Social Media and Cardiology Walsh, Mary Norine
Journal of the American College of Cardiology,
03/2018, Volume:
71, Issue:
9
Journal Article
Peer reviewed
Open access
Harlan M. Krumholz, MD, SM, FACC Professor of Medicine (Cardiology) and Professor in the Institute for Social and Policy Studies, of Investigative Medicine and of Public Health (Health Policy); ...Co-Director, Robert Wood Johnson Foundation Clinical Scholars Program, Yale University; Director, Center for Outcomes Research and Evaluation, Yale-New Haven Hospital “Social media in general and Twitter in particular has its opportunities and challenges. Robert M. Califf, MD, MACC Professor of Medicine and Donald F. Fortin, MD, Professor of Cardiology, Duke University School of Medicine; Commissioner of Food and Drug Administration 2016-2017 “I started using Twitter a few years ago while serving as principal investigator of the National Institutes of Health Healthcare Systems Research Collaboratory Coordinating Center. ...I was not dismayed when I was told that FDA policy prohibited me from tweeting. 6 L. Sinnenberg, C.L. DiSilvestro, C. Mancheno, Twitter as a potential data source for cardiovascular disease research, JAMA Cardiol, Vol. 1, 2016, 1032-1036 7 R. Al-Lamee, D. Thompson, H.R. Dehbi, Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial, Lancet, Vol. 391, 2018, 31-40 8 #ACC17 Conference hashtag.
Cardiology remains a specialty that is dominated by men. Even though half of all medical students and over 40% of internal medicine residents are women, the number of women in the field of cardiology ...remains low. The reasons for the persistent lack of increase in cardiology trainees are not well understood and are likely multifactorial. Despite this under‐representation, women cardiologists are increasingly visible in leadership roles, including those in research science, health systems administration, professional societies, and clinical practice. This review will highlight the various leadership roles and paths taken on by prominent women in the practice of cardiovascular medicine.
...they vote with their feet. In 2015, the Medicare Access and CHIP Reauthorization Act repealed the Sustainable Growth Rate, established a framework for rewarding clinicians for value over volume, ...streamlined quality reporting programs into 1 system, and reauthorized 2 years of funding for the Children’s Health Insurance Program. 3 E. Javorsky, A. Robinson, A. Boer Kimball, Evidence-based guidelines to determine follow-up intervals: a call for action, Am J Manag Care, Vol. 20, 2014, 17-19 4 L.C. Yasaitis, J.P.W. Bynum, J.S. Skinner, Association between physician supply, local practice norms, and outpatient visit rates, Med Care, Vol. 51, 2013, 524-531 5 D. Cutler, J. Skinner, A.D. Stern, D. Wennberg, Physician beliefs and patient preferences: a new look at regional variation in health care spending, National Bureau of Economic Research working paper no. 19320, August 2013, Available at:, Accessed July 11, 2017 6 I. Ganguli, J.H. Wasfy, T.G. Ferris, JAMA, Vol. 313, 2015, 1905-1906
Cardiology Takes the Hill Walsh, Mary Norine
Journal of the American College of Cardiology,
10/2017, Volume:
70, Issue:
18
Journal Article
Peer reviewed
Open access
1361, a bill that would expand access to cardiac rehabilitation by allowing physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and ...pulmonary rehabilitation programs. ...when meeting with members of the U.S. House of Representatives, we encouraged ACC members to thank their Representatives for proposing to increase NIH funding by $1.1 billion in fiscal year 2018 and urge them to support level funding of $205 million for the Office on Smoking and Health within the CDC. Since 2015, he has been the lead Democratic cosponsor of a cardiac rehabilitation bill, strongly supported by the ACC. A certified public accountant by training, Rep. Jenkins serves on the House Ways and Means Committee and is an active member of the Subcommittee on Health. In addition to being a member of the Republican Study Committee, the Republican Main Street Partnership, and the Team Party Caucus, she is also a founder of Maggie’s List, a political action committee designed to increase the number of conservative women elected to federal public office.
Advocacy can seem daunting. Understanding the complex political process on Capitol Hill and at the state house is difficult and can be intimidating. And in our current partisan and divisive ...environment, it may be tempting to avoid all interaction with our political processes in favor of avoiding conflicts in the workplace, among friends, and even at home. But, the time is also ripe for physicians and other clinicians to make their voices heard on behalf of our patients, our hospitals, our health systems, and public health.
Cardiovascular disease (CVD) is the number 1 killer of women in the United States, yet few younger women are aware of this fact. CVD campaigns focus little attention on physicians and their roles in ...assessing risk.
In 2014, the Women's Heart Alliance (WHA) conducted a nationwide survey to determine barriers and opportunities for women and physicians with regard to CVD.
