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GMC: Open heart program under attack
Area hospitals question state's approval

LAWRENCEVILLE - Three area hospitals are questioning the state's approval of Gwinnett Medical Center's $33 million open heart program, a development GMC president and CEO Phil Wolfe blasted Thursday.

Piedmont Hospital, Emory University Hospital and Emory Crawford Long Hospital - all Atlanta-based - have filed appeals with the Georgia Department of Community Health asking the state agency to reverse its decision last month that cleared the way for GMC to establish an open heart surgery program at its main campus in Lawrenceville.

Gwinnett is the largest county in the nation without an open heart surgery program, hospital officials have said.

"During the state's review process, all three hospitals made their case addressing the key points," Wolfe said in a statement. "But the Department of Community Health was clear and emphatic in its judgment that Gwinnett County is ripe for the establishment of its own program.

"None of these hospitals are in a position to effectively serve our community, nor are they prepared to do so in the future. However, we are confident that GMC will ultimately bring open heart to Gwinnett."

Diana Lewis, spokeswoman for Piedmont Hospital, said Thursday that GMC's open heart program lacks on two fronts - quality and need.

Lewis said the metro area already has a shortage in nurses and health technologists. A new program will compound that scarcity.

"Once you take those skilled health care workers from an existing open surgery program and send them somewhere else, it starts diluting the system and that's obviously going to affect quality.

"What are we going to replace them with?"

In addition, Lewis said, GMC has not sufficiently proven a need for the program exists, citing that less than 1 percent of GMC's procedures are emergency cases. GMC routinely transfers patients to open heart facilities in Hall and Fulton counties, she said.

A representative with Emory Healthcare did not return phone messages.

Details surrounding the state's appeal process were unavailable Thursday; GDCH officials could not be reached for comment. A GMC official, however, said the rules were revised during the last legislative session.

Piedmont Hospital's misgivings are in stark contrast to the GDCH's rationale for approving GMC's Certificate of Need, which was submitted for approval in January. The nod permitted GMC to join Atlanta-based Saint Joseph's Health System to create Gwinnett Cardiovascular Services. Under the agreement, Saint Joseph's will provide consultative services, including training and clinical advisory support to GMC's cardiovascular center, which will include open heart surgery services sometime in 2010.

According to excerpts from the GDCH's approval letter, which was made public June 5, GMC fulfilled three critical benchmarks: adverse impact, community need and service alternatives.

Here is an excerpt:

· "Several hundred letters of support were submitted ... from all segments of the community ... the overriding theme of the letters from doctors was concern and angst over the limited care available to patients presenting at GMC, due to the absence of an open heart surgery program. Patient outcomes could have been much better if they did not have to be transferred or redirected to existing open heart surgery providers."

· "The proposed project will improve the quality, access and overall efficiency of adult open heart surgery services available within the local health care delivery system."

· "As Gwinnett County's traffic congestion continues to increase, the creation of an open heart surgery program at the center of the county significantly improves the ability of the residents of Gwinnett County to access timely care, thereby reducing heart damage and the likelihood of poor health outcomes."

Barring the state overturning its initial decision, GMC will build two operating rooms - known as the "West Expansion" - on the back end of the facility facing Lawrenceville-Suwanee Road. The design process will begin in August and construction is anticipated to begin in July 2009, with an expected open date within two years of the start of construction.