December 19, 2014
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Bringing cardiology care close to home
Dennis D. Keefe

It is no secret that here in New England we have world class health care. At Care New England, we offer a highly trained team of physicians who work to ensure that we keep the patient close to home whenever possible.

This is particularly the case for cardiovascular care. Last year, when Care New England launched our clinical affiliation with Boston’s Brigham and Women’s Hospital (BWH), we began offering cardiovascular experts, capable of providing all but the most complex care here in Rhode Island. With Rhode Island-based clinicians, telemedicine consultation, and, complex treatment, if needed, in Boston, this unique system of care allows for coordination and continuity for the patient among the same group of caregivers. We believe this model sets a new standard of care in Rhode Island. 

Recently, through the expansion of Brigham & Women’s Cardiovascular Associates at Care New England, we are able to provide new and more complex services. We have integrated the Kent program with that at Memorial Hospital of Rhode Island, the newest hospital in the Care New England family, and we have a new Providence site located near Women & Infants Hospital. 

It could be suggested that this BWH clinical affiliation has done nothing but drive patients out of Rhode Island to send them to Boston. This couldn’t be further from the truth. 

Prior to the BWH affiliation, Kent Hospital performed only about 50 simple electrophysiology procedures, such as pacemaker implantations, each year. In contrast, this past year BWH cardiologists at Kent performed more than 300 electrophysiology procedures, including such complex ones as ablations of dangerous heart rhythms and implantation of cardiac defibrillators. Many of these procedures would have previously been performed in Boston. Now they can be done close to home in a hospital where patients’ primary care team practices every day.

We are also bringing new cardiovascular research studies into Rhode Island and affording local patients access to some of the most pioneering clinical trials taking place anywhere in the nation. Likewise, the BWH relationship has also assisted us as we participate in new population health projects. Kent Hospital is a participant in a Center for Medicare and Medicaid Innovation demonstration project for patients with congestive heart failure (CHF). In this pilot, Kent is responsible for the total costs for these Medicare CHF patients for a 30-day period post-discharge. BWH has been a valuable partner developing new protocols that could well serve as a national model for improving care and reducing the total cost of that care for this chronic condition.

Importantly, the affiliation with BWH has helped us raise the quality bar. The past year has seen substantial improvements in publicly reported cardiology quality measures at Kent, with many now having 100 percent compliance rates. Due to a strong focus on educating a multidisciplinary team of caregivers in evidence-based protocols, quality oversight of important procedure and tests, such as cardiac catheterization, echocardiography and nuclear cardiology, have benefited local patients tremendously.

Finally, thanks to the technological innovation of telemedicine, we are able to seek second opinions from leading experts in Boston for patients hospitalized right here. These consultations help us formulate the most appropriate care plan, oftentimes negating the need to transfer and allowing the patient to remain close to their family and the providers who know them best. We are providing patients with an important choice for their care.  This is good for them and for the health care landscape here in the state.

Consider the compelling story of a 68-year-old Coventry woman who had been treated for some time for serious heart complications. Through her a visit to BWH at Kent, it was determined that she needed an immediate visit with the group’s advanced heart failure specialist, who sees patients locally in Warwick. In light of her grave condition, it was recommended that she be listed for a heart transplant. Just four weeks later, she received a new heart at BWH in Boston. After discharge, she returned home to be with her family, receiving outpatient cardiac care at Memorial Hospital in Pawtucket. She will have follow up visits with her BWH Cardiovascular Associates doctors back at Kent right where her journey began. All of this from the same care team means overall continuity of her care. Today, this patient is getting her life back, spending time with her grandkids and cheering on her beloved Red Sox.

Keeping care local, providing great outcomes and offering patients the assurance of care coordination, isn’t that what providing the best possible health care should be all about?

Dennis D. Keefe is president and CEO of Care New England, the parent organization of Butler, Kent, Memorial and Women & Infants hospitals and the VNA of Care New England.


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