Heart disease remains the leading cause of death in the United States with the most common reason being coronary artery disease. According to the Center for Disease Control and Prevention, in 2008, an estimated 770,000 Americans will have a new coronary event and 430,000 will have a recurrent event. Since 1963 Congress has required the president to proclaim February “American Heart Month.” The American Heart Association (AHA) works with the administration to draft and sign this annual proclamation. During the month volunteers from the AHA raise funds for research and education and provide information regarding heart disease and stroke to their neighbors. It is also good time for us to take stock of the health of our hearts and determine what we can do to decrease and/or eliminate our risk factors for developing heart disease.

While we as individuals take stock of our personal cardiac health, February is also a good month for healthcare institutions to assess their cardiac programs and the services they offer. Results of these assessments may indicate that hospitals could enhance their services by adding additional diagnostic and/or treatment modalities. CT angiography is becoming quickly embraced as a modality that can be offered even by those institutions that do not provide invasive cardiac services such as catheterization and percutanous coronary interventions.

Many health care institutions through out the country either have a 64 slice CT scanner or are in the process of purchasing one and plan to implement a cardiac CT angiography service line. Health Care Visions, Ltd. conducted a survey regarding hospital’s acquisition and use of 64 Slice CT scanning for cardiac diagnostic work. Two hundred and forty-one responses were received. The survey included hospitals with bed sizes from less than 100 (11.7%) to hospitals with greater than 300 beds (34.2%) with the majority of respondents from the South (37.2%) and Midwest (36.8%). Remarkably, over half (54.4%) of the hospitals already have 64 slice (or higher) CT scanning capability with over 85% already performing CT angiography of the coronary arteries.

One of the pressing issues for hospitals has been the competition between radiologists and cardiologists for the opportunity to interpret these studies. This survey indicated that most facilities have opened reading to both disciplines; 54.3% have both radiologists and cardiologists interpreting cardiac studies. Only 7.9% have interpretations performed exclusively by cardiologists while 32.3% have radiologists exclusively performing interpretation.

Recent articles discussing use of cardiac CT angiography have debated its impact on cardiac catheterization and cardiac stress testing volumes and raise the issue that CT angiography could become just another “layer” of diagnostic testing. Results from the survey seem to bear out this concern, at least at this early stage of cardiac CT angiography use. The survey indicated:

  • No net impact on diagnostic cardiac catheterization volumes as reported by 81.8% of the respondents
  • No net impact on cardiac stress testing volumes as reported by 82.6% of the respondents
  • Cardiac CT angiography was used as an additional “layer” of diagnostic testing by nearly three quarters of the respondents, and
  • Only 16.2% of respondents used cardiac CT angiography “in place of” other screening tools

Study results also concluded that most facilities are maintaining the location of CT scanning within the Radiology department (88.5%) and most staff CT cardiac imaging with Radiology/CT Technologists and an RN (66.7%). Over 90% of the facilities performing cardiac CT angiography are using established imaging protocols. Hospitals continue to choose to own the equipment (96.4%) as opposed to joint venturing with the physicians in some manner. Imaging is not available 24/7 at more than half of the facilities (55.6%) and of those were imaging is available 24/7 often interpretation was not. In essence, less than a quarter of the facilities (23.1%) were able to provide cardiac CT imaging and interpretation on a 24 hours a day, seven days a week basis.

More than half of the facilities performing cardiac CT angiography report having difficulty receiving reimbursement (59.6%) for the testing. Most hospitals stated that several of their insurers consider it to still be investigational and not a covered service. Several of the surveyed facilities are in the very early days of offering cardiac CT imaging and have yet to determine if they will be successful in receiving reimbursement. Those facilities who are receiving some reimbursement are seeing it from both commercial payors as well as from CMS. It is believed that CMS will issue a statement on payment for cardiac CT in the spring of 2008.

Of the respondents who do not currently have 64 slice (or higher) CT available, a total of 49% are planning to purchase a system within the next 12 months with an additional 27.9% planning a purchase within two years. Only about 10% of respondents have not planned for this type of purchase. Of those planning to purchase a high level CT scanner over 80% said that cardiac work will definitely be included in the scanner’s use.

Overall, the survey indicates:

  • The majority of hospitals that were surveyed have 64 slice CT scanning and of those who don’t the vast majority are planning to add this equipment in the next 1-2 years.
  • The facilities that have 64 slice CT scanning are employing it for cardiac work (coronary CT angiography) and the majority are using it as an additional layer of testing as opposed to using it to replace other diagnostics.
  • The overwhelming majority of facilities that plan to add a 64 slice CT scanner expect to perform cardiac work on that equipment
  • Reimbursement remains a questionable area with mixed comments on the ability to receive reimbursement.
  • The majority of facilities surveyed have radiologists as well as cardiologists involved in study interpretation.


