Getting to the Heart of Cardiology Alignment

Joe Cantlupe, for HealthLeaders Media , February 9, 2012

Success key No. 4: Collaboration
Scotland Health Care System, in Laurinburg, NC, an affiliate of Carolinas HealthCare System, joined with FirstHealth, based in Pinehurst, NC, to build the $2 million Scotland Cardiovascular Center on the outpatient wing of the Scotland Memorial Hospital campus in 2011.

The hospital systems are separated by 45 minutes, and sometimes compete for patients. Yet they joined together to build the cardiovascular center with a catheterization lab for improved patient care, a move that each hospital's leadership says can be replicated successfully elsewhere, for cost savings.

"As a small community hospital we have always been proactive in creating alliances with regional partners to bring the best technology and services to our community to allow patients to remain close to home," says Greg Stanley, director of cardiovascular services for Scotland Memorial Hospital.

The new relationship evolved from a long-standing, albeit much smaller, partnership. Over the past decade, FirstHealth managed a mobile cath unit that Scotland Health Care rented twice a week to perform diagnostic cardiac catheterizations.

The new cath center includes the catheterization lab as well as four preparation and recovery rooms. By having the cath lab on site, Scotland Health Care can serve patients each day, instead of only twice a week.

The lab allows the Scotland medical staff to transmit images from the procedures directly to FirstHealth, where doctors can review results and decide whether the patient needs additional care or services. Patients who need additional percutaneous transluminal coronary angioplasty or coronary artery bypass graft would be transferred to FirstHealth, which provides around-the-clock coverage for such cases.

"Scotland provides follow-up care to the majority of these patients—if we transfer for intervention or surgery, we get many of those back into our cardiac rehab program," Stanley says. "And the physicians at FirstHealth work well with Scotland cardiologists so patients can receive the advanced care when needed in Pinehurst and then return to their Scotland physicians," Stanley says.

Noble, of FirstHealth Moore Regional Hospital, agrees. While the part-time mobile lab provided some benefit to the community, "what was really needed was something five days a week," he says. "We want to improve access to care and improve the mortality rates. We'd like to deploy the lab to other areas and help people in other areas. We're lockstep in this."

The mobile lab, originally based in Laurinburg, has been replaced with a fixed lab available to patients five days a week, he says.

Under the joint-venture agreement, Scotland Health Care and FirstHealth invested $750,000 each to "purchase the fixed procedure room and support equipment," says Stanley. Scotland Health Care added another $1 million to renovate a hospital wing and then "relocated a couple of departments to make space for the new cardiovascular center," he adds.

Stanley described management of the center as a "team approach from both organizations." Stanley and Scotland Health Care's vice president of patient care services partner with administrators at FirstHealth. As for the day-to-day operations, "We utilize some of their staff on the procedure side, and we pay their organization per procedure," Stanley says.

Although there is no firm data because the project is relatively new, Stanley says more than 30 patients can use the new cath center each week, easily more than doubling volume.

Scotland Memorial Hospital statistics show that one in five emergency room visits has some sort of cardiac issue from either chest pain or high blood pressure.

"We are getting a better snapshot of cardiac disease in our county and in our region," Stanley says. "As we see it, our volumes will continue to grow on the cardiac side, and we are going to take care of more patients in a more timely manner. Patients will be getting started on the road to recovery quicker, getting cardiac rehab and some kind of medicine regimen.

"In this corner of North Carolina, there is a lot of cardiac and vascular disease, with diet, lack of exercise, food options, and smoking," says Stanley. "We can make inroads on this."

This article appears in the January 2012 issue of HealthLeaders magazine.

Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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