Road Map to the Future: Shaping a Common Agenda Donna Katen-Bahensky and Jean E. Robillard.

Road Map to the Future:Road Map to the Future:Shaping a Common AgendaShaping a Common Agenda

Donna Katen-BahenskyDonna Katen-Bahenskyandand

Jean E. RobillardJean E. Robillard

UIHC Overriding PurposeUIHC Overriding Purpose

To improve the health of To improve the health of patients, populations and patients, populations and

communities communities

in Iowa, nationally and in Iowa, nationally and internationally.internationally.

Specific MissionsSpecific Missions Excel in Education Lead in Research Facilitate Technology Transfer Provide quality care and services to

our patients Improve Iowa communities

Pressures Affecting Our MissionPressures Affecting Our Mission

• External Market Forces

• Decreased State Support

• Decreased Reimbursement

• New Demands and Standards of Accountability

• Changes in Health Care Needs

Pressures Affecting Our MissionPressures Affecting Our Mission Health Care Spending as Percentage of GDPHealth Care Spending as Percentage of GDP

Health-care spending in the U.S. soared to $1.42 trillion in 2001 - 14.1% of the GDP in 2001.

2006 - $2.0T (40% increase from 1999) - 16.6% GDP.

Hospital spending, due largely to greater use of services and higher prices, was responsible for 30% of the increase in overall spending.

Prescription-drug spending continues to increase at a very rapid rate -15 to 16% per year.

Annual Percentage Change in Per Capita Healthcare SpendingAnnual Percentage Change in Per Capita Healthcare Spendingand Gross Domestic Product, 1991 - 2002and Gross Domestic Product, 1991 - 2002

Pressures on Academic Pressures on Academic Medical CentersMedical Centers

Academic medicine is under tremendous pressure to recruit, hire, and maintain its leaders.

• 15% of Medical School are searching for a new dean• 16% are searching for a new chair of Internal

Medicine (compared to 7% 10 years ago)• 30% are searching for a new chair of surgery• 40% of internal medicine’s residency training

program directors turned over last year

Nothing new:

“Every generation believes that

it is living in a period of unprecedented

changes.”

Are We Going To Survive?

YESWe Are Going To

Survive

But

“Business as Usual”

Will Not Suffice

How Can We Prepare For The Future?

How Can We Continue to Focus On Our Missions

and Maintain Our Responsibilities?

Road Map To the FutureRoad Map To the Future

Medical Education

What are our educational What are our educational challenges?challenges?

The scientific basis of medical practice expands exponentially.

The nature and demands of medical practice are changing.

Methods of instruction in medical education evolve at a rapid pace. Innovations can be costly to implement and to sustain over time.

The clinical environment is often perceived as unreceptive to medical education.

Pressures on the clinical enterprise undermine financial support for medical education.

What Do We Need To Do To Overcome What Do We Need To Do To Overcome The Road Blocks In Medical Education?The Road Blocks In Medical Education?

Continue to include improvement of medical education among our highest priorities.

Develop new ways to measure the costs and quality of our medical education missions.

Establish mechanisms that encourage faculty to engage in educational activities and to expand and improve their teaching skills.

Increase our efforts to recruit underrepresented minorities and to prepare young physicians to care for an increasingly diverse population.

Cultural Diversity and Cultural Diversity and Medical School EducationMedical School Education

“Adequate representation among students and faculty of the diversity in our society is indispensable for quality medical education.”

(Jordan J. Cohen)

US Population ForecastUS Population Forecast

0

20

40

60

80

100

120

2000 2050

Per

cent

of P

opul

atio

n

Asian/PI

Black

Hispanic

White

Source: US Bureau of the Census

Underrepresented Minorities (URMs) in the US Underrepresented Minorities (URMs) in the US Population and Among Medical School Population and Among Medical School

Matriculants, 1960 to 2001Matriculants, 1960 to 2001

(JAMA. 2003;289:1143-1149)


“Increasing the diversity of the physician workforce will improve access to health care for underserved populations.”


“Increasing the diversity of the research workforce will accelerate advances in medical and public health research.”


Research

Road Map To the FutureRoad Map To the Future ResearchResearch

How Do We Perform?

