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Keeping Them Close 

Kootenai Health's new partnership with Mayo Clinic enables some patients to get specialized care, right at home

click to enlarge Kootenai Health oncologist Kevin Mulvey (left) can now seek quick second opinions via the Mayo Clinic; (inset) Kootenai's Chief Medical Officer Dr. Walt Fairfax. - ANNIE KUSTER
  • Annie Kuster
  • Kootenai Health oncologist Kevin Mulvey (left) can now seek quick second opinions via the Mayo Clinic; (inset) Kootenai's Chief Medical Officer Dr. Walt Fairfax.

Since last summer, the roster of Kootenai Health has been several thousand physicians deeper — sort of.

Thanks to a recent partnership with the renowned Mayo Clinic, made official in August, the Coeur d'Alene-based health care provider now has access to the expertise, advice and best practices of Mayo's more than 4,000 physicians across a range of diverse specialties.

Kootenai's membership in the Mayo Clinic Care Network goes beyond simply referencing Mayo's depth of medical knowledge. The nonprofit health care provider's Chief Medical Officer, Dr. Walt Fairfax, says the collaborative partnership allows some of its patients to receive more advanced medical care without leaving town, rather than having to travel out of the area to specialty hospitals or clinics. As anyone who's experienced it can attest, travel for specialized health care is often disruptive, stressful and creates financial strain.

"Mayo's philosophy is one we share," Fairfax says. "People do best if they can receive care as close as possible to home."

Kootenai Health is currently the only member of the Mayo Clinic Care Network in the Northwest, with the nearest member organization in Billings, Montana.

One of the most used features of the care network collaboration on Kootenai's end is what's called the AskMayoExpert database, Fairfax says. The online information system, compiled by Mayo's physicians, serves as a reference tool when doctors seek additional information on specific diagnoses, treatments and general medical conditions. While Kootenai physicians still reach out to each other for advice, Fairfax shares an example of how the Mayo database would be used.

"Say you have a patient with psoriasis who is the patient of a cardiologist, and who comes in to be evaluated for heart disease, but they say, 'You know, I also have psoriasis.' And the cardiologist needs to advise the patient who to see," he explains. "The cardiologist hasn't been up to date on psoriasis treatments since medical school, so they reach out to [the database] and are then able to have a conversation with the patient about what specialist to see."

Since joining Mayo's Care Network, Kootenai's medical staff has accessed this continually growing database multiple times a day, Fairfax adds.

One of the more innovative tools that comes with Care Network membership is the ability for Kootenai physicians to consult electronically with Mayo's team of specialists.

"We have a very sophisticated medical community in this region in Spokane and Kootenai counties, and we usually share consultation practices across those borders. But sometimes, you reach the limits of what a community like that can offer," Fairfax says.

For those rare and more unusual medical cases that perhaps have never been seen by any of our region's specialists, Kootenai can now reach out to Mayo for advice.

The electronic consultations require Kootenai's staff to transmit all pertinent medical records, including test results, radiology, pathology and other lab reports, to be evaluated by Mayo specialists. The consult results usually come back to the requesting physician within 24 to 48 hours.

"They have their physicians in the specialties review and give the same level of advice as if the patient was there in front of them," Fairfax explains.

Since August, Kootenai has reached out to Mayo for many of these second opinions through its eConsult program, to confirm a patient is getting the most appropriate diagnosis and subsequent treatment without ever having to step foot into a Mayo Clinic.

Another collaborative aspect of the Care Network that's available to Kootenai is what's referred to as the eTumor Board. Tumor boards are meetings of various care providers and physician specialists to discuss treatment for individual cancer patients. In the case of the Mayo Care Network, its member organizations can request tumor boards via video conference calls for patients who may have rare forms of cancer, and then discuss the most appropriate treatment approaches.

In addition to these patient care tools, Fairfax says Mayo also shares information relating to practice administration and internal policies with its Care Network members. All of the patient care resources are offered to Kootenai's patients at no additional cost to them. The collaborative aspects of the Mayo Care Network are offered to its members through a fee-based model.

Mayo Clinic is consistently recognized as one of the top hospitals in the nation, and is known for its research and work in difficult medical cases. Founded and based in Rochester, Minnesota, Mayo also has major campuses in Jacksonville, Florida and Scottsdale, Arizona. The Mayo Care Network was established in 2011, and currently counts 31 health care organizations as its members.

"If the patients are the true focus of what we do in health care, this is a win for them," says Dr. Stephen Lange, a physician medical director for Mayo's southeast region clinics. "They get new knowledge and expanded expertise in their communities at no cost to them."

While the Mayo Care Network has been growing steadily since its inception less than four years ago, the plan isn't for it to become a vast conglomerate of providers across the world. Each organization that has joined the care network was first required to undergo a rigorous due diligence process. Mayo also seeks out health organizations that mirror its own mission and beliefs in patient care.

As technology continues to play a bigger role in health care, the potential for Mayo's network and others like it are vast.

"The core concept is transfer of knowledge, and if we do that more efficiently and rapidly than in the past, the new standard of care is delivered to the regional systems at a faster rate. I think that is the primary innovation we focus on through this relationship," Lange emphasizes. ♦

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