Transitioning Memorial Health System to an Academic Medical Center to Benefit Physicians and Patients

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Dr. Jonathan Roberts is Medical Director of Clinical Research and Education, Interventional Cardiology for Memorial Health System and Program Director of its Cardiology Fellowship Program

(Memorial Cardiac and Vascular Institute) enrolled its first class of physicians in 2021 and is participating in the Harmony, Freedom and TAVR UNLOAD trials, enabling it to offer patients a level of care that has traditionally only been available in large academic centers .

Longtime observers of the healthcare industry may remember the Memorial Healthcare System (MHS) as a collection of community hospitals that provided quality care to regional audiences. Its cardiac program exemplifies the patient- and family-centered approach that the system and its specialists have taken when providing clinical services.

And while that’s still true to the core, it’s now just the foundation on which an academic medical center has been built.

When Memorial received initial institutional accreditation to start a Graduate Medical Education (GME) program in 2015, it took a leap forward as a healthcare provider. Becoming a teaching hospital system allowed it not only to tap into a broader pool of physicians pursuing residency or fellowship training in what are now 15 specialties, but also to position MHS to participate in trials of cutting-edge research that would provide patients with access to treatment and care. protocols not yet available elsewhere.

This value proposition is what the Memorial Cardiac and Vascular Institute is known for today. With a cardiovascular disease fellowship that enrolled its first class of physicians in 2021 and ongoing research that includes participation in the Harmony, Freedom, and TAVR UNLOAD trials, to name a few, he is in able to provide patients anywhere with a level of care that has traditionally only been available in large academic centers.

“TAVR” (Transcatheter Aortic Valve Replacement) is the most recent example of how Memorial’s rise as an academic and research leader is benefiting patients with congestive heart failure and stenosis of the heart. the aortic valve. Currently, only patients with severe aortic valve stenosis are eligible for TAVI, while those with moderate aortic stenosis and congestive heart failure receive medical treatment and are observed under guideline-directed medical therapy until their condition worsens and a valve replacement meets current guidelines (i.e. severe aortic stenosis). ‘Unloading’ the left ventricle (the heart’s pumping chamber) by inserting a new aortic valve is currently only indicated in people with severe aortic stenosis.

The current randomized trial Memorial is participating in, called TAVR UNLOAD, will randomize patients with moderate, non-severe aortic stenosis to ongoing medical treatment in 50% of cases versus TAVR in the remaining 50%. “Randomized trials have clearly shown that patients with severe aortic stenosis benefit from aortic valve replacement, with the procedure significantly extending their lives,” said Dr. Jonathan Roberts, Medical Director of Clinical Research and Education, of Interventional Cardiology for the Memorial Healthcare System and program director. of its cardiology fellowship program. “Will patients with only moderate aortic stenosis benefit from aortic valve replacement over medical treatment? We currently don’t know the answer, but trials such as TAVR UNLOAD will help determine if the procedure in patients with only moderate aortic stenosis and symptoms of heart failure will allow individuals to feel better, stay out of hospital, and live longer with prior TAVI.”

In almost all cases, patients with moderate aortic stenosis are not eligible for TAVI, but with the Memorial Cardiac and Vascular Institute’s involvement in this important clinical trial, it is able to offer patients with aortic stenosis moderate an option not previously available to them.

After the TAVR procedure, most patients go home the day after the aortic valve replacement. This is in stark contrast to an aortic valve replacement which required open-heart surgery which involved a one-week hospitalization and a six-week recovery period.

This potential breakthrough is made possible by research and clinical trials conducted at academic centers that have the infrastructure, patient volume and experienced clinicians that Memorial has. One of the largest public health systems in the United States, it has a combined inpatient bed count of over 1,000 at Memorial Regional Hospital and Memorial Hospital West and over 160,000 emergency room visits at these hospitals every year. Fellowship training in its GME program enables physicians to experience all aspects of primary, tertiary and quaternary cardiovascular care, ensuring that graduates will be able to correctly diagnose, treat and refer almost any problem encountered in cardiovascular medicine today. .

It is also a significant benefit to the Memorial Cardiac and Vascular Institute patient population, which not only has access to cutting-edge research and testing, but also to highly qualified physicians with expertise in the sub -specialties that are part of the Memorial Healthcare System during fellowship training and may elect to remain after the program is completed.

The Memorial Cardiac & Vascular Institute is a leader in cardiovascular care, offering a wide range of services dedicated to the prevention, detection and treatment of cardiovascular disease. Its multidisciplinary specialists work together using sophisticated diagnostic equipment and facilities. Outcomes of cardiovascular care are regularly reviewed by committees of doctors and nurses to ensure quality assurance that uses computerized data collection. For more information on Total Cardiac Care, you can visit their website.

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