Sometimes seemingly random events and situations have a way of coming together to create something good.

That’s just how FirstHealth’s Mobile Health Services program acquired new ultrasound equipment and the incentive to develop a new screening program for vascular disease.

“This program evolved as a result of special interests and efforts from many directions,” says Kathleen Westover, president of the Foundation of FirstHealth.

Westover’s involvement in the project began when she was approached by a longtime Foundation supporter about the possibility of providing scholarships for aortic aneurysm screenings. The Foundation supporter had a personal history of aortic aneurysm, knew that screenings can reduce the risk of sudden, and life-threatening, rupture of these balloon-like areas, and wanted to help high-risk individuals who need financial assistance to pay for them.

About the same time, a new physician with a special interest in vascular care joined the medical staff at FirstHealth Moore Regional Hospital. The addition of cardiothoracic and vascular surgeon John Streitman, M.D., to Pinehurst Surgical and Moore Regional has expanded the care options for patients with vascular disease in general and aortic aneurysm in particular.

Shortly after Dr. Streitman’s arrival in Pinehurst, discussions among health care providers, Mobile Health Services and the Foundation identified a critical need for aortic aneurysm screenings and for the necessary equipment to provide them.

That’s when the puzzle pieces began to fall into place.

A $50,000 grant from the Moore Regional Hospital Foundation allowed Community Health Services to purchase ultrasound equipment, which is used to screen for aortic aneurysm risk, for its Mobile Health Services van. As a result, Mobile Health Services will soon be in communities providing screenings for this life-threatening vascular condition.

“It was a ‘perfect storm’ of donor interest, Dr. Streitman’s interest and the Mobile Health program,” Westover says.

Screening program
The Mobile Health Services program will begin later this spring and actually provide three different screenings: abdominal aortic aneurysm, stroke/carotid artery and peripheral vascular disease (PVD.)

Abdominal aortic aneurysm, the condition experienced by the Foundation donor, is an enlargement in the lining of the artery that leads from the heart to the lower abdomen. Rupture often leads to sudden death.

Carotid artery disease occurs when there is a blockage in the arteries in the neck that supply blood to the head and neck. It is the number-one cause of stroke, a leading cause of disability and death in the United States.

Peripheral vascular disease, sometimes known as hardening of the arteries, is a blockage of the arteries that supply blood to the arms and legs. Generally, only 40 percent of PVD cases have symptoms and 75 percent of the cases with symptoms go undiagnosed. As a result, only 10 percent of the population with PVD gets treatment for the condition.

Historically, the FirstHealth service area—with its high incidence of diabetes, hypertension and obesity—has had a high risk for all types of vascular disease.

“The addition of ultrasound screening services to the Mobile Health van will expand the basic screening services that we already provide and meet the public demand of this type screening,” says Barbara Bennett, administrative director of FirstHealth Community Health Services. “It will also increase access to these services for those who are underserved or unable to access services, and that’s the overall mission of Mobile Health.”

According to Bennett, the screenings are easy to perform and are known to identify patients at risk for aortic aneurysm, carotid artery disease and PVD. “These screenings are proven to detect patients at risk who may otherwise have gone unnoticed until a life-threatening event occurred,” she says. “The screenings will allow for early intervention and prevention of these life-threatening issues.”

Dr. Streitman agrees. “Ultrasound is a very effective way of finding aneurysms,” he says. “They’re also effective in identifying carotid artery disease.”

According to Dr. Streitman, individuals most at risk for abdominal aneurysm are male Caucasian smokers over age 65, but women and minorities are at risk, too. In fact, 8 to 10 percent of people over the age of 65 will have an abdominal aneurysm.

Another risk factor is the existence of other arterial disease.

“The aorta is one single artery, so a lot of people who have an abdominal aneurysm will have another aneurysm in other area,” Dr. Streitman says. “These ultrasounds can help us find and treat aneurysms before they rupture and carotid artery disease before it causes a stroke.”

Although unlikely to produce a sudden catastrophic health emergency, peripheral vascular disease can be a painful and debilitating condition that also can be detected with ultrasound.

“It’s a good screening tool,” Dr. Streitman says.

Making a difference
According to Amy Hamilton, outreach manager for Community Health Services, everything is in place for the new ultrasound screening program to get immediately under way.

“The van has been updated, the staff has been secured, and Dr. (Scott) Hees has stepped up to read the images,” she says.

Dr. Hees is a radiologist at FirstHealth Richmond Memorial Hospital, where much of the planning for the ultrasound program took place. John Tucker, the hospital’s director of Imaging, helped develop the program, and ultrasound technician Eric Eisner will conduct the screenings.

Most of the screenings will be conducted in Montgomery, Moore and Richmond counties, although Hamilton foresees opportunities in Chatham, Hoke and Harnett counties as well. All have populations with proven vascular and cardiovascular health risks. “It’s typical for our state and typical for our region,” she says.These vascular screenings mark the first major expansion of Mobile Health services in several years, and note a common Community Health/Mobile Health/Foundation goal of prevention and early detection.

“The prevention element in health care is becoming more and more important,” Hamilton says. “There’s got to be more focus on prevention and easier access that allows people to take a more preventive look at their own health care. These new screenings show FirstHealth’s commitment to look forward to prevention.” (See the related chart, click here.)

The Foundation’s Westover agrees, noting the particular contributions of Foundation supporters in the development of the new screening program.

“We talk at length about how the community ‘owns’ this health care system and how there is a mutually beneficial relationship among the community, the hospital and the physicians,” she says. “This story is a great example of how needs are identified and then addressed through each of the three components focusing on caring for people.”