As a non-profit organization, the ICAEL is supported by sponsoring organizations while operating independently of their activities. Representatives from these organizations, physicians and sonographers, serve on the ICAEL's Board of Directors. While sponsoring organization status signifies each organization's support of the ICAEL program, both the American College of Cardiology (ACC) and the American Society of Echocardiography (ASE) recently released statements emphasizing their stances on accreditation and certification.

Official Statement From ASE

The statement from the American Society of Echocardiography (ASE) was released in the form of proposed Local Coverage Determination (LCD) language), specifically related to laboratory accreditation and physician and sonographer qualifications for transthoracic echocardiography:

"The accuracy of a transthoracic echocardiogram depends on the knowledge, skill, and experience of both the individual performing the study and the physician interpreting the study. For this reason, a transthoracic echocardiogram must:

a) be performed in a laboratory that is accredited in transthoracic echocardiography by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories and interpreted by a physician who is subject to the quality assurance program established by that laboratory; or

b) meet all of the following requirements:

(i) performed by a physician with Level II training in transthoracic echocardiography, or the equivalent, as defined by the American College of Cardiology / American Heart Association / American College of Physicians Task Force on Clinical Competence in Echocardiography, or by an individual who is credentialed as a Registered Diagnostic Cardiac Sonographer (RDCS) through the American Registry of Diagnostic Medical Sonographers or as a Registered Cardiac Sonographer (RCS) through the Cardiovascular Credentialing International, working under the general supervision of a physician who meets the qualifications stated above; and

(ii) interpreted by a physician who has Level II training in transthoracic echocardiography, or the equivalent, as defined by the American College of Cardiology / American Heart Association / American College of Physicians Task Force on Clinical Competence in Echocardiography.

These requirements shall become effective [two years from the date of the notice]."

Official Statement From ACC

The American College of Cardiology (ACC) Statement on Accreditation/Certification, adopted by the ACC Board of Trustees on March 5, 2005, reads as follows:

"The American College of Cardiology (ACC) is a leader in the promotion of high quality cardiovascular care. The mission of the ACC is to advocate for quality cardiovascular care through education, research promotion, development and application of standards and guidelines, and to influence health care policy.

To improve health care quality, the ACC strongly supports participation in physician certification and/or laboratory accreditation programs developed by physicians and appropriate to the field of practice. Certification and accreditation programs clearly have a role in quality improvement by providing independent evaluation and validation of performance of providers and facilities.

To achieve improved clinical performance and quality, the ACC encourages all providers to implement and utilize quality measurement and improvement tools, combined with outcomes data monitoring in all settings. The ACC strongly encourages adherence to ACC clinical practice guidelines and expert consensus documents that translate evidence-based medicine into clinical practice. The ACC also promotes the use of clinical competency statements and adherence to Core Cardiology Training Symposium (COCATS) recommendations where competency guidelines do not exist. Accreditation/certification programs provide a convenient means for meeting these criteria.

The ACC encourages governments and payers to make accreditation/certification programs mandatory conditions of participation. In implementing such requirements, ACC encourages a gradual approach to ensure a realistic timetable for compliance which minimizes economic impact on current practitioners. Exceptions to mandates may be necessary to ensure that patients have access to care in underserved areas.

The American College of Cardiology Foundation (ACCF) produces the following quality improvement tools that can assist physicians and other cardiovascular care providers to analyze their performance and participate in a continuous quality improvement process:

• Guidelines Applied in Practice (GAP), customizable tools to improve adherence to evidence-based guidelines
• The National Cardiovascular Data Registry (NCDR), which provides participants with standardized data elements and definitions and quarterly comparative reports on the safety and effectiveness of cardiac catheterization (and soon, electrophysiology and carotid stenting) procedures
• CathKIT, a tool for use in improving the performance of cardiac catheterization laboratories through self-assessment and evaluation to effectively and efficiently improve quality and outcomes of care.

The ACCF has also been a partner in developing Intersocietal Accreditation Commission programs for vascular, nuclear, echocardiography, and magnetic resonance imaging laboratories.

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