Dr. Heather Ross says putting
fewer people in hospital for
cardiac treatment will mean better
treatment for everyone long term.
Dr. Heather Ross and the Ted Rogers Centre for Heart Research aim to end an "epidemic", cut hospital stays
Dr. Heather Ross loves talking about the heart and all its medical machinations and mysteries, but there’s one term she’s not fond of – "heart failure."
"It’s a terrible name," says Dr. Ross, Cardiologist, Peter Munk Cardiac Centre, and Medical Director, Cardiac Transplant Program, Toronto General Hospital, and a driving force at the Ted Rogers Centre for Heart Research.
"Really, heart failure implies that you’ve lost before you started. That’s why it’s the Centre for Heart Research. I think ‘heart function’ is a reasonable term," she adds, though she acknowledges "that the global community still calls it ‘heart failure.’"
While the world-respected cardiologist believes that the terminology matters, Dr. Ross will relent and use the not-her-favourite term to talk about her goal — actually, the research centre’s goal – to reduce hospitalization for heart failure by 50 per cent over the next decade.
"Heart failure is an epidemic," she says. "There are about half a million Canadians with heart failure. About 50,000 new cases are diagnosed each year, and the average life expectancy for those diagnosed is about 2.1 years, a little longer for women."
Putting fewer people in the hospital for treatment will mean better treatment for everyone in the long term, she explains. "Hospitalization is one of the markers of poor prognosis. As much as we know that we do amazing, good work in hospitals,if you’re a heart failure patient coming to the hospital, it’s a marker that you’re in some trouble."
Treating hearts in a hospital is also more expensive and less cost-effective than prevention and outpatient treatment. A 50 per cent reduction is "a reasonable expectation of what’s preventable," she says.
"There’s a convergence. We have an epidemic. We have government trying to deal with costs and, at the same time, we have the issue of benchmarking for what we should be doing to ensure the standard of care," Dr. Ross explains.
She credits the Rogers family and the late Ted Rogers himself for understanding that establishing the research centre can address all three issues. She agrees that, for all the Rogers’ accomplishments in communications and business, in a few generations the name may be best remembered for the family’s contribution to heart research.
"That would be nice," Dr. Ross says.
"I had the privilege of caring for Mr. [Ted] Rogers. When we talked, he always wanted to talk about ‘what’s next’ – that’s what he was like," she says. The Rogers family’s $130-million donation toward creating the research centre is the largest single monetary gift ever made to a Canadian health-care institution.
Top-quality research and attracting the world’s best experts to work here can lead to more effective treatment, more efficient use of health-care funds and better measurement of what treatments work best and what breakthroughs are on the way.
In addition to the target of reducing hospitalizations by 50 per cent over a decade, "I added the goal of reducing length of stay by 20 per cent," Dr. Ross says.
"On average, the length of stay is about 10 to 12 days [at the Cardiac Centre], and we’d like to reduce it to five or six. It feels like
the right time to make all these things happen."
Dr. Ross says that since the Ted Rogers Centre for Heart Research was established last November, "I find myself waking up at three in the morning with ideas." She smiles at the notion that she develops ideas the same way as Rolling Stones guitarist Keith Richards, who composed
Satisfaction after waking up in the middle of the night. Then Dr. Ross pulls out a chart, showing how to streamline patient care, which she, too, conceived in the middle of the night.
“What’s really fun is bringing people together in the same room who wouldn’t have gotten together if it weren’t for the Rogers’ gift. We probably should have gotten together and now we are, and all of a sudden people are talking, and ideas are bouncing,” Dr. Heather Ross, Cardiologist, Peter Munk Cardiac Centre, and Medical Director, Cardiac Transplant
Program, Toronto General Hospital
"I had it laminated, so I could show it to everyone at the centre, and we could discuss it," she says. The research centre’s blend of expertise and enthusiasm is already leading the way toward breakthroughs that still seem like science fiction, though they are real.
"We were told to be bold, be aspirational, and that’s what we’re doing," says Dr. Mansoor Husain, Interim Director, Ted Rogers Centre for Heart Research (and Senior Scientist, Toronto General Research Institute).
For example, researchers are gaining new insights into diastolic heart activity, which occurs "when the heart pumps properly, but it doesn’t relax properly," he says. This is leading to new treatments and medications that address specific functional problems with more precision than ever before.
Doctors aim to be able to take cells from a patient’s skin or blood and grow a "piece of your heart" in a dish, which can be used to replace worn-out parts, he says. "This is personalized medicine," Dr. Husain explains, taking account of the individual variables in everyone’s makeup and minimizing the chance of rejection after a transplant.
Dr. Barry Rubin, Medical Director of the Peter Munk Cardiac Centre, is similarly excited about the breakthroughs taking place already.
He conducts tours at the centre, showing three operating rooms: one from a few years ago that’s well-equipped with diagnostic, as well as surgical, equipment; a newer one with more sophisticated imaging tools; and the newest state-of-the-art room that integrates ultra-fast body scanning, so the medical team can see images of the patient’s heart while they work.
The next step is to use a hologram, now being tested in Israel, that produces a three-dimensional image of the heart in the air above the patient on the table. Doctors can measure different-sized stents using the hologram to see which one fits best, without invasive trial and error.
The technology is breathtaking, but perhaps what’s most important is how the centre encourage collaboration and teamwork, Dr. Ross says.
"What’s really fun is bringing people together in the same room who wouldn’t have gotten together if it weren’t for the Rogers’ gift.
We probably should have gotten together and now we are, and all of a sudden people are talking, and ideas are bouncing, "she says." And it’s great."