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Opportunities in Outpatient Cardiology
Procedures are moving to ASCs, but regulatory and reimbursement hurdles present challenges.
Joe Paone | Senior Editor
Publish Date: September 13, 2021   |  Tags:   Regulatory Affairs Cardiology
Derian-and-Rafi
ARTERY ACCESS Dr. Wissam Derian (left) and Dr. Adam Rafi perform cardiac catheterizations through the wrist to help speed recoveries.   |   QMG Surgery Center

The catherization lab built in the new Quincy Medical Group (QMG) Surgery Center is the first of its kind in Illinois and showcases the tantalizing potential of outpatient cardiac care. Physician owners of the multispecialty ASC say adding the cath lab is a significant step forward in providing patients with convenient and cost-effective access to procedures that detect blockages in coronary arteries. 
QMG cardiologist Wissam Derian, MD, FACC, CCDS, says cardiac catheterization has evolved to the point that patients can often safely have the procedure and go home the same day. During the procedure, a thin flexible tube is inserted into the arteries of the patient’s heart, and dye is injected to visualize blockages.

The procedure has traditionally been performed from the large artery in the leg. Over the last several years, however, cardiologists have started utilizing the radial artery in the wrist. “In about 90% of the cases, we have begun using access in the wrist instead of the groin area,” says Dr. Derian. “This reduces the risk of complications and the length of stay for the patient.” Patients at this facility are ready to return home about two hours after a diagnostic cardiac catheterization.

That’s not the only cardiac procedure QMG Surgery Center will perform. The physician owners have plans to add left and right diagnostic and interventional heart catheterization; pacemaker and ICD generator exchanges; loop recorder insertion and extraction; and transesophageal echocardiogram with cardioversion. Patients will be carefully screened to ensure the procedures are appropriate for the outpatient setting.

“Patient safety is our number one priority,” says Dr. Derian. “There is much research that goes into any approved procedure, and we will always follow appropriate guidelines for any procedure performed in our facility.”

Patients are referred internally to the cath lab by the practices of QMG physicians. Ted Johnson, director of cardiac services at QMG, says the cath lab within its ASC adheres to state and national regulations. “Our cardiologists have led the way from start to finish — from patient eligibility and selection to equipment, policy and protocol development, competency tools, emergency preparedness and staffing selection,” says Mr. Johnson. 

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