About Cardiomark

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HEALTH TECH ENTERPRISES IS NOW CARDIOMARK, L.L.C.

Medical Management

HEART IDENTIFICATION CARDS
EXPEDITE APPROPRIATE CARE
The "medic alert" program is a well-established health notification system that facilitates rapid and appropriate medical intervention for thousands of individuals with chronic and/or life threatening conditions. Now, a similar principle is being applied in cardiovascular care at Pikes Peak Cardiology, LLP, Colorado Springs.

In 1997, the nine-physician practice launched Pocket EKG, a card carrying program for at-risk individuals with known or suspected coronary artery disease. The laminated wallet size card contains a copy of the most current electrocardiogram (ECG), a complete cardiac history, and the physician contact information for patients enrolled in the program.

Pocket EKG, and its new companion, Pocket Angiogram, are distributed by Cardiomark, L.L.C., a healthcare marketing company based in Fresno, CA. The medical identification system package includes patient education materials, procedural guidelines for implementation of the program, patient satisfaction surveys, a community education slide kit, and promotional material.

For an enrollment fee of $250 to $500, and a per card charge of $15 (the Pocket Angiogram is $20), Health Tech manufactures the cards, distributes the patient satisfaction surveys, analyzes the data, and produces periodic Patient Satisfaction Survey Reports. The reports include data for some of the indicators tracked by the National Committee for Quality Assurance via the Health and Employer Data Information Set (HEDIS).

BASELINE INFO MORE INPORTANT THAN EVER
WITH NEWER CHEST PAIN PROTOCOLS
The evolution of new myocardial preservation strategies for management of acute coronary syndromes makes ready access to baseline ECGs more critical than ever before. "Many of our patients travel quite a bit, and having the Pocket EKG gives them a clinical advantage," says Ronald Blonder, DO, FACC, an interventionist at Pikes Peak Cardiology. "We've received very favorable feedback from physicians across the country about the clinical value of the card in appropriately treating our patients."

In addition to maintaining the continuity of care, the pocket medical information system helps Pikes Peak Cardiology "right-size" hospital utilization for its at-risk patients. The Multicenter Chest Pain Study, published in the Journal of General Internal Medicine ("Impact of the availability of a prior electrocardiogram on the triage of the patient with acute chest pain," vol. 5, December 1990), reported that when ED physicians had a prior ECG available for comparison, individuals with noncardiac chest pain were two times more likely to be discharged home.

To date, Pikes Peak hasn't formally tracked the hospital utilization rates among its card members, but anecdotally Blonder and his colleagues have noted specific occasions when patients haven't been admitted because of the clinical information that is available on the Pocket EKG.

"The cards are offered to individuals with significant coronary disease, and those who are likely to present themselves to an ED with chest pain," says Blonder. "Patients with repeat episodes of noncardiac chest pain and normal or minor ECG changes are also good candidates."

The cards are updated whenever there is significant change in a patient's baseline ECG, or following a percutaneous coronary intervention, cardiac surgery, or defibrillator or pacemaker implant.

PRIVACY ISSUES AND PATIENT SATISFACTION
The lack of confidentiality of the information imprinted on the pocket cards is a concern for some patients, notes Blonder. "For the most part, patients are concerned about having their social security number on the card, and not about having their medical history revealed," he says. "In fact, the patients actually feel more secure having the information with them, rather than relying on the medical system to provide it."

Pikes Peak Cardiology finds the satisfaction data gathered from the patients enrolled in the program is information that wouldn't otherwise be available to us without incurring a considerable cost," says Blonder. "Combining the survey process within a program that enhances clinical care delivery is cost-effective for the group."

The patient satisfaction instrument gathers a variety of service-related data including office wait times, length of time from appointment to visit, and timeliness in reporting test results. The amount of time a provider spends with the patient and how well the provider communicated information about the diagnoses, treatments, and medications is also measured.

In addition to the satisfaction data, the summary report provides details about patient demographics, number of visits, and types of payers. A list of patients who are interested in obtaining information about how to improve their cardiovascular health is included, which helps the group in its population health initiatives.

"The data have been a definite advantage in our contract negotiations," says William Mantia, MBA, CEO, Pikes Peak Cardiology. "Many of the payers we contract with are surprised that we have this level of HEDIS-compliant data, and that it's organized by an objective third party intermediary."
Patient Satisfaction Survey Report

According to Mantia, the Pocket EKG has been a marketing success with patients and primary care providers as well. "The card gives patients a sense of being 'connected' with their providers regardless of where they are," he says. "And the primary care physician is listed as a contact on the front of the card, in addition to the cardiologist, so he/she can stay in the communication loop."

POCKET ANGIOGRAM OFFERS MORE INFO
Health Tech's newest medical information system is definitely a cocktail party conversation piece. The Pocket Angiogram displays essentially the same detailed medical information on the front as seen on the Pocket EKG (the patient's ejection fraction and dominant vasculature, and the name and phone number of the cardiothoracic surgeon are added), but the back of the card provides a "mini replica" of the patient's most recent angiography findings .

The specific details depicted on the back of the card location and severity of lesions, site of percutaneous coronary procedures, and cardiac surgeries�are based on information provided by a patient's medical provider.

Reprinted with permission from COR Healthcare Resources 805/564-2177.

CDM Review JCM How to Market
Gateway Strategic Partner JCM EKG Benefits