Kootenai Health, Mayo Clinic solving rare cases together

Nathan Sheffield has to be careful for the rest of his life. He moves deliberately, knowing a simple accident like a stumble or fall — or even a minor cut — could be the beginning of the end.

The 39-year-old Coeur d’Alene man lives with an excessive blood clotting disorder that if left untreated could kill him.

“You have to be very aware of what you do,” Sheffield said. “You want to avoid major bleeding. You can’t be in a situation where you get hurt. Last November, I had a blood clot in my leg that went up to my lungs. I ended up in the ICU at Kootenai. My body produces clots 10 times the normal person. There is no cure. You have to be proactive about it. I have a 9-year-old daughter and this is scary.”

He was diagnosed with Factor V Leiden Syndrome in 2006. Complicating matters, Sheffield didn’t respond to the medicine that had been proven to help other patients with the rare genetic condition. The mystery confounded the medical professionals at Kootenai Health for years. Then about six weeks ago, his doctor, David Bartels, D.O., a medical oncologist with Kootenai Clinic Cancer Services, began working with the Mayo Clinic Care Network specialists and a successful treatment was found.

“It’s made a ginormous difference in my life,” said Sheffield. “I don’t have to inject myself four times a day in the stomach anymore. Instead, I just take two pills and it’s improved my quality of life. I can’t thank my doctor and my social worker enough for taking on this massive research and finding a solution.”

Kootenai Health hopes Sheffield’s success story is one of many to come as the North Idaho health care provider celebrates its one-year anniversary of belonging to the Mayo Clinic Care Network.

Kootenai Health is the only hospital in Idaho that’s part of the Mayo Clinic Care Network and CEO Jon Ness described the relationship as a “resounding success.”

“Through the network we have been able to provide many local patients with second opinions from some of the world’s leading experts,” Ness said. “They have received the benefit of Mayo Clinic specialists’ expertise at no charge and without having to leave home.”

And that’s a big deal to North Idaho patients. The consequences of traveling to see medical specialists in the Midwest to receive care would have been financially devastating for Sheffield and an emotional burden on his wife and young daughter.

“If I had gone all over the world to get care for my disorder, it would have been very traumatic to my family,” said Sheffield. “The financial impact would have been huge, too. It’s tremendous that Kootenai Health has this relationship with the Mayo Clinic.”

“We have been surprised to receive numerous calls from outside our region from patients seeking access to the Mayo Clinic Care Network," Ness added. "Many of these patients see the value of a second opinion from Mayo Clinic specialists and a trip to Coeur d’Alene is much easier for them to make than a trip to Arizona or Minnesota.”

Sheffield is one of 110 local patients who received eConsults through the Mayo Clinic Care Network. Those numbers are expected to increase this year.

“All in all, it’s off to a great start with Kootenai Health,” said Dr. David Hayes, Medical Director and Provider Relations for the Mayo Clinic Care Network in Rochester, Minn. “The first year is just the beginning. There are a lot of things we can do to enhance the relationship on both sides.”

There are more than 104 hospitals in 30 states and three countries in the network, providing participating health care providers with access to 4,000 physicians and scientists who specialize in everything from oncology to cardiology.

“These patients can have very complex issues and get access to specialists who have handled unusual cases in the past,” Hayes said. “We can filter these cases to the right specialist because of the network. You might have an eConsult with 32 subspecialists involved to help on a rare form of cancer.”

Here are the three primary services Kootenai Health receives as a network member:

eConsults allow network physicians to connect electronically with Mayo Clinic specialists when they want additional input regarding patient care. The response time from Mayo is about two business days.

Every doctor and nurse at Kootenai can access the AskMayoExpert. It provides point-of-care information compiled by Mayo physicians on disease management, care guidelines, treatment recommendations and reference materials for a wide variety of medical conditions.

eTumor Board Conferences allow physicians to present and discuss management of complex cancer cases with a Mayo Clinic multidisciplinary panel and other members of the network.

But benefits go beyond the individual patient to the operational levels of the organization, including consulting on best practices and advice on launching new services, Ness said.

“Our family birth center staff have been working closely with Mayo Clinic staff as we further develop our special care nursery into a level 3 neonatal intensive care unit,” he said. “And our orthopedic nurse practitioner recently visited Mayo Clinic to study their total joint replacement program.”

Walt Fairfax, Kootenai Health’s chief medical officer, is intrigued by the research possibilities.

“One of the most interesting things is our ability to participate in the academic portions of what they have to offer in terms of their research programs,” said Fairfax. “It’s a two-way street. The Mayo Clinic recently asked to be a part of one of our programs.”

Dr. David Bartels, Sheffield’s primary physician, said the eConsults worked well and he expects to use the Mayo Clinic for 1 percent to 5 percent of his patients.

“Mayo Clinic is an excellent adjunct to patient care, especially in the setting of rare and uncertain cases,” he said. “The partnership with Mayo Clinic and their recommendations gave me the confidence to work outside what is standard. Nathan's quality of life and long-term health expectations have improved because of the Mayo Clinic relationship and consultation. It’s important for our patients to be confident and encouraged by the decision-making of our physicians.”

Marc Stewart is the director of Sponsored Content for the Coeur d’Alene Press. He can be reached at mstewart@cdapress.com or (208) 664-8176, ext. 2011.