Partnering with providers for heart transplant care

This Q&A with Daniel S. Yip, M.D., a transplant cardiologist and the medical director of the heart transplant program at Mayo Clinic in Jacksonville, Florida, answers questions about referring patients to Mayo Clinic for cardiac transplant care.

How does Mayo approach working with patients who are referred for possible heart transplant, and with their providers?

Each patient has their own unique needs, and our primary value is to put those needs first for the best possible care. We are also committed to building strong collaboration with providers in the ongoing care of their patients. Our transplant cardiologists are easily accessible and communicate frequently in whichever way a referring provider prefers.

Can patients be seen quickly?

We can meet the individual needs of the patients. Some patients need to be seen quickly, and we can accommodate that. Others prefer to wait for a time convenient for them if their conditions allow for that. We are available whenever the patient and their local provider decide the time is right.

What can providers expect when they contact Mayo to refer a patient for a heart transplant evaluation?

Our goal is to provide a positive experience and make the referral as easy as possible for the provider. Our transplant center staff will ask for the information we need, including:

  • Demographic information
  • Patient history and physical
  • Recent notes
  • Appropriate cardiovascular studies
  • Results of recent lab tests

Having this information allows us to provide the highest quality and most efficient care to patients when they arrive at Mayo Clinic.

How long does it take Mayo to schedule the patient's appointment?

Every referral sent to our transplant center is reviewed within one business day by a Mayo transplant cardiologist. If we need additional information to determine the urgency of an appointment, we will contact the referring provider.

A transplant nurse coordinator then speaks with the patient to get additional clinical information and check the patient's availability for an appointment at Mayo. If the patient's condition allows, we can take into account their appointment preferences. For example, a teacher might want to see us over a school break. During the conversation with the nurse coordinator, the patient learns about expectations and next steps.

All of this information is quickly assembled, and the patient's appointment is scheduled. We then notify the referring provider about the patient's appointment date.

How are referring providers kept informed about their patients' care at Mayo?

Every referring provider receives a letter with notes about the patient's visit. In addition, we call the provider or send a text, whatever the provider prefers.

Can referring providers remain involved in a patient's care after referral to Mayo for possible heart transplant?

We encourage patients who are referred to us to continue to see health care providers who have been involved with their care prior to seeing us. We believe that patients can benefit from that ongoing relationship with a local cardiologist. Because we are in contact with the referring providers, they know exactly what care their patients are receiving at Mayo.

Our goal is to develop strong relationships with referring providers, so we are happy to partner with them to the extent they'd like to be involved.

What does follow-up care look like for patients who received a heart transplant at Mayo? How do Mayo and the local provider work together to ensure that long-term outcomes are strong?

We follow patients closely immediately after heart transplant, as they remain locally for the first two to three months following transplant. Patients typically return home after that, and we then see them monthly. After the second year, the visits to us become less frequent.

Once patients have returned home, we invite their other health care providers to be involved with their care. This includes periodic diagnostic testing and other care that's needed between annual checkups at Mayo.

What about follow-up care for patients who don't have a transplant after referral to Mayo?

We always communicate with the referring provider about our recommended treatment plan and encourage these patients to continue seeing their local cardiologists and other health care providers. If the patients continue to do well and don't need heart transplantation, we may see them if necessary once or twice a year, in addition to their visits to their local cardiologists.

Patients who are listed for heart transplant are seen by us more often, in addition to seeing their other health care providers.

Patients who require complex heart failure care, such as continuous intravenous inotropes or a ventricular assist device, are closely managed at Mayo when treatment is initiated. Once these patients have achieved a level of stability that allows them to return home, we partner with their health care providers to assure that they receive optimal care.

For all patients, we tailor our approach to the needs of the patient and the referring provider. We are always available for the patient and referring provider should the need arise.

Does Mayo work with a patient's insurer?

Mayo is always willing to work with patients, their insurers and referring providers.

When a patient is referred for possible heart transplant, we contact our finance coordinator, who contacts the insurer. Most insurance companies respond to Mayo within a day or two, so we have that information about coverage before the patient comes to Mayo.

Insurance varies, of course. Transplant services are often considered separately from regular medical and surgical care.

At Mayo, we do everything we can to accommodate the needs of the patient and the referring provider. If patients or providers have any concerns, our finance staff can assist them.

I'm ready to make a referral. What's next?

To refer a patient or arrange a telephone consultation, contact the Referring Provider Office:

  • Arizona campus: 866-629-6362 (toll-free), 8 a.m. to 5 p.m. Mountain time, Monday through Friday
  • Florida campus: 800-634-1417 (toll-free), 8 a.m. to 5 p.m. Eastern time, Monday through Friday
  • Minnesota campus: 800-533-1564 (toll-free), 24 hours a day, seven days a week