NIH Funding to Public Medical SchoolsRanked by Total NIH Funding

FY 2001Total NIH Total $$'s per Number of

Rank Institution Funding Faculty* faculty Grants1 University of California-San Francisco-School of Medicine 303,214,901 1387 218,612 7222 University of Washington School of Medicine 222,507,127 1647 135,098 6143 University of Michigan Medical School 203,254,062 1541 131,898 5614 University of California Los Angeles School of Medicine 201,097,654 1887 106,570 5695 University of North Carolina-School of Medicine 170,782,162 977 174,803 4436 University of Alabama School of Medicine 170,379,277 896 190,155 4357 University of California-San Diego- School of Medicine 163,944,593 659 248,778 3848 University of Texas Southwestern Medical Center/Dallas 144,649,172 1114 129,847 3789 University of Colorado Health Science Center School of Medicine 137,030,596 994 137,858 393

10 University of Iowa Roy J. and Lucille A. Carver College of Medicine 129,456,504 739 175,178 34711 University of Minnesota-Minneapolis-Medical School 111,000,943 1303 85,189 34212 University of Virginia School of Medicine 103,697,502 764 135,730 33413 Oregon Health Sciences University School of Medicine 102,913,908 960 107,202 36114 University of Wisconsin Medical School 99,297,948 916 108,404 30115 University of Maryland School of Medicine 87,688,914 968 90,588 293

* Total faculty figures from AAMC Institutional Profile information.

NIH Funding to Public Medical SchoolsRanked by Number of Grants per Faculty

FY 2001 Number ofTotal NIH Total Number of Grants

Rank Institution Funding Faculty* Grants per faculty1 University of California-San Diego-School of Medicine 163,944,593 659 384 0.5832 University of California-San Francisco-School of Medicine 303,214,901 1387 722 0.5213 University of Alabama School of Medicine 170,379,277 896 435 0.4854 University of Iowa Roy J. and Lucille A. Carver College of Medicine 129,456,504 739 347 0.4705 University of North Carolina-School of Medicine 170,782,162 977 443 0.4536 University of Virginia School of Medicine 103,697,502 764 334 0.4377 University of Colorado Health Science Center School of Medicine 137,030,596 994 393 0.3958 Oregon Health Sciences University School of Medicine 102,913,908 960 361 0.3769 University of Washington School of Medicine 222,507,127 1647 614 0.373

10 University of Michigan Medical School 203,254,062 1541 561 0.36411 University of Texas Southwestern Medical Center/Dallas 144,649,172 1114 378 0.33912 University of Wisconsin Medical School 99,297,948 916 301 0.32913 University of Maryland School of Medicine 87,688,914 968 293 0.30314 University of California Los Angeles School of Medicine 201,097,654 1887 569 0.30215 University of Minnesota-Minneapolis-Medical School 111,000,943 1303 342 0.262

* Total faculty figures from AAMC Institutional Profile information.


How Should We Perform?


We Should Be #1

In

Number Of Grants Per Faculty


What Do We Need To Do To Be #1?


To Climb to #1

85more grants 4 new grants per department 1 new grant / department / year over 4

years


How Do We Do This?

Research EnterpriseResearch EnterpriseOpportunitiesOpportunities

Create Biological and Clinical Scholar Programs to attract the best.

Foster interdisciplinary research: Cancer Center Center for Aging Cardiovascular Center Neuroscience Center Center for Organogenesis Center for Proteomic Research

Involve other schools and colleges in participatory programs:

Genetics Bioinformatics Bioengineering …

Re-engineer our clinical research enterprise Invest in Health Services Research.

ResearchResearch

Traditional laboratory is to become a virtual “collaboratory” PI’s laboratory will become “hub”

interfacing with series of multiple collaborators across the country and the world.

Investigators will be academically independent but constructively partnered.


Clinical Research

Translating Biomedical Translating Biomedical ResearchResearch

Fu

nd

ing

TimeSocietal Impact

NIH Support Non Federal Support

Outcome Research

Clinical Guidelines

Clinical Trials

Basic Research

Clinical Research

Translation•Tech Transfer•Conflict of Interest

Clinical Studies•Database – IT•IRB•Participants•Investigators

Improved Health

Road Map To the FutureRoad Map To the Future Clinical ResearchClinical Research

Create new ways to increase research study participants.

Streamline the regulatory process and compensate faculty for IRB activities.

Develop biomedical informatics programs and invest in IT systems that specifically address clinical research needs.

Develop an adequate clinical research workforce: interdisciplinary arrays of clinical investigators.

Develop incentives to attract faculty in clinical research.

Develop Health Service Research agenda.

