CardioExchange Archive

Several Cardiology Fellows who are attending ACC.13 in San Francisco this week are blogging for CardioExchange. The Fellows include Tariq Ahmad, Megan Coylewright, Jeremiah Depta, Kumar Dharmarajan,  Payal Kohli, and  Sandeep Mangalmurti. View the previous post here and the next one here.

In the FIT Forum ‘Outside the Box Cardiology’ session, a series of talks focused on lateral thinking related to training, innovation, and clinical practice.

Social media for cardiologists? Robert Harrington started the session by talking about social media and its uses in clinical practice and research. The message was clear — patients are clamoring for interactions with physicians through forums, blogs, Twitter, Facebook, etc., which all provide a unique opportunity to engage in meaningful dialogue with our patients. Social media can also be used to recruit patients into studies and might even become an avenue to coordinate follow-up and tracking in a clinical trial . Still, social media would need to be carefully handled to avoid introducing bias into the trial (e.g., discovery of treatment arm, placebo effect, or safety monitoring). Nevertheless, I think each practicing physician, should make efforts to incorporate social media as a routine part of clinical practice.

How can you take an idea from design to market? Paul Yock presented interesting examples from Stanford’s  unique Biodesign fellowship, which brings clinicians together with engineers, scientists, and others to design novel solutions for the clinical needs in medicine. A group of Biodesign fellows spend time in the clinical arena and must create a list of 200 “needs” in medicine based on their observations. The needs are narrowed down; a minimum of three solutions are designed for the clinical need, and then the winning solution is created, modified, patented, and brought to market. This Biodesign paradigm represents a fantastic model for innovation because it organizes a group of like-minded individuals from diverse fields to work systematically to design solutions to common problems.

What is the potential role for the cardiology intensivist? David Morrow shared his sign-out list from the CICU at Brigham, which was quite reminiscent to my own experience in the CCU during fellowship. Most patients on his sign-out list had a cardiac history but were in the CICU for non-cardiovascular complaints that are typically seen in the MICU. After hearing his discussion, I understood that we must fill the educational void and be able to handle the complexities of managing patients who are critically ill regardless of the reason for admission to the CICU. Dr. Morrow was the first author on a recent AHA scientific statement published in Circulation on this topic. The current options for further training are to complete an additional year of critical care training (i.e., traditional 1-year fellowship) or to complete a dedicated critical care cardiology fellowship. Regardless of the pathway, the training period would be 48 months total. Brigham is currently piloting a dedicated critical care cardiology fellowship.

What sorts of  unique approaches to clinical practice and research have you thought about?

For more of our ACC.13 coverage of late-breaking clinical trials, interviews with the authors of the most important research, and blogs from our fellows on the most interesting presentations at the meeting, check out our Coverage Headquarters.