More than 200 patients, physicians and donors crowded into the second floor of Boca Raton Community Hospital’s Christine E. Lynn Heart Institute to celebrate the first anniversary of the first new open-heart program in Palm Beach County since 1984. The event featured heart-felt presentations by founder Christine E. Lynn, hospital president and CEO Gary Strack, cardiovascular surgeon and medical director of the institute Dr. James Morris, cardiologist and chief of cardiology Dr. Jonathan Seckler, and patients who have been treated at the institute since it opened in Sept. 2006.

(l-r) Melissa Durbin, R.N., executive director of the Lynn Heart Institute; Christine E. Lynn; Gary Strack, president and CEO of Boca Raton Community Hospital; cardiovascular surgeon and Medical Director of the institute Dr. James Morris

Since it opened on the campus of Boca Raton Community Hospital, the institute has conducted more than twice the anticipated open heart procedures at 270, as well as 2172 cardiac catheterizations, 733 angioplasties, and implanted 388 pacemakers. With more than 50 cardiologists and two cardiovascular surgeons on staff, it has eliminated the need for patients to travel potentially life-threatening distances to receive comprehensive emergency cardiac care.

The institute has also cited an extremely low mortality rate of 0.6 percent for coronary artery bypass surgeries, versus an expected rate of 4.2 percent, according to the national cardiac database. Physicians said a significant contributing factor is that they specialize in bypass surgery done “off-pump,” where 98 percent of bypass surgeries performed there were done without a heart-lung machine and without stopping the patient’s heart.

In just one year, the team of physicians have also performed a number of other life-saving operations, including removing a very rare tumor in Boca Raton based-resident Susan Gerding’s heart and then just a few months later, performing heart surgery on her husband, Ed. In June, they also performed a triple by-pass surgery on Freda Lynn Frey, sister-in-law of the institute’s founder Christine E. Lynn.



She got the call while having lunch with her daughter and some friends. A patient she had been visiting for more than two years as a VITAS volunteer was actively dying. The social worker thought she might want to know. She dropped everything and went to the patient’s bedside.

“I said to her, ‘I’m here, it’s okay. If you want to go now, I love you and I will miss you, but it’s okay.’ And she died,” recalls Diane J. Nardiello, a volunteer for VITAS Innovative Hospice Care® of Dade-Monroe. “I had become her only family over those two years, so she was very special to me.”

It’s those special connections that Diane, a VITAS volunteer for six years, treasures most. In fact, she’s known for finding ways to connect with even the most challenging patients.

“I just look around for something that might serve as a common denominator in order to spark conversation,” explains the retired graphic sales manager. “I once had a patient who I had been warned didn’t talk much. I noticed she had a dish of chocolates on her table, so I asked her if she liked chocolate. That led to a conversation in which we discovered that we both love chocolate-covered raisins. I was able to open up a dialogue with her – even if it was just about chocolate.”

Diane started volunteering at VITAS after witnessing the company’s care of her own father – and of her, a grieving daughter. “When he died, the VITAS team was with me through the night. Just knowing they were there if I needed anything was reassuring.” She decided she wanted to give a little of that reassurance back.

When she’s volunteering, Diane tries to make each patient’s day special. She drives them to doctors’ appointments, bakes them birthday cakes or plays a round of dominoes. She says hospice volunteering helps her put her own life into perspective. She doesn’t think about the fact that her patients are terminally ill.

“They’re just people I know and visit,” she says. “We talk about what we’re going to do next week. We don’t look at a calendar, thinking that they might not be here. We just live.

“It’s gratifying and uplifting,” concludes Diane. “I get a good sense about myself.” And when the day came that Diane got another call from VITAS, it was for a reason that made her efforts pay off – she had won the Dade-Monroe program’s 2007 Volunteer of the Year award.



Mary-Jo Horton

One of the most important things in Mary-Jo Horton’s life is a well-organized, reliable calendar. “If I ever lost it I’d be in trouble,” she said with a smile. “There’s so much going on.”

That’s something of an understatement.

Horton, who has been a member of the Martin Memorial Auxiliary for 22 years, is heavily involved in community organizations such as Soroptimist International, Daughters of the American Revolution and Rotary Club.

But much of her time is also devoted to Martin Memorial. Horton serves as a member of the guest relations team, which greets visitors as they come into the Martin Memorial Medical Center and guides patients or visitors where they need to go. She works behind the front desk of the Medical Center as well, answering phone calls and providing information to visitors. Horton also serves as secretary of the Martin Memorial Board of Directors – a body she chaired from 1993-95.

“I haven’t learned how to say no very well,” she said. “I keep being asked to do things. I have the time, I have the interest. And this is a wonderful community. There are many different ways of contributing to it.”

