President's Column: An Epoch of Belief

Robert S.D. Higgins, MD, MSHA

Robert S.D. Higgins, MD, MSHA

STS News, Spring 2019 — "It was the best of times, it was the worst of times …”

This is the opening line of Charles Dickens’s A Tale of Two Cities, a celebrated novel about the French Revolution that describes a tumultuous time of highs and lows—not unlike our current time in cardiothoracic medicine.

Notwithstanding this tumult, I am honored to have been elected this year as the Society’s 55th President. Words are inadequate to express my appreciation for all of the support I have received from former partners and trainees, mentors, and colleagues. In my career, this certainly is a capstone accomplishment that warrants pride and appreciation for the opportunities to serve STS members. In my opinion, it is the best of times!

The Society is an extraordinary organization that has impacted so many people in the cardiac, general thoracic, and congenital heart communities. Through the efforts of cardiothoracic surgeons as members and leaders of multidisciplinary teams across the world, we have been responsible for treating and often saving millions of lives. Atherosclerotic heart disease and lung cancer are among the most lethal conditions in the western world, and STS members have helped to significantly reduce morbidity and mortality related to these diseases, in part through quality assessment and process improvement from participation in the STS National Database.

Since 1989, the Database—the Society’s crown jewel—has evolved into the premier clinical outcomes registry in cardiothoracic surgery and, arguably, in all of medicine. It recently was recognized by The Joint Commission and the National Quality Forum with the John M. Eisenberg Patient Safety and Quality Award for being a champion of quality improvement initiatives to provide safe, high-quality care.

Despite these remarkable accomplishments and accolades, we recognize that there are opportunities to enhance and optimize the current Database experience for our participants.

We recognize that there are opportunities to enhance and optimize the current Database experience for our members.

Our goal is to continue assessing the foundations of appropriate risk-adjusted performance measurement while enhancing participant satisfaction, reducing data entry burden, and maximizing Database utilization and ease of use.

We anticipate data element reduction (without eliminating important data components), engagement with EHR platforms to facilitate the automation of data extraction, and the creation of readily accessible dashboards for easy access and “real-time reporting.” We know that these efforts can happen only with concerted efforts using new “natural language processing” to facilitate extraction from state-of-the-art, cloud-based technologies. We are actively exploring an enhanced data warehousing relationship and recruitment of a staff informatics manager to guide these activities.

“It was the age of wisdom, it was the age of foolishness …”

In his 2002 STS Presidential Address, Dr. Mark Orringer described the contributions of the STS National Database to improving patient care. He also focused on the value that the Database provides when the Relative Value Unit Committee (RUC) evaluates fee structures and decides on reimbursement. He provided an example of how data helped positively influence financial decisions in a time of budget constraints: “Our STS representatives, armed with credible ‘compelling evidence’ … recommended increasing cardiac surgery fees … [and] substantial reimbursement for pulmonary and esophageal resections and other general thoracic operations. … These data ‘won the day’ for the entire specialty.”

That was then and this is now, but—without fail—data derived from Database participation continue to save lives and help lawmakers make decisions that favor cardiothoracic surgeons.

But we can’t do this without the undivided support of the membership and our national cardiothoracic surgical leadership.

It would be “foolish” for another database initiative by any organization to compete with our current highly regarded efforts. We welcome and encourage those who are not satisfied with our current database to join our efforts in improving and optimizing it. We need every hand on deck – join the effort!

“It was the epoch of belief …”

I am optimistic as we move forward into this new year. There is much to appreciate and be thankful for. Since the decision to become a self-managed organization, STS has enjoyed unparalleled success in part because of the conviction and efforts of our volunteer leaders and staff. Our profession has been fortunate to have had outstanding administrative leadership for nearly 2 decades from Executive Director & General Counsel Rob Wynbrandt. We thank Rob for his leadership and commitment.

And now we herald the start of a new era with the selection of Elaine Weiss as CEO/Executive Director. With her extremely impressive background and experience, she will make a real contribution to the Society, and we look forward to her arrival on April 15.

We have many important mission critical issues on our plate—optimization of the Database, public reporting, onboarding a new executive director, and so many other important opportunities. Please join us in this renaissance journey as we honor our illustrious past and create a new and sustainable future!

With our membership, volunteer leaders, and staff engaged to direct our future, I am optimistic that it will be the best of times!