InSightCleveland Clinic Lerner College of Medicine

Hotspotting Project Spells Success for PatientsFor six patients from the Cleveland Clinic Stephanie Tubbs Jones Health Center,

a year-long research project not only helped them reduce an over-reliance on the

healthcare system, but also improved their overall health and well-being.

Three CCLCM students — Alex Ulintz (’19), Joe Featherall (’19) and Blair Mitchell-Handley (’19) — and 10 students from Case Western Reserve schools of Medicine, Nursing, Dental Medicine, Social Work and Law participated in the project.

Called hotspotting, the project aims to identify high-need, high-cost patients that visit hospitals on a frequent basis. The goal of hotspotting is to study patients at high-use extremes to better understand where the current healthcare system has failed, particularly in this era of value-based healthcare, so costs can be reduced and healthcare outcomes improved.

“Healthcare is seeing more high-use patients, and the effects are becoming costly to both the patients and healthcare organizations. We need to look at each patient as a case study to look for larger systematic issues overall with the healthcare system,” says Alex.

The team traveled to Camden, NJ, to meet with hotspotting leaders Jeffrey Brenner, MD, and Andrew-Morris Singer, MD, to learn about the principles of hotspotting. After learning

July 2016

CONTINUED ON NEXT PAGE

Cleveland Clinic Lerner College of Medicine InSight | 2Cleveland Clinic Lerner College of Medicine

patients at the Cleveland Clinic Stephanie Tubbs Jones Health Center, located in East Cleveland, Ohio. (High use is defined by more than two hospital admissions in six months and a higher than 50 percent no-show rate for primary care appointments.)

Through medication reconciliation, students were able to identify the source of one patient’s health condition -- lack of B12 supplementation -- and obtain the appropriate supplements, allowing this patient to achieve mobility without a walker. Another patient was interested in eating healthier and losing weight, but she was having difficulty chewing vegetables because of dental issues. One of the dental students helped fit her for dentures. Another patient lost her mobility, social connectedness and independence after a bilateral fasciotomy. By setting her up with counseling, physical therapy and exercise interventions she could do at home, along with increasing her social connections through a local church and YMCA, the students helped her lose weight, increase her mobility and decrease her inpatient admissions, which was estimated to cost $76,500 in the 18 months prior to the intervention.

“We worked in interdisciplinary teams to get to know the patients, understand their goals and needs, and design appropriate interventions,” says Alex, adding that the team received guidance through monthly webinars and case conferences.

The interdisciplinary team concept helped the students appreciate the interactions between all members of the healthcare team, which is of particular importance as value-based care evolves into the predominant model of care.

“There were times I was impressed with how insightful the social work, dental, nursing and law students were about different aspects of patient care that I and the other medical students had not considered,” says Blair. “I feel that more widespread collaboration amongst the disciplines while we are still trainees would greatly augment our educational experience.”

Over the course of a year, students learned how to establish relationships with high-utilizers, use trauma-informed care, apply motivational interviewing techniques to understand patient behaviors, and collaboratively design appropriate interventions that capitalized on each student’s area of expertise. The students, along with 19 other student hotspotting teams from across the country, presented the results of their project at a wrap-up meeting in New Jersey. The project ended in March 2016.

“This success can be transferrable to Cleveland Clinic. Our research shows that we can reduce continuous patient emergency use and direct patients to the primary care system,” says Alex. “It would even be beneficial to incorporate hotspotting into CCLCM curricula,” he adds.

The hotspotting project was made possible through a mini-grant from the Association of American Medical Colleges, the Camden Coalition of Healthcare Providers, and Primary Care Progress, with generous matching contributions from CCLCM and CWRU School of Medicine.

The team is grateful for support and guidance from James Young, MD, Executive Dean of CCLCM; Alan L. Hull, MD, PhD, Associate Dean of Curricular Affairs; and internal medicine physician Andrei Brateanu, MD, with Stephanie Tubbs Jones Health Center.

NEWS

InSight | 3Cleveland Clinic Lerner College of Medicine

CCLCM Faculty: Three QuestionsMargaret McKenzie, MD Discipline Leader, Obstetrics/Gynecology

Q: What inspires you to teach?

We live in a fast-paced discovery and innovative environment, with new drugs and disease mechanism elucidation happening every day. This creates the need for lifelong learning mastery by our students. This passion for lifelong learning skill development is what I bring to my students. That is what inspires me to teach. Besides, “when you teach, you learn”….

Q: What’s one lesson you wish you would have learned in college/medical school?

Don’t beat yourself up! While acquiring a broad knowledge base is key to being a proficient doctor, you can’t know everything. Knowing how to be a critical thinker and problem solver should be a major focus. Then, learning to engage the support of the literature, peers, faculty and other professionals, and building a good support system to get you through tough times are really most important.

