How I Do It: A Collaborative, Interinstitutional Program to Improve the Care of Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

Chronic thromboembolic pulmonary hypertension (CTEPH), a subcategory of pulmonary hypertension (PH) and chronic sequela of acute pulmonary embolism (PE), is often underdiagnosed due to nonspecific symptoms. Pulmonary endarterectomy (PEA) remains the optimal, potentially curative therapy; however, determination of operability is based on multiple factors that may be relatively unique to each patient and largely based on physician expertise. Patients with CTEPH should be referred to CTEPH centers for comprehensive confirmatory diagnostics and operability assessments by multidisciplinary teams. As CTEPH center experience and expertise are key to improving clinical outcomes, challenges arise when they are not available or easily accessible to patients. This article describes the Michigan Multi-center CTEPH Collaboration, a multidisciplinary, interinstitutional collaboration program developed by healthcare centers in Michigan, USA. PH and PE teams from centers across the state share expertise and clinical opinions in a monthly virtual conference. This collaborative approach tackles the two main challenges in the treatment of CTEPH head on: accurate diagnosis and patient access to CTEPH centers. Our collaboration model can be used as a best practice across the nation to benefit patients, multidisciplinary teams, and CTEPH centers.