Volume IX | Issue 10 | October 2017
THE HCI SPOTLIGHT
HCI's Monthly Review of the Healthcare Industry
 Robert J. Stilley
President, CEO
HeartCare Imaging, Inc. 
A Message from the CEO
Dear Colleague-

The end is near! OK, I'm really only talking about the year. Every year around Halloween I realize that the year will be over before I know it. Multiple holidays combined with end of year business activities seem to make the days fly by. But, while the end is near, so is the beginning...of a new year. This is a great time to reflect on the good and the bad of the past year while putting in place the plan to make 2018 the best year ever. At HCI, we will be focusing on a strong finish to what has been an incredible year while reviewing what we can improve to make 2018 even better. This includes working with our partners/clients to review what we can do to continue improving patient care, financial success, and the stability of the projects we are mutually working on. Internally, expect to see more products and services from HCI as we expand our rural healthcare and cardiology imaging services.

We invite you to contact us if we can be of any assistance in your review and planning process.

Best Regards,
Cardiology
Traumatic Experiences May Raise Women's Heart Disease Risk
Experiencing a high number of traumatic events could increase a woman's risk of developing heart disease, especially after menopause, a new study suggests.

Prior Nonfatal CV Event Increases Mortality Risk in Diabetes
Adults with type 2 diabetes and atherosclerotic cardiovascular disease have an increased risk for mortality if they have experienced a prior nonfatal CV event, according to findings published in Diabetes Care

Non-Vitamin K Oral Anticoagulants with Other Medications Increase Bleeding Risk in A-Fib
Nonvalvular atrial fibrillation (AF) patients who take non-vitamin K oral anticoagulants (NOACs) along with certain other medications are at increased risk for major bleeding, and antithrombotic medications are significantly associated with increased rates of hematuria-related complications in older adults, according to two studies published online Oct. 3 in the Journal of the American Medical Association.

Parents, Take Note: Eating Greens Can Improve Your Teenage Child's Heart Health
New research has revealed another reason for kids to eat their greens, with a US study finding that those who eat a diet with a sufficient amount of vitamin K, found in vegetables, have a healthier heart structure and function than those who are lacking in the nutrient.

Coronary Artery Calcium Progression May Increase Risk for CVD Event
Progression of coronary artery calcium was associated with a composite CVD event in asymptomatic individuals, according to findings published in the Journal of the American Board of Family Medicine.

ASNC Imaging Guidelines for Nuclear Cardiology Procedures
As was noted in the prior document, ASNC continues to support the mandatory use of structured reporting as a mechanism to improve the communication and reporting of nuclear cardiology reports. This has begun to be incorporated into the laboratory accreditation process, and there has been significant improvement over the course of eight years. There remain significant areas for improvement, particularly with regards to defect size and severity, and consistent reporting of these important variables.16 This guideline is designed to provide imaging physicians and technologists the necessary information to report nuclear cardiology procedures in a structured format using standardized data elements. While the content of the document has been carefully reviewed by many experts, the document should not be considered as a source of medical advice or professional service.

Even a Little Exercise Helps Those with Heart Disease
A little exercise can go a long way toward a healthier life, even for patients with serious heart disease, according to a new study published in the Journal of the American College of Cardiology.

Take Charge of Your Heart Health
When it comes to preventing and treating heart disease, you have more control than you might think

Imaging Crucial to Cardio-Oncology Strategy
Imaging is an important component of preventing HF in patients with cancer, especially in patients treated with therapies known to cause left ventricular dysfunction, the president of the American College of Cardiology said at the American Society of Nuclear Cardiology Annual Meeting

Stopping Aspirin Tied to Quick Rise in Heart Attach, Stroke Risk
People who stop following their doctor's advice to take a daily aspirin may see their risk of heart attack and stroke quickly rise, a new study suggests.

