Author + information
- Akshay Khandelwal, MD, FACC, Chair, ACC Board of Governors∗ (, )@KhandelwalMD,
- Daniel M. Philbin Jr., MD, FACC, Chair-Elect, ACC Board of Governors,
- Marci Farquhar-Snow, ACNP-BC, AACC, Chair, ACC CV Team State Liaisons and
- Alice Betz, Chair, Chapter Executives Steering Committee
- ↵∗Address for correspondence:
Dr. Akshay Khandelwal, American College of Cardiology, 2400 N Street NW, Washington, DC 20037.
The American College of Cardiology’s (ACC's) Strategic Plan is centered around 4 strategic goals: 1) increase relevance as the cardiovascular professional home; 2) generate and deliver actionable knowledge; 3) advance quality, equity, and value of cardiovascular care; and 4) ensure organizational growth and sustainability. If implemented as intended between now and 2023, the Strategic Plan will move the College and its members closer to the vision of “a world where innovation and knowledge optimized cardiovascular care and outcomes.”
However, truly achieving the strategic goals will not and cannot happen without tangible actions by grassroots members working together to bring about change, foster collaboration, and provide bidirectional feedback on the challenges and opportunities faced by the profession and patients. To that end, the ACC Board of Governors (BOG) and state chapters, representing all 50 U.S. states; Washington, DC; and Puerto Rico, as well as Canada and Mexico, continue to play a very important role in bringing the ACC Strategic Plan, vision, and mission to life.
Each year, the College compiles a State of the States report, which has long been an important resource for ACC leadership and state chapters as a whole, providing a playbook of best practices and serving as a key compendium of state and regional activities that occurred over the course of a year. As the ACC continues to grow and evolve, the State of the States report continues to adapt as well—making it even more valuable to College leaders, state chapters, member sections, and others looking to develop tools and initiatives tied to the Strategic Plan; to identify opportunities for collaboration; to set goals and priorities for the year ahead; and/or simply to report on what has been done to date. This year’s report outlines the many ways ACC chapters are on the front lines, delivering on ACC’s strategic goals, promoting member wellness, and advancing cardiovascular enterprise.
The 2019 State of the States report is truly a testament to the commitment of every chapter and every BOG leader to the ACC’s Strategic Plan and core values of teamwork and collaboration, professionalism and excellence, and patient-centered care. It is truly a privilege to lead the BOG at this important time in ACC history. Highlights from the State of the States report are outlined in the following text.
Increase Relevance as the Cardiovascular Professional Home
Part of increasing the ACC’s relevance as the cardiovascular professional home is finding ways for ACC members to feel welcome in the “home.” To that end, ACC chapters often hold the proverbial keys to making this happen—providing local opportunities for networking, leadership growth, and collaboration. For example, ACC chapters continue to play pivotal roles in the expansion and growth of the ACC’s Women in Cardiology (WIC) Section and related programs.
In 2019 alone, the Kentucky Chapter planned and launched the 2019 Midwest WIC Symposium in Louisville, Kentucky, while the first-ever Southeastern WIC Conference also made its debut thanks to the leadership and vision of Alabama Chapter WIC Representative Wynne Crawford, MD, FACC, and her counterparts from the Tennessee Chapter and others. The Iowa Chapter jointly sponsored the first WIC and Imaging in Cardiology Conference in collaboration with the Midwest Cardiovascular Research Foundation.
In Rhode Island, one of the top chapter accomplishments in 2019 was the creation of the Rhode Island ACC WIC Committee, spearheaded by a number of female leaders including incoming ACC President Athena Poppas, MD, FACC, and designed to foster diversity and inclusion and to promote an increased number of women in cardiovascular leadership positions. Similarly, the Mississippi Chapter also launched a WIC Section aimed at growing the number of female cardiologists in the state from the current number of 24.
