the next

five yearsOhSU is moving into a new era. Our work will be defined by health reform and the decline in public resources, and we will be challenged in profound ways. Yet we are well positioned to succeed because of the achievements of the past five years. Past success is the best predictor of future success.

Progress in recent years has occurred amid a series of setbacks: the loss of tort cap protection (from December, 2007 until legislative action to raise and restore the cap in 2009), the cyclical global economic downturn that began in fall 2008, and the structural changes in the economy that are propelling health care reform and reduced public funding.

OHSU laid the groundwork for success in 2007 by adopting Vision 2020, a roadmap for achieving future goals in a rapidly changing world. The emphasis is on innovation and collaboration:

“OHSU will partner to make Oregon a national leader in health and science innovation for the purpose of improving the health and well- being of all Oregonians.”

Collaboration makes the most out of limited resources. OHSU has fostered closer ties to communities throughout Oregon and Southwest Washington,

allowing residents to receive care close to home when possible but access OHSU’s unique complex care when necessary.

OHSU has joined forces with partners in Salem and Vancouver, Astoria and The Dalles, among others. Closer to home, we are charting a new course in collaborating on oncology with Legacy Health.

In education and research, OHSU formed a strategic alliance with Portland State University to better meet the state’s educational needs. We successfully

launched construction on the Collaborative Life Sciences Building in partnership with Portland State, the Oregon University System, and Oregon State University. We also established the Living Laboratory for Cell Biology in conjunction with FEI, a local scientific instruments company.

This focus on collaboration has put OHSU ahead of most academic health centers and played a key role in recent success.

looking back

measuringsuccess

Progress can be measured in a variety of ways, but the most important is the growth of the missions:

• OHSU treats more patients and educates more students than ever.

• The trend in research grants is up.

• OHSU’s nearly 14,000 employees touch the lives of Oregonians in all 36 counties.

• Philanthropy has grown significantly —

» $40 million anonymous gift to medical education

» $100 million gift by Phil and Penny Knight to the OHSU Knight Cancer Institute

» $25 million gift by Bob and Charlee Moore to establish the Moore Institute for Nutrition and Wellness

» More than $27 million in gifts, including $10 million from Gene and Bonnie Skourtes, enabled the building of a new OHSU School of Dentistry in the Collaborative Life Sciences Building.

In addition, OHSU has strengthened its community ties and environmental leadership. The Portland Aerial Tram increased connections between Marquam Hill, South Waterfront and the rest of Portland. OHSU is a recognized leader in supporting bicyclists and other alternative commuters, promoting a tobacco-free campus, and sustainability and green building practices.

OHSU has been vocal and active in the health reform conversation, supporting the goals of increased access and quality and reduced costs. Yet while there are challenges in this process — and financial risks — OHSU is poised to lead. As Oregon’s only academic health center, we have a special obligation to lead

change — developing new systems of care, new methods of training for providers and more rapid ways to apply science. And while there will be setbacks along the way, we know that we have the right people in place to help us emerge from this period stronger than ever.

lookingforward

find out moreIf you missed the April 5 Town Hall, with presentations from the president, chief financial officer and provost describing OHSU in the

next five years, view the video on Staff News (just search for “Town Hall”). Next up: Learn how health care reform will affect all of us.

HealtH reform and oHsu how we’ll changeHealth reform will touch all of oHsu’s missions. the coming changes are about more than public policy and health insurance. We will see transformation in how care is delivered, how health professionals are trained and how we decide what health care to buy. oHsu’s missions will have to grow and adapt to meet new challenges.

For years, health reform has been a political football. Nationally, the debate has focused on how to address growth in health care costs and the number of uninsured. Proposals have been controversial, and the process has often stalled, but Oregon has often been ahead of the country.

What makes further change inevitable is the looming shortfall in funding for Medicare and Medicaid. The green portion of the chart to the right — representing spending required for Medicare and Medicaid — expands dramatically in the next few years. The solid line — representing expected revenues — is quickly outpaced, squeezing out other spending. The situation is unsustainable. Change must come.

whaT’S aheaD

the next five years

Health care is the primary driver of future federal spending

40

35

30

25

20

15

10

5

0

40

35

30

25

20

15

10

5

0

Revenues

ProjectedActual

Other FederalNoninterest Spending

SOURCE: Congressional Budget Office, June 2009

Medicare and Medicaid

Social Security

1962

1968

1974

1980

1986

1992

1998

2004

2010

2016

2022

2028

2034

2040

2046

2052

2058

2064

2070

2076

2082

Perc

enta

ge

of

gd

P

Produced by OHSU Strategic Communications, May 23, 2012If you need printed copies stop by Baird Hall 1048 or call 503 494-8231.

healTh care transformationOregon sees the crisis in health spending as an opportunity to transform health care in our state. The recent agreement between the State of Oregon and the federal government is a big boost for Governor Kitzhaber’s transformation initiative, which lays the groundwork for a different kind of care for the patients served by the state’s Medicaid program.

