A recent editorial in the Gwinnett Daily Post summarized a viewpoint that Gwinnett Medical Center should receive a certificate of need (CON) from the state of Georgia to start an open-heart program in Gwinnett County.
Recently, Emory Hospitals, along with Piedmont Hospital, appealed Georgia's Department of Community Health's decision to allow Gwinnett Medical Center to perform open-heart procedures. The appeal was made to support and uphold the stated purpose of the CON rule and legislation to ensure patient access through coordinated planning of new services and to reduce overall health and medical costs by avoiding unnecessary duplication of services.
It is also important to note that open-heart surgery is very rarely performed on an emergency basis for heart attacks. Gwinnett Medical Center has, in fact, recently submitted a request to the Department of Community Health to treat emergency heart attack patients in their cath labs with balloon angioplasty. This is a procedure that mechanically widens a narrowed or obstructed blood vessel, which was exempted by the Georgia Legislature from CON review and no longer requires open-heart backup. This new service would dramatically reduce the number of heart attack patients that currently require transfer from Gwinnett Medical Center for the treatment of cardiac emergencies.
In short, emergency heart attack victims in Gwinnett need emergency balloon angioplasty provided in cath labs, very seldom open-heart surgery.
The hearing officer correctly found that Gwinnett County residents in need of open-heart surgery currently have access to open-heart surgery services in metro Atlanta and northeast Georgia. Because of this, an exception to the current regulations, which would have to be based on documented barriers to access, is not needed.
The hearing officer noted that for patients living in the most densely populated portion of Gwinnett County, the closest hospital might be an already existing open-heart surgery provider. For example, Saint Joseph's Hospital of Atlanta, the highest volume open-heart provider in Georgia, is just five miles from the Gwinnett County border and is closer to many Gwinnett County residents than Gwinnett Medical Center or any other hospital.
As Emory cardiologists stated during the hearing, the focus should be to improve the coordination of hospitals and first responders to provide services to heart attack patients, so that these patients have faster access to potentially life-saving treatments such as angioplasty. Again, this a procedure that can be done in Gwinnett County using existing facilities and equipment.
John Fox is CEO of Emory Healthcare.