From September 18 to 26, 2014, a total of 1,011 U.S. women (age 25 to 60 years) were interviewed using the GfK ("Gesellschaft für Konsumforschung" Knowledge Panel). From May 6 to 12, 2014, the e-Rewards Inc. Physician and Healthcare Professional Panel surveyed 200 primary care physicians (PCPs) and 100 cardiologists.
Overall, 45% of women were unaware that CVD is the number 1 killer of women; only 11% knew a woman who died from CVD. Overall, 45% of women reported it was common to cancel or postpone a physician appointment until losing weight. CVD was rated as the top concern by only 39% of PCPs, after weight and breast health. Only 22% of PCPs and 42% of cardiologists (p = 0.0477) felt extremely well prepared to assess CVD risk in women, while 42% and 40% felt well-prepared (p = NS), respectively. Few comprehensively implemented guidelines.
CVD was rated as the top concern less frequently than weight issues by both women and physicians. Social stigma particularly regarding body weight appeared to be a barrier. Physicians reported limited training and use of guideline assessment, whereas most supported a campaign and improved physician education. Campaigns should make CVD "real" to U.S. women, countering stereotypes with facts and validated assessments. Both community women and physicians endorsed investment in women's CVD research and physician education.
...even as our daily lives continue to be changed by companies such as Amazon, Apple, and Google, these tech giants are still struggling to figure out healthcare. Importantly, the U.S. Food and Drug ...Administration has recently released a digital health innovation action plan, and is launching a novel pilot program to facilitate digital health product approvals (4,5). The ACC Innovation Strategy is currently focused on 6 key innovation topic areas (Figure 1): Digital health: wearables, biosensors, mobile applications, telehealth, and so on; Health analytics: big data analytics, machine learning/artificial intelligence, and so on; Precision health: advancing individualized diagnosis and treatment, utilizing “omics” and/or other novel data sources or approaches; Care delivery innovation and population health management: leveraging technology and analytics to support novel modes of care delivery or management of populations of patients, achieving more efficient care and improved health outcomes; and Health technology evidence: promoting evidence across innovation topic areas and the entire spectrum of health technology, ranging from apps to medical devices. 2 J. Noseworthy, J. Madara, D. Cosgrove, Physician burnout is a public health crisis: a message to our fellow healthcare CEOs, Health Affairs Blog, March 28, 2017, Available at:, Accessed October 11, 2017 3 C. Sinsky, L. Colligan, L. Li, M. Prgomet, S. Reynolds, L. Goeders, Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties, Ann Intern Med, Vol. 165, 2016, 753-760 4 U.S. Food and Drug Administration, Center for Devices and Radiological Health Digital Health Program.
Hypertension Across a Woman’s Life Cycle Wenger, Nanette K.; Arnold, Anita; Bairey Merz, C. Noel ...
Journal of the American College of Cardiology,
04/2018, Volume:
71, Issue:
16
Journal Article
Peer reviewed
Open access
Hypertension accounts for 1 in 5 deaths among American women, posing a greater burden for women than men, and is among their most important risk factors for death and development of cardiovascular ...and other diseases. Hypertension affects women in all phases of life, with specific characteristics relating to risk factors and management for primary prevention of hypertension in teenage and young adult women; hypertension in pregnancy; hypertension during use of oral contraceptives and assisted reproductive technologies, lactation, menopause, or hormone replacement; hypertension in elderly women; and issues of race and ethnicity. All are detailed in this review, as is information relative to women in clinical trials of hypertension and medication issues. The overarching message is that effective treatment and control of hypertension improves cardiovascular outcomes. But many knowledge gaps persist, including the contribution of hypertensive disorders of pregnancy to cardiovascular disease risk, the role of hormone replacement, blood pressure targets for elderly women, and so on.
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There is growing evidence that rural and racial disparities and social determinants of health (SDOH) impact adverse pregnancy outcomes (APOs) and overall maternal mortality in the United States. ...These APOs, such as preeclampsia, preterm birth, and intrauterine growth restriction, are in-turn associated with increased risk of future cardiovascular disease (CVD) later in life. Importantly, SDOH such as socioeconomic disadvantages, poor health literacy, transportation barriers, lack of access to adequate health care, food insecurity, and psychosocial stressors have cascading effects on APOs and downstream cardiovascular health. These SDOH are also deeply intertwined with and compounded by existing racial and rural disparities. Pregnancy thus provides a unique opportunity to identify at-risk women from a social determinants perspective, and provide early interventions to optimize long-term CVD and mitigate cardiovascular health disparities. Addressing the challenges posed by these disparities requires a multi-pronged approach and involves national, regional, and individual level solutions. Eliminating disparities will necessitate a nationwide obligation to ensure health care equity via enhanced health insurance coverage, resource investment, and public and clinician accountability.
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