State partnership dramatically improves follow-up adherence after interventional procedures
Following a statewide effort, hospitals throughout Michigan were able to dramatically improve follow-up imaging adherence for patients who undergo a common aortic aneurysm procedure,
Endovascular aneurysm repair, or EVAR, requires long-term imaging follow-up to monitor for potential complications. In doing so, providers are able to spot problematic changes before they progress. However, many patients fail to comply with follow-up imaging recommendations, putting them at risk of adverse events related to the procedure.
A group of physicians and researchers at Michigan Medicine, alongside the Blue Cross Blue Shield of Michigan Cardiovascular Consortium, or BMC2, recently sought to close this care gap. They partnered with more than 30 hospitals statewide to create a care pathway that would improve follow-up adherence among EVAR patients.
And their efforts are now paying off. Prior to the initiative, one-year follow-up rates were calculated at around 28% in 2017; by 2023, that figured increased to nearly 80%.
"Through this partnership, we saw sweeping improvements in surveillance imaging that will allow clinicians to detect early problems that can lead to device failure or future, threatening complications such as aortic rupture,” noted Frank M. Davis, MD, a vascular surgeon at the University of Michigan Medical School and U-M Health Frankel Cardiovascular Center.
The initiative included financial insurance reimbursement for hospitals that encouraged patients to return for imaging in the year after EVAR, along with hospital-level process changes to make scheduling and reminders easier. The goal was to turn surveillance into a routine part of post-surgical care rather than an optional step. Researchers used data from the BMC2 registry, which tracks cardiovascular care across Michigan, to compare follow-up imaging rates before and after the initiative began.
Before the program, hospital rates ranged from 3.7% at smaller facilities to 62.5% at larger ones. By 2023, 95% of participating hospitals had surveillance rates above 60%. Individuals who complied with follow-up imaging recommendations were much more likely to undergo additional interventions, which led to lower mortality rates in this group; patients who received follow-up imaging were nearly 60% less likely to die within one year of surgery, even after accounting for other health conditions.
“The long term success of a surveillance program like this depends on identifying processes at each participating hospital that can be built into routine practice,” Nicholas Osborne, MD, director of BMC2, said in a news release.
The findings suggest that coordinated, statewide programs have the potential to improve outcomes by ensuring patients receive the follow-up care they need.
Learn more about the group’s efforts here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.