Outpatient Cardiac Catheterization: Its Role in Managed Care' The Journal of Cardiovascular Management, January/February 1993, pages 40-42. Charles L. Baird, Jr., M.D.

The late Dr. F. Mason Sones. Ir.. of the Cleveland Clinic, developed the technique of cine-coronary arteriography over 30 years ago and supported efforts to broaden its application as an ambulatory procedure. Many hospitals, including the Cleveland Clinic, Duke University Medical Center and Emory Clinic, now have well-established outpatient cardiac catheterization programs. Subsequently, acceptance of outpatient cardiac catheterization in ambulatory centers was supported by the U.S. Public Health Service Report in 1988, which documented the low complication rates in outpatient facilities that led to Medicare facility reimbursement. The growing recognition of outpatient cardiac catheterization. as well as support for screening of silent heart disease, will stimulate the growth of ambulatory facilities that are owned by physicians solely or jointly with hospitals. The purpose of this article is to describe the activities of the Virginia Heart Institute, which hasacted as a prototype facility forscreening, outpatient cardiac catheterization and rehabilitation of the potentially high-risk ambulatory patient.