Gradual growth
"The opportunity in outpatient cardiology is tremen-
dous," says Ms. Bemis. "We're really in the infancy
stages of it migrating from hospitals to ASCs." She
suggests starting slowly with diagnostic cases or
device work before you can safely and confidently
move into interventional procedures.
Ms. Bemis notes the cardiac patient population is
typically more vulnerable than most others. "These
patients often have more than one comorbidity,"
she says. "They tend to be older, they likely have
blood pressure issues and can even have some
peripheral vascular disease or diabetes."
Because freestanding surgery centers often don't
have direct access to hospital services, safety meas-
ures at cardiac ASCs must be strict. "We're
extremely careful," says Ms. Bemis. "Our adverse
event rate is less than half of one percent, but we
always have emergency equipment available."
Of the new procedures approved by CMS for
2021, National Cardiovascular Partners likely won't
perform a few at first. For example, one involves
extracting defibrillator leads, which can become
heavily lodged after six months due to the creation
of scar tissue. "During extraction, severe complica-
tions could occur," says Ms. Bemis. "So, we're put-
ting parameters around the procedure. We're very
careful and thoughtful about the cases we're willing
to do at our centers."
Ms. Bemis is in no hurry to add complex or dan-
gerous procedures. "Looking ahead, as technology
advances to make cardiac devices safer and smaller,
I believe we'll see structural heart disease proce-
dures and transcatheter aortic valve replacements in
the outpatient setting.
"The safety of our patients is our number one con-
cern," she continues. "We're trying to be good stew-
ards of the business, take excellent care of our
patients, and focus on the procedures we should and
could be doing in an outpatient environment."
OSM
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