Coronary CT Angiography (CCTA) is a non-invasive imaging test that uses advanced CT technology and contrast dye to provide highly detailed images of the coronary arteries, allowing for the early detection of Coronary Artery Disease (CAD). CCTA directly visualizes the coronary arteries, identifying blockages and plaque buildup with greater accuracy than traditional tests. Unlike stress testing, which is the predominant testing strategy today and can misdiagnose up to 30% of the time, CCTA has less than a1% chance of missing significant disease.

The 2021 ACC/AHA guidelines recommend CCTA as the first-line diagnostic tool for evaluating stable chest pain, largely due to its superior diagnostic precision. With earlier and more accurate detection of coronary artery blockages, CCTA enables physicians to intervene sooner, preventing more serious cardiac events. Studies show that using CCTA to diagnose CAD can reduce heart attacks and cardiac-related deaths by 41% compared to traditional pathways that rely heavily on stress testing.

CCTA is not just a diagnostic tool—it is a means of driving a broader change in managing CAD. The disease is preventable in up to 80% of cases, and CCTA’s ability to identify CAD earlier in its course allows for lifestyle interventions, medical therapies, and revascularization that can prevent progression. By enabling earlier diagnosis and more targeted management, CCTA not only improves short-term outcomes but also plays a critical role in long-term heart disease prevention, making it the preferred tool in transforming cardiovascular care.

The majority of cardiovascular CT capacity is currently tied to busy hospital radiology departments, where scanners are shared across multiple service lines. These scanners must accommodate not only inpatient volumes but also a wide range of imaging needs beyond cardiovascular care, such as trauma, oncology, and routine diagnostic scans. As a result, access to CCTA is often limited.

The Unique Demands of CCTA

CCTA presents unique challenges from both a technology and patient care perspective. The technology required for CCTA must be capable of imaging fine, moving coronary vessels with precision. This involves:

• High-resolution scanners to accurately capture detailed images of the coronary arteries through larger detector coverage and/or faster resolution with dual source or energy capabilities.

• Advanced software to reduce motion artifacts due to the constant movement of the heart.

• Advanced artificial intelligence (AI) tools enhance the capabilities of dedicated cardiovascular CT scanners by offering Fractional Flow Reserve CT (FFR-CT) and Quantitative Plaque Analysis. These analyses provide richer, more detailed insights into both the functional significance of coronary blockages and the composition and volume of plaque, allowing physicians to make more informed decisions about patient management and treatment pathways.

• Specialized expertise in patient care and preparation, as even slight movement or improper timing of the scan can impact image quality. Also, heart rate control is essential in high quality imaging requiring support from expert nurses.

Given these demands, most hospitals are only able to perform a few cardiovascular CT scans each day, significantly restricting patient access and slowing the diagnosis of CAD.

The Emerging Solution: Dedicated Cardiovascular CT Scanners

To overcome these limitations, the emerging preferred solution is to invest in a dedicated cardiovascular CT scanner. When set up and operated appropriately, a dedicated scanner can handle well over 20 patients per day during normal business hours, dramatically increasing access to life-saving diagnostic services. The benefits of this approach include:

• Increased capacity: By having a dedicated scanner for cardiovascular patients, health systems can perform significantly more CCTA scans, allowing them to serve a larger patient population and reduce wait times.

• Specialized care: Dedicated scanners enable staff to develop focused expertise in cardiovascular imaging, leading to better patient care and more accurate diagnoses.

• Operational efficiency: With a scanner solely dedicated to cardiovascular imaging, systems can optimize scheduling, streamline workflows, and eliminate competition for scanner time from other departments.

This investment in a dedicated cardiovascular CT solution not only enhances patient care but also positions health systems to meet the growing demand for CCTA and other cardiovascular imaging services, helping to reduce delays in diagnosis and treatment for at-risk patients.

The shift from traditional stress testing to CCTA as the first-line diagnostic tool for stable chest pain represents a major change in the standard of care. While this transition promises improved patient outcomes and earlier detection of Coronary Artery Disease (CAD), it also introduces operational and clinical challenges for healthcare systems. Managing the volume shift from stress testing to CCTA at the diagnostic level can strain Radiology and Cardiology services, while changes in the diagnostic-to-revascularization mix can affect the balance of procedures in the cath lab. Hospitals need to ensure their diagnostic and interventional pathways can support this evolving landscape without disrupting existing workflows.

Balancing Economic and Clinical Challenges

One of the key concerns for health systems is ensuring that this shift is economically sustainable while maintaining quality care. As more patients are funneled through CCTA, the challenge is to balance increased diagnostic volume without overwhelming capacity and managing the inevitable rise in PCIand CABG cases in the cath lab. Additionally, hospital systems must be prepared to adjust their financial models to account for the reimbursement structure changes and ensure their services remain both profitable and accessible.

The complexity is further heightened when considering the operational hurdles of integrating CCTA into existing workflows. Health systems must address:

• Pathway Development: Building clinical pathways that integrate these new diagnostics into current service lines is essential to ensure that the patient journey, from referral to diagnosis and treatment, is efficient and supports high-quality care.

• Integration with EMRs and PACS: Seamless integration of new diagnostic tools with existing electronic medical records (EMR) and picture archiving and communication systems (PACS) is critical to ensure streamlined workflows and minimal disruption for providers.

• Scheduling and Revenue Cycle Management: Managing patient scheduling and optimizing the revenue cycle for a procedure like CCTA—which may have different reimbursement and pre-authorization requirements compared to traditional stress testing—requires thoughtful planning.

