Cardiac care continues to be a priority for Hilo Medical Center, and legislation introduced in the state Senate will help expand those services.
Senate Bill 2814, introduced by Hilo state Sen. Kai Kahele, would appropriate $3.5 million in general revenue funds in the 2020-21 fiscal year for a second catheterization lab.
Regional imaging administrator Lauri Redus said the funding will be used to remodel space in the hospital adjacent to the current lab and purchase equipment.
“It will establish a secondary cath lab suite for us so that we have more availability to take care of patients,” she said. “We only have one suite right now so we can only take care of one cardiac patient at a time.”
While cardiology uses the lab “tremendously,” Redus said the existing suite is also used for interventional radiology and vascular surgery cases.
Interventional Cardiologist Jamison Wyatt said elective procedures have to be done during normal business hours, which can be problematic when there are emergencies during the day.
If elective procedures are being done in the lab, care could be delayed if an emergent case presents itself, he explained.
Wyatt said having a second lab is also important for heart attack patients, “because if the lab were to go down … (there is) not a great backup system in place. It would again kind of limit our ability to treat them. So it’s nice to have two different lab capabilities, so if one is inoperable, you can move into another one.”
HMC has long been working to treat cardiac patients closer to home and early last year hired its first interventional cardiologist, Carl Juneau.
Prior to Juneau’s arrival, HMC could administer clot-busting medications and perform diagnostic catheterizations to determine if a patient needed to be transported off-island, usually to Oahu.
The hospital can now perform interventional catheterizations to stop a heart attack in progress and insert stents to maintain blood flow.
Four cardiologists and a nurse practitioner are now on the hospital’s cardiology team.
Kahele said getting a second cath lab at the hospital is one of his legislative priorities this year.
It’s “clear that this is something we need in our community,” he said, adding that he was also told about the need when he met with hospital administrators in the fall.
The legislation aims to continue the success of treating East Hawaii heart attack patients at HMC, which is “something we didn’t have in 2016 when my dad had his heart attack,” ultimately leading to the late Sen. Gil Kahele’s death, he said.
HMC sought additional funding for the cardiac program during the 2019 legislative session, but the funding bill stalled in the final stages of the legislative process.
But Redus said the hospital is “extremely hopeful” this year.
“It’s honestly an urgent need at this point,” she said. “… There are multiple competing priorities as far as patient condition and treatment availability that we need to have a second interventional suite available so that the interventional cardiologists can work, the interventional radiologists can work, our vascular surgeons can work and that patients don’t have to wait.”
According to Redus, HMC did more than 400 heart catheterizations in 2019 and are on track to do “700 easily” this year, if not more.
In January alone, 100 cardiac cases were treated in the cath lab.
The Senate Committee on Commerce, Consumer Protection and Health recommended SB 2814 be passed with amendments.
Written testimony submitted before public hearing on the bill supported the appropriation.
Redus said HMC will have to expand even if the funding isn’t appropriated by the Legislature, but it will take much longer, adding at least two years to the project timeline because other funding sources will have to be sought.
“But we have to do it,” she said. “I mean, that’s what we’re here for. That’s the work that we do is to provide that care to our community, so we have to figure out a way. This would get it quicker, which would be great for the community — make it a whole lot faster process to implement increased capacity here.”
A second bill, Senate Bill 2535, which was also introduced by Kahele, would appropriate an undetermined amount of general revenues to improve services related to cardiac care. The Committee on Commerce, Consumer Protection and Health, however, deferred the measure.
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