HCA Midwest Health - March 21, 2019

Emergencies happen. But what if we had a way for one emergency to prevent another? What if kidney stones could help prevent a heart attack? Or one stroke could prevent a second? That would be pretty amazing, right? Well, right now in Kansas City, it’s a reality. Here’s how:

Detecting Potential Future Emergencies

The first step to preventing emergencies, like a heart attack or a stroke, is to identify the signs one is likely to occur. How can we do that?

At HCA Midwest Health, we use a patented information technology system called Care Assure to pull data from various sources. This program can help us identify people who may need crucial care in order to prevent a future cardiac emergency.

“If you go to an ER with symptoms or an issue that affects the area from your nose to your navel, most of the time best practices call for an EKG to rule out or confirm heart issues. If your EKG is abnormal and you are experiencing other symptoms like shortness of breath, an echocardiogram might also be ordered,” says Tamra Fisher, HCA Midwest Health’s division director of Care Assure. “We use these same tests to screen patients for arrhythmias, heart valve issues or other problems that otherwise may have gone undetected until someone experiences symptoms or it becomes an emergency.”

The Care Assure program automatically leverages these tests that are already being performed during an emergency, inpatient or outpatient visit to detect heart issues so they can be treated preventively before they become an emergency.

But HCA Midwest Health doesn’t stop at just identifying the cardiac issue. Once a potential future issue is recognized, a specially trained nurse navigator is automatically notified through the Care Assure system.

Connecting You to the Right Care – Your Personal Healthcare Assistant

After being released from the hospital, it can be difficult to know where to start. Research tells us:

  • Approximately 18 to 21 percent of people remember what they are told while in the hospital
  • About 80 percent of people do not understand their discharge instructions
  • Roughly only 41 percent of people follow up with a doctor, even when recommended

This is where the second part of emergency prevention comes into play.

Once a nurse navigator is notified through the Care Assure system, he or she becomes a second set of eyes on your health records. The nurse navigator reviews your chart, treatment plan and then reaches out via a phone call.

“Patients sometimes don’t understand the importance of follow-up care. It is imperative for his or her health to attend any recommended follow-up appointments. Our nurse navigators help connect patients to the care they need to help reduce the chance of a future cardiac emergency,” says Tamra. “The navigator is like a healthcare personal assistant.”

A nurse navigator will call you to:

  • Ensure you understand your discharge instructions, treatment plan and any necessary medications
  • Recommend resources to help lower the cost of prescriptions
  • Help you find doctors, specialists, and schedule and track necessary appointments
  • Explain test results, answer any questions and help with education about your condition

Traditionally, you go to an ER and have your emergency taken care of. If a heart issue is detected it may only be included in your discharge instructions without out any explanation or follow-up about how important it is to see a cardiologist. Care Assure and nurse navigation prevents many of those cardiology needs from falling through the cracks.

“It’s really going above and beyond what normal hospital or emergency room care looks like. This is a way for us to be proactive and get patients the care they need, potentially saving them future ER visits, and more important, sometimes saving their lives,” explained Tamra.

Treatment and Expertise from Some of the Region’s Leading Cardiologists

Detecting cardiac issues and helping you navigate through follow-up care are only the first steps. The right capabilities and clinical excellence are needed to truly prevent cardiac emergencies and save lives.

“Our ability to identify unmet clinical needs through our ERs and make sure patients receive proper follow-up is way above the standard of care in 2019,” states HCA Midwest Health’s medical director of cardiovascular services, Steven Marso, M.D. “The final crucial piece of that is having a multidisciplinary team who can care for these patients and change the course of their health.”

Over the last two and a half years, Dr. Marso has worked tirelessly to elevate the HCA Midwest Health cardiology program to one of the best in the region. The team consists of some of the most skilled and experienced clinical cardiologists, cardiac imagers, electrophysiologists, interventional cardiologists and cardiac surgeons from around the nation.

“Our cardiac program has grown exponentially. We now have the ability and proven track record to treat the most advanced cardiovascular problems,” states Dr. Marso. “Over the last year we have performed over 100 CTO PCIs, over 100 TAVRs, performed the first bi Impella in the region, are the only health system in the area to offer surgical hybrid revascularization, and have the best left atrial appendage team in the region with deep experience and talent.”

Between advanced cardiac care, the patented prevention program and personalized follow-up navigation, ER care that helps prevent cardiac emergencies is a reality in Kansas City. But, what does it all mean?

Extending Quality Years of Life

Preventing emergencies and connecting people with the right care saves lives and improves quality of life.

“We are actually able to measure the number of years a person’s quality of life will be improved or extended by the early identification and treatment of disease. So we can say, ‘Because we were able to proactively identify a potential issue and get you the care you needed, we were able to give you this many years back.’ That’s something no other health system can currently say,” says Tamra.

Since the program launched in July 2015, HCA Midwest Health has given Kansas City patients back over 3,600 quality years of life.

Not Only Saving Hearts in Kansas City

Currently, Care Assure is primarily used to prevent cardiac emergencies, but that’s not all it is capable of. By analyzing enormous amounts of data, other potential health risks were identified, such as a person being over the age of 50 without a primary care physician.

“We are going to continually be looking at more ways to expand this program to help modify risk, prevent more emergencies and help Kansas City become a healthier community,” says Tamra.

Care Assure is the only program of its kind and is exclusive to HCA Healthcare hospitals. It was initially launched at HCA’s JFK Medical Center in Atlantis, Fla., in 2012. It is currently implemented at 156 HCA hospitals nationwide and in the process of being rolled out to all other HCA facilities.

Care Assure is part of HCA Midwest Health’s larger care navigation and emergency prevention initiative, Care Connect.