Cardiologists set pace of outpatient CHF care
Centers don’t steal patients
You should be aware of a potential problem associated with outpatient infusion centers getting referrals and dealing with the paranoia of referring doctors.
Cost Management in Cardiac Care asked Jackie Torpy, RN, BSN, coordinator of the Health Heart Institute’s Heart Failure Center located in the Alegent/Immanuel Medical Center in Omaha, NE, and Lori Heaney, RN, program coordinator of the Heart Failure Unit of the Cardiovascular Institute of Columbia Michael Reese Hospital in Chicago, how they deal with the issue. The two program coordinators agree that a problem they continue to struggle with is identifying their programs to referring physicians. Since Alegent’s Heart Failure Center has a referral arrangement with a cardiology group, primary care physicians are to be reckoned with there. Some physicians hesitate to refer patients because they fear they won’t get them back, both women say.
"Many times," says Torpy, "if a primary care physician cares for the CHF patient, he or she will see the patient only every six months or so. That way, a patient typically ends up using hospital resources. We have to convince physicians to allow us to care for their patients so that can be avoided. The care program here is more concentrated than a primary care physician could offer. We see them weekly for a month, then about every two weeks, then every month. In addition, we have the staff to educate patients. The team effort really works. The primary care physician’s practice is not set up to offer such care."
The Heart Failure Unit at Michael Reese receives referrals from cardiologists all over Chicago. "We make clear from the start that we don’t steal patients," Heaney says. "We first determine how much participation the referring cardiologists want to have in the patients’ plan of care, then provide service based on that. If the cardiologists want to be in constant control of the patients’ meds, we’ll call them before changing anything. If, on the other hand, they say, Whatever you think is right, go ahead and do it,’ we’ll limit their involvement and send progress letters with the patients every time they go to see them."
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