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I am writing you from the 'Orange City' - want to guess where I am?  No, not someplace in Florida.  Southern California hanging with the 'Real Housewives' of Orange County....NO, definitely not southern California!! 

I am half way across the world in the Orange City of India!!!

     

Endorsed by American Society of Echo, Echo Nagpur 2014, is a hands-on and case-based echo course that I had the pleasure of being part of this weekend.  Course directors (and active ASE members) Drs. Shantanu Sengupta, JC Mohan and Mahesh Fulwani
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I just got back from a wonderful meeting (in a wonderful place) and wanted to share it with you.

ASE is rapidly becoming an international organization (about 15% of our members are outside the US) and as such, our members are often involved in CV Imaging meetings throughout the world.  As your new president, I was very proud to represent ASE (and have ASE associated with) the Global Congress of Echo and CV Imaging by SONECOM (Sociedad Nacional de Ecocardiografia de Mexico).  Check out the  video by course director Hugo Valaquez Moreno on YouTube at:  http://www.youtube.com/watch?v=BGT4ZTek5cE

This 4 day meeting had a 'who's who' of experts.  During the opening ceremony, I was sitting on the stage with the president-elect of the ACC, president-elect from European Assoc of CV Imaging, president of the Chinese echo society and editor of JACC Imaging.  The faculty was also excellent with great talks on a variety of subject.
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What will echocardiography’s place be as health care in the United States transforms to a value-based system? We who are versed in cardiac ultrasound know cardiac ultrasound as a cost-effective, versatile technology which yields high value information and enhances patient care. It is not enough for us to merely believe this statement, however; we have the responsibility and need the tools to demonstrate the evidence behind it.

The ASE Foundation is hosting Value-Based Healthcare: Summit 2014, The Role of Cardiovascular Ultrasound in the New Paradigm on September 12 in Washington, DC, to provide a better understanding of echo’s impact in patient care and research. We will explore the important roles that echocardiography plays, and how to demonstrate its value in patient-centered healthcare. This forum will feature speakers and panelists from across the healthcare spectrum, each offering their unique perspective on the transition to value-based healthcare, with a focus on the role of cardiovascular ultrasound, specifically echocardiography, in this changing environment. 

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Where are you going to be on June 13, 2015? 

Well, Boston, of course!  Why, you ask?  Well because I can already tell you that there is going to be one great ASE Scientific Session in a great city with fabulous colleagues.

How do I know this? Because I just came from a weekend work session with the 2015 Scientific Session planning committee.  This group, led by Dr Becky Hahn from Columbia University, is putting together one of the most exciting scientific sessions yet.  It will have a combination of cutting edge advances in technology, highly interactive small group encounters and program aimed to meet the needs of non-traditional users.  Being in Boston with a high density of medical schools (many of whom are incorporating ultrasound into medical education), we will also look to partner with other organizations to provide educational content for new users of CV ultrasound.

And

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WOW - can you believe it's already been one month since we held our Silver Anniversary Scientific Sessions in Portland. 

So many of you have commented on my opening President's remarks that I thought I would share some of it with you here for those that could not attend the session in person.

I started by pointing out how quickly technology is moving.  There is a great video available on YouTube called Did You Know that reinforces how quickly things are changing. I showed the following slide as one example of this change and then showed how this rapid change is going to effect our field of cardiovascular ultrasound:


    

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Greetings from DC after a wonderful holiday weekend! There is nothing like celebrating Independence Day in the Nation’s capital.  It’s a special experience but it does remind me how quickly the summer is going by. 

This fall, ASE will host its 3rd Annual Echo Florida: Contemporary Echocardiography. As an attendee and faculty member for the past two years, I know this is a wonderful opportunity to experience the 'magic'  of an ASE course.   Mike Picard, from Mass General, has done an outstanding job planning a course that will give you insight into new techniques while solidifying your clinical skills.

Did you know that 98% of previous attendees would recommend this course to a colleague? Mike, along with his co-chair, Becky Hahn, have put together a stellar course featuring a truly outstanding faculty. Those of you who have attended an ASE course know that access to luminary faculty is a hallmark of our meetings.   This year, we are moving to a new location at Walt Disney World, The Grand Floridian.  It’s still on the monorail so getting around is a breeze.

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Hi,
We just had this come up in our office meeting. The Doctors were not happy with the choppy images. We found the resolve! We now take 5 cycle clips. This does take some time to get use to but the end result is a smooth clip. This will increase your image quality and give more information to the reading Doctor to make an accurate  diagnosis. The clips are seamless. 

JulieAnn, RCS
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Thanks to persistence, hard work and a bit of luck, ASE welcomed Senator Ron Wyden to address attendees during the recent Silver Anniversary Scientific Sessions in Portland, Oregon.

