Physicians and staff at Oklahoma’s first freestanding, dual-entity heart & vascular center has successfully treated over 3,000 patients.
“It’s exciting to have successfully treated so many patients in this incredible facility” says Dr. Jim Melton, a vascular surgeon who is one of the two founding members of Advanced CardioVascular Solutions (ACS) and Advanced Surgical and Research Solutions (ASRS), each one of the clinical entities that create the ‘dual entity’ facility opened in 2017. “From the very beginning, we were committed to establishing a first-class facility, capable of treating a broad spectrum of heart and vascular disease patients in a very patient-centered environment.”
Located in northern Oklahoma City, the ‘dual entity’ facility consists of two independent clinical entities: A physician-owned Office-Based Surgical Center (ACS) (aka Office Based Lab or ‘OBL’); and a physician-owned, Federally Licensed, Joint Commission Accredited Ambulatory Surgical Center (ASRS). ACS (the OBL) and ASRS (the ASC) each utilize the same facility on separate days. This structure allows for a wide range of service offerings for patients who seek treatment for elective procedures in a non-acute care setting.
Having been cofounders of the most successful physician owned heart and vascular hospital in Oklahoma, Dr. Melton and Dr. Dwayne Schmidt, an interventional cardiologist, were experienced in not only building, but also establishing winning brands for health care facilities. In 2015 they re-established their independent practice after leaving their employment and ownership status with the hospital they had helped build and open in 2002.
“The overpriced services, out of control overhead, and gradual erosion of the patient focused care emphasis drove us to look for a better solution for our very busy heart and vascular practices. The hospital we had opened had ultimately evolved into the hospital we had built it not to be,” stated Dr. Schmidt.
“We had a vision to create a highly efficient, very economically competitive entity that could be used to leverage the local health care market towards better outcomes, lower costs for patients and health plans, and at the same time improve patient satisfaction.”
“We knew we needed a physical environment and operational business model that would be regulatory compliant and offer a full range of heart & vascular services; and thereby provide a compelling value proposition for not only commercial payers, but a broad spectrum of interested direct contract employers and TPAs” stated Dr. Melton and Dr. Schmidt. “The Dual Entity OBL/ASC made sense, but even with our experience with building hospitals and free-standing diagnostic heart and vascular catheterization labs--and operating mobile Cath labs since 1994--we elected to get some assistance with the development of these entities. We reached out to Heartland Partners because of their strong background in heart & vascular care and their successful track record in building these models in other markets. With their assistance, we have been able to bring our vision to reality in Oklahoma.”
“We opened the OBL in May 2016 and the ASC 11 months after that” says Dr. Schmidt. “Since then, we have performed over 200 Cardiac Rhythm Device Implant procedures; 1,100 Cardiac Cath’s; 50 Coronary Interventions (Stents, Atherectomies, PTCAs); 1,400 Peripheral Angiograms; 825 Peripheral Interventions; 30 Interventional Radiology procedures; and 300 Pain Management procedures. All of our coronary interventions, device implants, and peripheral interventions are discharged the same day.”
“The newer, minimally invasive peripheral vascular disease management strategies and payments have spurned the expansion of OBLs across the national market place, but coronary disease management procedures and cardiac rhythm management implants have been slow to arrive in this space, for a number of reasons—economics, risk concerns, and the lack of experienced and independent cardiologists since the Provider Based Fee schedules and employment models beginning in 2009. We had the experience and enough market control to move a large percentage of our Medicare and commercial cardiac procedures out of the hospitals, into this space. A significant number of commercial payers, TPAs, and self-insured entities have benefited from the dramatically reduced costs and excellent outcomes. We have experienced the significant beginnings of ‘medical tourism’ to our facility, from as far away as North Dakota, El Paso Texas, and Florida.”
“We also perform a lot of limb salvage and pedal access cases here. It allows us to treat patients that would otherwise be facing amputation” said Dr. Melton. “Our patient selection protocols are driven by evidence-based national society guidelines. We maintain transfer agreements with the local hospital in the event of emergencies, and we monitor our clinical quality & outcome data rigorously.”
New members of the physicians group include interventional cardiologist Dr. Marcus Smith, and interventional radiologist Dr. Blake Parsons. Dr. Parsons has brought additional procedural expertise with vascular ablation of uterine fibroids and benign prostatic hypertrophy, pain management, spine disease interventions, complex deep vein disease interventions, as well venous insufficiency management.
Amanda Stanley, RN, CNOR is the Clinical Director of the facility, and notes that patient satisfaction and clinical outcomes are very high. “Our Patient Satisfaction scores are at 98% and above, and our clinical outcomes are excellent. We have had no serious adverse outcomes or emergency hospital transfers, and our post procedural infection rate is below 1% for all cases.”
Designed with the patient experience in mind, the facility is comprised of approximately 10,000 square feet and is equipped with all new, hospital-grade diagnostic imaging and patient monitoring systems. There are two dedicated operating rooms, one of which is equipped with a floor-mounted Toshiba 5-Axis Infinix Imaging System and the second OR with a mobile digital C-arm system. There are8patient prep/hold rooms which are all completely private, and equipped with dual purpose monitors for display of procedural films for patient education and consent. The facility is co-located downstairs from the privately owned and operated Cardiovascular Health Clinic (CHC), the clinical practice.
Tonya Casey, COO of CHC states that “In our office patients can have all of their ambulatory evaluation procedures including SPECT and PET scans, echocardiography, non-invasive vascular imaging studies, rhythm management, and their long term clinical management needs met--at one location.”
The center has gained national and international recognition for its approach to limb salvage and pedal access techniques, broadcasting live cases via satellite and hosting numerous physician site visits from as far away as Japan. According to Dr. Melton, the center is also working with Heartland Partners to develop a customized workshop for physicians interested in developing their own dual entity centers, which should be available in Q1 2019. The workshop will incorporate key developmental, clinical, operational, and financial considerations for dual entity heart & vascular structures.
About Advanced Surgical & Research Solutions, LLC
Advanced Surgical and Research Solutions is a multi-specialty Ambulatory Surgery Center that is Joint Commission Accredited and dedicated to providing the highest quality comprehensive care in a patient-centered, outpatient environment. The facility is equipped with the latest in technology and equipment to assist in performing minimally invasive procedures without the inconvenience and hassle of going to a large hospital. Specialties include Cardiac, Peripheral Vascular, Electrophysiology, Interventional Radiology and Pain Management. For more information, please visit https://cvhealthclinic.com/advance-surgical-and-research-solutions/
About Advanced Cardiovascular Solutions, LLC
Utilizing state-of-the-art imaging technology, the physicians at Advanced Cardiovascular Solutions perform at the leading edge of all available cardiovascular and peripheral vascular out-patient procedures. The facility and staff are focused on providing procedures in a cost-effective manner with a personal, patient-focused approach. Services include diagnostic and interventional cardiac procedures, diagnostic and interventional peripheral vascular procedures, and rhythm management device implants. There is a strong focus on limb salvage utilizing the latest techniques, equipment, and devices. For more information, please visit https://cvhealthclinic.com/advance-surgical-and-research-solutions/
About Heartland Partners
Established in 2007, Heartland Partners has developed several dual entity heart & vascular centers across multiple states. The firm has been successful in working with commercial payors to demonstrate cost savings and secure in-network contracts for the centers they work with. In addition to their expertise in developing free standing OBL’s & ASC’s, the firm offers extensive post-operational management and analytical services to each of their clients. For more information, please visit http://www.heartlandpartners.net