Expanding Access to Specialized Adult Congenital Heart Disease Care Using a Hub-and-Spoke Model of Care.

BACKGROUND: Access to specialized adult congenital heart disease (ACHD) care remains limited given workforce shortages and geographic concentration of accredited centers in urban regions. PROJECT RATIONALE: Southwest Florida lacked a board-certified ACHD specialist despite a growing population of adults with congenital heart disease. Patients frequently traveled long distances for subspecialty evaluation, contributing to delays in care, fragmented follow-up, and inequitable access to specialized services. PROJECT DESCRIPTION: A regional hub-and-spoke model was developed through collaboration between Lee Health and Memorial Healthcare System to expand access to ACHD expertise. The spoke site established a locally based ACHD clinic embedded within pediatric cardiology clinic and staffed by an advanced practice provider. ACHD physicians from the accredited hub center were credentialed within the local system and provided teleconsultation, telehealth support, weekly multidisciplinary conferences, and monthly onsite collaborative clinics. TAKE-HOME MESSAGES: Geographic and workforce disparities remain major barriers to equitable ACHD care. Hub-and-spoke models can extend specialized ACHD expertise into underserved regions.