Taking root along Cleveland Avenue 30 years ago with the opening of St. Ann's Hospital, Westerville's "Medical Mile" has become an economic force in the city.

Taking root along Cleveland Avenue 30 years ago with the opening of St. Ann's Hospital, Westerville's "Medical Mile" has become an economic force in the city and the go-to place for residents in need of everything from a routine physical to open-heart surgery.

"Having that hospital come here was big," says Janet Tressler-Davis, CEO of the Westerville Area Chamber of Commerce. As she sees it, the opening of St. Ann's and its subsequent success showed the fast-growing city and surrounding communities could support a full-service hospital.

St. Ann's, part of Mount Carmel Health System, has continued to grow since opening in 1984, including the recent completion of a $110 million expansion project. Nationwide Children's Hospital and OhioHealth took note and built their own facilities to fill the growing need for healthcare services in central Ohio's northeast quadrant.

Today, the three hospital systems employ nearly 2,700 workers in Westerville and have a total of 726,615 square feet under roof in buildings stretching from the St. Ann's campus along Cleveland Avenue to OhioHealth's five-year-old medical complex off Polaris Parkway. That doesn't include several physician-owned facilities along the Medical Mile.

"It has made us more visible in central Ohio," Tressler-Davis says. "These are signature facilities for these health systems. It's also a driver for jobs."

The availability of high-quality medical facilities also makes Westerville an easier sell to companies looking to locate in the city or expand existing operations, says Westerville Economic Development Administrator Jason Bechtold. He lists the city's decision to back bonds that helped bring St. Ann's to Westerville three decades ago as one of the turning points in the city's development and growth.

"That has been a catalyst for us," he says. "We are now a regional player for access to healthcare in Franklin and Delaware counties. People have access to the best healthcare in central Ohio over a mile or two."

Westerville's growing population-it almost tripled from 12,500 in 1970 to 37,000 in 2013-and an accompanying residential boom in southern Delaware County obviously were major drivers in the hospital systems deciding to make multi-million-dollar investments in Westerville. Also in play were some less quantifiable but equally important factors.

Chief among them was the need to deliver medical services closer to where patients live, says Dr. David McClure, an internal medicine specialist who practices at OhioHealth's Westerville Medical Campus.

"They don't want to drive 20 miles to get medical care," he says. "OhioHealth responded to that with this facility."

Another factor, McClure says, is that medical care has shifted from what he calls "hospital-centric" to "community office-centric." That means an increasing amount of care is delivered at outpatient facilities, and doctors do more procedures in their offices.

Part of that is for cost-control reasons, says Denny Freudeman, president of Hplex Solutions, a Lewis Center-based healthcare real estate development company that works with hospitals and doctors across Ohio.

"Stays in hospitals are less and less in today's healthcare environment," he says. "So much more can be done on an ambulatory-care basis and at a lower cost. It's all about access for patients and controlling costs."

Freudeman, whose roots in healthcare development go back 30 years, says Mount Carmel, OhioHealth and Nationwide Children's saw the steady growth in the Westerville area and unmet needs for access to local medical-service providers.

So did one of Hplex's clients, Orthopedic One, a physicians group that opened a 20,000-square-foot orthopedic medicine office off Cleveland Avenue in 2012. It's in the Westar area that is also home to three buildings operated by Nationwide Children's Hospital; the Center for Surgical Dermatology; and an office building that houses Mount Carmel outpatient services and an urgent care center operated by emergency room physicians at St. Ann's.

"Lots of doctors up and down the Medical Mile make their affiliation with St. Ann's," says Janet Meeks, president of the 330-bed hospital.

Some 700 physicians are on staff at the hospital, working with 1,900 Mount Carmel employees and 300 volunteers. The hospital is Westerville's second largest employer, trailing only JPMorgan Chase.

"We started with 90 beds (in 1984)," Meeks says, "and there's been perpetual growth ever since then … This part of metropolitan Columbus is still growing at a healthy pace. We also know that if we continue to provide the needed depth and scope of medical services, then we will continue to grow."

With that in mind, Mount Carmel invested $110-million in an expansion that is bringing open-heart surgery to St. Ann's and transforming the hospital to a regional medical center. The construction project, completed in late 2013, added 186,000 square feet to the campus footprint, boosting it by about a third. The work included a new patient tower, cardiovascular care center, orthopedic, spine and general surgery unit, new main entrance, new dining facility and kitchen, a three-level parking garage and road improvements.

"It's been an incredible experience to be involved from the initial conversations about the need to expand St. Ann's to a regional medical center," says Meeks, St. Ann's president for eight years. "It has been like a dream come true to see it come to reality."

Thirty of the 60 beds in the new patient tower are for cardiovascular patients. Six of those beds are in an intensive care unit for patients who undergo open heart surgery and complicated vascular or thoracic procedures.