And Horton has certainly contributed on many different levels. A native of Florida, Horton has been an influential leader her entire career. In the 1970s, she became the first female vice president of Burdines Department Stores. She also served on the Florida Hospital Association’s board of directors.

Through the years, much has changed at Martin Memorial. What began as one hospital in a tiny town has grown to a multi-faceted health system that serves two growing counties. Through it all, Mary-Jo Horton has been involved with that progress.

“There is always change going on and that’s part of the challenge,” she said. “I love to see things change, for people to be challenged and to think outside the box. It keeps you young.”

Joan Lemke

Joan Lemke is not the retiring type.

Not that she hasn’t tried it before. After 25 years in the banking industry she left that line of work only to take on volunteer duties. After working at the American Heart Association for years, she joined the Martin Memorial Auxiliary in 1995 and has been there ever since.

For the past two years, Lemke has served as the Auxiliary president, a job she relinquished April 1. But true to form, she won’t be going far – Lemke is staying on as recording secretary for the health system’s volunteer organization.

“I don’t think I could exist without volunteering,” she said. “I tell my family I’m going to retire and they laugh. They tell me I’ll never do it.”

Just keeping up with her family could be challenging enough for some people. She and her husband, Bill – who also volunteers at Martin Memorial – have 10 grandchildren and 13 great-grandchildren, most of who still live in the area.

But Lemke’s heart is in volunteering. After volunteering at Martin Memorial’s Volunteers in Medicine Clinic and in pastoral services, Lemke was asked to interview for the Auxiliary’s vice president position. However, after the interview they called her back and said they wanted to offer her the president-elect position.

It’s easy to see why. She is cheerful and gregarious, whether at the annual holiday tree lighting or an Auxiliary meeting, a public relations event or just walking around the halls of the hospital.

“I love it. It’s been one of the highlights of my life,” she said. “I love all the volunteers and I love this hospital. I am so impressed with the doctors, the nurses and the administrators. We’re very blessed.”

Eva Kemp

Spin a globe, point at a random spot and there’s a good chance Eva Kemp likely has been there.

A native of England, her husband, Philip, had a job that sent them to places like Sri Lanka, Australia, and finally the United States. She’s also traveled to South Africa and India, wearing out passports along the way.

Through the years and her travels, Kemp has always been active in volunteer work – including hospitals. Though she did volunteer at hospitals in England and in Australia, she feels hospital auxiliaries seem to be “uniquely American.”

“There is no equivalent organization in England,” Kemp said. “My friends are amazed when I explain what we do and the number of hours we work. I tell them that it is a symbiotic relationship, one that gives great satisfaction and pleasure to us, along with an enormous sense of worth.”

Kemp joined the Martin Memorial Auxiliary in 2003, working in the maternal-child department.

“I particularly love kids,” said Kemp, a mother of three and grandmother of eight. “I truly have a soft spot for kids.”

After transferring departments in 2005, she accepted a new role in 2006 that came with a great deal of responsibility – president-elect of the Auxiliary. On April 1, 2008 she took over as president.

“I simply can’t stay at home. I don’t play golf and I wanted to do something, to go out and meet people,” Kemp said. “I’ve learned an awful lot (as president-elect) and I’m looking forward to this new role.”



The board of directors of Palm Healthcare Foundation has approved a $1 million grant to support the capital campaign for the new regional hospital in the Glades, Palm Beach County’s only public hospital. The grant was awarded to Glades Healthcare Foundation who is leading the fund raising campaign for the $73 million project.

(l-r) John Lacy, Treasurer of Palm Healthcare Board of Trustees and Vice-Chairman Glades Healthcare Foundation; David Zechman, CEO of Glades General Hospital; Pat Lord, Executive Director of Glades Healthcare Foundation; Suzette Wexner, President of Palm Healthcare Foundation; David Goodlett, Chair of the Glades Healthcare Foundation Board; and Bob Jaffe, Chair of the Palm Healthcare Foundation Board of Trustees.

“We believe this is one of most important capital campaign projects in Palm Beach County today,” said Bob Jaffe, Palm Healthcare Foundation board chair. “As we have focused on increasing healthcare access for the underserved across Palm Beach County, we recognized that there is no area in our community that is more greatly in need than the Glades region where one-third of residents are living below the Federal Poverty Level. We’ve awarded this grant to help transform healthcare for over 50,000 people served by the hospital because we believe a healthy community—from east to west—benefits us all.”

The grant will be used to support the capital costs for the Palm Healthcare Center for Better Nutrition. This state-of-the-art center will allow the hospital to provide high nutritional value meals to aid patients in their recovery. The center will also serve as a community destination for healthy eating and nutrition education—a critical need in the Glades region where the population experiences high rates of diabetes and cardiopulmonary disorders.

Construction of the new 70-bed, technologically-advanced hospital to replace Glades General began in November 2007 and is well underway with an anticipated opening in early 2010.