Celebrating Milestones, Preparing for the Future

One year ago, the American College of Cardiology (ACC) was entering the final year of one Strategic Plan while putting the finishing touches on the next; interviewing for a new chief executive officer; and preparing for a milestone 70th anniversary. This time of transition and approaching celebration was a perfect opportunity to reflect on the College’s fundamental strengths, while also taking stock of the challenges—new and old—keeping our members, health systems, and patients awake at night. Even more importantly, it was time to clearly define a path forward as we look to commemorate three quarters of a century of transforming cardiovascular care and improving heart health in 2023.

What did we learn as part of our reflection? First, the foundation built by the ACC’s early leaders has not only withstood the tests of time, but also allowed us to expand and grow to meet the changing needs of the cardiovascular work force over the last 7 decades. With more than 53,000 members around the globe, the College is truly the professional home for men and women spanning the entire cardiovascular care team who are seeking education and knowledge-sharing opportunities to improve the lives of patients living with or at risk of heart disease.

The ACC is always innovating and always learning—growing our educational tools and programs to meet the changing needs and learning styles of members everywhere. From clinical guidelines, to appropriate use criteria, to the more recent expert consensus decision pathways, putting science into practice and helping physicians and other cardiovascular clinicians navigate those areas where evidence is new or lacking continues to be a fundamental priority. Long considered a top member benefit, the ACC’s JACC Journals not only continue to rank among the top cardiovascular journals in the world, they too are growing with international issues, as well as 2 new online journals debuting this year. On the advocacy front, the College continues to serve as the voice of cardiology at the state, national, and international levels; helping to shape health policy and improve patient access to quality, cost-effective, and appropriate cardiovascular care. The 2018 Legislative Conference was the largest ever, bringing together many cardiovascular clinicians, as well as subspecialty partners, to Capitol Hill to effect change.

Despite these strengths, ACC members continue to face myriad challenges: from an increasing number of administrative burdens, including continuing education and maintenance of certification requirements and electronic health records, to changing federal and state reimbursement programs, prior authorization, and more. Physician burnout and an aging workforce with a limited pipeline of new cardiovascular clinicians who are not as diverse in race, sex, and ethnicity as the patients they serve pose their own set of challenges. The next generation of physicians and cardiovascular care team members are asking for leadership and mentoring training, as well as guidance on how to best engage in complex environments. Investment here is sorely needed.

Hospitals and health systems, which now employ a large majority of ACC members, are also struggling with data collection and quality improvement requirements; an increased focus on the value equation of improving outcomes and lowering costs; and finding ways to engage the physician leaders they now employ. Last, but certainly not least, our patients are not immune to the changing health care landscape. Access to care, appropriate drugs, and treatments are often limited by prior authorization requirements, while access to a literal worldwide web of information—real and fake—can be overwhelming and even harmful. Our patients desire to share in decision-making with their clinicians, who are often buried in endless computer work.

So, how do we harness our strengths and overcome these challenges? By engaging together and moving quickly. Over the last 3 years, the College and its leaders have looked inward and transformed our governance structure to be smaller, nimble, more efficient, and more strategic. More recently, the ACC welcomed its dynamic new chief executive officer, Timothy Attebery, DSc, MBA, FACHE, who understands nearly every aspect of the changing cardiovascular landscape and is already helping to move the College forward. Our next 5-year Strategic Plan, drafted collaboratively by hundreds of volunteer members—and ultimately culminating with ACC’s 75th anniversary—is a critical vehicle powering the College into the future. This new plan sets the College on an ambitious, but achievable, path that builds on the legacy of ACC’s founders to create a place where cardiovascular professionals—no matter where they live and work—can find the tools and resources necessary to achieve a vision of a world where innovation and knowledge optimize cardiovascular care and outcomes.

