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Cardiac care represents a burgeoning investment opportunity for local health systems, with the number of Americans diagnosed with heart failure set to rise by 46% between 2017 and 2030. However, patients’ risk isn’t equal: the American Heart Association reports that heart attack hospitalization rates are on the rise for women over 55 while they fall among men.
Amid these shifts, Northwell Health has invested more than $600 million into facilities to help expand cardiac care since the end of last year. A new $560 million surgical tower at North Shore University Hospital will perform open heart surgery, heart and lung transplants while a $52 million center in Rego Park provides cardiology among other specialties. Now the system has created a new role for and hired Dr. Nisha Parikh as the new system director of the women’s heart program at Northwell’s Cardiovascular Institute and Katz Institute for Women’s Health, a network of more than 800 experts with 190 locations in New York.
The role is a first for Parikh, too, who comes from an academic and clinical background focused on preventing cardiovascular disease and studying disparities between pregnant patients. She spoke to Crain’s about how she plans to expand Northwell’s programs and services for pregnant patients, treat specific stressors such as caregiving stress and depression and make care less fragmented.
This interview has been edited for length and clarity.
Other local systems have invested in cardiac catheterization labs to expand their heart care. What are your plans for new programs or facilities?
A lot of what we’re planning on doing in the women’s heart space is creating multidisciplinary clinical programs that address important cardiac health conditions and women. An example would be to expand our current cardio obstetrics team to take care of both high-risk patients as well as moderate- or lower-risk patients. We’d love to create a team approach that incorporates cardiac input, obstetrics and maternal-fetal medicine, anesthesia, even social work to address disparities. One of our plans is to create multidisciplinary clinics so that pregnant women can be seen at the same time by cardiology and obstetrics. I think that one of the challenges in our current health care system is just the fragmentation of care–and that becomes more acutely a problem for pregnant women.
Another [focus] is to develop [and] expand our expertise in taking care of chest pain and heart attacks in women that aren’t necessarily due to garden-variety plaque that we currently think of as the cause of most angina and heart attacks. We want to develop expertise to diagnose those conditions. One [method] is training our entire workforce and our referring providers. And then the second is partnering with specialized chest pain centers around the country to share expertise.
How is caring for women’s hearts different from caring for male patients?
I think the lived experiences of women are often different than men. So that can range from their experiences of emotional stress or stress in the workplace, for instance, and we know that those factors can relate to cardiac disease. There are a lot of life transitions that women go through that men don’t always go through: the childbearing years, menopause. There’s a lot of caregiving stress that women experience with taking care of aging parents, and that can relate to heart disease.
So a lot of our focus is, how can we develop programs for women that are sensitive to these various life stages? Can we measure these? Can we help treat some of those risk factors that would be considered non-traditional such as anxiety, depression [and] emotional stress? We would factor that into our risk stratification and we might have a shared decision-making discussion about doing further testing if we noticed that she has some of those female-specific risk factors.
Everyone is talking about artificial intelligence in health care. What are your plans for incorporating AI into heart care?
A lot of my research work has been in risk prediction. And I’ve done some work looking at machine learning algorithms, AI algorithms to mine large databases and women to see if we can better predict outcomes by using larger datasets and some of these newer modeling techniques. And I think that Northwell would be really well poised, especially as we transition our electronic medical record into sort of the more standardized Epic [system], to start to study or test some of these research ideas. For women’s heart care, it’s definitely an area that we’re very interested in.
You come from a clinical, academic and research background. How will you transition into a more operational role?
Although I haven’t had an administrative role, I have had several leadership roles, so I’ll certainly use that expertise in the current administrative role. But I think the wonderful part of having a 50% nonclinical role and a 50% clinical role is that your patient experiences in clinic and in the hospital can really inform what the priorities should be in terms of building clinical programs and the administrative part of the role. I think an important thing for me has always been to have that clinical piece because otherwise you’re too far divorced from the patient, the reality of what patients need.
If Northwell’s potential takeover of Nuvance Health is approved, how would that broaden or complicate your role?
I would welcome that opportunity if it were to arise. My role is a system role so I imagine that if we were to acquire new locations that would fold under my purview, but I couldn’t say specifically about the Nuvance deal.
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Jacqueline Neber , 2024-04-19 11:33:04
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