The International SHAPE Accreditation and Early Detection Program Report

Transcription

1 The International SHAPE Accreditation and Early Detection Program Report Jeffrey Fine MS, PhD

2 Introduction The implementation of a guideline based early detection program using coronary calcium scoring is essential to heart attack eradication as well as the overall clinical and economic success of your CT department and Cardiovascular Service line. The majority of hospitals, imaging centers, and practices use direct to consumer marketing to attract patients and report that their calcium scoring patient volumes remain very low. The SHAPE Accreditation and Early Detection Program utilizes comprehensive and validated training materials based upon clinical and scientific recommendations from the leading medical societies around the globe. These education and training components, delivered by well trained team members, educate the referring physician community, at risk patients, and self-insured employers to increase appropriate patient referrals and improve patient outcomes. This clinical approach within the medical community is a more scientific and collaborative approach to early detection efforts. The International SHAPE Accreditation is awarded to medical providers having goals of improving the identification of appropriately indicated patients for testing, developing a clinical partnership with their referring physicians, and maintaining the highest calcium scoring program standards including ongoing data collection and analysis. These attributes, coupled with the SHAPE Early Detection Program, serve to differentiate these sites as superior local and regional heart attack prevention providers. Methodology The SHAPE Early Detection Program and International Accreditation has been implemented at 33 medical facilities (25 hospitals, 4 practices/clinics, 4 imaging centers) in 7 different countries between January 2012 and June The SHAPE Patient Appropriateness Criteria along with multiple societal statements identify an appropriate calcium scoring patient population as; asymptomatic individuals, without known heart disease, males 45 and older, females 55 and older, and classified as intermediate risk on traditional risk algorithms such as Framingham or SCORE. The average reimbursement for a coronary calcium score test at SHAPE sites was $ during the measured period. The average additional CV Services revenue (CAD related reimbursements within 90 days post CAC score test) was $382 per patient.

3 Program Patient Volumes Coronary calcium score patient volumes generally increased over time as new sites became Accredited and additional training efforts and educational strategies were completed at each site and their program matured. Patient encounters via SHAPE Early Detection Program: n = 82,214

4 Patient Demographic Data Age: U = /- 13 Range (22-84) Patient Age Frequency Distribution: years 2% years 6% years 21% years 36% years 27% >70 years 8% Patient Gender:

5 Patient Ethnic Background:

6 Clinical Background of Calcium Score Patients CAD Symptom Prevalence:

7 Known CAD: Risk Factor Prevalence:

8 SHAPE Program Coronary Calcium Score Outcomes N = 82,214 Calcium Score Risk Category Frequency Patients 0 Low Risk 41% 33, Moderate Risk 34% 28, High Risk 12% 9,568 >400 Very High Risk 13% 10,722 Calcium Score Results over 1000 N = 2,801

9 Calcium Score Outcomes by Country

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13 Calcium Score Patient Referral Sources

14 Calcium Score Patient Payment Methods Radiation Dose Data Calcium Scoring Radiation Exposure for SHAPE Program Sites:

15 Economic Performance Data Mean reimbursement for coronary calcium scoring procedure: $129

16 Mean Additional CV Services Revenue from calcium scoring patients: $382 Additional CAD related procedure revenue within 90 days of the coronary calcium scoring test.

17 Summary An analysis of hospitals and practices using direct to consumer marketing or internal referral building efforts to increase calcium scoring patients suggests that significant growth is attainable to strengthen the CT program, and the Preventive Cardiology, Imaging, and Cardiovascular Services units. Growth including new patient encounters, increased patient referrals, revenue enhancement (direct and post calcium scoring services), and community involvement via employer participation are suggested. The goals and components of the SHAPE Early Detection program with International Accreditation provide for substantial overall growth of the coronary calcium scoring program resulting in an increased appropriate patient base and improved economic performance for both the CT department and hospital or practice as a whole. It is projected that SHAPE Accredited providers have the potential to increase coronary calcium scoring patients to 8 per day on average. This benchmark has been attained following program implementation at 33 SHAPE Accredited sites in seven (7) countries to date. Patients referred for calcium scoring at SHAPE Accredited sites were consistent with published appropriateness criteria indicating that the referring physicians are selecting guideline indicated patients for testing. The SHAPE Accredited Early Detection program has identified 48,553 individuals with asymptomatic coronary artery disease between Another 33,661 individuals were re-categorized as low risk for a cardiac event as the result of a 0 calcium score. 10,722 asymptomatic individuals were found to be at very high risk for a coronary event based upon a calcium score greater than 400. These subjects were at substantial risk for a heart attack or sudden cardiac death and have now been treated before the onset of an acute event. Finally, 2,801 asymptomatic individuals were identified having coronary calcium scores over 1000 between , as a result of the SHAPE Early Detection Program. Many of these patients went on for surgical intervention to reduce the imminent risk of a major cardiac event.