Q: If I weren’t a physician at Cleveland Clinic and a faculty member at CCLCM, I would be…

…a wandering philanthropist and physician teacher. There are so many people in the world who are in need of our knowledge about disease and how to be proactive in their health that I want to raise money so these people can have access to education, and to train practitioners to serve their communities and develop simple solutions to caring for their health in a preventive way. I feel this way particularly about the women in the world. Not even in third-world places. Right here in Cleveland is a great place to start.

Dr. Rick Drake Delivers Commencement Address at Mount Union

Richard Drake, PhD, Director of Anatomy with the Lerner College of Medicine, delivered the commencement address at the University of Mount Union’s 170th Commencement Ceremony on May 7. Dr. Drake shared his insights on “Taking Advantage of the Next Opportunity” with graduates.

Dr. Drake is a graduate of Mount Union, where he studied biology and was actively involved in a number of campus activities including theatre, track, football and the Alpha Tau Omega fraternity.

Currently, he is a member of the Mount Union Board of Trustees and serves as an adjunct faculty member with the Department of Physician Assistant Studies.

ROUND UP

Cleveland Clinic Lerner College of Medicine InSight | 4

Interested in Teaching at the Medical School?

Would you like to learn more about the Cleveland Clinic Lerner College of Medicine? Have you thought about getting involved in teaching at the medical school? There are a number of roles that you can take within the medical school. To learn more about teaching and advising opportunities, a CCLCM faculty appointment and the approach to teaching that we use in our unique program, please join us at the next New Faculty Orientation:

Tuesday, Oct. 25, 2016 NA3-57 7:30 – 11 a.m.

Register via COMET using a Cleveland Clinic computer with access to the intranet. (You will not be able to register using a personal laptop or mobile device.) Choose “Catalog,” then hover over the “Search by Category” and choose “Global Leadership and Learning Institute.” The 10-25-16 session for “CCLCM New Faculty Orientation” is listed under the Essentials heading.

Please remember to request meeting time and block your clinical schedule well in advance so you can attend this event.

If you have already participated in a New Faculty Orientation event, thank you for attending. We hope you have found a satisfying role in the medical school.

Questions? Please contact Michaela Stiber at stiberm@ccf.org or Colleen Colbert, PhD, at colberc2@ccf.org in the Office of Educator Development. We look forward to seeing you in October.

Memorial Service Honors Body Donors and Families

On June 2, the Cleveland Clinic Body Donation Program held its annual memorial service to honor the 215 people who donated their bodies to the program from mid-April 2015 through April 2016. Approximately 125 family members and friends of our donors attended the service.

Speakers at the memorial service included Jennifer McBride, PhD, Director of Histology; James K. Stoller, MD, MS, Chairman, Education Institute; and James B. Young, MD, Executive Dean, Cleveland Clinic Lerner College of Medicine.

Hearing from medical students and residents — the main beneficiaries of the body donation program — helps families better understand the importance of this priceless gift. Medical students Shehryar Sheikh (‘20) and Erin Sieke (‘18), and Ahmed Hashem, MD, Plastic

Surgery fellow, shared their experiences and sincere gratitude with the audience.

The Rev. Amy Greene, DMin, Director of the Cleveland Clinic Spiritual Care Department, offered the invocation and benediction.

For many family members and friends, attending the memorial service gives them a sense of closure and the knowledge that their loved one’s gift will help advance the future of medicine. For us, the service offers a chance to honor our donors and express our gratitude for their priceless generosity.

Learn more about our Body Donation Program.

If you have any ideas about how our medical students might further contribute to the memorial service, please email bodydonation@ccf.org.

ACCOLADES

InSight | 5

2016 Neurological Institute Research Day Award Recipients

Award Rec ip ien t S ta f f Superv isor Presenta t ion Ti t l e

Best Platform Award Jaes Jones, BS (’19) Jorge Gonzalez-Martinez, MD, PhD Does the Volume of Resection Matter? Resection Volume and Seizure Analysis in SEEG-Guided Frontal Resections

Medical Student Award Daniel Sexton, BS (’18) Jorge Gonzalez-Martinez, MD, PhD Outcomes of subdural grid electrode monitoring in the SEEG era

Medical Student Award Connor Wathen, BS (’18) Andre Machado, MD, PhD A Novel Rodent Forelimb Task to Enable Activity Dependent Stimulation

Weller Pediatric Research Award

Nicholas Szoko, BA (’17) Marvin Natowicz, MD, PhD Proteomic Analyses of Autism Spectrum Disorder Brains

Jaes Jones Daniel Sexton Connor Wathen Nicholas Szoko

Four CCLCM Students Clinch Neuro Research AwardsThe Cleveland Clinic Neurological Institute hosted 98 presentations at the annual Neurological Institute Research Day in May. Congratulations to the medical student award recipients below!

