GWTG HF Study finds overall referral rates for patients eligible for cardiac rehab is only 25% and participation is <5%. Referral rates have risen since 2014 with the expansion of coverage but opportunity still exists. #GWTGResearch https://t.co/M6BHVi8cYX

Cardiac rehabilitation for HF referral rates have increased from 2010 to 2020 Among eligible patients who received CR referral, participation was low, with <1 of 20 participating in CR. An Analysis From the GWTG-HF Registry | Circulation: Heart Failure

Fantastic UTSW CardioMetabolic Research Unit dinner yesterday evening at AHA! @ambarish4786 @thomasjwang1

GWTG-HF data finds HFrEF patient care remained high during the COVID-19 pandemic, but pts. with both HF and COVID-19 patients had higher risk of in-hospital mortality and LOS than pre-pandemic times. @neilkeshvani @ambarish4786 @gcfmd #GWTGResearch https://t.co/Zi7pSKqFFE

Research from @UTSWNews about a different way hospitals should be evaluated, with more focus on the patient.

Southern migration of @IUMedSchool alumni continues! @UTSWNews

An accompanying commentary discusses possible system-level interventions to reduce shocks in end-of-life situations @JAMAInternalMed

Many patients with ICDs who elect for DNR status do not have their preferences regarding their ICD addressed, and shocks at end-of-life can cause pain and suffering

Our piece published @JAMAInternalMed advocates for considering a patient’s ICD status in discussions regarding end-of-life care with current @UTSWIMchief IM residents @S_A_Kelly and @RyanKabirMD @UTSWCardfellow

Our findings in @CircAHA highlighting home time in MI:

Overall 30-day Home Time reclassifies ~30% of hospitals in performance as compared to 30-day readmission and should be considered as a hospital-level performance measure @CMSGov

The home time metric is patient-centered and describes the amount of time a patient spends at home and outside of a hospital or healthcare facility and correlates with 30-day readmission and mortality

Our study highlighting 30-day home time as a quality metric in heart failure was published @JAMACardio. This study builds on our work @CircAHA highlighting home time as a metric in MI care w/ @ambarish4786 @saketgirotra https://t.co/yjo7mIViCA

One of the most rewarding aspects of my two weeks as a @UTSWCardfellow has been the ability to prescribe #GDMT like #ARNI #SGLT2i to the most vulnerable patients @Parkland without difficulty. Quality of care should not depend on ability to pay out of pocket costs

Link to the full paper: https://t.co/72rQNjT5lw @thomasjwang1 @dhjutsw1 @guptaarjun90 @DinoKazi @UTSWCardfellow @GailPetersonMD @josephahill

Our hope is that the home time metric may lead to greater scrutiny into utilization of post-acute care facilities by discharging hospitals and encourage preferential use of home-health care as well as higher performing post-acute care facilities.

While no metric can be absolutely "gaming"-proof, we hope that the comprehensive nature of the home time metric would make it more sensitive to approaches which adversely effect patient care.

However, intentional withholding of indicated post-acute care may contribute to excess readmission and/or mortality events, which would adversely affect hospital performance based on the home time metric and speaks to the value of a composite metric for hospital performance

As an unintended consequence, It is plausible that utilization of home time may disincentive use of SNF and LTACs in patients who are frail and require these services in the post discharge period.

These observations highlight the need for a more shared approach to value-based care and associated financial incentives such that both discharging hospitals and the post-acute care facilities are held accountable for 30-day patient outcomes