Perspective from Stuart F. Seides, MD, Physician Executive Director, MedStar Heart & Vascular Institute
As healthcare professionals, we are trained to deal with crises. Still, it is the unexpected and seemingly unimaginable crisis that tests our mettle. The coronavirus pandemic was like nothing any of us has ever encountered, but “necessity being the mother of invention,” we stepped up to tackle this novel disease, which posed a unique threat to patients, providers, and our community.
What we do understand is the value of true leadership during adversity. As leaders in cardiovascular medicine and surgery, we approached this challenge by setting priorities, rapidly gathering information, creating a safe environment for our patients and caregivers, and adapting quickly to deliver needed clinical care. Treatment pathways were adjusted in real time: Like flying the plane while building it, there was no “timeout.”
We saw a geometric progression of knowledge in just months. Today we better understand how to treat COVID-19 patients, especially those with cardiovascular disease. We are learning more every day about how the virus affects the heart. And we have made important changes to cardiovascular service delivery that will have an impact far beyond this pandemic and into the future of cardiovascular care.
MedStar Heart & Vascular Institute—and the entire MedStar Health system—came together to fast track innovative solutions, and we have featured several of them in this special issue of Cardiovascular Physician.
Rising to the challenge.
Across our region, each of our hospitals kept its doors open to patients with cardiac conditions—COVID-related or not—who required urgent care and treated them safely and efficiently.
We rapidly deployed our cardiovascular physicians to COVID units when needed. At MedStar Washington Hospital Center, our teams helped staff an emergency department overflow unit when our regular ED saw a surge of COVID-19 patients. New protocols for care delivery were developed for the CVICU, and as always, our nurses remained front and center in the care delivery process. A rapid transport system between hospitals was used to transfer cardiovascular patients to the most appropriate level of care.
As the pandemic put extraordinary pressure on institutions throughout the country, including other large heart transplant centers, our medical and surgical advanced heart failure teams stepped into the breach. We continued to serve those patients in need of transplantation, achieving historically high numbers of successful procedures during the past three months.
Telehealth takes center stage.
Among the most dramatic shifts in service was an extraordinary increase in the use of telemedicine and other “virtual” capabilities to evaluate and monitor patients, educate medical teams, and provide critical consultation for emergent situations. Our IT professionals worked with clinicians around-the-clock to effect evolution in weeks that could have taken half a generation in ordinary times.
Virtual appointments by the network’s ambulatory care cardiovascular physicians grew exponentially to thousands each week—and some payers (including CMS) promptly recognized the value of these interactions with fair and timely reimbursement. Additionally, licensing and credentialing were fast-tracked across our tristate area.
We made great use of the virtual systems in our cardiac cath labs to rapidly triage and treat some of our most critically ill patients. Many of our teams employed telehealth tools to closely monitor patients in the safety of their homes from across our entire geographic footprint.
And during it all, we shared knowledge with colleagues throughout the country as we concurrently conducted research and published results in nearly real time.
During these extraordinary times, I have seen the MedStar Heart & Vascular Institute team accept the challenges with grace, flexibility, compassion, optimism, and good humor, while always putting patients first. I am so grateful to them all.