So, what can you expect in the next year and beyond? First, you can count on the ACC to provide continued recognition that we are truly one world, and that our mission has no borders. As such, a global approach to transforming cardiovascular care and improving heart health is needed. As my time as president comes to a close, I am excited about the comprehensive international strategy that the Board of Trustees recently approved to move forward that will allow us to make real progress in improving global health. From National Cardiovascular Data registries in India and Africa, to localized education and training in Asia, Latin America, and the Middle East, to programs focused on identifying and fostering new global leaders and ST-segment elevation myocardial infarction care, and to ongoing work to combat the epidemic of noncommunicable diseases, we are already making a difference.

On a more granular and local level, look for the ACC to focus on several activities that will build upon our core strengths of education and science. Education is truly thriving. The ACC’s Annual Scientific Session in New Orleans, Louisiana, with its interactive sessions, greater integration of diverse perspectives, increased use of social media, and live streaming to drive engagement and discussion within—and outside of—the Convention Center walls, was a great example. Innovation, technology, and many tremendous trials that will change guidelines and practice led the way. Add to that a growing number of focused, year-round educational activities targeted at regions, countries, cardiovascular interest, and/or specific roles on the cardiovascular care team, many of which are in concert with our cardiovascular society partners. We are living our new core values of collaboration and teamwork.

Earlier this year the College announced the launch of 3 brand-new self-assessment programs: Adult Clinical Cardiology Self-Assessment Program (SAP); CathSAP, developed in collaboration with the Society for Cardiovascular Angiography and Interventions; and EP SAP, developed in collaboration with the Heart Rhythm Society. All 3 products have moved to a continuous update model, with new science and guidelines added yearly. Plus, each product includes learning material and practice questions that offer continuing medical education (CME) credit, and Maintenance of Certification Medical Knowledge points. The ACC and the American Board of Internal Medicine have announced a new Collaborative Maintenance Pathway (CMP) option that will allow cardiologists to use versions of these newly updated SAPS as an alternative to the traditional 10-year recertification examination.

Beyond products and meetings, the College is also looking closely at how best to optimize clinical guidelines, appropriate use criteria, and expert consensus clinical pathway documents. Among the considerations: digital transformation, integration of patient voice, speed of updates, streamlined incorporation of focused recommendations at point-of-care, tools and resources that can enable shared decision-making discussions with patients, and more. In addition, we are boldly forging ahead in areas necessary to further transform cardiovascular care. What will our members of the future look like? What tools and information will then need to thrive professionally, while also taking the best care of patients? Look for enhanced mentoring opportunities using the College’s new Member Hub, as well as educational tools and resources to reduce clinician burnout and improve professional well-being and member engagement. We will strive to place these resources in your hands with better communication.

Look to the ACC to continue to find new, streamlined, and innovative solutions to help clinicians, hospitals, health systems, and institutions improve quality and value. The College, through its Innovation Pipeline led by Chief Innovation Officer John Rumsfeld, MD, FACC, is working closely with health care startups and engaging in discussions with tech companies on truly transformative algorithms and technologies. ACC leaders and staff are also hard at work to identify tools that will help members address administrative burdens and improve individual and system quality. MedAxiom, ACC’s newly acquired company, offers a whole new suite of options to engage clinicians, administrative leaders, clinical leaders, and others in driving quality and process improvement within their respective practice setting. We are thrilled to partner with MedAxiom and believe they will fill an increasingly important need for ACC members, hospitals, and health systems everywhere. We will drive health care innovation and critical knowledge in the nonclinical competencies forward, together.

How can ACC members engage with the College along the path to 75? The possibilities are truly endless. The ACC exists because of you, our members—no matter where you live and work. The College is always patient-centered but member-focused and -driven. The only way to truly optimize cardiovascular care and outcomes is to do so together. We are strong and vibrant, but we will be even stronger in the future with your help. Five years from now—on our 75th anniversary—I hope we can come together to share in the joy of a job well done and look to a future that is even brighter than we had dared to hope. Thank you for the honor and opportunity to serve.

• 2019 American College of Cardiology Foundation