N.J. hospitals urge continuation of Johns Hopkins angioplasty project
Nine N.J. hospitals are participating in a demonstration project that will help determine national healthcare policy, and they collaboratively began a public education effort to highlight the continuation of the ongoing project by the New Jersey State Department of Health and Senior Services (NJDHSS).

The study, launched in six states by cardiologists at Johns Hopkins Medical Institutions, will compare the patient outcomes of those treated with elective angioplasty at hospitals with cardiac surgery on-site versus hospitals that have off-site cardiac surgery back-up. Expanding the number of sites allowed to perform elective angioplasty lets patients remain in the continuous care of their primary-care physician and cardiologist. Hospitals without cardiac surgery back-up on-site already perform diagnostic and emergency angioplasty.

The project is designed to evaluate patient outcomes when an interventional cardiologist, who diagnoses a blockage during a catheterization at a hospital without on-site surgical back-up, immediately moves on to clearing the blockage via a balloon angioplasty. Conversely, the cardiologist would have to stop the procedure and transfer the patient to another hospital. Rather than undergo two separate procedures for diagnosis and treatment, patients could have both done during one procedure at the same hospital.

The nine N.J. hospitals participating in this demonstration project meet a stringent set of safety and clinical requirements, and have been approved by NJDHSS. To participate, hospitals must have a combined emergency and elective angioplasty volume of at least 200 cases per year after the first year and a staff whose training meets national standards set by the American Heart Association and American College of Cardiology.

Three New Jersey hospitals—Cooper University Hospital, Deborah Heart and Lung Center, and Our Lady of Lourdes Medical Center—have filed suit against the NJDHSS and Virtua Health, a project participant, to stop the study due to procedural issues. The N.J. Supreme Court ruled that the NJDHSS had the right to approve the study, but the state would have to re-write the regulations for the project to continue beyond Nov. 30.

In the Johns Hopkins study, participating patients who require angioplasty are randomly assigned to have angioplasty at either the hospital without on-site cardiac surgery or at a center with on-site cardiac surgery. Researchers follow the patients for nine months to determine their health status, and whether they have subsequent heart-related problems. At the project’s end, the researchers will compare outcomes, or well-being, of patients treated in the two groups.

So far, six states have approved hospitals to participate in the project: New Jersey, Georgia, Illinois, Ohio, Pennsylvania and Alabama. The nine hospitals selected by the NJDHSS to participate in the project are: Bayonne Medical Center, Holy Name Hospital, Monmouth Medical Center, Muhlenberg Hospital, Raritan Bay Medical Center, Robert Wood Johnson University Hospital–Hamilton, Somerset Medical Center, Trinitas Hospital and Virtua West Jersey Hospital Marlton.