RMC: ‘The best technology right here in Orangeburg’; hospital shows new programs, procedures

From new technologies and services lines – ranging from cardiac procedures to minimally invasive surgery – the hospital is moving forward with cutting-edge advancements.

The hospital’s offerings were on display during a drop-in expo Wednesday.

Among the newest service lines at RMC is a percutaneous coronary intervention program, formerly known as angioplasty with stent, which is used to open clogged heart arteries.

“Historically the hospital has only been able to do diagnostic pictures to find blockages, but if we did find them we would have to send patients to Columbia and Charleston. We are now able to do that here locally,” RMC Director of Interventional Cardiology Dr. John Fry said.

In certain conditions with heart artery blockages, “timely treatment is very important as far as outcomes are concerned and patients having a better chance of improvement,” Fry said.

“We are excited about it,” he said.

An “ST” elevated myocardial infarction, also known as a STEMI heart attack, occurs when a major artery to the heart is completely blocked.

If a percutaneous coronary intervention is performed within 90 minutes of arrival at the hospital, STEMI patients see a significant reduction in heart damage. Time lost equals muscle loss. Because of this, patients with suspected STEMIs have been transported to neighboring hospitals for the procedure.

“The ability to treat patients here is essential for optimal patient outcomes,” RMC Chief Operating Officer Sabrina Robinson said.

“Every minute counts and research has proven that the quicker a patient undergoes the procedure, the less heart damage he/she will have. The time spent transporting patients an additional 35 or more miles is treatment time lost,” she said.

The procedure entails using a catheter to place a small structure called a stent to open up blood vessels in the heart that have been narrowed by plaque buildup.

The first two percutaneous coronary intervention procedures were done at the hospital Jan. 23 and there have been about seven done in a week’s time, Fry said. The first patient had about a 90% blockage.

RMC is currently working on patients who are stable and need elective procedures but is hoping to expand.

“We are waiting to see what the affiliation with MUSC (Medical University of South Carolina) is going to look like,” Fry said. “Once they are fully on board, the plan is to integrate some of their providers with ours and to provide emergency care and heart attack care 24/7.”

“At that time within the next several months, we will be able to take care of everyone’s heart needs short of bypass surgery,” he said.

Fry said the demand for percutaneous coronary intervention is high.

“The volume is definitely there,” Fry said. RMC estimates it will have about 200 cases per year.

Fry said there are challenges in the Orangeburg area that have contributed to heart disease, including high rates of hypertension and diabetes. That can be exacerbated by socio-economic factors such as poverty, delayed care, unhealthy eating habits due to the high cost of healthy foods, lack of education about proper diets, lack of exercise, and the perceived lack of care in the area.

“Over half of the patients in this area will go outside of the area for their medical care historically,” he said.

Fry said RMC has also increased its subspecialties over the years and foresees the partnership with MUSC further improving RMC’s capabilities.

He foresees the partnership increasing telehealth and doctors on the ground, as well as leading to an upgraded medical electronic medical records system.

Fry has done percutaneous coronary intervention work for about 28 years.

He received his medical training at Ohio State University, residency at Ohio State University’s Cardiovascular Fellowship, and then interventional fellowship in stenting and vascular disease at William Beaumont in Detroit, Michigan.

He then practiced in Indianapolis, Indiana for over 14 years before joining Cardio Solution, a company that sets up new heart programs in rural communities.

Other services and programs discussed at the media expo included the hospital’s Zero Harm Initiative, Mabry Cancer Center, primary care services, community health needs and concerns, general surgery, women’s health, orthopedics, behavioral health and neurology, and the Dialysis Access Institute.

RMC has also implemented robotics surgery over the past three years.

OD-GYN Dr. Bruce Williams uses the Da Vinci Surgical System to treat patients.

“The huge benefit as far as robotics is concerned is it allows for better visualization,” Williams said. “We are able to magnify images as much as ten times.”

“When we are working in really tight areas when the patient has significant adhesions, we are able to see crucial structures that are typically at risk for transection or for injury,” Williams said.

Williams said the robot also helps with women who may have had multiple C-sections or endometriosis because the robot is pliable.

“I can use them pretty much like I can use my fingers,” Williams said. “I can bend the instruments.

“It is a lot safer if I just need to push adhesions off instead, as opposed to having to use energy – specifically heat or even cutting.”

Williams said the energy is more focused and that eliminates the spread of heat and potential damage to nearby structures.

“The beauty of what we call minimally invasive surgery is the decrease in blood loss, decrease in hospital time,” he said. “My patients typically go home the day of surgery or they go home the following day.”

In the past, patients who had a hysterectomy were out of work for six weeks. Now patients return after two to three weeks.

Williams said he trained on the Da Vinci over a decade ago. He says this is the fourth version of the robot.

“We had a pretty simple robot at that time,” he said. “Based on where we started with the robots to where we are now, it was a huge difference.”

The robot is integrated with the surgical table, which makes adjustments easier.

RMC Surgical Specialty Services Manager Beth Love said the Da Vinci robot is also used in the hospital for general surgery and abdominal surgeries.

The hospital’s first surgery with the Da Vinci was performed in February 2021. It has primarily been used for hysterectomies and gallbladder, hernia and colon surgeries.

“Before the Da Vinci robot came, most of our surgeries were done laparoscopically or open,” Love said. “We know that we prefer not to do open surgeries because you have more of a risk of complications.”

Love said the Da Vinci has resulted in faster recovery times and shorter length of stay.

“The imaging that the Da Vinci robot gives is so much clearer than with laparoscopic surgery,” Love said. “You can see it with 3D and the surgeons are really able to get in there with more accuracy with this new technology.”

RMC also has the Mako robot for use on hip and knee replacements.

The hospital’s first Mako surgery was done in February 2020.

RMC has three Mako-trained orthopedic surgeons and four – soon to be five doctors – trained on the Da Vinci.

Love said the Mako robot has reduced recovery time, length of stay and pain for patients.

“It really helps pinpoint how much bone to take away without taking too much of the good bone away, which helps you recover faster and gives you better outcomes,” Love said.

Love said the bottom line is that the RMC has “all the best technology right here in Orangeburg to make sure we can give the best care and provide the best outcomes.”

AI and stroke care

About two months ago, RMC also introduced an artificial intelligence stroke tool that identifies whether a stroke patient has a blockage in a large vessel.

The Viz.ai tool is phone alert app that lets providers immediately know the results of a patient’s computerized tomography scan through their cellphones and identifies if the patient needs a thrombectomy procedure or can benefit from a thrombolytic or a “clot buster” drug.

“Time is so important with the thrombolytic agent as well as with the thrombectomies,” RMC Stroke and Telemed Program Coordinator Sherry Davis said. “We have to get patients out of here as quickly as we can or get that medicine in them as quick as we can.”

The AI tool piggybacks on the telehealth stroke capabilities RMC has provided for the past nine years.

The hospital has partnered with MUSC in the effort, which helps RMC engage with an MUSC doctor to determine the treatment protocol for a stroke patient.

The RMC has two such machines – one in the CT department and one in the emergency department.

“We call immediately if we think we have a stroke,” Davis said. “They (MUSC) connect within 5 or 10 minutes and they will help us decide whether or not that patient is a candidate for that thrombolytic.”