Cardiology Practice Analytics: Heart Failure Management, Cardiac Rehab, and Readmission Prevention

Guideline-Directed Medical Therapy (GDMT) adherence for heart failure with reduced ejection fraction (HFrEF) is one of the most evidence-based quality metrics in cardiology. The four pillars of HFrEF management — ACEi/ARB/ARNI, beta-blocker, mineralocorticoid receptor antagonist (MRA), and SGLT2 inhibitor — each independently reduce mortality and hospitalization. A cardiology practice managing a panel of HFrEF patients should know their GDMT adherence rate by medication class, which patients are on sub-therapeutic doses, and which patients have documented contraindications versus which simply were never started on indicated therapy. Most cardiologists don't have access to this population-level view without a dedicated analyst pulling EHR data.

The cardiac rehabilitation referral gap is a well-documented quality failure with significant outcome consequences. Post-MI, post-CABG, and heart failure patients who complete cardiac rehab have 26% lower mortality than those who don't participate. Yet only 20-30% of eligible patients are ever referred, and only about half of those who are referred complete the program. Without analytics that cross-reference procedure codes (MI, CABG, valve surgery, heart failure hospitalization) with cardiac rehab referral and enrollment status, cardiologists cannot identify which eligible patients are falling through the referral gap.

Atrial fibrillation management analytics span rate control vs. rhythm control strategy documentation, cardioversion success rates and recurrence, AF ablation 12-month recurrence rates, and anticoagulation management — warfarin time in therapeutic range (TTR target above 65%) and DOAC prescribing patterns by stroke risk profile (CHA₂DS₂-VASc score). These data points live across the EHR, the anticoagulation management service, the EP lab documentation system, and the billing system simultaneously.

MIPS cardiology quality measures include heart failure beta-blocker therapy at discharge, anticoagulation therapy for AFib (proportion of patients on anticoagulation with CHA₂DS₂-VASc ≥2), cardiac rehab referral for appropriate patients, and coronary artery disease lipid therapy. Cardiology is also affected by hospital HRRP measures — cardiologists who admit HF patients contribute to hospital readmission rates that affect IPPS payment adjustments.

The ACC/AHA cardiovascular data registries — PINNACLE (practice-level quality), NCDR CathPCI (cardiac catheterization), ICD Registry, and LAAO Registry — provide benchmarking and accreditation for cardiology practices. Registry participation is increasingly required for hospital cardiac program credentialing and for commercial payer cardiac center of excellence designations. Registry data submission requires the same patient-level data that underlies MIPS quality measures, creating an opportunity for unified data workflows.