Study doubts need for 2nd heart lab > St. Joseph proposal called unnecessary

A private consultant’s report suggests a new cardiac catheterization lab at St. Joseph Hospital in Bangor would be unnecessary, while proposals for labs in Aroostook County and the Waterville-Augusta area should be considered strongly by state officials.

The report, compiled for the state Department of Human Services by the Public Health Resource Group of Portland, considers whether the populations served by certain hospitals have adequate access to cardiac catheterization services, also taking into account the overall cardiac health of the area.

Cardiac catheterization is used to look for cardiovascular blockages. A flexible tube is inserted into a vein or artery in a leg or arm and slithered toward the heart. Without considering discounts, the procedures cost about $3,000 each at Eastern Maine Medical Center.

Earlier this year, a surge in applications to offer cardiac services, including proposals from seven hospitals to open catheter labs, prompted the state to call a halt to its certificate-of-need process, which determines which hospitals can offer expensive new services. The Department of Human Services said it needed time to order a statewide analysis of what services are in short supply or oversupply and where those conditions exist.

The debate about new cardiac services has been volatile. Hospitals with existing services generally are opposed to applications that might draw off patients and make the existing services less economically secure.

Applicants like St. Joseph argue that they must provide the diagnostic service to remain competitive. St. Joseph chief operating officer Wayne Woodford said in an interview earlier this year that cardiac catheterization has become a common procedure for heart patients. For St. Joseph, it would be a “bread-and-butter” service, he said.

St. Joseph executives still were studying the report, a spokeswoman said Monday, and did not comment.

Ronald D. Deprez, president of the consulting firm, said St. Joseph executives had clearly described their need to offer the service in order to be a full-service community hospital. But the arguments weren’t relevant, he said.

“That’s a health planning issue but not a [certificate-of-need] issue,” he said.

Deprez said the St. Joseph recommendation was difficult in that there is a large volume of patients served in Bangor. But the need is being met by Eastern Maine Medical Center, he said. EMMC offers a full range of services including open-heart surgery.

P. Jerry Whalen, vice president for business development for Eastern Maine Healthcare, EMMC’s parent corporation, said EMH generally is happy with the report.

“We find it very supportive of the position that we’ve taken for a long time that there doesn’t need to be a lot of duplication of cath labs in the state,” Whalen said.

He noted the report also advised strong consideration of new labs in the Augusta-Waterville and Aroostook County areas. Those areas pose geographic challenges for patients who are a significant distance from existing facilities, he said.

Projections show the number of procedures that might be performed at The Aroostook Medical Center in Presque Isle would be less than most other catheter labs in the state. But Deprez said it was clear strong consideration was merited, not only because of the distance to Bangor but also because of the possibility that not having a facility had a negative impact for people with cardiac problems. The center is an affiliate of EMH.

As to the Waterville-Augusta area, Deprez said which city the laboratory would be placed in isn’t important. But the consultant felt MaineGeneral Hospital would be the better choice because it is bigger and offers more services than Inland Hospital, an EMH affiliate in Waterville.

The report also argues for an improved certificate-of-need process.

“The guidelines used to evaluate special clinical programs are brief, and lack the robustness to handle rapidly changing services such as cardiovascular care,” the report states.