News | May 29, 2014

Two ACC Chapters Awarded Grants to Boost Clinical Decision Support

Collaborative tools reduce costs while engaging patients

May 29, 2014 — A federal grant will support a pilot project designed by two chapters of the American College of Cardiology to reduce health care costs by providing tools to help doctors and patients communicate about options for their care while helping physicians apply the latest guidelines to the decision-making process.

The $15.8 million grant from the Center for Medicare and Medicaid Innovation will support the development of SMARTCare pilot projects in Wisconsin and Florida. SMARTCare brings together five tools to help physicians and patients work collaboratively to make decisions about the treatment of stable ischemic heart disease. The tools also provide performance benchmarking and immediate feedback to physicians to ensure appropriate use guidelines are considered.

“We believe involving patients in an evidence-based decision-making process is the best way to improve outcomes while providing the highest value for the health care dollar,” said American College of Cardiology President Patrick T. O’Gara, M.D., FACC. “This grant will give us an opportunity to demonstrate how data from clinical registries can be leveraged to enhance physician/patient communication.”

The SMARTCare program was developed by doctors from the Wisconsin and Florida Chapters of the ACC along with health care professionals from health systems, employer health coalitions, insurers, patient advisors, payment reform advisors and primary care that believe that appropriate use of data can improve quality of care while also containing rising health costs.

“The overarching goals of SMARTCare are to increase the percentage of stable ischemic heart disease patients with optimal risk factor modification and to reduce imaging procedures and percutaneous coronary interventions not meeting appropriate use criteria while achieving high levels of patient engagement and lower rates of complications,” said Thomas Lewandowski, M.D., FACC, SMARTCare project director and immediate past governor of the ACC’s Wisconsin Chapter. “These are big goals, but we have the right people at the table to make them a reality.”

The SMARTCare program has potential to save hundreds of millions of dollars annually while improving the decision-making process to benefit patients. SMARTCare is focused on the treatment of coronary artery disease, but it is a model that could be applied across medicine and across the country.

“This model should motivate and inspire other specialists to achieve the same standard of care for their patients,” said Tim Bartholow, M.D., chief medical officer, WEA Trust. “Physicians all over the country should be able to look to SMARTCare and apply it in their local facilities.”

CMMI grants were established to foster health care transformation by identifying and supporting innovative models that establish new ways to pay for and deliver care that improve care while lowering costs. The SMARTCare model is expected to save ten participating sites $42.2 million over the three-year pilot program.

“Our ability to utilize care patterns from separate states demonstrates how flexible and successful the program can be,” said ACC Florida Chapter Governor Juan M. Aranda Jr., M.D., FACC. “We are hopeful that someday, patients from all over the country will be able to take advantage of the tools included in the SMARTCare program.”

Tools included in the SMARTCare program:

  • Decision-support tools: FOCUS program to support imaging decisions,
  • Shared decision-making
  • Individual risk profiles: PRISM individualized patient consent for stent procedures; INDIGO individualized patient cardiac risk profile
  • Performance benchmarking: CathPCI; PINNACLE outpatient registry

For more information:


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