Swedish Medical Center is the largest, most comprehensive, not-for-profit health provider in the Pacific Northwest. Swedish is comprised of three hospital campuses (First Hill, Providence and Ballard), Swedish Home Care Services and Swedish Physicians — a network of 11 primary care clinics. In addition to general medical and surgical care, Swedish is known as a regional referral center, providing an array of specialized services including cardiac care and clinical research.
A consortium of health-care administrators, physicians, researchers, educators, and business leaders are coming together to create a world-class center for cardiac care and research in the Pacific Northwest. The Seattle Heart and Vascular Center, or “Seattle Heart,” is envisioned as a collective of the region’s top health-care and educational institutions, a place that will draw patients and personnel from all over the world. The program is expected to be operational in 2004.
The idea for Seattle Heart started with Richard Peterson, President and CEO of Swedish Medical Center in Seattle. He saw that by centralizing the many cardiac-care resources in the region, those resources could be used more efficiently. In addition, he saw that a cooperative effort would elevate the standard for cardiac care in the region and beyond, producing better outcomes for patients.
Peterson’s research showed him that if area institutions providing cardiac care continued to independently invest in new facilities, technology and personnel, they could be spending upwards of $30 million for each generational upgrade. Those upgrades might be required every 10 years or less.
Since the initial planning for Seattle Heart, support has been strong. In June 2003, the Washington State Legislature appropriated $4 million in seed money. Then, in July, The Seattle Times ran an editorial calling the Seattle Heart and Vascular Center “a brilliant idea.” The editorial went on to point out that Seattle already had such an institute for cancer care (Fred Hutchinson Cancer Research Center), but was lacking one that concentrated on cutting-edge cardiac services. The closing thought of the editorial was that “with some thought, cooperation and work — a lot of work — this city could have both.”
We are now working to meet an initial goal of $100 million for Seattle Heart. That figure seems to be a reasonable investment in the fight against heart disease. As those of us in health care know, the cost of heart disease is high. Currently, the cost to the U.S. economy due to disability and related medical expenditures for cardiac conditions is estimated at anywhere between $80 to $330 billion annually.
In Washington state alone, about 1.5 million people have some kind of heart condition requiring care. In King County, where Seattle is located, an estimated 4,000 people lose their lives to heart-related illnesses each year.
Also, as health-care professionals, we know that many of the same conditions that cause heart disease cause a variety of other life-threatening conditions, including stroke, hypertension, arteriosclerosis and kidney disease. An average of one person every 53 seconds suffers a stroke in the United States; every three minutes, someone dies from it. Costs total about $28 billion annually for long-term care and treatment of stroke patients. The indirect costs, such as those associated with lost productivity, bring the total to about $43 billion.
Research Facilities a Key Component
One of the most exciting components of Seattle Heart will be its emphasis on research. Mark Reisman, MD, is currently Director of Cardiovascular Research at the Swedish Heart Institute. From the beginning, he has been a strong proponent of the idea of a cooperative cardiac care and research center in Seattle.
“By focusing the intellectual horsepower in this community on research projects where we are all working together, we can continue to make incredible progress in developing new ways to treat heart disease,” says Dr. Reisman. Researchers working in sync toward a common goal, he says, will create a “synergy” that would not otherwise be possible.
Dr. Reisman is also cognizant of the enormous cost of cardiovascular research. “A lot of what we do requires a major investment in new equipment and in training support personnel,” he notes. “Rather than each one of us as individual institutions making that investment, we can pool our resources and make the funding go farther. We can take the work we’re doing to a new level.”
The creation of Seattle Heart would, says Dr. Reisman, be a natural evolution of the way that a lot of cardiovascular research is already being done in the Northwest. “We’re doing a lot cooperatively now,” he says, “but pooling our resources in a bigger way will only help. Everyone who cares for patients wants to stay on top of and be a part of all the developments that are happening every day.”
Dr. Adam Zivin, a Swedish-affiliated cardiologist specializing in electrical disorders, agrees. “As anyone working in this area will tell you, we all want to have the latest equipment and procedures as available options for our patients,” says Dr. Zivin. He notes that the field of electrophysiology was almost unheard of 10 years ago, but technological advancements have made it more prevalent with every passing year.
“We’ve made incredible progress in not only treating certain disorders, but also in actually curing patients,” he says. “If we can put together something like Seattle Heart,” he says, “it can only benefit us and our patients. We’ll have better equipment and more patients coming through that will increase our knowledge of what works and what is less effective in terms of treatment.”
Right now, dozens of cardiovascular research projects are under way at Swedish Medical Center and will only increase with the Seattle Heart alliance. Those projects involve everything from new surgical procedures and new ways to use EP devices to the use of experimental medications.
Currently, one such project is focused on preventing strokes in people with atrial fibrillation (AF). Swedish Medical Center is leading the way in determining the effectiveness of PLAATO (Percutaneous Left Atrial Appendage Transcatheter Occlusion) in controlling AF by sealing the opening in the left atrium, where nearly 95% of all AF-related strokes are believed to originate.
