Taxonomy I Part VI-A (Cardiology)

NATIONAL PROJECT ON THE COMMUNITY BENEFITS

OF FAMILY PRACTICE RESIDENCY PROGRAMS

CUMULATIVE QUESTIONNAIRE RESPONSES
Taxonomy Section I Part VI

Cardiology

SD I.13k(2.1) (new) Does your residency provide the following kinds of specialty care. k(2.1) cardiology? Yes __ No __

Yes:

Natividad

Klamath Falls

Lehigh Valley

Mercy Toledo

Kaiser LA

Tyler

Las Vegas

Fresno

Springfield

Glasgow

Lexington

OHSU Portland

SD I.13k(2.2) If you do provide cardiology, are these services provided as normal family medicine center appointments? Yes __ No __

Yes:

Natividad

Klamath Falls

Lehigh Valley

Mercy Toledo

Kaiser LA

Tyler

Las Vegas

Fresno

Springfield

Glasgow

Lexington

OSHU Portland

SD I.13k(2.3) If you do provide cardiology, are these services provided during special clinics? Yes __ No __

If the answer to SD I.13k(2.3) is yes, what is the number of patients seen? What revenues are generated in each specialty service?

No:

Natividad

Klamath Falls

Lehigh Valley

Mercy Toledo

Kaiser LA

Tyler

Las Vegas

Fresno

Springfield

Glasgow

Lexington

OHSU Portland

NPCB P2 I.13.2k(20) (SD I.13k(2.4)) Describe the kinds of cardiology that typically takes place within the family medicine center (whether as normal appointments or during special clinics):

Natividad (chest pains; coronary artery disease; post-MI follow-up; heart failure; arrhythmia)

Klamath Falls (mostly CAD; follow-up of angina; investigation and treatment of valvular heart disease; hypertension; assessment and treatment of peripheral vascular disease)

Lehigh Valley (coronary heart disease; CHF; EKGs; do not do stress testing)

Mercy Toledo (EKGs in office; no stress testing; all procedures sent to hospital)

Kaiser LA (post-MI; CHF; arrhythmia)

Tyler (EKGs; cardiac auscultation; auid Doppler sound for peripheral pulses; Doppler vascular exam; finger tick blood sugar testing (Accucheck); Coumadin clinic)

Las Vegas (stress tests; EKGs; management of patients with CHF; CAD; cardio-myopathy; risk factor reduction)

Fresno (full scope of non-interventional cardiology)

Springfield (chest pain; atrial fibrillation; angina; CAD)

Glasgow (EKG interpretation; 24-hour blood pressure monitoring; bio-impedence testing; management of chronic heart disease, CHF and arrhythmia)

Lexington (evaluation and management of chest pain syndromes; CHR; arrhythmia; hypertension; valvular heart disease; post-operative valve management; pericorditis)

OSHU Portland (EKG; diagnoses and treatment of angina; CHF; arrhythmia; chest pain)

Phase 2 Responses:

Sparrow (Follow-up on CAD; arrhythmia management; valve disease; murmur evaluation; cardiac risk factor management – smokers, lipids; chest paid evaluation risk assessment)

Huntsville (Management of hypertension; CHF; CAD; hyperlipidemia; anti-coagulation for patients with atrial fibrillation; valvular disease; post-MIs)

Ventura (Evaluate cardiology patients of a wide variety of types: CHF, CAD, arrthymias, valvular disease)

Long Beach (Everything: hypertension, lipids, arrhythmia management)

U Penn (Normal appointments – physician specific)

Crozer-Keystone (Chest pain evaluation and management; exercise stress testing; risk factor management)

Jefferson (Hypertension; atrial fibrillation; chest paid; high cholesterol; CHF; CAD; valvular disease)

McKeesport (EKGs; evaluate chest pain)

Oahu (EKGs; routine history and physical; evaluation and treatment of hypertension, heart disease)

NPCB P2 I.13.2k21) For what conditions would your residency program refer patients to cardiologists? What is the expected wait time before the patient is seen?

Sparrow (CAD workup for tests; 3 weeks turnaround)

Huntsville (stress tests; unstable angina; electrocardiogram, invasive cardiology; a week turnaround)

Ventura (Difficult to control cardiology problems; patients needing cardiac catherization; operative interventions; difficult arrhythmia; valvular disease management; a week or less)

Long Beach (If someone has a high-risk rhythm, or if there is a need for angiogram, echos; those who fail medical management; 4-6 weeks)

U Penn (Physician specific; same day to 1 month)

Crozer-Keystone (catherizations; arrhythmia; chronic CHF management; 2 weeks)

Jefferson (we refer out some CAD, CHF; 4 weeks)

McKeesport (arrhythmia; stress tests; within a couple of days to a week)