Senator Wyden is one of Washington’s highest profile figures and most sought after legislators. He is Oregon's senior US Senator and the new Chair of the Senate Finance Committee. As Chair of the Senate Finance Committee, Senator Wyden has jurisdiction over a multitude of issues from health care to taxes, including broad authority over Medicare, Medicaid, the Affordable Care Act and the tax provisions that subsidize insurance coverage for millions of Americans.

Politico magazine recently ran an article, titled Suddenly, Everybody Loves Ron Wyden, which stated: “few lawmakers have become more influential in the 113th Congress more quickly.” Thanks to Dr. Jonathan Lindner and our lobbyist, Peggy Tighe, ASE had the rare chance to directly speak to one of the key decision makers on the Hill and discuss some of the most controversial issues facing healthcare today, emphasizing the shortsightedness of funding a permanent repeal to the Sustainable Growth Rate (SGR) via cuts to echocardiography.

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1.  When and how did you get involved with cardiovascular ultrasound?

After other degrees, jobs, and life experiences, I completed a completed a degree program in nursing in 1978.  I worked in critical care/intensive care environments for the next 12 years, but had always had photography as a main interest and passion.  By 1989, I was ready for a change and had explored other nursing positions and degrees in photography and secondary education, but had been talking quite a bit with the cardiac sonographers at Sacred Heart Medical Center in Eugene, OR.  The imaging was what hooked me.  I’m a very visual person, and echocardiography seemed like the perfect combination of making images with my medical experience.  I went to Spokane, WA, talked with Dennis Carney, and entered the Non-Invasive Cardiovascular Technology Program in 1990.  It was the best decision I had ever made!

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Today was the final day of a great scientific sessions but first, before I get into that........... I need to thank Jonathan Linder and the entire program committee on putting together an exciting program.

Last night we (the faculty, award winners and industry round table partners) had a chance to celebrate together at the Portland Art Museum. Here are some pictures: 1) picture from entrance to museum entrance, 2) Drs. Pearlman (JASE editor), Mertens (Fiegenbaum award winner), Hahn (next year's program chair) and Linder (current year scientific session chair); 3) Drs Asch (guidelines chair) and Plana (first author for upcoming cardio-oncology guidelines and 4) Sonography Council chair Elizabeth McIlwain and Board of Director Partho Sengupta):

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Just another great day in Portland at the 25th Annual Scientific Sessions of the ASE. 

I woke up to more sun, blue sky's and crisp 70 degree weather, realized that I am now a pro at taking the tram around town. The day started with the Weyman Young Investigator award competition and the Feigenbaum honorary lecture by Luc Mertens. I was amazed at the variety and quality of the research these investigators presented.

   

For me, it was then off to chair a really interesting session on the role of imaging in science.  This session had presentations that spanned from pre-clinical (echos in mice), to the industry perspective of echo in drug development and ending with insights from molecular imaging.

While all of that was intellectually stimulating for me, the highlights of the day were meeting and spending time and meeting new colleagues from around the globe. We had a great meeting of representatives from around the world who each gave a short update on what is happening with CV ultrasound in their country.  Here is a picture of the group:

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Portland is beautiful! I left 90 degree temperatures and 100% humidity in Washington DC to come to lovely Portland with temperatures in the 70’s, crisp air with the smell of their famous coffee on every street corner.

And yes, the meeting is also off to a great start too!  We started Saturday early with 7 am breakfast sessions from echo in stroke to incorporating 3D into daily clinical practice. Then the main sessions started as the convention center started to fill up. Mitral valve procedures, diastology, chamber quantification and a ‘sonic adventure’ in physics are just a few examples of the offerings. Pediatric echo jeopardy and a ‘Clash of the Titans’ debate rounded out the educational session.

For me, I also packed in an investigators meeting (for those taking part in the Coapt study), meetings with our ASE chairs and council leadership and a JASE editorial board meeting. And what better way to end the day with a President’s Reception inside the Exhibit & Poster Hall to informally meet with your friends and colleagues over a glass of wine.

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Welcome back to the ASE President’s blog!  I am excited to become your ASE President and am committed to represent you and your interests in cardiovascular ultrasound excellence in quality, education, advocacy and research. I want ASE to be your go-to place for anything related to CV Ultrasound.

Many of us belong to several organizations.  Some are meaningful, important memberships while others are only an occasional newsletter or email.  I want ASE to be the type of organization that becomes part of your everyday professional life.  However, to do that, I need to hear from you.  ASE is doing A LOT of things but is it doing the right things?  Is it your ‘go to’ place?

