Laurence S Sperling M

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

Introducing the Cardio. Metabolic Health Alliance The Cardio. Metabolic 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 Professional Membership The Forum patient records that define disease prevalence, costs and outcomes at the zip code level • ACC’s NCDR patient records that define clinical cardiac outcomes • 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

CMHA Began with a Registry Data Participants find QI Opportunities through Registries üComparison of practice and physician-level data to national benchmarks üMeasureable adherence to established clinical guidelines and performance measures üCreation of registry-driven quality improvement programs

ACC’s National Cardiovascular Data Registry NCDR: A Generation of Quality The premiere source of clinical outcomes data The NCDR® is the most comprehensive, outcomesbased 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. 4

GAP Analysis of PINNACLE Data Suggested…

Prevalence of Obesity in U. S. Adults 1991 1996 2008 Percentage of State Obese (BMI > 30) No Data <10% CDC Overweight and Obesity 10– 14% 15– 19% 20– 24% 25 -29% >30% 6

Four Core Goals Operationalize Our 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 refer and/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.

Science and Quality Improvement § Link Cath. PCI Registry and PINNACLE Registry data with NMQF’s National Health Index Findings 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 Community—launched Oct. 10, 2013 § Cardiometabolic Toolkit—to launch 2014 § Cardiometabolic Think Tank— June 20, 2014 at Heart House

Cardiometabolic Toolkit Online toolkit helping clinician assess and manage cardiometabolic risk in cardiology practices

Cardiometabolic Toolkit - Development

ACC and INTERVENT: The Partnership 14

Cardio. Smart @Work: How We Help 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) 15

ACC and INTERVENT: The Partnership • Doctors are enthusiastic about prevention. However, they often don’t have the time, resources or infrastructure for the provision of certain preventive services (especially lifestyle management). • Cardio. Smart On. Call 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. 16

Cardio. Smart On. Call: Mobile Patient Referral and Tracking App 17

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, endocrinology or diabetes, and primary care • Full care team representatives such as advanced practice nurses, physician assistants and diabetic educators • Broad range of stakeholders to sit in on proceedings

Additional Resources § Cardio. Metabolic Health Alliance Website www. cardiometaboliccha. org § Cardio. Smart Website www. cardiosmart. org § Cardiometabolic Disease Clinical Community hhttp: //www. cardiometabolic. cardiosource. org/ § Current ACC Toolkits can be found at http: //www. cardiosource. org/Science-And. Quality/Clinical-Tools. aspx

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