UPMC Heart and Vascular Institute Brings Advanced Care Close to HomeJun 30, 2016 08:53AM ● By North Hills Monthly Magazine
(l-r): Bradley Heppner, MD, Michael Curren, MD, Michael Fallert, MD and Joon Sup Lee, MD
UPMC Heart and Vascular Institute Brings Advanced Care Close to Home
When people are suffering from cardiac issues, such as atrial fibrillation, congestive heart failure or acute heart attacks, they want to know that their care is being provided by physicians who are not only specialists in the field, but who have the technology and most up-to-date knowledge to provide them with the best care possible. To this end, UPMC has combined the talents of its team of cardiologists, cardiac surgeons and vascular surgeons under the umbrella of the UPMC Heart and Vascular Institute (HVI) as a way to ensure that patients have access to a multidisciplinary team of experts.
“Historically, there have been divisions in the medical community, for example, between cardiac surgeons and interventional cardiologists, electrophysiologists and imaging specialists,” explains Joon Lee, MD, chief of cardiology and the co-director of UPMC’s Heart and Vascular Institute. “One of the focuses of the HVI is to deliver care in a much more integrated way across these silos of disciplines.
“If I’m a patient, I don’t care about the dividing line between specialties,” he adds. “All I want is for doctors to figure out what’s wrong with me, and give me the best care possible.”
The UPMC Heart and Vascular Institute provides the infrastructure that delivers heart and vascular care throughout the UPMC system, and includes services from prevention to transplantation. Its 113 cardiologists and 21 cardiac surgeons provide a high level of cardiovascular care to the communities surrounding Pittsburgh, enabling them to receive the majority of their treatment closer to home.
"UPMC St. Margaret has a very robust group of cardiologists who provide the full range of diagnostics and therapeutic modalities, including advanced cardiology procedures such as cardiac catheterizations and electrophysiology services,” says Dr. Lee. “UPMC Passavant is able to provide these same services, as well as advanced interventional cardiology, ablations and cardiovascular surgery."
Cardiologists and cardiac surgeons see patients out of the same offices at UPMC Passavant and UPMC St. Margaret, which is relatively rare across the country, according to Dr. Lee. “Traditionally, cardiologists would see a patient, and then hand him or her over to the surgeon,” he explains. “We take a team-based approach that involves everyone from the outset.
“Our experience has been that patients have a much higher level of comfort when they are treated by the same physicians consistently in their own communities,” he continues. “The worst-case scenario is for the patient to have to see a whole new group of caretakers at a whole new campus. It is better for them to have the same integrated group of doctors—for example, to be diagnosed by the same doctor at UPMC St. Margaret who will also do the stent procedure at UPMC Presbyterian.”
According to Michael Curren Jr., MD, clinical instructor of medicine, his patients appreciate that they can receive the majority of their care in a familiar place, but still have access to the UPMC system’s expertise and technology. “To have all of these services available is very costly, which is why health systems can’t have all of these specialized technologies at all sites,” he explains. “The benefit to patients at UPMC St. Margaret, for example, is that we have access to everything they need; I can see a patient at our satellite office in Natrona Heights, and if they require more complicated tests, I just pick up the phone and facilitate a referral so that they can get the test done very quickly. They don’t have to try to navigate the health system on their own; this really facilitates care.”
“One major advantage of being an HVI physician is that the doctors all know each other’s skill sets,” adds Brad Heppner, MD, a cardiologist at UPMC St. Margaret. “Rather than a patient trying to find a specialist on his or her own, we know exactly who we’re sending our patients to. We can just pick up the phone and discuss the case, and sometimes even save them a trip.
“It’s a very efficient system,” he continues, adding that UPMC St. Margaret is able to see new patients within 24 hours, and that the hospital is covered by a cardiologist 24/7. “All HVI doctors use the EPIC electronic record system, which centralizes medical records, so we are able to easily send messages to the other doctors as well as follow up on our patients. It’s a well-oiled machine.”
