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and must be addressed by highly
qualified cardiologists supported by
other cardiovascular specialists with
access to appropriate technology.
Bureaucratic hurdles were also
a significant challenge. We
encountered a disjointed and
unwieldy approval process which
added significantly to the exposure
to financial risk and general cost
of doing business. These hurdles
arose partly because of scepticism
and partly because of the complexity
of the operations we proposed. This
was compounded by the absence of
accessible finance and favourable
terms of trade. Most multilateral
agencies appear to be structured
to provide non-regenerative basic
aid supporting short-term medical
missions to developing and low-
resource countries rather than
financing sustainable healthcare
development projects. We believe
that this paradigm is rooted in
a mindset aligned with deeply
entrenched affinity to dependency
and so difficult to shake from the
collective consciousness. The
transition in thinking has to be
made from dependency and short-
term fixes to long-term, meaningful
and sustainable development.
To bridge the access gap and make
high-quality cardiovascular services
available to all Jamaicans, HIC
recognised that relevant education
and appropriate use of technology
were the main components
of sustainable healthcare
development. The programme at
HIC is designed to maximise use of
the advances in technology focusing
on multi-modality systems that are
readily adaptable to low-resource
settings, easily serviceable and
durable enough to withstand the
stresses of the local environment.
The programme further focuses on
skills acquisition and the training of
local personnel to improve internal
capacity and minimise the need for
dependence on foreign entities.
Eleven years since beginning
operation, HIC has made a complete
transition to a full service Heart
Hospital and is the only Heart
Hospital in Jamaica. We provide full
outpatient and inpatient services
in our locations in Kingston and
Montego Bay, including complex
cardiovascular interventions like
coronary angioplasty and device
implantations. Both facilities
are open 24 hours a day, seven
days a week and have facilities
for angioplasty within minutes of
patients experiencing an acute
cardiac event. We have two
additional full-service cardiovascular
clinics in Mandeville and Ocho
Rios operating as outpatient
facilities but with referrals to
facilities in Montego Bay and
Kingston for more demanding
care. We have also opened Heart
Stations across Jamaica to make
care easily accessible to indigent
patients in lower income and
rural communities. In addition to
operating a 24-hour Emergency
Chest Pain Center and providing
specialised cardiac ambulance
service, HIC has designed a new
model that grants open access
to emergency cardiovascular care
to the most vulnerable group
of patients at no cost. The free
emergency angiogram programme
launched in 2015, is based on the
belief that open and accelerated
access to coronary angiograms
without financial consideration
would lead to a quick diagnosis
and allow clinicians to define
effective treatment strategies and
give patients early diagnosis. By
eliminating the financial hurdle to
diagnosis in an emergency, patients
can apply their often stretched
resources toward treatment if
necessary. For the past 10 years,
HIC has provided USD1.5 to 2.0
million annually in free or subsidised
care to financially challenged
patients. We also supported many
programs aimed at nation-building
including providing free cardiac
screening for young Jamaican
athletes and their coaches, funding
youth development programs and
sporting activities and providing free
cardiovascular care to Jamaican
icons in their golden years. We
also lead many innovations that
have improved the overall system
of healthcare services delivery in
Jamaica. For these efforts, HIC won
several awards and recognition
including the NBC Nation Builder
and Innovation Award 2014 and the
American Chamber of Commerce
Corporate Social Responsibility
Award 2015.
We continue to work towards our
mission of opening access to
high-quality cardiovascular care in
the Caribbean through innovative
and creative solutions, and believe
that many lessons can be learned
from our experience in Jamaica.
We have used critical innovations
to expand access and empower
patients despite the challenges,
including the use of a telemedicine
platform where patients can access
a second opinion from international
experts on demand (employing a
cross-subsidy model to allow those
with more limited income to pay
less), financing care for the most
vulnerable through our self-financed
HIC Foundation, the establishment
of Heart Stations in communities
where patients can access basic
heart checks locally at heavily
subsidised rates, and the hosting
of public health forums where
patients can gain information that
will encourage them to take steps
towards achieving a heart-healthy
lifestyle.
Our experience reinforces our
core belief that high-quality
cardiovascular care based on smart
use of technology and expertise, is
achievable in low-resource nations
if driven by the appropriate dose of
passion and commitment.