AHA/ACC Issue New Performance, Quality Measures for MI
For the first time in nearly a decade, the American College of Cardiology (ACC) and American Heart Association (AHA) have released a new set of performance and quality measures for ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI)

Americans are Self-Monitoring Blood Pressure More Often--If They're Married
More Americans are monitoring their blood pressure at home, according to new research presented at the American Heart Association’s Scientific Sessions, but those more likely to do so have partners and college degrees.

Cardiovascular Risk in Urban Food Deserts Linked to Income, not Food Access
Americans who live in poorer, urban areas and those who have less income are least likely to consume healthy food, regardless of their access to it, according to a study published in the American Heart Association’s journal Circulation.

'Food as Medicine' Feasible in Pilot Heart-Failure Trial
A small randomized study intrigued observers here at the Heart Failure Society of America 2017 Scientific Meeting, even if it was mostly a wash for its primary end point, health-related quality-of-life scores in patients discharged after a heart-failure hospitalization. But the intervention, regular home delivery of specially prepared, low-sodium, high-potassium meals for a month, seemed in the greatly underpowered trial to improve a composite score for symptoms and physical limitation and reduce both the risk of rehospitalization and number of hospitalization days.

High BP Reasons DIffer by Sex in Young Adults
The factors that drive high BP differ among men and woman aged 36 to 65 years, suggesting a need for sex-specific treatments, according to findings presented at the American Heart Association Council on Hypertension, AHA Council on Kidney in Cardiovascular Disease, American Society of Hypertension Joint Scientific Sessions

Health
CDC: Nearly 40% of American Adults have Obesity
The steady increase in obesity prevalence is likely due to several factors, Isaacs said, including an increase in highly-palatable unhealthy foods, an increasingly sedentary lifestyle, disrupted sleep patterns and environmental endocrine disrupters, such as BPA.

Ibuprofen Better than Morphine for Kids After Minor Surgery
The study, published today in the Canadian Medical Association Journal, found the two drugs had similar efficacy for pain but ibuprofen had fewer adverse effects than morphine.

Circadian Gene Linked to Severe Epilepsy in Children
Loss of the CLOCK protein, which researchers find is decreased in pediatric epilepsy patients, makes mice more prone to seizures during sleep.

Researchers Identify Genetic Drivers of Common Form of Lymphoma
A recent study by the Duke Cancer Institute helps identify genetic drivers for the most common form of lymphoma, the most common blood cancer.

Being Unaware of Memory Loss Tied to Greater Risk of Alzheimer's
A new Canadian study published in the  Journal of Clinical Psychiatry shows that people who are aware of their memory problems are actually less likely to develop dementia or Alzheimer’s disease. On the other hand, individuals who are unaware of their memory loss, a condition known as anosognosia, are more likely to develop Alzheimer’s.

Promising New Prostate Cancer Test Developed
Known as 68Ga-THP-PSMA, the new tracer, which was developed with support from the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, can be made very quickly and easily in a radio-pharmacy, meaning that smaller hospitals and clinics can produce it. It is hoped that this will mean more patients will have access to high-quality 

Propranolol Use Inversely Linked to Melanoma Recurrence
For patients with melanoma, use of propranolol is associated with reduced risk of recurrence, according to a study published online Sept. 28 in JAMA Oncology.

Obesity-related Cancers Rising, Threatening Gains in U.S. Cancer Rates
The rates of 12 obesity-related cancers rose by 7 percent from 2005 to 2014, an increase that is threatening to reverse progress in reducing the rate of cancer in the United States, U.S. health officials said on Tuesday.

Study Reveals Novel PET Tracer Identifies Most Bacterial Infections
The results of this pre-clinical study demonstrate that 6″-18F-fluoromaltotriose is a promising new tracer for diagnosing most bacterial infections and has the potential to change the clinical management of patients suffering from infectious diseases of bacterial origin. 

U.S. Pays Hefty Price for Obesity
A U.S. adult who is "healthy" but obese could eventually cost society tens of thousands of dollars in medical care and lost wages, a new study estimates.