Dr. Reisman is the national principal investigator for the PLAATO project. For this and other research projects currently under way, patients come to Swedish Medical Center from all over the region. However, when Seattle Heart is up and running, it is expected to draw them from even farther locations, including overseas.
Seattle is in a great position right now to take advantage of emerging technologies, says Dr. Reisman. One technology he has been able to secure for trials at Seattle Heart is the Stereotaxis Cardiac Navigation System. Seattle Heart will be the first institution to fully investigate uses for the system, which are expected to include electrophysiology studies. The Stereotaxis is a “hands-off” device that allows physicians to use a computer console to steer magnetized devices through cardiac chambers and coronary vessels. Dr. Reisman believes the system will facilitate the development of new procedures that will improve outcomes for patients with a variety of challenging vascular conditions not easily addressed by today’s technology.
Dr. Zivin is particularly interested in seeing how the Stereotaxis system might be used in correcting or diagnosing electrical malfunctions of the heart. Without a cooperative effort like Seattle Heart, he says, he and other EP physicians probably wouldn’t have access to such state-of-the-art equipment. “This could prove to be a big leap up for us,” he says.
“As anyone working in this area will tell you, we all want to have the latest equipment and procedures as available options for our patients.”
Stereotaxis has agreed to fund $150,000 over three years to Seattle Heart for research that is focused on the advancement of products and services associated with the system. As the cooperative effort of Seattle Heart comes together, the Stereotaxis system will be available for training and use by many area cardiologists, just as Swedish’s SimSuite® education center is currently.
SimSuite® is a “virtual” cardiac catheterization lab system set up as a training environment. Its primary function is to provide a way for physicians and other medical technicians to practice procedures on a “patient” made of plastic and other materials. Visual monitors inside the simulated patient help both cardiologists and cardiac cath lab teams learn and practice current procedures as well as experiment with new devices. Physicians from throughout the Pacific Northwest have access to Swedish’s SimSuite® technology; in fact, each year a Swedish-sponsored symposium draws hundreds of doctors from across the country to view SimSuite® procedures and to share knowledge about recent breakthroughs in cardiovascular research.
With the creation of Seattle Heart and a greater ability to share knowledge, facilities and equipment, we hope those breakthroughs will come at an even faster pace.
New facilities
While the idea of Seattle Heart rests largely on a cooperative effort among partnering organizations spread out around the Seattle area, there will be a centralized campus. Plans call for a hospital and research facility to be located on the grounds of the former Providence Seattle Medical Center, which Swedish Medical Center acquired in 2000. Major renovation and new construction is expected to begin as early as 2003. In discussion are plans for surgical suites at the hospital that may likely include:
• Speech-recognition systems to allow surgeons to control the operating-room environment and many devices using voice commands;
• Surgical robots to give surgeons hands-off control of cameras and other equipment that may even be able to perform delicate microsurgery;
• Virtual displays that will provide three-dimensional images to help surgeons visualize microscopic anatomy and pathology; and
• Universal monitors to provide a global view of systems and allow images and data to be called up from a patient’s electronic medical records. In addition, the overall environment and individual patient rooms at the hospital will be designed to promote comfort, healing and rehabilitation. The research facility will also be designed to allow for continuous updating of equipment and technologies.
Patients from around the world
When Seattle Heart is fully up and running, patients will come from the Swedish program and other regional cardiac-care programs. Right now, Swedish Medical Center’s heart specialists perform twice as many cardiac surgeries as any other program in Washington state and more non-surgical procedures as well. When these numbers are folded into the Seattle Heart program, it should prove to have a positive impact on patients, since studies show that the more cardiac procedures a facility performs, the better the outcome for the patient.
The increase in patients for Seattle Heart is also expected to come from a greater emphasis on serving patients from around the world. We’ve been looking specifically at Pacific Rim countries that have good baseline heath-care programs, but lack specialty services such as high-level cardiac care.
Right now, there are Pacific Rim patients literally flying over Seattle on their way to the Midwest locations of the Mayo and Cleveland Clinics. Canadian patients are also expected to come south of the border for specialized cardiac care. We believe an alliance such as Seattle Heart provides a chance to share knowledge among a variety of institutions who might otherwise not be able to do so.
Seattle University (SU), whose campus is adjacent to several health-care institutions, was particularly quick to embrace the idea of a cooperative effort. Father Stephen Sundborg, S.J., President of SU, says “we’re delighted to see this major science and health-care initiative developing in our neighborhood. Seattle Heart Alliance will enhance our efforts to engage students in research and internships with community partners.”
George Simmons, SU dean of the School of Science and Engineering, is excited about both the hands-on training and the research possibilities. Seattle University has about 120 pre-med students each year; the cooperative approach of Seattle Heart “will create opportunities we couldn’t otherwise provide for students,” says Simmons.
In addition, Seattle Heart and Vascular Institute is expected to create about 600 new jobs and infuse more than $50 million into the local economy. Seattle Heart is also expected to attract ancillary research dollars and community-based businesses created to serve patients, visitors and workers.
While all of the activity surrounding the creation of Seattle Heart is exciting, it’s important for all of us involved to keep our focus on the ultimate goal: better patient care and better patient outcomes — now and in the future.
For more information, please visit www.swedish.org |