Finding new ways to engage fellows-in-training (FITs) and cardiovascular team members was also high on the list of chapter accomplishments in 2019. Some examples include a June “Member Engagement Dinner” held by the South Dakota Chapter that brought together FACCs, cardiovascular team members, cardiovascular administrators, and FITs from the University of South Dakota fellowship program for important discussions on topics ranging from value of ACC membership to Maintenance of Certification. A successful cardiovascular team symposium hosted by the Wisconsin Chapter provided important networking opportunities for cardiovascular team members from across the state, while member engagement efforts by the Minnesota Chapter resulted in a 150% increase in cardiovascular team membership. Similarly, both the Arizona Chapter and Iowa Chapter saw spikes in cardiovascular team memberships thanks to focused recruitment and/or targeted educational programming.
On the FIT front, the New Jersey and New Mexico Chapters increased the number of FIT-focused educational activities over the past year. Specifically, in New Mexico, ACC Past President Patrick O’Gara, MD, MACC, presented at the University of New Mexico (UNM) Cardiology Grand Rounds and met with FITs, while also devoting time for a roundtable conversation with UNM medical students. As the Nevada Chapter continues to grow, it provided several opportunities for FITs to join ACC national meetings such as the annual Legislative Conference. The Texas Chapter also found ways to sponsor FITs and cardiovascular team members at larger ACC meetings.
Generate and Deliver Actionable Knowledge
Annual ACC chapter meetings are one of the primary ways for generating and delivering actionable knowledge at the state level. Both the Michigan and Colorado Chapters hosted their largest annual meetings ever, while the Delaware Chapter hosted its inaugural annual meeting, aptly called “ACC by the Sea.” The Puerto Rico Chapter, rebuilding post-hurricane, reinstated its popular annual meeting, which was attended by an invigorated and motivated number of FITs as well as patients.
The Alaska, Oregon, and Oklahoma Chapters list their annual meetings as their top accomplishments in 2019 because of the unique opportunities they provided to their local cardiovascular communities to network and learn from each other. Meanwhile, ACC Past Presidents, David Holmes Jr., MD, MACC, and C. Michael Valentine, MD, MACC, were among the highlights from the Nebraska Chapter’s second-ever annual meeting and the Massachusetts Chapter’s first annual meeting since 2016, respectively.
Many state chapters have found value in combining their educational meetings. For example, the Utah, Idaho, Montana, Nevada, New Mexico, and Wyoming Chapters partnered to hold the nearly sold-out Fourth Annual Rockies Chapter Meeting in August, while the North Carolina and South Carolina Chapters continue to engage cardiologists, cardiovascular team members, and FITs with a robust educational program targeted at members in both states.
Outside of annual meetings, several chapters looked for innovative ways to foster knowledge exchange and learning. The Hawaii Chapter sponsored regular clinical case reviews and journal clubs on topics ranging from heart failure to imaging to congenital heart disease. Montana Chapter members also engaged in developing the academic curriculum for the only internal medicine residency in the state. The Virginia Chapter developed a working partnership with the British Cardiovascular Society around an Emerging Leaders Programme for British FITs and Early Career physicians, while the Illinois Chapter entered into a collaborative relationship with the Chicagoland Cardio-Oncology program. In Missouri, the chapter’s Cardiology Research Grant Program provided 6 early career members with research awards totaling $60,000.
Advance Quality, Equity, and Value of Cardiovascular Care
Ensuring quality, equity, and value of cardiovascular care is no easy feat, but ACC chapters have accepted the challenge and are helping to change culture, improve outcomes, and ultimately save lives.
In Arkansas, the state chapter has led the way in helping the Arkansas STEMI Council procure funding to help all percutaneous coronary intervention facilities in the state participate in ACC’s CathPCI Registry. The Arkansas state government is also considering funding a statewide single app-based activation and coordination of care for ST-segment elevation myocardial infarction patients.
In Wyoming, the state chapter and Mission Lifeline continue to work together to improve ST-segment elevation myocardial infarction care. In addition, the Wyoming Chapter successfully advocated for the Wyoming Department of Health to require newborn screening for congenital heart disease.
