Across the nation, hospital leaders are migrating many of their electrophysiology services to ambulatory surgery centers and satellite locations. So what does that mean for hospitals?
Electrophysiology, a cardiology specialty that treats the heart’s electrical system, is the fastest-growing subspecialty in the U.S., hospital leaders told Becker’s, thanks to factors such as the country’s aging population, which has increased the number of atrial fibrillation, heart failure and other complex rhythm-disorder cases; advanced technology that allows more patients to receive procedures; and updated clinical guidelines encouraging earlier intervention for many arrhythmias.
Health systems across the nation are seeing an increase in electrophysiology service demands and restructuring their services to meet increased volume.
“The ideal scenario is to reserve hospital-based care for the more complicated patients,” Usha Tedrow, MD, director of fellowship and the Clinical Cardiac EP Program at Boston-based Brigham and Women’s Hospital, told Becker’s. “The real strength of the hospital environment is having consultants from every specialty in medicine available to help care for patients who truly need that level of support.”
Leaders at New York City-based Columbia University Vagelos College of Physicians and Surgeons and New Orleans-based LCMC Health said they will continue migrating some EP procedures into ASCs, including device implants and select ablations.
“Hospital-based EP programs remain fundamental for complex ablations, lead extractions, ventricular tachycardia procedures, patients with significant comorbidities and cases requiring multidisciplinary support or advanced hemodynamic management,” Olivia Fleming, MSN, RN, corporate vice president of cardiovascular service line at LCMC Health, said. “Outpatient centers improve access, increase procedural capacity and enhance patient experience, while hospitals concentrate resources on the most clinically complex patients.”
ASCs are also an ideal location for ongoing follow-up care, said Jessica Hennessey, MD, PhD, a cardiac electrophysiologist and assistant professor of medicine at Columbia University Vagelos College of Physicians and Surgeons. The system is expanding device clinics in its satellite offices that are staffed by advanced practice providers who are overseen by electrophysiologists. This arrangement allows patients to have routine device checks and urgent programming changes closer to home.
“Importantly, we don’t see the growth of ambulatory EP as competing with the hospital-based cardiology program; it actually strengthens,” Dr. Hennessey said. “By moving the appropriate services into outpatient settings, we can reserve hospital-based resources for the most complex patients and procedures. In that sense, we are continuing to create a more efficient and more integrated model of care across the entire health system.”
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.