The Critical State of Cardiovascular Care in Rural America

For people living in rural America, being diagnosed with a cardiac condition truly is a life-or-death situation.

There are no cardiologists working in more than 85 percent of rural counties in the United States, according to research published in the July 2024 issue of the Journal of the American College of Cardiology. Further, in those counties without cardiologists, patients must travel an average of 87 miles to see one.

“The time these patients need to travel to find a cardiologist is heroic,” says Dr. Bradley Serwer, chief medical officer of VitalSolution-Cardiology. “It may as well be traveling across the country for people without transportation.”

Unfortunately, access isn’t the only challenge rural cardiology patients face. While the rate of cardiovascular disease is 40 percent higher in rural areas, patients receiving treatment for acute myocardial infarction in the region have lower rates of catheterization, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) compared with patients living in urban areas. Perhaps due to these factors, patients in rural counties have a higher age-adjusted cardiovascular mortality rate and, on average, live one year less than their urban age-matched cohorts.

“This lack of access to not just care but quality care contributes to poorer outcomes and lower life expectancy,” Dr. Serwer explains. “With an estimated 60 million people living in the rural United States, these trends are concerning. The first steps toward addressing these disparities are raising awareness that they exist and gaining a better understanding of the factors that contribute to them.”

Supporting Rural Hospitals and the Communities They Serve

Community hospitals are closing at a higher rate than their urban counterparts, according to Dr. Serwer. These critical access facilities are often plagued by poor reviews and lackluster reputations within their communities, so they are often undervalued for their ability to deliver lifesaving care. Administrators face an uphill climb when attracting and retaining quality seasoned clinicians, who often have established roots in less geographically remote areas, while physicians fresh out of residency or fellowship are typically drawn to urban centers, where volumes are higher and cultural attractions abound.

“It’s not just recruiting physicians. Rural community hospitals often have difficulty recruiting and retaining talented nurses, techs and administrators, too,” Dr. Serwer explains.

VitalSolution: Bridging the Rural Cardiology Gap

VitalSolution, founded in 2011, is not just a staffing company. It partners with facilities of all sizes to develop creative solutions to address their specific challenges. Its unique model enables specialty physicians like interventional and general cardiologists to work for seven days and then rest for seven. When physicians are off, they recharge their bodies and minds, reconnect with family and friends or engage in recreational activities. There is no call to take.

“With our innovative model, doctors work where they are needed and live where they want,” Dr. Serwer says.

Through VitalSolution, hospitals in nearly 30 states benefit from reliable 24/7/365 coverage from high-caliber, dedicated cardiologists, cardiac nurses, and technologists.

“We provide the invigorated energy and experience to establish or grow interventional and general cardiology programs,” Dr. Serwer says. “Our teams are incentivized to drive program growth while meeting—and often exceeding—evidence-based standards of care and quality.”

Cardiology Program Development and Enhancement

VitalSolution provides clinical oversight and quality and safety expertise in an engagement that fosters frequent communication and support, both for its hospital partners and team members. We:

“We are not a one-trick pony. We ask the questions necessary to understand each facility’s challenges and opportunities,” Dr. Serwer explains. “Often, the hospital has the vision but needs help executing it. Our teams are experts in cardiology program design and implementation.”

Success Story: Wayne Memorial Hospital

An example of a thriving partnership is the one between VitalSolution and Wayne Memorial Hospital, where Dr. Serwer worked for four years. The 90-bed community hospital in blue-collar northeast Pennsylvania launched its interventional cardiology program in 2016. Program volume grew year over year, but when it lost its only interventional cardiologist in 2019, the hospital contracted with VitalSolution.

During Dr. Serwer’s tenure at Wayne Memorial:

• No cases were canceled due to lack of coverage
• A chest pain committee was implemented, giving cardiology, administration, ER, nursing and radiology an equal voice at the table
• Door-to-balloon times improved to 55 minutes or less (90 minutes is the national standard)
• Patient outcomes improved
• Patient volume grew
• The program became an accredited Chest Pain Center

In 2023, the hospital performed 125 PCIs between its two contracted interventionalists. If the program at Wayne Memorial didn’t exist, patients would need to travel 40 minutes to the nearest program in Scranton.

“We saved hundreds if not thousands of lives through this heartwarming—and heart-saving—endeavor with Wayne Memorial,” Dr. Serwer says. “It’s been a beautiful union.”

Connect with VitalSolution

Ready to bridge the rural cardiology gap? Partner with VitalSolution and join hospitals like Wayne Memorial in enhancing heart care for your community. Reach out now for a personalized assessment.