CCLCM Students Bring Home Best Poster Award from National Meeting

Congratulations to the Department of Urology from Cleveland Clinic’s Glickman Urological and Kidney Institute on their successes at the annual meeting of the American Urological Association, held in San Diego in May. Fourth year CCLCM students Vishnu Ganesan (’17) and Charlie Dai (’17), who researched prostate cancer active surveillance, were selected for the best poster award for their session. Their research investigated the role of prostate biopsy in men on active surveillance, made possible through the use of a database the students started under the guidance of Urology faculty members J. Stephen Jones, MD, President, Regional Hospitals & Family Health Centers; Eric Klein, MD, Glickman Institute Chairman; Ryan Berglund, MD; Michael Gong, MD; Andrew Stephenson, MD; Khaled Fareed, MD; and Robert Stein, MD.

With hard work and help from numerous residents and fellows, Vishnu and Charlie completed and analyzed the

database, which led to many great presentations at the meeting. Overall, the Urology team took home five competitive awards.

Congratulations, Vishnu, Charlie, and the entire Urology Department on your incredible work and achievement!

Cleveland Clinic Lerner College of Medicine

Dr. Louis Ross Named Resident Teacher of the Year

Louis Ross, MD (’12), a fourth-year neurosurgery resident at Cleveland Clinic, earned the Resident Teacher of the Year Award from the Department of Neurological Surgery at its 2015-16 graduation ceremony.

Congratulations, Dr. Ross, for your commitment and dedication to education!

Dr. Louie Hendricks is First Recipient of New Fellowship

Congratulations to Louie Hendricks, MD (’13), who was the winner of the Department of Defense - Shock Society Battlefield Health and Trauma Fellowship.

One of 13 excellent applicants, Dr. Hendricks is the first recipient of this fellowship, which is designed to support individuals who wish to develop into outstanding investigators in the areas of trauma, shock and sepsis. The initial appointment is for one year, with an option to renew for an additional year.

Dr. Hendricks was presented this award at the 39th Annual Conference on Shock, held in June in Austin, Texas. He has moved to San Antonio to begin his fellowship at the Navy Medical Research Unit-SA.

Congratulations again on this outstanding opportunity and achievement!

Alumnus Offers Ways Parents Can Model Good Behavior

CCLCM alumnus Sara Lappé MD, MS (’09), writes a regular column for U.S. News Health. In May, she published “Why Focusing on Personal Habits Will Result in Better Care for Your Child,” offering advice to parents on how to set a good example.

Following her pediatric residency at Duke University Children’s Hospital, Dr. Lappé joined Cleveland Clinic, where she serves as the medical director of the Be Well Kids Clinic, a weight management clinic at Cleveland Clinic Children’s. She and her husband, Jason (’09), a cardiology fellow at Cleveland Clinic, have two daughters.

Student Daniel Li Chosen for Prestigious Fellowship

CCLCM student Daniel Li (’18) is among only 13 students across the country who were awarded a Sarnoff Fellowship for 2016-17. Dan’s sponsor is W. H. Wilson Tang, MD, cardiovascular researcher and Director of the Center for Clinical Genomics. He’ll be going to the University of California, Los Angeles, to work in the laboratory of Jake Lusis, PhD.

A Sarnoff Cardiovascular Research Fellowship, designed to help develop medical students into leaders in cardiovascular innovation, research and medicine, provides lifelong mentorship; a stipend and travel allowances to identify a preceptor; financial support to attend the Sarnoff Annual Scientific Meetings and American Heart Association Scientific Sessions; and financial support for travel to present a paper at two national conferences.

Congratulations, Dan, on this notable accomplishment!

Cleveland Clinic Lerner College of Medicine InSight | 6

A LU M N I N E W S

InSight | 8Cleveland Clinic Lerner College of Medicine InSight | 7

© Cleveland Clinic Foundation 2016

Laura R. Greenwald, MBA, Managing Editor Taylor Patterson, Writer Melissa Kus, Writer Thomas A. Fenn, Art Director

MARK YOUR CALENDAR

Cleveland Clinic Lerner College of Medicine

Alumni: Share Your NewsWe’d like to hear about what you’ve been doing since graduation. If you have news to share (maybe you’re involved in an interesting research project or you recently returned from a global health mission), please email Laura Greenwald at greenwl@ccf.org.

July 5-10, 2016 Orientation for the new class Cleveland Clinic

July 10, 2016 | 11 am New Class White Coat Ceremony Severance Hall

July 15, 2016 | 3-5 pm Student Clinician Ceremony CWRU, Ford Auditorium

July 27, 2016 | 7-8:30 am CCLCM State of the College Address Cleveland Clinic, NA5-03/04

Philanthropic GivingThe Education Institute welcomes donations to advance its mission of educating those who serve.

Individuals, families, foundations and corporations that believe in the value of education are making a

difference in the future of patient care with their generosity. To learn how you can help, please contact

Amy Kubacki, Senior Director of Development, at 216.636.5024 or at kubacka@ccf.org.