Cone Health is known for groundbreaking cardiovascular care — now the goal is to prevent disease before it begins
Building world-class cardiovascular care
Dr. Jake Hochrein first learned about Cone Health’s reputation for heart and vascular innovation as a budding cardiologist in 1995.
He was on rounds in a coronary care unit with one of his professors at Duke University School of Medicine — Dr. Robert Califf, future commissioner of the U.S. Food and Drug Administration. “(Califf) said to me, ‘If you're having a heart attack in North Carolina, you want to be at Cone Hospital.’ And we were standing inside Duke Medical Center,” Hochrein says.
Today, Hochrein is chief of Cone Health’s cardiovascular service line and Cone Health Medical Group HeartCare. And he’d venture to say that Califf’s pronouncement still holds true.
Case in point: In 2014, Cone Health cardiologists installed the second and third wireless pacemakers in the country. Only one other hospital in the world — Cleveland Clinic — had used the innovation before they had. The procedure was part of his department’s commitment to cutting-edge care — through clinical trials, through the LeBauer-Brodie Center for Cardiovascular Research and Education, and through life-saving treatments that later become standard-of-care. “Our patients have access to innovative approaches before the rest of the world does,” Hochrein says.
This trailblazing mindset started around the time Hochrein was in medical school. Cardiologists Dr. Joe LeBauer, Dr. Bruce Brodie, Dr. Thomas Stuckey and Dr. Richard Weintraub shared a vision for bringing new therapies to the area — not just to benefit their individual cardiology practices, but for a community-wide effect.
For example, cardiologists didn't know then whether the best treatment for a heart attack was to give a patient thrombolytics — an injectable medicine that breaks up clots — or to perform an angioplasty “balloon” procedure during the heart attack. Clinical trials were showing that direct angioplasty beat thrombolytics, so the Cone Health cardiologists started doing angioplasties and collecting data for clinical trials in a real-world setting.
“Everybody beat a path to their door,” Hochrein says. “They were accessible to academic medical centers who wanted a partner that could be nimble. They worked really hard and built that reputation, and we’re working to maintain that legacy.”
Nearly three decades later, Cone Health’s newest physicians bring that same focus and drive to preventive care. The system works collaboratively with community partners to understand patients, their individual situations and their barriers, and then design programs that will improve health outcomes.
“We first seek to understand — and that's an innovation,” Hochrein says.
According to Hochrein, heart and vascular disease is the No. 1 reason for hospitalizations, both here and nationally. “That comes with a huge toll on patients and families in terms of impact on just about every aspect of their lives — not just their lifespans, but financially,” he says. “It's hugely impactful and it's a national and local epidemic.”
Prevention is critical, but it’s a long-term approach, something that doesn’t yield the same immediate transformation as, say, performing life-saving angioplasty on a patient with significant blockage. Trying to convince patients to adopt lifestyles that reduce the need for such procedures? Getting people jazzed about culinary medicine and exercise programs and mindfulness, which won’t produce instant results? That’s a much more subtle process, but ultimately just as transformative.
“We could keep somebody from having to take a pill, from having a heart attack, from losing a limb, from ending up on dialysis or having a stroke,” Hochrein says. “It’s extremely exciting that we could prevent disease. To me, that’s the story of cardiovascular care and where we’re headed next.”