Road Map To the Road Map To the FutureFuture

Business and Innovation Research

UI Research FoundationUI Research FoundationPatents Filed & IssuedPatents Filed & Issued, FY87 to FY02, FY87 to FY02(Total No. of Patents Issued, FY87-02 =316)(Total No. of Patents Issued, FY87-02 =316)(Total Patent U.S. Applications Filed, FY87-02=601)(Total Patent U.S. Applications Filed, FY87-02=601)

0

10

20

30

40

50

60

70

80

90

PatentsIssued

PatentApplicationsFiled

UI Research FoundationUI Research FoundationTotal Income*Total Income*, FY87 to FY02, FY87 to FY02(Total Income from FY87 to FY02 = $27.4 million)(Total Income from FY87 to FY02 = $27.4 million)

0

2

4

6

8

10

FY87FY88

FY89FY90

FY91FY92

FY93FY94

FY95FY96

FY97FY98

FY99FY00

FY01FY02

*This chart reflects UIRF earnings, patent cost reimbursements are not included.

$ M

illion

s

2000 AUTM Survey Results2000 AUTM Survey ResultsBig Ten Conference ComparisonBig Ten Conference ComparisonCollege Gross Licensure

Revenue (Millions)AUTM National License Revenue Ranking

Big 10 License Revenue Ranking

Illinois (Chicago & Urbana)

5.4 28 4

Indiana 2.7 45 7

Iowa 5.1 32 5

Michigan 4 38 6

Michigan State 26 11 1

Minnesota 23 13 2

Northwestern 1.1 72 11

Ohio State 1.8 58 8

Penn State 1.3 66 10

Purdue 1.6 60 9

Wisconsin 23 14 3

Iowa State 1.2 69 N/A


Faculty Development

Road Map To the FutureRoad Map To the Future Faculty Development Faculty DevelopmentEnhance recruitment, retention and

multi-stage career development of outstanding faculty.

Create a supportive environmentDevelop and recruit leaders to

address accelerating institutional and societal needs

Faculty Satisfaction Faculty Satisfaction Productive Academic OrganizationProductive Academic Organization

Great Faculty

Outstanding Environment

Superb Leadership

Productive Organization

The University of Iowa The University of Iowa Presidential Biomedical Scholar ProgramPresidential Biomedical Scholar Program

The objective of this new program is to recruit and support new investigators of outstanding promise in the basic biological and clinical sciences.

Three tenure-track assistant professors either in basic sciences and/or in clinical sciences will be appointed annually to the program.

Each scholar appointed to the program will be provided with seed funds of $300,000 for the first year and annual funding of $100,000 for three years thereafter for a total of $600,000.

The scholars may apply themselves or be nominated by department heads and directors of basic and clinical academic departments and research centers.


Philanthropy

Big 10 Total Gifts ReceivedBig 10 Total Gifts ReceivedInstitution Total Private Gifts Rec’d

Indiana $126,112,957

Ohio 38,331,008

Michigan 37,100,812

Minnesota 31,818,967

Iowa 22,563,315

Illinois 12,307,380

Michigan State 1,750,000

Big 10 Ratio of $ per Development Big 10 Ratio of $ per Development OfficerOfficer

Institution Ratio Gifts to DOs Total Private Gifts Rec’d

Indiana $18,016,137 $126,112,957

Ohio State 4,791,376 38,331,008

Penn State 3,356,008 16,780,042

Iowa 3,223,331 22,563,315

Michigan 2,650,058 37,100,812

Michigan St. 1,750,000 1,750,000

Illinois 1,367,487 12,307,380

Minnesota 1,325,790 31,818,967

We Will Continue to Exist? We Will Continue to Exist? Which other institutions should teach the nation’s health

professionals?

Which other institutions will train the next generation of clinical and clinically oriented biomedical researchers?

Which other institutions will provide their clinicians the protected time necessary to conduct clinical research and to experiment with new forms of clinical care?

Which other institutions will serve as providers of last resort in their communities?

Which other institutions will test and implement nascent clinical practices when they are still relatively unproven?

“We must adjust to changing times

and hold to unchanging

principles.”-- Jimmy Carter Nobel Peace Prize Lecture

Road Map to the Future: Shaping a Common Agenda Donna Katen-Bahensky and Jean E. Robillard.

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Transcript of Road Map to the Future: Shaping a Common Agenda Donna Katen-Bahensky and Jean E. Robillard.