Heart failure (HF) affects more than 26 million people across the globe, and the incidence is growing as the population ages. In addition, acute decompensated heart failure (ADHF), new or worsening HF symptoms, is the most common cause of hospitalization in both the U.S. and Europe. Although new guideline-directed medical and device therapies have improved both HF survival and symptoms in recent years, comprehensive, optimal management relies upon coordination and communication amongst multiple cardiovascular sub-specialists as well as primary and ancillary providers. Despite this need, HF care too often remains fragmented and episodic, leading to suboptimal patient outcomes.
AdventHealth cardiovascular and transplant surgeon Scott Silvestry, MD, specializes in caring for heart failure patients and helped lead a research study to better understand and address this concern. He worked in partnership with colleagues from other tertiary health centers across the U.S., including St. Vincent Heart Center, The Mount Sinai Hospital, Hospital of the University of Pennsylvania, Columbia University Irving Medical Center, Kansas University Medical Center, University of North Carolina Health Center, Tufts Medical Center, and Cleveland Clinic. Their findings corroborated the need to improve intra-disciplinary coordination in the treatment of advanced cardiovascular disease patients.
This research team suggests a paradigm shift from a linear model to one that allows both lateral and vertical movement. Their proposed new model encourages communication, collaboration and ownership of patients to flow freely from primary cardiology providers to subspecialists and back. It also calls for improved integration amongst primary care, general cardiology, electrophysiology, interventional cardiology, cardiothoracic surgery, cardiac imaging, and heart failure providers when caring for mutual patients. The researchers organized this new model into two different phases: cardiomyopathy and advanced heart failure, and the ultimate goal is to reduce variability and ensure HF patients consistently receive evidence-based, cost-effective, coordinated care at the right time by the right providers.
View the full article here: A manifesto of collaborative longitudinal cardiovascular care in heart failure (springer.com)