"People in Westerville deserve to have this kind of complicated care delivered close to home," Meeks says, adding there are also two operating rooms, 21 pre- and post-op bays, two cardiac catheterization laboratories and an electrophysiology lab in the patient tower.

While proud of its new status as a sophisticated regional medical center, St. Ann's has not lost sight of its humble beginnings. The Sisters of St. Francis opened St. Ann's as an orphanage for infants and home for unwed mothers in 1908 along Bryden Road on Columbus' East Side. They added maternity and other services through the decades before moving the hospital to Westerville 30 years ago.

"St. Ann's is the anchor and foundation of the Medical Mile. Historically the investments we have made speak volumes about (Mount Carmel's) appreciation for this part of the market … We will continue to look at meeting the unmet community needs. That's part of our DNA," Meeks says.

OhioHealth, parent to Riverside Methodist, Grant, Dublin Methodist, Grady Memorial and seven other hospitals, decided it could make a difference in Westerville by offering outpatient services and a freestanding emergency department, says Sean Huffman, president of OhioHealth's Neighborhood Care division. It opened the Westerville campus on former farmland in 2009 and added the emergency department in June 2012. The complex totals 225,000 square feet and employs 550.

"They used to sell pumpkins, corn and vegetables on that corner," Huffman says. "Who would have thought there would ever be an emergency department there?"

Looking to do more to serve patients from the Westerville area, OhioHealth initially formed an advisory board of physicians from the Medical Group of Ohio. The campus developed based on those discussions.

"We heard from the physicians that patients wanted a choice," Huffman says. "(Patients) wanted Grant and Riverside experts and OhioHealth in that community. That's the basis from which we built there."

The Westerville campus offers myriad services including endoscopy, heart and vascular, laboratory, neurological, physical and occupational therapies, sports medicine, orthopedics, sleep testing, women's health, and X-rays and other imaging. The freestanding emergency department, which had 16,000 visits last year, was a first for OhioHealth.

"It's not just an advanced urgent care center," Huffman says. "It's more like a hospital (emergency room) than anything else."

He says the emergency department has seen a higher-than-anticipated number of patients-about 11 percent-with illnesses and injuries severe enough to require transport to Riverside or Grant hospitals. In addition, patients have become more selective on when to seek emergency department services. OhioHealth has also worked closely with emergency squads to transport patients to the proper place for care.

The OhioHealth campus has drawn more doctors to Westerville, McClure says. In addition, he has seen large numbers of new patients seeking the services of primary-care physicians there. It's a trend he thinks will continue because of the expansion of Medicaid and Obamacare health coverage for the previously uninsured. Patients and doctors also like the convenience of having examinations, lab work and other services done at one facility, he says.

"For me personally," McClure says, "the last few years have probably been the most rewarding of my career. Being in this state-of-the-art facility has been a wonderful experience."

Nationwide Children's Hospital opened its first Westerville facility, a 32,000-square-foot Close to Home Center with urgent care, in 2003. It followed with a 23,000-square-foot Sports Medicine and Orthopedic Center in 2008 and a 46,000-square-foot surgery center in 2012. Clustered in the Westar development at Cleveland Avenue and County Line Road, the buildings represent a total investment of $30.7 million by Nationwide Children's, says Patty McClimon, the system's senior vice president of strategic and facilities planning. Children's also offers autism and other behavioral health services in leased space off Schrock Road in Westerville.

McClimon says population growth in the Westerville area has been one of the big reasons for such a large investment in a medical complex located about 16 miles from Children's main campus on the east side of Downtown Columbus. The Westar site is also close to the Interstate 71 corridor, providing ease of access for patients living north of central Ohio. It's also just a stone's throw from Polaris.

"When you say 'Polaris,' they get it," McClimon says. "Connectivity to the greater region is important to us."

The development of the Westerville campus also reflects the huge growth in outpatient services at Children's. "In many instances," she says, "we've run out of room at the main campus and need to consolidate services. We saw an opportunity to do that in Westerville."

While there is room to expand at the Westerville site, don't look for the campus to add an emergency room or grow into a full-service hospital, McClimon says. That runs counter to Children's hub-and-spoke model in which suburban facilities provide outpatient services and patients in need of more complex care are seen at the main hospital.

St. Ann's also has room to grow at its Westerville campus, but Meeks would not get into specifics about future expansion there. Huffman says expansion by OhioHealth in Westerville, including a full-service hospital at the Polaris Parkway campus, is under review as well.

"That's part of our discussions," Huffman says, "but we have not reached any decision about that. We have 40 acres there. We've only used 20."

Hplex Solutions' Freudeman says he doesn't expect to see much new construction by the three hospital systems any time soon in Westerville. That includes a full-service OhioHealth hospital.

"I'd say not right now," he says, "but maybe long term. With the new addition at St. Ann's and the OhioHealth and Children's projects, I'm not sure we'll see much more development in Westerville. A lot of health care has come on there in the last six or seven years."

Jeff Bell is freelance writer.