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closeGood Sam approved for key procedure
Work to obtain permit for elective angioplasties has been nine years in the making at Puyallup center
Neil Pierson/of The Herald
When Dr. Vinay Malhotra moved from Chicago more than nine years ago to work at Puyallup’s Good Samaritan Hospital, he recognized early on that East Pierce County was a place screaming for quality health care, he said.
“One of the first things I observed was this was a growing community and no longer a bedroom community for Seattle,” Malhotra said. “The access to care was something that was lacking in this area.”
Malhotra had studied at the world-renowned Mayo Clinic in Rochester, Minn., and wanted to incorporate some of its ideas into Good Samaritan’s cardiac care center. Techniques for treating heart disease, the No. 1 killer of men and women in the United States, was at forefront of efforts for Malhotra and other officials.
PCIs fix narrowed or obstructed blood vessels inside the heart. John Long, the hospital’s president, said in a press release that Good Sam expects to begin offering the elective PCIs early in 2010.
Glenn Kasman, the hospital’s vice president of professional services and business development, said several Good Samaritan team members worked tirelessly to obtain the certificate of need permit from the Washington Department of Health (DOH). Kasman explained the process was so time-consuming because open heart surgeries like PCIs take place at only the most skilled medical centers. Good Samaritan was one of eight hospitals in the state that filed for certificates, Kasman added.
“You’ve got hospitals who can do (PCIs) in an emergency matter and they couldn’t do it in a non-emergency matter,” he said. “That didn’t make sense in terms of access.”
Malhotra said he has seen similar access problems in terms of the population Good Samaritan serves. The area has a large percentage of elderly residents and many are coming from smaller towns such as Eatonville, Roy or Yelm. In the past, anyone seeking elective care had to go to Seattle, Tacoma or Olympia and “the logistics of getting there aren’t so easy” because of the need to travel on major highways, Malhotra said.
“I had heard from a lot of my patients, older people don’t want to drive later at night,” he added. “If patients came from far away to Tacoma, they’d have to find a place to stay overnight and have to drive on freeways. …Initially it didn’t sound that important to me but talking to patients that are 70 and over, it’s a major concern for their spouses.”
Kasman agreed.
“This is a significant, stressful procedure and having it closer to home is unquestionably in the patient’s interest,” he said.
One of the key moments in the process happened in 2007 when state lawmakers forced DOH officials to revamp rules for elective angioplasties and “include hospitals that have shown the capabilities to provide this service without risk to the patient,” a Good Samaritan press release said.
Medical centers wishing to offer PCIs then had to apply for certificates of need to prove their skills, show they could put patient welfare above costs and show a “reasonable level of assurance for existing providers that the new system will recognize local economic realities.”
Malhotra said Good Samaritan’s ability to use PCIs “reduces the cost of care and could prevent re-admission.”
For example, he said, a patient from the Eatonville area who hasn’t had a heart attack but is showing symptoms might come to Puyallup for observation and receive medication. If the patient requires an emergency procedure later on, however, they would be taken to Tacoma. Malhotra said patients and physicians are often confused during first-time meetings and discrepancies in medication can occasionally occur.
Kasman said the cardiac care center has largely embraced the new procedures. Interventional cardiologists like Malhotra like to use PCIs and it’s more likely that experienced, talented cardiologists would work in Puyallup based on the changes.
Malhotra said that 40 percent of the cardiac care patients throughout Pierce County come from Puyallup. With 2,500 interventional surgeries occurring in the county annually, Good Sam could reasonably expect to get 500 of them, he noted.
“We expect the number (of PCIs) to rise greatly over time,” Kasman said, explaining that the number of open heart procedures have generally declined in recent years because of PCIs and other treatments.
“A lot of us throughout Washington thought we were falling behind the curve, so we’re glad to catch up,” he added.