Becker's Hospital Review

Service Line Leaders' Roundtable 20 Key Specialties Roundtable: What's in Store for Service Lines and Their Leaders in 2013? By Anuja Vaidya A s the demand for specialized care increases, hospitals have to transform and innovate the care offered by their service lines to meet this demand. Each service line is unique, and the development of each differs. But, service line leaders are confident that with engaged physicians, creative solutions and care coordination, service lines can increase patient satisfaction and quality of care. In this article, several service line leaders from top programs across the country discuss the opportunities in and challenges facing the oncology, cardiovascular, neurology and orthopedic service lines in the coming year. They also talk about the latest technologies being used in their service lines and offer advice to service line leaders. Cardiology and Cardiovascular Question: What are some of the biggest developments or opportunities for growth in the cardiovascular service line in the coming year? Jennifer Bringardner, Vice President, National Cardiovascular Service Line, Catholic Health Initiatives (Englewood, Colo.): The cardiovascular service line is undergoing significant change. It is expanding from primarily a focus on episodic care to population health. That is, caring for the consumer across the continuum. Primary prevention will be a major area of focus. New models of care delivery will shift care from hospitals, historically the center of the healthcare continuum, to less expensive and more appropriate settings. As we form our clinically integrated networks, the role of the cardiovascuJennifer Bringardner lar specialist will evolve and develop to support these new delivery models. Tom Stys, MD, Medical Director of Cardiology, Sanford Health (Sioux Falls, S.D.): It is certainly a dynamic and fast-evolving world. The general trend is to provide care to patients in a less invasive manner, which also allows for expanding care to patients who are cannot undergo invasive procedures due to age. For example, minimally invasive valve replacement can be used for patients who are not candidates for open-heart surgery. Q: What are some of the newest technologies or applications that are being used in the cardiovascular service line? Greg Schwarz, Vice President of Business Development, St. Vincent Medical Center (Los Angeles): We have placed importance on diagnostic procedures and testing because this sets the course for the patient's cardiac care. We have spent a lot of money on improving the diagnostic equipment at the hospital. Additionally, we have placed greater emphasis on less invasive procedures as technology advances. Mr. Schwarz: The challenge today, in Southern California, is that the physician community is fragmented. Physicians and hospitals will need to become more organized and create centers of excellence. This will allow for comprehensive heart care to be delivered under one roof with increased efficiencies, better patient outcomes and lower costs. Dr. Colavita: A lot of the challenges have to do with increasing the size of the care team. In the past, physicians felt as though they were pretty much in charge of the patient's care. It was an individual physician-patient relationship. Now, we are creating partnerships with advanced care practitioners, primary care physicians and also pharmacists, social workers and dieticians. Q: How would you recommend overcoming some of the challenges facing the cardiovascular service line? Greg Schwarz Paul Colavita, MD, President, Sanger Heart & Vascular Institute, Carolinas HealthCare System (Charlotte, N.C.): We now use telemonitoring. We have an implantable device that monitors blood pressure in congenital heart patients. The data from the device is sent to a large remote diagnostic clinic and to the patient through their cell phone. This helps us make recommendations to the patient regarding medication and diet. Q: What are some of the challenges currently facing the cardiovascular service line? Tom Stys, MD Paul Colavita, MD

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