Oahu (cardiac procedures – stress tests, cardiac catherization, cardioversion; cardiac disease refractory to routine management; disease of severe states; within one day if urgent)

*NPCB P2 I I.VI-A 1 Does your residency program manage the following cardiac disorders for your family medicine center patients either in the inpatient or outpatient settings (or both):

a) congestive heart failure? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I I.VI-A 1 Does your residency program manage the following cardiac disorders for your family medicine center patients either in the inpatient or outpatient settings (or both):

b) coronary heart disease? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I I.VI-A 1 Does your residency program manage the following cardiac disorders for your family medicine center patients either in the inpatient or outpatient settings (or both):

c) hypertension? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I I.VI-A 1 Does your residency program manage the following cardiac disorders for your family medicine center patients either in the inpatient or outpatient settings (or both):

d) common arrhythmias? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.VI-A 2 Does your residency program participate in cardiac wellness and surveillance programs consistent with professional guidelines?

Yes __ No __

Yes:

Shadyside (wellness programs, yes; we do not have formal surveillance programs)

Johnstown

Altoona

Reading

York (we actually have a cardiac rehabilitation center that we would refer the appropriate patients to)

Lebanon

Billings

Monroeville (not sure what is meant by “programs”; we do community information programs and screening, mostly through “one on one” screening)

Beaver

Latrobe

Erie (we kind of do it; we have a lipids nurse that manages these conditions)

Lawton

Fairfax

No:

St Margaret

No Response Recorded:

Santa Rosa

*NPCB P2 I.VI-A 3 Does your residency program participate in the identification, management, referral and follow-up care of patients requiring the following tertiary care services:

a. CABG? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.VI-A 3 Does your residency program participate in the identification, management, referral and follow-up care of patients requiring the following tertiary care services:

b. valve replacement? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.VI-A 3 Does your residency program participate in the identification, management, referral and follow-up care of patients requiring the following tertiary care services:

c. aneurism repair? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.VI-A 3 Does your residency program participate in the identification, management, referral and follow-up care of patients requiring the following tertiary care services:

d. peripheral vascular disease? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.VI-A4 Are you able to assure that your family medicine patients have access to the following diagnostic tests, either within your family medicine center or through a process of referral or consultation?

a. EKG? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona (Both in the family medicine center and the hospital)

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

Previous Questions About Exercise Stress Tests

SD I.13q(1) (L32) Does your residency program provide the following kinds of specialty care? q. Exercise Stress Tests? Yes __ No __

Additional Info: If yes, are these services provided during special clinics? What is the number of patients seen? What are the revenues that are generated?

Yes:

Durant (on occasion, in adjoining clinic)

OSU Tulsa

USC Univ & SG (in family medicine centers)

Modesto

Indiana U Methodist

No:

Saints (exposed to it in an office used in rotations)

SD I.13q(1.1) )SD I.13q(2) (L32)) Does your residency program provide the following kinds of specialty care? q. Exercise Stress Tests? Yes__ No __

Yes:

Arrowhead

Loma Linda

Stockton

OU Tulsa

OU Oklahoma City

Mercer

Klamath Falls

Las Vegas

No:

Whittier

Pomona

Louisville

MCE Birmingham

Glendale

Dayton Community

Miami Valley

Decatur

Natividad

Lehigh Valley

Mercy Toledo

Kaiser LA

Tyler

Fresno

Springfield

Glasgow

Lexington

OHSU Portland

SD I.13q(1.2) (SD I.13q (3)) If you do provide exercise stress tests, are these services provided as normal family medicine center appointments?

Yes __ No __

Yes:

Loma Linda

Mercer

No:

Arrowhead

Stockton

OU Tulsa

OU Oklahoma City

Klamath Falls

Las Vegas

SD I.13q(1.3) (SD I.13q(4)) If you do provide exercise stress tests, are these services provided during special clinics? Yes __ No __

If the answer to SD I.13q(1.3) is yes, what is the number of patients seen? What revenues are generated in each specialty service?

Yes:

Arrowhead (150/year)

Loma Linda (150/year)

Stockton (6/clinic; revenues are generated)

OU Tulsa (2-3 per half-day clinic)

OU Oklahoma City (3-4 clinic; 4 clinics a week; will provide estimate of revenues)

Klamath Falls (2 a week; $250/week)

Las Vegas (2-4 per clinic; revenues to be generated unknown)

No:

Mercer

*NPCB P2 I.VI-A4 Are you able to assure that your family medicine patients have access to the following diagnostic tests, either within your family medicine center or through a process of referral or consultation?

b. stress testing? Yes __ No __

Yes:

Shadyside (one of our faculty does stress testing)

Johnstown

Altoona (in the hospital and in cardiologists’ offices)

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton