|Since Cardiology Associates in Mobile, Ala., acquired a GE LightSpeed VCT three years ago, they have performed more than 4,300 coronary CT angiography scans, and total procedure volume has grown 10 percent per year since the first year.|
Whether it’s the latest CT scanner, wireless ECG transmission from the field, or hybrid lab, facilities and practices are capitalizing on those technologies that will help them carve out a niche in the cardiovascular marketplace.
Competition is fierce within the cardiovascular industry and healthcare consumerism has become prevalent. While this consumerism does not translate into a patient deciding which stent or catheter should be used in a procedure, it does mean organizations have started to consider the patient, who is demanding quality and safe services provided in a timely, well-communicated way, as they work to gain a competitive edge. The newest technologies are simply expected as part of the entire care package, otherwise, patients could go “shopping” elsewhere. Cardiovascular Business spoke with a cardiology practice, a small community hospital and a health system hospital to find out how they are utilizing technologies to sustain a competitive edge.
64-slice CT and 3D EP mapping
Sixty-four-slice CT has helped Cardiology Associates, a 28-physician practice in Mobile, Ala., gain more referrals and increase market share, according to Vance Chunn, CEO and administrator. Since adopting GE Healthcare’s 64-slice LightSpeed VCT in April 2005, the practice has performed more than 4,300 coronary CT angiography scans, and total procedure volume has grown 10 percent per year since the first year, as Medicare and many insurers now cover cardiac CTA.
The application of 64-slice CT has spilled over into other areas of cardiology for Chunn’s practice, particularly in the electrophysiology (EP) and peripheral vascular arenas. Utilizing CT in EP procedures as a preliminary look at the anatomy shortens procedure time by creating a more accurate map of the heart. In peripheral vascular cases, CT speeds up interventional procedures by creating a roadmap of kidney or leg blockages.
Within EP, Chunn says another valuable technology has been EnSite 3D mapping software from St. Jude Medical. “Now the technology exists so that EP docs can go inside the heart and ablate certain areas more precisely than before,” he notes. In four to five hours, a cardiologist can make precise burns with ablation equipment and cure the problem of atrial fibrillation.
Shorter procedure times translate into increased volume, according to D. Scott Kirby, MD, of Cardiology Associates, who reports performing anywhere from 35 to 50 ablation procedures per month and has done more than 60 atrial fibrillation ablations this year alone.
The EnSite system maps the electrical activity of the heart, localizing and visualizing electrophysiology catheters in real-time, creating 3D displays of cardiac anatomy and arrhythmias and enabling the navigation of non-proprietary catheters without the use of fluoroscopy. “We are able to much more precisely locate, with single heartbeats, where the irregularities are, and go in and burn that area,” says Kirby.
“There are new technologies being developed all the time, but it is the combination of new technologies and the people who use them that make the difference,” Chunn concludes.
D2B times and hybrid labs
The NIH Heart Center at the 228-bed, acute-care Suburban Hospital in Bethesda, Md., provides cardiac surgery, elective and emergency angioplasty as well as inpatient, diagnostic and rehabilitation services to the surrounding Montgomery County. The arsenal of technology offered is provided in an environment that combines high tech with high touch, says Regina Deible, RN.
In the last month, the center has met its 90-minute door-to-balloon time 100 percent of the time. Since opening two years ago, the center has been running at 85 to 90 percent of the 90-minute parameters, according to Deible. She attributes this to the dedicated effort by a special collaborative team that reviews core measure data to identify shortcomings. “Couple this with prompt identification of a STEMI via notification from the field ECG monitors and quick cath lab access via a 24/7 ‘one-call-does-all’ physician phone line and you have the makings of a successful D2B program,” Deible says.
The growth of the cardiac program at Suburban is largely attributed to the combination of non-invasive imaging modalities, electrophysiology