October 29, 1975
Page 34192
HEART HOUSE
Mr. MUSKIE. Mr. President, the American College of Cardiology is a professional medical specialty society composed of physicians and scientists dedicated to research, education and treatment in the field of cardiovascular diseases. At the present time, the college has a membership of over 6,500 professionals.
As the complexity of the college's services increased, it was realized that greatly expanded and unique facilities were needed for the college to attain its objectives. The form of this expanded effort will be a facility known as Heart House. For reasons stated later in my remarks, the American College of Cardiology chose to locate Heart House in Bethesda, Md. In essence, Heart House is the culmination of the college's efforts to set up a National Cardiovascular Education Center.
Heart House will aid in the continuing education of physicians all over the world through development and distribution of educational materials including tapes, slide sets, manuals, films and self assessment examinations.
Inasmuch as the college membership reaches into virtually every medical teaching facility and medical activity, Heart House will have the expertise and the resources of the entire Nation at its disposal to assist in the development of programs and the accumulation of educational materials.
All teaching materials developed by the Heart House educational program will be made available to cardiology teaching centers that request them.
Within 5 minutes walking distance from the Heart House site are the National Library of Medicine and the National Institutes of Health, which include the superb Clinical Center and National Heart and Lung Institute. Other medical resources in the area include the United States Naval Medical Center, Walter Reed Army Medical Center, the future Uniformed Services University of the Health Sciences, the medical schools of Georgetown, George Washington and Howard Universities, and the Armed Forces Institute of Pathology. Within 50 miles are the Johns Hopkins Medical Institutions and the University of Maryland Medical School and Hospital in
Baltimore.
I join in welcoming Heart House to Maryland and look forward to the fulfilment of its great potential. It. was my honor to be present at the ground breaking for Heart House and to hear the remarks made by Dr. Theodore Cooper, Assistant Secretary of HEW and other distinguished speakers. I ask unanimous consent that excerpts from their speeches on that occasion be printed in the RECORD.
There being no objection, the excerpts were ordered to be printed in the RECORD, as follows:
EXCERPTS FROM THE REMARKS BY THEODORE COOPER, M.D.
The programs proposed for Heart House and the exceptional opportunities it will provide for the continuing education of practicing cardiologists are laudable. The previous experience and past successes of the American College of Cardiology in endeavors of this sort are guarantee enough that Heart House will fulfill in ample measure the great hopes we all have for it.
Today's practicing physician has problems in attempting to stay abreast of developments in his specialty, if he has one. And things are more difficult still for the general practitioner who is expected to keep reasonably up to date on developments in many medical fields.
Gone are the days of the "Renaissance Man" who once could aspire to mastery of the whole of human knowledge. It probably wasn't feasible even during the Renaissance and it certainly isn't today. We find ourselves in the midst of a data explosion in virtually every scientific field that, to mix metaphors, threatens to drown us in a sea of facts.
From past experience as Director of The National Heart and Lung Institute, I know that our scientists and grantees cranked out more than 4,000 papers and abstracts on cardiovascular disease topics during the average year. This was probably considerably less than half of the total output of all CV investigators during any given year.
As a past Director, it would be unseemly if I said that a great many of these papers were bilge. For while some confirmed and extended findings originally reported before the administration of William McKinley, others confirmed and extended findings reported somewhat later. And all contributed in one way or another to the accumulation of "important basic data". In science, it would seem, basic data is an invaluable resource, sort of like natural gas, perhaps. Basic data should not be treated lightly, and it isn't. Indeed, if there is one thing that can be said about the current crop of experts on information retrieval, it is that most of them go all out to retrieve it all.
Clinical research advances, however brilliant, are of only limited value in the prevention, diagnosis, or relief of illness unless they are widely applied. There are, of course, unavoidable time lags between the development of a promising new technique, adequate demonstration of its effectiveness in carefully controlled clinical trials, and its general acceptance as an established procedure in clinical medicine. It is a matter of concern to all of us that this time lag be kept as brief as possible.
But of course, simply narrowing the time lag between discovery and application of important new concepts and techniques in medicine is not enough to solve the multitude of problems facing us. For undoubtedly the number one problem — the overriding issue — that confronts the whole of the American health care enterprise is the problem of cost.