With this first blog post, I want to get us off on the right foot and let you know I am committed to open, transparent 2-way communication.  PLEASE post your comments, questions and suggestions on this blog and/or on Connect@ASE. You can also email me at

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Can anybody tell me during which year(s) two-dimensional echocardiography came into wide-spread clinical use? I can't find any such details in online articles about the history of echocardiography.
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1.  When and how did you get involved with cardiovascular ultrasound?

My involvement in cardiovascular ultrasound was inspired by a teacher in the ultrasound program I attended; he lectured so passionately about echocardiography’s role in diagnosing cardiovascular disease that I was hooked immediately. I’ve been involved in medical imaging my entire career, and echo seemed the perfect segue.

2.  Where do you work, and what is your current position?

I am currently with the Barnabas Health System in New Jersey, with a renowned cardiothoracic transplant division, and robust TAVR and VAD programs as well. Very exciting is the recent development of an Adult Congenital service, as echo imaging is an integral modality for following this population. Our echo department is led by a brilliantechocardiologist who is very quality-focused and supportive of the very talented echo staff. We have weekly QA meetings, and it is an environment for learning each day. I manage the lab, and do my best finding time to scan as often as possible. Our lab partners with several local cardiovascular imaging programs, offering opportunities to interact with the next generation of sonographers. I believe I learn as much from them as they do from us-I love their optimism and energy!

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These are challenging times for healthcare.  Washington is facing constant fiscal crises, driving legislators and policy makers to look for cuts in the federal budget. As one of the most used imaging procedures, echocardiography has been a tempting target, especially when a cut will mean significant “savings,” regardless of if it is short term and short sighted.

The need for strong representation on the Hill, solely dedicated to echocardiography, has never been greater. Therefore ASE has retained the services of its own lobbyist, Peggy Tighe, J.D.. She is working to ensure that care is not compromised and strives to learn and share how pending legislation will impact you.

ASE has had several significant successes on the lobbying front including:

  • Echo was excluded from the SGR patch bill that included a mandatory AUC requirement and pre-authorization for “outliers.”  
  • With Peggy’s extensive lobbying healthcare experience and numerous contacts, she makes sure echo is considered and discussed favorably at the highest levels.  During recent critical negotiations, Congressional leadership staff reached out to update her on the discussions and assure her that the deal for echocardiography was secure.
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1.  When and how did you get involved with cardiovascular ultrasound? 

I decided to go back to school for cardiovascular ultrasound in 2006.

2.  What is the name and type of facility/institution  where you work, and what is your current position?

I currently work at Duke Medical Center in Durham, NC, where I have a dual role as a sonographer and a research coordinator in the Cardiac Diagnostic Unit.

3. 

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Since ACC.14 took place in Washington, DC, several ASE members and staff took advantage of the proximity to the federal government to help enhance ASE’s profile and to oppose the site neutrality proposal.

Dr. James Thomas, one of ASE’s Past-Presidents, capitalized on the opportunity to meet with his US Senator, Sherrod Brown, and presented some of ASE’s talking points to Sen. Brown. Since Senator Brown serves on the Finance Committee, a committee that has considerable oversight over this issue, the meeting was incredibly beneficial to delivering ASE’s message. The importance of having a legislator hear from a constituent cannot be overstated. Additionally, while our lobbyist had met with Senator Brown office previously, she was thus able to follow up again and further ensure that our concerns are not forgotten.

Robin Wiegerink and Irene Butler, ASE’s CEO and Vice President of Health Policy respectively, attended a fundraiser for Patrick Hope during ACC.14. As one of ACC’s lobbyists, Patrick helped coordinate a recent fly-in focusing on opposing the site neutrality proposal, and repealing the flawed Sustainable Growth Rate (SGR) to replace it with a payment system that fairly reimburses for the costs of providing services.  He is running for Virginia's 8th congressional district (Arlington and Fairfax counties, Falls Church and Alexandria) and is a champion of efforts to reward providers for quality improvement and improved patient outcomes, and will stand with physicians to reduce unnecessary and burdensome regulations.

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1.  When and how did you get involved with cardiovascular ultrasound?


I was pre-med in college.  Advisors recommend that students have a plan B, in case you aren't one of the lucky ones to earn admission into medical school.  I happened to be working as the weekend secretary for our echo lab at the time, and was given the opportunity to cross over into the clinical world of cardiology.  In 1999, I started cross-training in EKG, Holter Monitor attachment and interpretation, stress testing and echo.    I was able to complete my echo training while I was a monitor tech in a Cardiac Cath lab, gaining exposure to the invasive side of cardiology.   I successfully passed the echo board exams in Dec. 2002, earning my RDCS.

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At new job site and they use different billing codes for stress echoes.  What codes are supposed to be used for
stress echoes and  stress echoes with complete echo first.
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