Cath Lab Digest talks with Bonnie H. Weiner, MD, MSEC, MBA, FSCAI, FACC Board Chair and Chief Medical Officer of ACE and Director of Interventional Cardiology Research at Saint Vincent Hospital at Worcester Medical Center, Worcester, Massachusetts.
What’s the purpose of the Accreditation for Cardiovascular Excellence (ACE) organization?
The overall purpose is to accredit facilities performing invasive cardiovascular and endovascular procedures. By doing so, we hope to set an objective, independent professional and peer-based standard for what should be occurring at those institutions, and will continue to monitor them with the goal of improving patient care.
Why create this type of organization?
There really hasn’t been any type of cath lab-specific accreditation available to facilities. If you look at medical accreditation from a larger perspective, many facilities accredit their echo labs, CT labs and a whole host of other diagnostic procedures. But, at the moment, there is nothing to accredit invasive diagnostic and therapeutic interventional procedures and procedure facilities.
The SCAI actually started discussions over 5 years ago with the Centers for Medicare & Medicaid Services (CMS) about accrediting carotid stenting facilities. Most of the professional societies involved with discussions with CMS at the time thought that facilities should be accredited to perform carotid stenting, but there was no organization available to perform those activities. CMS, because they agreed with the idea of accreditation, wrote it into the coverage decision, but then CMS itself became the default for actually performing accreditation. Their system is pretty lean and is not really based on outcomes. It does not use the currently available data and standards to actually hold facilities accountable for their outcomes.
After talking with CMS over the last 5 years, we are cautiously optimistic that the next time CMS does open the coverage decision, that ACE will be able to be acknowledged as an accrediting body. Right now, carotid stenting is the only thing mandated for facility accreditation, but we think the same type of standards should be applied to the rest of the procedures that we all do. Also, we expect that when percutaneous valve therapies become available, then it is likely that CMS will write something similar into the coverage for those procedures.