This is neither the time nor the place for me to launch into a lengthy and probably well-worn sermon on the cost issue. Yet it certainly is germane to this occasion for the simple reason that cost is inseparable from quality of health care, and the whole thrust of the Heart House program — and the most important contribution that the American College of Cardiology is making and will continue to make — is in the area of improving the quality of care available to CV disease patients throughout the country.
When you stop to think about it, we have some rather odd ways of trying to assure quick health care. I mean, for instance, the whole fault system based on the threat of malpractice litigation is hardly what one would call the ideal way to guarantee high quality care. Certainly well organized peer review systems are fundamentally more sound. And it is my sincere hope that PSRO, not by itself certainly, but in concert with other mechanisms, will be able to elevate the quality of health care by enabling physicians in every specialty and subspecialty to benefit from the knowledge and good counsel of recognized authorities and responsible professional organizations like the College.
Clearly when this country adopts a system of national health insurance — and that is probably not very far down the road — the need to exercise prudent cost control without sacrificing quality will be paramount. I hope that our profession will be prepared to take the lead in that endeavor, rather than to turn it over to government. And here again, this Ground Breaking and the work that will be carried forward one day here at Heart House should give us all reason for guarded optimism.
One of the most effective means yet devised for helping physicians, not only to keep them from drowning in a swirling sea of new research and clinical information but to ride the crest of the waves, has been refresher training courses.
In the cardiovascular disease field, of course, the American College of Cardiology has been a leader in the development and administration of such courses. Prepared and taught by experts, eliminating extraneous material, and concentrating on proven concepts directly applicable to the solution of clinical problems, these courses have enabled participating physicians to stay abreast of fast-breaking developments in the cardiovascular field without forsaking their clinical practice for prolonged periods.
The establishment of Heart Home marks an especially significant milestone in a continuing program with a proud record of achievement and an exceptionally promising future. The courses, educational materials, and teaching techniques that will be developed, used and evaluated here are likely to have profound and salutary effects on cardiovascular training programs everywhere.
EXCERPTS FROM THE REMARKS BY E. GREY DIMOND, M.D., F.A.C.C.
Our Earth is saturated with problems, all essentially manmade; therefore, it is a. special dividend on this magnificent Fall day in late September 1975 to share an adventure that has no possible misinterpretation.. We pause here to recognize that mankind is also capable of positive actions. This is a therapeutic moment for all of us.
In my own years of academic life, I have learned well that "institutions are but the lengthened shadows" of the abilities of the men and women who created them. But I have also learned that when the shadow makers have left the scene, that the remaining bricks and mortars may enhance their message beyond the founders' dream.
People and ideas are important — but place them in a great grove of ancient trees nearby the stimulus of national resources for health knowledge and health care, and shelter them in a symbolic building — a House with a Heart — then you will have set in motion the greatest strength the human mind can generate:
People — ideas lifted by their environment — working together to improve the life of their fellow man.
Last night I was asked "how large will Heart House be?" — My own answer must be "who knows?" — Those of us who have brought it to this stage have to our surprise discovered that many of us have grown older in the years required to reach this stage. In fact, many of us find ourselves almost at the end of our active careers — yet the organization on whose behalf we have worked ... The American College of Cardiology ... has only become a youth of age twenty- five — and The College will still be in its prime in twenty-five more years, yet by then, even the younger men and women now active in The College will have left the scene. So there is no definition of the "size" of Heart House. What happens on this ground will depend upon the energies and ambitions of successive generations of physicians. What we start today is only the beginning. In fact, the largest contribution we have made, any of us, for this project — has not been in money — but in moving The College from the limitations of its original base — here to the unlimited potential of Bethesda — and this beautiful piece of earth.
EXCERPTS FROM THE REMARKS BY B. L. MARTZ, M.D., F.A.C.C.
