Unprecedented Three Health System Collaboration To Address Cardiac Care Disparity in Niagara

Erie County Medical Center, Kaleida Health and Niagara Falls Memorial Medical Center recently announced the Full Circle of Heart Care project, a three-point plan to establish a cardiac catheterization lab at Memorial's Heart Center of Niagara.

In order to achieve this, ECMC will decertify its license for one of its three cardiac catheterization labs and transfer the license to Kaleida Health. Kaleida's  Gates Vascular Institute would then staff and operate the cardiac catheterization lab at Memorial.

The Niagara Falls cardiac catheterization laboratory will perform coronary angiograms and interventional procedures such as cardiac stenting and angioplasty.

The lab will be located on the second floor of the ER l/Heart Center directly above the Emergency Department and adjacent to Memorial's cardiac diagnostic testing services and cardiologist offices.

"The lack of access to cardiac catheterization services, largely attributed to a lack of transportation, has created significant disparities in heart care for African-Americans and people from low income households in Niagara County," Niagara Falls Memorial President and CEO Joseph Ruffolo said.

Niagara County's cardiovascular mortality rate is one of the highest in the state and among the highest in the country. Nearly one in three county residents dies from heart disease – and the death rate among African Americans is 23 percent higher than the county's rate.

"The rate of cardiac catheterization care for whites is twice that for African Americans," Ruffolo said. "And while we know people from low-income households are much more likely to suffer from high blood pressure, high cholesterol and heart attack, the rate of cardiac catheterization for whites is nearly three times the rate for Medicaid beneficiaries."

Ruffolo noted that Niagara County is the second most populated county in Western New York.

"Despite that fact, the lack of a cardiac catheterization laboratory forces Niagara County residents to travel a considerable distance for that service. This lack of accessibility results in an excessive time lapse – typically 125 minutes – between onset of a heart attack and interventional treatment," Ruffolo said.

Niagara County's cardiovascular mortality rate (336.4) is the second highest among the eight counties of Western New York, higher than the WNY rate (286.5)and the statewide rate of 230.l.

Kaleida President & CEO Jody Lomeo said the three-way collaboration of the health systems will "improve access to lifesaving cardiac care in an area where it is clearly lacking," Lomeo said. "This is all about bringing the Gates Vascular Institute – a top 15 program in the nation – right into the community and improving the quality of care for patients."

The Full Circle of Heart Care project is designed to meet the state's Delivery System Reform Incentive Payment (DSRIP) Program goal which provides funding if innovative and preventative medical services result in a reduction of avoidable hospital use by patients covered under Medicaid by 25 percent over five years. The county has 28,387 adult Medicaid beneficiaries.

"ECMC is proud to be part of this three-way collaboration," said Richard C. Cleland, President/Chief Operating Officer and Interim Chief Executive Officer of the Erie County Medical Center Corporation. "We are pleased to transfer the license to this valuable resource so it can employed where most needed -- driving improvement in the region's health status without imposing burdensome long term costs to the healthcare system."

Cleland noted that ECMC is lead applicant for Millennium Collaborative Care, a DSRIP Performing Provider System (PPS) that includes Kaleida and Niagara Falls Memorial.

"Our community through DSRIP will be addressing health disparities throughout Western New York. This is a great start and an example of how DSRIP will make a difference in our community's health care," Cleland said.

The participating parties will seek $1.05 million in DSRIP capital funding for the $2.1 million catheterization lab project with Kaleida Health and Niagara Falls Memorial contributing about $550,000 each.

In addition to eliminating barriers to local, accessible cardiovascular care, the Full Circle of Heart Care will manage patients with cardiovascular diseases through the use of best practices, and will implement preventative measures such as a comprehensive screening program for cholesterol, blood pressure and smoking, providing free access to blood pressure monitors at primary care sites and community locations, Early detection of heart disease leads to a reduction in the number of more costly invasive procedures required at more advanced stages of cardiac disease.

For identified tobacco users, they will receive cessation intervention.

In addition, Memorial will join with ECMC and Kaleida in promoting heart health education using the Centers for Disease Control and Prevention's Million Hearts Campaign and other evidence based social marketing materials to educate and link patients to healthy eating, exercise and smoking cessation programs.

"Taken together these three strategies will involve healthcare providers including mental health providers, agencies serving the developmentally disabled, churches and other community organizations in a comprehensive and collaborative approach to better heart health in our communities," Ruffolo said.