Hospitals all over the country are purchasing cutting-edge operating rooms in anticipation of a new wave of minimally invasive heart procedures expected to gain federal approval over the next few years.
Called hybrid ORs, the new operating rooms meld modern surgical innovations with equipment and staffing for conventional open-heart procedures.
If something goes wrong during a simple stent procedure, for example, the rooms also have surgical equipment to quickly cut open someone’s chest and operate. Without the new rooms, a patient in trouble might have to be moved to another operating room, increasing the risk of infection and other complications.
Hospital officials expect the trend will pay off in better care, savings and better efficiencies, but it’s too early to know.
The rooms may include robotics and videoconferencing systems to teach young doctors. The most fortunate hospitals find well-heeled donors to pick up the tab.
Michigan hospitals with the new rooms or building them include St. John, the University of Michigan, the Detroit Medical Center, Beaumont Hospital in Royal Oak and Detroit’s Henry Ford Hospital.
One of the biggest issues so far is paying for the rooms.
At costs from $1.5 million to $9 million, the expense is a major challenge for hospitals at a time when the sluggish economy leaves many without large surpluses that typically pay for new equipment and renovations.
Hybrid operating rooms costly, but in demand
Allen Williams was confident when he had a heart operation last month that he’d be in the right place if anything went wrong.
Williams, 65, of Detroit, had a ruptured artery that doctors fixed with a minimally invasive procedure.
Had the operation gotten tricky or gone wrong, his doctor could have switched immediately to do the rest of the operation with a large chest incision in a new type of operating room at St. John Hospital and Medical Center in Detroit.
A father of six and grandfather of 12, Williams said he tried “not to get upset and not worry” about the surgery. He relies on his faith: “The Lord takes care of me.”
Hybrid operating rooms, as they are called, bring together the most modern of surgical innovations with the equipment and staffing for conventional open-heart procedures.
The ECRI Institute, a nonprofit Pennsylvania organization that advises hospitals on spending and planning for new technology, estimates that fewer than 100 U.S. hospitals have hybrid rooms but the number “is expected to climb rapidly” with 15% or more yearly increases in hospitals adding them over the next few years, said Robert Bense, a senior health care technology executive.
Procedures suited to the new hybrid rooms use minimally invasive methods to fix and replace heart valves; correct abnormal heartbeats, and place tiny metal coils, or stents, to fix stiffened, aging heart vessels.
At costs of $1.5 million to $9 million, if robots and videoconferencing technology are included, hospitals seek out generous donors to help pay for the new operating suites.
A $5-million donation from Grosse Pointe philanthropist Gretchen Valade paid for the hybrid operating room, including a robotics system, opened in June at St. John Hospital and Medical Center, Detroit.
At Beaumont Hospital, Royal Oak, Suzanne and Herbert Tyner of Bloomfield Hills provided a large, unspecified donation toward the $8.5-million cost of its new room; the project includes $4 million in research and videoconferencing technology to train students at Beaumont’s new medical school with Oakland University.
Planning the rooms and finding money to pay for them “is a challenge,” Bense said.
He said there’s no “giant rush” to add the rooms but expects many hospitals will do so in the next decade.
In theory, the rooms aim to save lives, reduce infections and speed recovery because patients won’t have to be unhooked from tubes and machines and transferred to other surgery rooms in the middle of a procedure.
For now, the proof is “sort of soft” that the rooms improve care, though most health care experts presume they will, Bense said.
At St. John, more than 40 procedures have been performed in its new hybrid room with a robotic surgery system and cutting-edge fluoroscopy machine that allows doctors to immediately view X-ray pictures taken of structures inside the body during an operation.
“I can do the operation with more confidence because the image quality is very good,” said Dr. Kumara Rama, Williams’ doctor and an experienced vascular surgeon, as he viewed a large picture next to him showing the exact place of his aneurysm where Rama placed a stent. “The better I see, the better I do.”
Dr. Michael Deeb, a U-M cardiovascular surgeon, said he believes the rooms will deliver on efficiencies and patient-care improvements.
Recovery time is longer and complications greater the longer heart-lung machines have to circulate blood and breathe for patients during open-heart procedures, Deeb said.
U-M has three hybrid rooms and plans to add another for its new children’s and women’s hospital, he said.
Most minimally invasive procedures can be done in standard operating rooms and catheterization labs, doctors said. Costs also may force larger hospital systems to invest in the rooms at one facility but not at others.
“It would not make any sense for Henry Ford to put these in all of its hospitals,” said Dr. Douglas Weaver, cardiology chief.
Still, more chest and other procedures will be done in these rooms in the years ahead, he said.
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