On Fridays, we schedule our rounds with Healthcare Brew readers. Want to be featured in an upcoming edition? Click here to introduce yourself.
This week’s Making Rounds spotlights Briana Costello, a general and interventional cardiologist at the Texas Heart Institute Center for Cardiovascular Care in Houston. Costello discussed the center’s new location, which opened for patients at the end of last year, as well as the latest technology in cardiology.
This interview has been lightly edited for length and clarity.
What’s the best change you’ve made or seen at a place you’ve worked?
The biggest change that has impacted us physicians and workers at the Texas Heart Institute Center for Cardiovascular Care has also impacted patients—and that’s our recent move to our new space, which is really cutting edge with the newest technology for both diagnosing heart disease and taking care of patients.
From an aesthetic perspective, we have beautiful views into the [Texas Medical Center], which is the largest med center in the country, but more importantly, we have very new high-tech stress testing equipment, which is called a PET/CT stress test. It’s amazing and can help us more accurately identify if someone’s having an issue with their heart arteries. Secondly, we have beautiful exam rooms with ample space to do procedures in our rooms, which has made the patient experience very positive.
What healthcare trend are you most optimistic about, and why?
One of the biggest trends in cardiology is actually in the arrhythmia department, and that is with wearables. I love them. When we talk about wearables, at least in cardiology, most of us are talking about watches or activity trackers, as well as heart monitors, which are usually placed at your doctor’s office and they sit on your chest. I think of them like a little spy into your heart rhythm at all times of the day.
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What healthcare trend are you least optimistic about, and why?
There’s been a huge uptick of people that I see in the office, in particular women but also the men, who are being treated with hormone replacement therapy—in particular testosterone. Five years ago, I don’t think I saw a single woman on testosterone therapy in the office, but over the last one, two years that has just skyrocketed. So testosterone again, in particular for women, but also in men, can increase the risk of having arrhythmia, can increase your risk of clotting in the venous system, such as if you’ve heard of a DVT (deep vein thrombosis) or pulmonary embolism. That being said, there is some utility for hormone replacement therapy in menopausal women or men with low testosterone, but close monitoring of these hormones is really critical so that we’re not overtreating patients or putting them at risk from a cardiovascular standpoint.
Tell us one new or old health tech product or platform that’s made your life easier, and why.
Hands down, the electronic health record is huge for making life easy for patient care and ensuring that records are adequately both available and transmissible. The electronic health record—while it certainly can be improved and we should be able to share records with every hospital—it’s still great as it stands. I would love to see some push even from, dare I say, the government to make health records universally shareable and accessible for everyone—all providers and patients.