Centers providing evaluation and treatment of pediatric cardiac and congenital issues must at a minimum possess a wide array of resources involving technological investments and a broad group of highly specialized personnel. Some of the referral tools are based upon marketing in a geographic catchment area. Pediatricians and parents may learn about particular services through media outlets such as television, radio, and print advertisements. While media outlets are helpful, they do not allow for differentiation of the end-product (high-quality care) and the equitable dissemination of resources being made available to all needy parties.

In the U.S. marketplace, almost every major city has a children’s hospital that typically mounts media campaigns to promote the availability of particular medical service resources. Additionally, pediatricians may oftentimes meet pediatric specialists at continuing medical education events in their local community; these are designed to expose primary care providers to new service lines and highly trained pediatric specialists in their community. Otherwise, pediatricians and patients living in less urban or more rural areas face increased barriers to entry for proper care.

Focus-specific care groups, such as the Pediatric Congenital Heart Association (PCHA), provide large platforms to distribute information to both healthcare providers and patients directly. Groups such as PCHA possess the ability to reach large populations of patients through coordinated communication systems. Unfortunately, in the United States, rapid coordination and referral to an appropriate congenital pediatric specialist remain a byzantine process that delays evaluation and care.

Optimal and highly organized care would allow initial evaluation with multiple specialists all in one centralized setting. The advantage of this “setup” is that the evaluation team members can confer with one another and provide a higher level of assessment during one single encounter with the patient and family members (Fig. 14.2). After the initial assessment has been completed, additional diagnostic testing can be coordinated during a follow-up visit. Again, it is advantageous to schedule the follow-up testing on a single day or sequential days to minimize the disruption to the patient and family while also yielding a short period of evaluation and assessment so that interventions can be planned if necessary.