Region hospitals work to stop health care migration - March 19, 2017
Courtesy of nwitimes.com • March 19, 2017
By Giles Bruce
Dr. Hussam Suradi keeps a lot of Northwest Indiana residents from having to travel to Chicago for health care.
The interventional cardiologist has been expanding the cardiovascular service line at Munster Community Hospital and St. Mary Medical Center, offering procedures that previously were available only at university hospitals in Chicago.
Suradi fixes things like heart valves that are too narrow, holes in the heart and atrial fibrillation with new technologies that allow the procedures to be done in a minimally invasive fashion.
“For all these treatments, patients used to have to go to tertiary university centers in Chicago to have them performed,” he said. “Now we’re able to bring all this technology to Northwest Indiana.”
Suradi’s recruitment to Community Healthcare System is part of a strategy by the hospital group, which mirrors its competitors in Northwest Indiana, to capture patients who traditionally have migrated to Chicago for care.
Roughly 3,000 Northwest Indiana residents get inpatient care in Illinois every year, to the tune of $112 million annually, according to a 2014 study looking at the feasibility of an academic medical center in Northwest Indiana. Another estimate has put the total out-migration from the Region as high as $1 billion a year.
Solutions being worked on
State Rep. Charlie Brown, a Gary Democrat, helped secure the funding for that feasibility study, believing that constructing an academic medical center with a Level I trauma center would be the best way to keep health care dollars in the Region. But the final report recommended against the idea, saying Northwest Indiana had too many empty hospital beds, already.
Instead, the study suggested local hospitals expand their trauma care and form a consortium to train medical residents in the Region.
Methodist Hospitals Northlake Campus in Gary and Franciscan Health hospital in Crown Point have since been designated by the state as Level III trauma centers, allowing them to treat many traumatically injured patients who previously would have had to go to Illinois.
And Pat Bankston, associate dean of the Indiana University School of Medicine at IU Northwest in Gary, has brought together a coalition of local hospitals and federally qualified health centers to bring as many as 165 medical residents to Northwest Indiana.
Bankston and other advocates say such a program would enhance health care access and quality in the Region, helping to stem some of that out-migration.
Even so, there will remain procedures that Region residents still have to go to Chicago or Indianapolis for, organ transplants being a prime example.
Hospitals expand service lines
When Franciscan Health, which has hospitals in Crown Point, Dyer, Hammond, Michigan City and Munster, underwent a restructuring in 2015, it focused on beefing up five service areas, in part to keep patients in the Region: oncology, orthopedic/neurosciences, cardiovascular, women and children, and behavioral health.
The hospital system has identified, in order, oncology, orthopedics and cardiovascular as the areas where the most out-migration occurs, said Gene Diamond, senior vice president and chief operating officer of inpatient services for Franciscan Health.
So Franciscan Health is developing an orthopedic center for excellence, featuring fellowship-trained joint-replacement orthopedists and a complete rehabilitation program. It is building a new $46 million cancer center in Munster that will provide diagnostics and treatment for a variety of cancers all in one place. And it is expanding access to behavioral health care.
“It’s hard to ignore the lure of the academic medical centers, when they loom over Northwest Indiana, are so close and in some cases are actually here in Northwest Indiana, exerting some gravitational pull on folks who live here,” Diamond said.
“Our hope is to raise the bar and make health care much better and compete very effectively with the academic medical centers in Chicago or Indianapolis.”
Diamond said that 25 percent to 30 percent of patients who get a diagnosis at Franciscan go elsewhere for treatment, a number he suspects is similar at other local hospital systems. But he asserts that the same quality of treatment can be found right here in the Region. And convenience is another factor.
“It’s a long drive to the academic medical centers, even the closest one,” he said. “It’s physically demanding to do that kind of traveling and stay there, recover there initially and recuperate there in between treatments. We think there’s a great deal to be saved in terms of convenience, time, fatigue.”
Systems recruit specialists
Valparaiso-based Porter Healthcare System has been expanding its service offerings so residents can get health care locally as much as possible. That includes participating in a state pilot project to become a Level III neonatal intensive care unit; being the first hospital in Indiana to offer the Watchman device to treat atrial fibrillation; adding a high-risk pregnancy program; and opening a female cardiology unit.
“One of the longstanding great things about health care is people can get second opinions,” said Steve Lunn, CEO of Porter Health Care System.
“But what I think they’ll find is we have great health care here, and we have really top-notch physicians in Northwest Indiana and really great facilities.”
Lunn said some local residents might perceive that certain Chicago medical centers provide better care because they’re considered teaching hospitals. But, he said, once the Northwest Indiana medical residency program kicks off in coming years, the participating Region hospitals will technically become teaching institutions as well.
To keep more patients in the Region, Methodist Hospitals has in recent years added 3-D mammography, new radiation technology and a cardiac device that allows physicians to monitor heart patients remotely. The hospital system, with campuses in Gary and Merrillville, also has recruited interventional cardiologists, orthopedic spine surgeons and neurosurgeons to its staff.
“Patients really want to be cared for in their community. They want to be close to home, where there is a sense of community,” said Dr. Vincent Sevier, chief quality officer for Methodist Hospitals.
“They want to know they can come to their local hospital to get top-notch care and great service. And if they’re going to be in the hospital, they want their loved ones around to support them in their time of need.”
New surgeries arrive in Region
Community Healthcare System’s hospitals in Hobart and Munster have lately been reconfiguring and expanding their surgical areas to do more minimally invasive procedures. Besides the addition of Suradi, Munster Community Hospital recently brought in Dr. Demetrius Lopes, a brain surgeon from Rush University Medical Center, to perform complex procedures to treat conditions such as strokes and aneurysms.
“Many patients don’t want to go to Chicago,” Suradi said. “They don’t want to drive there. They don’t want to deal with traffic. It’s too cold. Many patients refuse to go there to get treatment. So there is a huge need to provide these services in Northwest Indiana.”
If a patient has to go to Chicago for a procedure, she also has to go there for testing and follow-up appointments, so it all adds up to a lot of travel, away from family at that. And if the patient is on Indiana Medicaid, she has to get her care within the state, which means, for many procedures, Indianapolis.
For that reason, Suradi said the hospital system plans to continually offer new cardiovascular services in the future, such as a pediatric cardiology program.
“There’s a huge need in this area,” he said. “We’ve always been dependent on Chicago as, ‘It’s close by. Let’s just send the patient there.’ I think we’re at the point where we need a center in Northwest Indiana that will take care of all these conditions, take care of all these patients.”