William Kallquist, 60, of Penn Hills, knows this first-hand. His primary care physician sent him to UPMC St. Margaret for a stress test to determine the cause of his exhaustion. “Even though most tests didn’t show a problem, on the treadmill part of the test, I only did six minutes before my heart rate really started climbing,” he explains. “Dr. Heppner sent me for a heart catheterization that showed four blockages, and I had to have a bypass.
“I was sent to UPMC Presbyterian, where I had surgery, and I was pretty good right after—I was walking the next day,” he adds. “Now I’m going back to work, and I couldn’t have higher marks for the doctors and nurses at both hospitals. I’m very happy with the results; I give them five stars!”
At UPMC St. Margaret and UPMC Passavant, physicians deal with a number of conditions including hypertension, arrhythmias, coronary artery disease, peripheral vascular disease, congenital heart disease, valvular disease, acute heart attacks and more. In the last decade, UPMC Passavant has invested in advanced technology—including two new cath labs and state-of the-art digital imaging—and recruited sub-specialty trained physicians to be able to perform cardiac surgeries as well.
“Procedures that were not done at UPMC Passavant seven or eight years ago, such as advanced electrophysiology ablation procedures for atrial fibrillation, are now quite routine,” said Dr. Lee.
“At UPMC Passavant, we are able to do almost everything short of transplants and certain complex procedures such as aortic reconstruction,” explains Michael Fallert, MD, chairman of the department of cardiology, and assistant director of clinical cardiology at the UPMC Heart and Vascular Institute. “A lot of patients who require coronary bypass surgery don’t realize that we do a high volume of those surgeries here, as well as valve surgeries. We also have a cardiac catheterization lab that operates 24/7 to treat acute heart attacks and acute cardiology issues.”
UPMC Passavant physicians also work in conjunction with other HVI physicians to provide patients with access to everything they need. “If we have a patient who needs cardiac MRI imaging, for example, we send them to UPMC Presbyterian for that test, then have them come back to UPMC Passavant,” Dr. Fallert explains. “This adds a degree of efficiency, because they are able to go to a centralized area of expertise for services that are not used that frequently.
“A lot of physicians travel between the Oakland and Passavant campuses, and there is a lot of communication back and forth,” he adds. “It is not uncommon to be evaluated by a cardiologist and a cardiac surgeon in the same day at the same place; and if the patient needs tests, they can have them performed in the same building.”
Having all of these services available in the same place was very convenient for Ron Pietz, 79, of Valencia, who recently had a quadruple bypass at UPMC Passavant. “During my physical, my doctor recommended a stress test, and I kept putting it off,” he explained. “Then I needed to have cataract surgery, and my PCP wouldn’t sign off on it unless I had one, so I went to UPMC Passavant for the test, which showed that I had four closed arteries.
“Dr. Saleem Ahmed, who found the blocked arteries, recommended that I have surgery, and it was a great success,” he adds. “I stayed in the hospital for five days, and received wonderful treatment. I couldn’t have asked for better. I’m feeling great now, and in fact, I’m getting ready to go out and cut the grass.”
In addition to having all of the latest technology and expertise available through the HVI, patients at UPMC’s community hospitals also have access to the same clinical trials that are performed at quaternary facilities like UPMC Presbyterian and UPMC Shadyside.
“We do participate in a variety of different trials, including drug trials for congestive heart failure,” said Dr. Fallert, adding that the hospitals’ electrophysiologists have also implanted new versions of leadless pacemakers and leadless subcutaneous defibrillators in patients.
“Participation in clinical trials as a health care delivery organization is critically important, “adds Dr. Lee. “This gives us earlier access to newer modalities, therapies and technology, including newer drug therapies, and the most advanced pacemakers and stents.”
No matter whether patients go to UPMC St. Margaret or UPMC Passavant, the fact that they have access to all of the expertise of the UPMC Heart and Vascular Institute, which is nationally recognized for exceeding benchmarks for quality and patient outcomes, ensures that they are getting the best care possible.
“The goal of the HVI is to provide patients with access to the full spectrum of care available, while at the same time, allowing them to remain in their own communities for treatment as much as possible,” says Dr. Lee. “It’s not your typical hub-and-spoke model, which would require them to always come downtown; we try to minimize that through a community-based approach.”
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