During the last 50 years, cardiac and pulmonary rehabilitation programs have seen metamorphic changes that have helped patients lead longer, more productive lives. In five decades we have seen patient hospital stays decrease from 10 days to four, with exercise programs progressing from mere ambulation to vigorously intense programs using not only cardiovascular workouts but rigorous resistive training utilizing computerized equipment.
The act of monitoring has also evolved from hand-me-down monitors to advanced digital systems designed specifically for cardiac and pulmonary rehab programs. ECG tracings have transitioned from cutting and pasting strips to the digital storage of complete exercise session disclosures. Modern rehab systems now allow programs to monitor patients, manage programs, provide patient outcomes and even interface with a health system’s electronic medical records—all without paper.
While these changes have modernized the activities that cardiac and pulmonary rehabilitation comprise, one of the most significant changes has been to program accountability—including mandates by insurers to provide individualized care. In days past, patient treatment encompassed standardized, one-size-fits-all exercise. Today’s rehab patients now benefit from individualized treatment plans (ITPs) tailored to address their unique needs. Individualized plans allow rehab professionals to not only risk stratify but to incorporate specific program goals that identify each patient’s progression through the program and beyond. The emergence of ITPs has provided program support in the form of crucial documentation—particularly ITPs with advanced customization capabilities—that enable programs to continually adapt and apply new scientific findings for more effective and efficient care. Programs can now better equip themselves to provide targeted patient care as well as demonstrate evidence of value to healthcare systems and public and private insurers.
With the addition of advancements by AACVPR, rehab programs have been encouraged toward even greater accountability via certification protocol for programs and staff, which are greatly aided by the use of customizable ITPs. Equally important, the AACVPR data registries allow data collection for meta-analysis to help substantiate the crucial role cardiac and pulmonary rehabilitation play in every patient’s recovery and disease management.
The evolution of our profession and its standards of accountability has given birth to a new paradigm for patient care. We live in a time where rehab clinicians no longer administer a repetitive rendering of basic exercises and handouts; we now confidently serve as champions for our patients, relying on a wealth of expertise, data and technology to provide dynamic care that helps guide our patients’ success in recovery, substantiate our merit, and ensure the future of the profession.