Catalyst’s Expertise in Weaving CCTA into Your Operations

Maximizing the potential CCTA brings while ensuring current assets remain productive requires both strategic planning and execution. Catalyst brings unique expertise to help health systems succeed with both current and future investments. We offer a comprehensive approach, starting with the development of a tailored strategy that aligns with each hospital’s specific needs and goals. Our process includes:

1. Strategic Pathway Development: Catalyst works with health systems to build clinically sound pathways that efficiently integrate CCTA into existing workflows, from referral through diagnosis and treatment. This includes ensuring seamless integration with EMR, PACS, scheduling systems, and revenue cycle management platforms to avoid bottlenecks.

2. Flexible Management Services: We offer a portfolio of management services customizable to fit the unique needs of each partner. Whether you require support in managing diagnostic volumes, optimizing patient flow, or enhancing cath lab capacity, Catalyst offers the operational expertise to drive accelerated implementation and patient access.

3. Economic Sustainability: We understand the economic pressures health systems face when adopting new standards of care. Catalyst’s approach focuses on financially sustainable models ensuring diagnostic and revascularization services are optimized both for clinical efficiency and economic viability. We help institutions balance increased demand for CCTA without compromising the performance of their cath labs or other critical services.

Moving Forward with Confidence

As the healthcare landscape evolves and CCTA becomes the new standard of care, having the right partner to guide the transition and share the workload is essential. Catalyst’s experience in managing diagnostic and interventional services, combined with our flexible and comprehensive portfolio of management solutions, ensures that health systems and practices can meet the challenges of this transition with confidence.

We’re committed to helping health systems navigate these changes by creating sustainable strategies that improve patient outcomes, enhance operational efficiency, and position your institution as a leader in cardiovascular care.

A well-planned approach to integratingCoronary CT Angiography (CCTA)into your cardiovascular care pathway can deliver significant clinical and financial benefits. Success hinges on more than just adopting new technology—it requires a comprehensive strategy that seamlessly incorporates CCTA into the broader patient care continuum. When done effectively, health systems can see both improved clinical outcomes and enhanced financial performance.

Clinical Outcomes: Advancing Patient Care

The use of CCTA allows hospitals to enhance their approach to diagnosing and managing Coronary Artery Disease (CAD), as well as broader cardiovascular conditions. A comprehensive strategy involving CCTA can:

• Identify at-risk patients earlier: By shifting the diagnostic focus toward CCTA, physicians can detect CAD more accurately and earlier in its progression. This allows for timely medical intervention that can prevent more severe heart conditions from developing.

• Offer backup capabilities for structural heart and EP planning: Incorporating CCTA into your cardiovascular imaging strategy provides essential backup support for structural heart disease and electrophysiology (EP) planning, helping to reduce bottlenecks in these growing programs. This ensures that patients requiring these advanced procedures are diagnosed and scheduled efficiently, preventing delays that could affect outcomes.

• Perform other cardiovascular scans efficiently: CCTA centers can also offer calcium scoring, vascular imaging, and other cardiovascular scans to further support comprehensive cardiovascular diagnostics. This diversified capability enhances patient care by providing a full spectrum of diagnostic tools in one location, streamlining the care process for referring physicians and patients alike.

• Provide comprehensive cardiovascular care: CCTA enables better-informed treatment decisions, from early diagnosis to long-term management. Patients benefit from a more tailored and proactive approach to their care with the complete view CCTA provides.

• Streamline the patient journey: By integrating CCTA and other cardiovascular imaging capabilities into existing pathways, health systems can create a smoother and more efficient diagnostic and treatment process, ultimately improving the overall patient experience and quality of care. Cardiology practices can realize significant productivity gains leveraging the accuracy and prognostic value of CCTA, meaning helping those in need faster and avoiding unnecessary testing stemming from false positives.

These capabilities ensure that hospitals are positioned to drive significant improvements in patient outcomes, while also helping manage growing patient volumes across multiple cardiovascular programs.

Financial Outcomes: Unlocking Revenue Potential

The shift to CCTA offers substantial financial opportunities for hospitals, but it also plays a critical role in identifying patients in need of life-saving procedures. By diagnosing coronary artery blockages earlier, CCTA can direct more patients who need Percutaneous Coronary Interventions (PCI) or Coronary Artery Bypass Grafting (CABG) to the appropriate treatment pathway. These procedures can be performed safely in the hospital’s cath labs or surgical departments, ensuring that patients receive the care they need before their condition worsens.

Additionally, CCTA centers can provide access to non-affiliated physicians, such as primary care physicians (PCPs), concierge doctors, and specialists, who may not have ready access to advanced cardiovascular diagnostics. This approach expands the reach of your hospital’s Cardiology services, allowing non-affiliated physicians to refer their patients for modern, high-quality testing while exposing more patients to the expertise of your cardiovascular care team.

A correctly executed CCTA strategy, which includes support for structural heart and EP programs as well as comprehensive cardiovascular imaging, can:

• Maximize cath lab utilization: By identifying patients earlier in their disease process, CCTA ensures that your cath labs are consistently treating patients in need of advanced interventions. This not only improves patient outcomes but also helps ensure that your procedural services are being fully utilized.

• Reduce program bottlenecks: Having CCTA as a backup for structural heart and EP planning helps alleviate delays in these programs, allowing your health system to handle higher patient volumes more effectively without compromising care.

• Create a sustainable financial model: Beyond diagnostics, incorporating CCTA into the overall cardiovascular service line supports a stable revenue stream. Health systems can benefit from more predictable volumes of both diagnostic procedures and interventions, resulting in a more robust and financially viable cardiovascular program.

By adopting this strategic approach, health systems can deliver life-saving care to more patients, reduce program bottlenecks, and build a sustainable financial framework that supports the long-term success of their cardiovascular services.