Giant Cell Arteritis Diagnosis in Glucocorticoid-Treated Patients: Utility of PET/CT
The utility of positron emission tomography (PET) and computerized tomography (CT) imaging to complement temporal artery biopsy (TAB) in patients with newly diagnosed giant cell arteritis (GCA) who are receiving glucocorticoid therapy remains equivocal, according to the results of a recent prospective Canadian study published in The Journal of Rheumatology.

Business
MGMA: Physician Practices Must Evaluate Risk Before Moving to Value-based Care
Value-based care models are here to stay. But how aggressively a physician practice should pursue these arrangements depends on how much risk the practice wants to assume, according to Michael Cuffe, MD, president and chief executive officer, physician services at HCA Physician Services Group in Brentwood, Tennessee.

SNFs Seek Relief from Three-Day Hospital Stay Requirement
Critics call the three-day inpatient stay requirement for patients to qualify for Medicare coverage at a skilled nursing facility archaic, irrelevant, and a threat to patient safety.

Few U.S. Hospitals can Fully Share Electronic Medical Records
Less than one in three U.S. hospitals can find, send, and receive electronic medical records for patients who receive care somewhere else, a new study suggests.

Extra Attention to High Risk Patients Saves Money, Improves Outcomes
A physician network in California is addressing one of the biggest challenges in the healthcare community, high utilization that blows up budgets and cost projections, with a program that uses home visits to improve outcomes following hospitalization.

Politics that Affect Medicine
Trump Eases Obamacare Rules with Executive Order
President Trump on Thursday signed an executive order aimed at taking action on ObamaCare on his own after Congress failed to repeal the law.

Bundled-payment Joint Replacement Programs Winning Over Surgeons
In a study published in February in JAMA Internal Medicine, Navathe and his co-authors found that voluntary Medicare bundled-payment programs for joint replacements at Baptist Health System in San Antonio resulted in a 21% drop in average Medicare episode spending between 2008 and 2015. Readmissions, emergency department visits, and cases with prolonged lengths of stay all declined significantly.

Rep. Cummings to Trump: It's Time to Force Lower Prices on Biogen's New MS Drug Zinbryta
After kicking off a probe into multiple sclerosis drug prices last month, Rep. Elijah Cummings, D-Md., is asking the U.S. government for quick relief on one drug in particular. That's Biogen's Zinbryta, and Cummings said Americans shouldn't be forced to pay so much for a product they helped develop

FDA Aims to Speed Up Arrival of Complex Generic Drugs
The U.S. Food and Drug Administration on Monday announced a series of measures designed to speed to market generic versions of complex drugs such as Mylan NV’s emergency EpiPen in an effort to address the rising cost of pharmaceuticals.

Rare Bipartisanship as Senate Passes Medicare Reform Bill
The Senate unanimously approved a bill to give Medicare providers ― including accountable care organizations, Medicare Advantage plans, and clinicians ― more flexibility by delivering care at home or using telehealth or team-based care to manage beneficiaries' chronic conditions.

CMS Agrees with Complaints about MACRA
A top CMS official agrees with a congressional advisory panel that MACRA's payment model should focus more on outcomes and less on performance and says the agency will seek input from providers on changing the measurements.

Education/Conferences
Explore. Invent. Transform. The theme of RSNA 2017 invites attendees to investigate and advance radiology through innovation as a means of creating positive impact on patient care. It's a strong message with big implications--and radiology's most influential forum is the ideal place to share it.
For over 25 years, HRSI has provided Authorized User (AU) classroom and laboratory training to physicians. HRSI's training is recognized by the U.S. Nuclear Regulatory Commission (NRC) and fulfills the didactic training required by law.
Join top practitioners and thinkers to share strategies and resources for accelerating the shift to a more integrated, high performing, and sustainable rural health care system. We hope you'll join us in Phoenix.
Annual Rural Health Conference May 8-11, 2018 in New Orleans, LA. New Orleans Marriott Hotel.
HeartCare Imaging, Inc. | Phone: 561-746-6125 | Fax: 561-741-2036 | info@heartcareimaging.com