News | Published: Saturday, October 18, 2025
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As demand for cardiovascular care continues to surge amid a shrinking workforce and growing patient complexity, the Minneapolis Heart Institute (MHI) is redefining how patients move through the cardiovascular care continuum. At CV Transforum Fall’25 in Austin, TX, Craig Strauss, MD, MPH, vice president for Quality, Innovation, and Advanced Analytics; medical director, MHI Center for Healthcare Delivery Innovation; Allina Health MHI, and his colleagues outlined how the C5 Program is transforming referral patterns and streamlining care pathways to ensure patients receive the right level of care at the right time, improving efficiency across both community hospitals and tertiary centers.
Strauss outlined the current challenges facing cardiovascular programs, noting that the demand for cardiac care far exceeds available capacity, especially with many cardiologists nearing retirement and ongoing workforce shortages. At the same time, COVID-19 disrupted longstanding referral patterns, creating further gaps in access. MHI, which serves a broad referral base throughout the upper Midwest as part of Allina Health, saw an opportunity to intervene upstream in the triage process. “We had access issues and couldn’t bring in all the patients who wanted or needed our care,” Strauss said. “For our broad and large referral base, we had to go upstream to address the triage process for cardiovascular patients.”
The solution became the C5 Program – a structured approach to optimize cardiology referrals and transfers, supported by 24/7 physician access and integrated clinical workflows. What began as daytime curbside cardiology consultations grew into a fully operational, round-the-clock system incorporating e-consults, dedicated nurse triage, and an Epic-based C5 note for every patient requiring transfer to regional or metro hospitals. This model enables general cardiologists and advanced practice providers (APPs) to manage inpatient consults during the day and night, supported by clear processes for testing, prior authorizations and patient handoffs.
Implementing the program required significant operational changes. Clinic templates were restructured, the access center was fully integrated, and data tracking mechanisms were built to monitor outcomes. MHI added a second on-call cardiologist at night to address critical care issues and expanded its APP team with specialized training. Initially, there was anxiety among physicians about an unbalanced workload. Over time, shared governance and system alignment resolved those concerns. One of Strauss’s colleagues noted the importance of gaining buy-in by educating hospital leadership and administrators on the benefits of the new program, align administrators and teaching the health system a new language about why this mattered.
The impact of C5 has been measurable. The program has reduced length of stay, lowered readmission rates, and improved coordination for emergency cardiovascular care. By providing reliable 24/7 access to cardiology expertise, referring emergency departments and community hospitals now receive faster guidance and more appropriate transfer decisions. Nearly 30 to 40% of calls come in overnight – previously a gap period when patients often waited until morning for a decision.
From a business perspective, the C5 Program also proved cost-effective, generating net financial benefits for payers and hospitals through more efficient bed utilization and procedural planning. Extensive modeling helped the team anticipate volume, demonstrate system value, and secure administrative support. By bringing in the right patients, using beds appropriately, Strauss and his colleagues encouraged the health system to make the most out of procedural care.
Looking ahead, the C5 Program reflects a larger shift in cardiovascular care delivery: moving beyond fragmented referral patterns to a coordinated regional model that leverages scale, data and access. Strauss emphasized that cultural alignment across the health system is just as critical as operational structure. This type of program works when everyone understands the shared goal, according to the speakers. It creates a system where patients are triaged appropriately, hospitals operate at their best level, and care teams can focus on delivering high-quality, timely cardiac care.
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