Pediatric Heart Institute Impact Report

In the past two years, Monroe Carell has seen tremendous growth in the depth and breadth of our fetal cardiology program. By adding two new experts to our team, Drs. Bridget Zoeller and Jamie Colombo, we were able to grow into five new Tennessee communities — Clarksville, Franklin, Hendersonville, Jackson and Murfreesboro. This has allowed us to see fetal cardiac patients and collaborate with their physicians close to home.

As platinum sponsors of the Fetal Heart Society and pioneers in fetal cardiology innovation, we are a research-intensive team driven to improve patient care. We lead and collaborate in a range of single and multi-center research studies. These include fetal diagnosis and therapies for arrhythmias and structural heart disease, psychological family support during prenatal diagnosis and the impact of prenatal stress on postnatal maternal infant interactions and neurocognitive development in single ventricle patients.

Heart specialists at Monroe Carell trained physicians in Australia to perform procedures we pioneered. Now, we participate in fetal monitoring for fetal meningomyeleocele repairs and continue to train physicians across the nation.

Our recently added Remote Home Monitoring Program ensures continuity of care and gives parents peace of mind. The program was designed for patients who have single ventricle physiology, are shunt or stent dependent, or have other high-risk conditions. Our team meets families in the hospital following birth to assess cardiac health as well as development and oral skills, including feeding. Families enrolled in our program go home with pulse oximeters, scales and easy-to-use apps for monitoring for remote observation with direct access to our team to help ease the transition from hospital to home. 

We've also augmented our telehealth services. We use mobile health technologies and fitness trackers that integrate with Epic to effectively monitor patients and individualize treatment plans. Our systems allow virtual check-ins with each patient using the data from remote monitoring. 
  
In 2022, we opened a telemedicine clinic in Clarksville, Tenn. In 2023, we will be expanding our program further with the addition of clinics in Cookeville and Murfreesboro. 

Launched in 2022, the Fontan Clinic partners with referring physicians and families to provide regular assessment for children and teens, ages 10 to 19 years, who have had a Fontan procedure. Our team coordinates care to address the long-term impact of congenital heart conditions beyond the original diagnosis and initial intervention. To avoid unneeded family travel, appointments are scheduled on a single day. The team comprehensively assesses each child or adolescent, communicating results and partnering with referring providers and families to develop a long-term care plan. Patients are returned to their referring physician and seen in the Fontan Clinic about once every three years or as needed.  

Our cardiac catheterization laboratory is one of the 10 busiest in the nation. We upgraded our hybrid lab, adding capacity to see more patients and vastly improving technology. Access to the latest minimally invasive cardiac catheterizations and treatments for pediatrics allows us to correct more heart defects in the cath lab rather than through open-heart surgery. This reduces radiation exposure and shortens recovery. We remain dedicated to creating new techniques and devices that improve care.

Vanderbilt teams recognized the inherent communication challenges between fetal care EMRs and mother’s EMR and developed a way way to tie the two Epic EMRs together. The application allows us to move relevant records for infants with known heart conditions from the mother's medical record to the infant's immediately after birth. This ensures that our specialists have all the critical information to care safely and effectively for these newborns. We were the first institution to use this functionality. Conversations are under way to deploy this application on Epic platforms across the country.