Prior authorization continues to be a major pain point and administrative burden for cardiologists across the United States, and ACC chapters have been instrumental in helping to promote use of the College’s Prior Authorization Reporting Tool (PARTool) and to advocate at the national level for change. At the state level, the West Virginia Chapter played a central role in helping to draft a Prior Authorization Reform Bill (HB 2351) currently before state lawmakers. Additionally, the chapter created a pilot program in 2019 that reduced prior authorizations from the Public Employees Insurance Agency on certain procedures from over 4,000 to 2 in 1 year. In Ohio, chapter PharmD members created a new task force on Prior Authorization Best Practices that developed a resource list, sample documentation templates for new drug starts, and sample appeal letters to address some of the prior authorization issues that contribute to clinician burnout.
Smoking policies also continue to be front and center for many states, with several ACC chapters engaging with the College’s State Advocacy Team around Tobacco 21 legislation, smoke-free laws, and more. One of the success stories in 2019 was the Vermont Chapter’s successful efforts to pass Tobacco 21 legislation in the state. Vermont members, including Advocacy Chair Prospero Gogo, MD, FACC, spent countless hours testifying on the damaging effects of underage tobacco use, meeting with legislators, and working with partners around the state for a combined success.
What’s next for cardiology, and how can innovation help to advance care and improve outcomes? Several ACC chapters have started to engage their members in important conversations around these topics. In California, more than 120 participants heard from 18 cutting-edge presenters from Doximity, Verily, AliveCor, Stanford, Scripps, Cedars-Sinai, UC San Francisco, and others on topics like the role of artificial intelligence in imaging, future hospitals, and machine learning. Meanwhile, the New York Chapter held its first-ever “Shark Tank Challenge” competition where 7 individuals from across the state pitched their innovation ideas and prototypes. It was so successful that you can expect to see the challenge return in 2020.
Ensure Organizational Growth and Sustainability
Organizational growth and sustainability are fundamental to transforming cardiovascular care and improving heart health into the future. At the ACC chapter level, progress in this area took several forms, ranging from the development of strategic plans and updated governance structures to the development of programs targeted at the next generation of cardiovascular clinicians with the goal of building a professional pipeline of diverse leaders.
The Pennsylvania Chapter underwent leadership transitions in 2019, hired a lobbyist, and focused on member engagement, with the goal of hitting the ground running in 2020. In Indiana, the chapter successfully developed its own strategic plan in alignment with the broader ACC Strategic Plan and strategic goals. The chapter’s new mission is “to transform cardiovascular care and improve heart health for all Hoosiers.” Clinician wellness was on the minds of the Ohio Chapter leadership, recognizing that member well-being is paramount to being able to achieve improved outcomes, better care, and lower costs.
Growing the next generation of leaders was top of mind for the Georgia Chapter, which hosted several “Doctor 4 a Day” events with high school, undergraduate, and middle school students in the state. The Washington Chapter was also focused on the next generation, inaugurating the Washington ACC High School Scholars Program. The yearlong program currently includes 15 students, including 4 under-represented minorities and 9 women. The Young Scholars Program was also a success in Louisiana, with the chapter hosting participants at ACC.19 in New Orleans. In addition, the Louisiana Chapter piloted the CV Team Ambassador program to serve as a pipeline for recognition of ACC activities and recruitment strategies. The local ambassadors reach diverse cardiovascular team members at the local level.
Turning Toward Tomorrow
This report is not just a reflection of the past year’s accomplishments; it is a snapshot in time and foretells of future accomplishments. We look forward to witnessing even greater achievements by this grassroots body in the years to come. We remain more confident than ever that the chapters can complete any challenge and exceed every expectation not because of us, but because of the members we represent.
The authors commend the Chapters Affairs staff, Sarah Sears, Myrrh Arobo, and Miriam Surdin, without whom the State of the States report could not be compiled. The authors also thank the Board of Governors, the Chapter Executives, the CV Team State Liaisons, and the chapter leaders and members, without whom this tremendous summary of accomplishments would be impossible.
- 2020 American College of Cardiology Foundation