Having competing physician groups at the table is no easy task. "Those conversations were difficult at the beginning, sitting across the table with some history of competition that initially could not be overcome. It took many meetings and a lot of time and energy to get through it," Bowman says.
The hospital developed its service line to overcome what started as "unstable coverage" of a single cath lab in 2001, when two competing physician groups were involved, he says. Now, there are two cath labs accessed by eight cardiologists, who perform 2,500 procedures annually.
"The cardiology management committee set the foundation for how we engage physicians. The ... committee consists of one representative from each of the three competing cardiology groups," he says.
Gradually, the hospital coordination has resulted in substantial savings for the cardiology service line. In 2007, strategic performance improvements saved about $5 million, Bowman says, which he attributed to "front line staff, administrative operational leadership, and physician leaders."
Wellmont, an 8-hospital system in northeastern Tennessee and Western Virginia, has been evolving their cardiovascular service line within a co-management structure with physicians, according to Tim Attebery, system VP of cardiology vascular services.