This is a joyous day for all of those who have dreamed and labored so long and so hard for Heart House. President Fisch has allocated a few minutes for me to restate why most of us assembled here are excited about this project. The American College of Cardiology is committed that the building that rises on this site will not only be a headquarters symbolizing the prestige and status of a great professional organization, but more importantly, it will be an incubator for new approaches in the field of continuing education for practicing cardiologists. Heart House will be a place where all the necessary resources for innovation in education are assembled — the latest in electronic equipment — together with the best available people — of varying skills — communication technicians, educational theorists, knowledgeable teachers, artists, production experts — interacting to create new educational material and methods. I need not remind you that the means for communication have exploded in our generation — most of us can remember our first radio. Our children accept television as having been here forever. Coming fast on our heels is a generation which measures the interest level, the impact, the efficiency of a learning experience in the context of Sesame Street. How long do you think they will continue to patiently sit hour after hour in crowded rooms listening to a learned, but dull, lecturer with no, or poorly prepared, visual aids lecturing on topics selected by the teacher with no means of measuring his or her impact on the audience and the audience having no way of letting the teacher know how irrelevant the material is to their needs — both with no choice over the fixed time, place and pace of their essentially unidirectional communication?
Our children have grown up accustomed to a fast tempo of information transfer — sitting in front of a television set and having the most complex of the world's problems dramatically documented and miraculously resolved all in one hour, with time out for at least four commercials. Their tolerance for the inertia of our educational systems; our failure to take fuller advantage of today's technology toward improved learning is predictably short lived. Dr. Sterling McMurin, Dean of the Utah Graduate School who headed up the Congressional Commission on Instructional Technology, came away from that experience somewhat critical of educators. Two years ago at a Heart House meeting in Kansas City, he pointed out, and I quote him, "The American College of Cardiology in its planning for Heart House is in a position of potential leadership in the field of education, since it can proceed without all the impedimenta of the conservative educational establishment." At that same meeting Dr. Robert Saudeck of Boston pointed out that it would be possible today to bring together into one electronic room the John Hopkins immunologists, the native nurse in equatorial Africa, the NASA physicians, the soaring astronauts and a classroom filled with interested medical students at Guy's Hospital in London.
We could add that with Heart House the product of such an exercise in international and extra-terrestrial communication could be evaluated, edited, tested for its teaching value and relevance, packaged and distributed to practicing cardiologists to be experienced at a time and place of their choosing — hopefully accompanied by some mechanism to determine if the new information resulted in any change in the physician's handling of problems.
The technology for capture, storage and distribution of information is not standing still — a new chapter is just around the corner in the form of mass producible relatively low cost video discs. Satellites make the whole world a TV studio.
Creating a building may well be the easiest part of our total Heart House task. We will not have kept faith with Grey Dimond and other formulators of this concept unless this great organization measures up to its next challenge and opportunity — creating through Heart House an innovative, exciting, efficient, relevant, valuable system for providing continuing learning experiences over the years of the practice span of physicians caring for heart patients wherever they are!
EXCERPTS FROM THE REMARKS BY DWIGHT E. HARKEN, M.D., F.A.C.C.
It is no sacrilege to paraphrase noble words spoken 103 years ago and 80 miles north by north- west.
"Whether the world notes or long remembers what we say here ... it cannot possibly overlook what will be done here." It is for us the living and those to come to be dedicated to the unfinished work ahead.
In accepting this torch we are certain that we can harvest the materials, laboratory and clinical, from the multi-focal sources in the world and deliver it to the people who need that information. We shall also improve the methods of that delivery so that the Heart House attack on heart disease, and its improvement of the delivery of health care will become a landmark for the 20th Century.
EXCERPTS FROM THE REMARKS BY ROBERT I. LEVY, M.D.
The concept of Heart House as a center for continuing education and a focal point for innovative teaching should serve in the years to come as a model for the translation of biomedical research findings into clinical practice. The College's commitment to the medical profession is indeed praiseworthy. Data from research is of little value unless it can be applied either to additional research advances or translated into new and better techniques for prevention, diagnosis or treatment of man's ills.
Knowing so well the limitations of the federal resource it is indeed heartwarming to know that soon there will be a facility nearby that has a mission parallel to one of the Institute mandates as spelled out in the National Heart, Blood Vessel, Lung and Blood Act of 1972, namely, to provide the public and health professionals with health education and information. Heart House will make the professional education portion of our Government mandate easier. With this in mind, I pledge the cooperation of the National Heart and Lung .Institute and its staff to the concepts of Heart House. Any information that is generated as a result of investigations supported by the NHLI in the area of diagnosis, prevention or treatment will be made available to the College for dissemination to the medical profession. We stand ready to assist and support the College in the concept of continuing education.