July 23 Daily News editorial

The state Health Department has scheduled a public hearing Friday on St. John Medical Center’s application to perform non-emergency cardiac procedures. Some members of the community might want to be heard on this issue. Current and future cardiac patients in this area have a significant stake in the state agency’s decision.

Until the DOH gives the hospital permission to perform elective angioplasties, patients will continue to leave the area for the procedure. That will be the case for both non-emergency and emergency angioplasties. Although St. John Medical Center is permitted to perform emergency angioplasty, it is having difficulty attracting a full-time cardiologist for emergency-only work.

The need for this care locally is readily apparent. The number of patients here requiring interventive cardiac care is on the rise. Many of these cases involve charity patients. One St. John official, James Boyle, told Daily News reporter Cheryll A. Borgaard that, “Part of the (hospital’s) application reflects our charity care. For patients having trouble paying, it’s especially hard for them to got to Portland. This will really ease the burden for those patients.” To be sure, approval of St. John’s application would ease the burden for all area patients needing this interventive cardiac care.

The volume of cardiac care at the hospital will be a major consideration for the Department of Health in deciding on St. John’s application. The DOH believes hospitals must show that the need to perform at least 300 non-emergency angioplasties annually before they should be certified for the non-emergency procedure. St. John officials told Borgaard that their elective cardiac intervention program would reach more than 300 cases by year three of the program.

The numbers could make this a close call for state officials. That shouldn’t be the case in the view of officials at St. John and other similarly sized hospitals in the state. They say the 300-per-year threshold is too high, and there is science to back up their claim that a much lower volume of elective angioplasties would not compromise safety. National studies have found that facilities with between 150 and 200 procedures a year perform the non-emergency interventions safely.

Most states, in fact, allow or are considering allowing elective angioplasties at hospitals similar in size to St. John Medical Center. Washington lawmakers had smaller hospitals in mind when they enacted legislation in 2007 instructing the Department of Health to write new rules aimed at improving rural patients’ access to non-emergency angioplasties and stent replacements. The rule requiring that hospitals perform at least 300 such procedures a year has served to frustrate that legislative intent. It makes it very difficult for smaller hospitals to become certified for non-emergency cardiac procedures.

It’s difficult, but certainly not impossible if state health officials are willing to apply reasonable criteria and consider the benefits making cardiac care available in smaller communities. If St. John officials and members of the community can effectively communicate this need to state health officials, we’re optimistic that the hospital’s application will be approved.

If you wish to testify

The state Department of Health’s public hearing on St. John’s application begins at 9:30 a.m.j Friday at the Cowlitz PUD auditorium, 961 12th Ave., Longview. Those wishing to testify should contact St. John Medical Center at sjmc@peacehealth.org or call (360) 414-7547. The DOH also will accept written letters, which can be turned in at the Friday meeting.