New “Coordinated Care Organizations,” or CCOs, will receive funding to prevent health problems and improve health. With new technology, new ways to deliver care and new evidence-based information to determine what services are most effective, each CCO will provide dental, behavioral and physical health care for its “members.”

What Oregon is trying to show — and the idea the federal government is supporting — is that CCOs provide lower cost care with better outcomes. Commercial insurers will likely adopt similar approaches for their policyholders, driving down the overall cost of health care in the economy.

OHSU has already helped shape Oregon’s solutions, supporting the triple aim of better outcomes, better experiences and lower costs. But our biggest role may be ahead: The pressure on health care providers to deliver on the triple aim is an opportunity for academic health centers like OHSU to truly lead.

Reform will touch all of OHSU’s missions. Our hospitals, clinics and providers will improve the way health care is delivered — rethinking care across systems and with community partners. Our faculty will train health professionals to work together in the teams required to serve these new partnerships. Our researchers will move new knowledge to patients more quickly, design new systems of care and use outcomes studies to show how to keep everyone healthier.

Our mission is to improve the health and well-being of Oregonians. Our past success in achieving that mission depended on a system we must now help change. It won’t be easy, and we will face challenges. But we must adapt. We will grow, and the result will be a system that’s better for everyone — providers and patients alike.

role of ohsu

Next up: What’s happening to state and federal government funding for OHSU’s missions?

To see the whole series, search for “The Next Five Years” on the Staff News blog.

oHsu has already helped shape oregon’s solutions, supporting the triple aim of better outcomes, better experiences and lower costs.

Betteroutcomes

Betterexperiences

lower costs

tHe triPle aim

Future outlook

less public $$$How will future trends affect oHsu’s bottom line? Government funding is shrinking. Nearly half of oHsu’s resources come from government sources, many of which are under severe pressure.

STATE AndFEdERAL CUTS

the next five years

Produced by OHSU Strategic Communications, May 31, 2012If you need printed copies stop by Baird Hall 1048 or call 503 494-8231.

One expectation is that health reform

will make health care less expensive.

That translates into cuts at the state and

federal level. Oregon is aiming to cut $11

billion out of its Medicaid program over

the next decade. At the federal level,

the congressional “Super Committee”

was charged with finding $1.2 trillion

in cuts. Though the committee failed,

Congress hasn’t ruled out proposals like

decreasing the funding for the National

Institutes of Health (the major source

of OHSU research grants), reducing

Medicare payments and spending less

to support health education. All of these

changes would harm OHSU.

Lower Costs

source of oHsu’s budget

38% Commercialinsurers

7% Gifts andfederal grants

4% Other

3% Tuition

16% Medicare

15% Medicaid

52% private 48% public(Government)

15% Federal grants

2% State appropriation*

* State appropriation previously: 28% in 1985; 12% in 1995

A pARAdoxAt the same time as these trends in

government funding are emerging, demand

for everything we do is skyrocketing. We are

moving into a golden age for biomedicine,

when scientific discoveries like our own Brian

Druker’s revolutionary cancer treatment are

accelerating. People are living longer and

more people than ever before are reaching

retirement age, when people typically need

more health care.

The challenge posed by that dynamic

means that OHSU must drive innovation

and educate more providers. We also must

help design better ways to improve the

patient experience and the overall health of

the population while lowering costs, even

though that will leave us with less revenue.

Our continued ability to serve

Oregonians depends on careful

stewardship of our resources. In the last

fiscal year, OHSU earned $57 million in

operating income, a $28 million return on

our investments, and an $89 million net

gain from philanthropy. This capped the

strongest five-year financial performance

in OHSU history. The difficult decisions

that made this possible were achieved

against the backdrop of significant

external challenges.

This achievement has allowed us to grow

and find new ways to improve the health

and well being of Oregonians. Continuing

to do so will require OHSU to develop

new revenue sources and industry

partnerships, control costs and improve

efficiency, and raise more money from

private donors.

OHSU is in a strong position, but careful

planning and good stewardship of scarce

resources will help us get even stronger.

STRong STEwARdShip ESSEnTiAL

Next up: The increasing importance of philanthropy and entrepreneurship.

To see the whole series, search for “The Next Five Years” on the Staff News blog.

0

20

40

60

80

100

65-84 years

85 Years and Older

2030202020102000199019801970196019500

people are living longer

Number in millions

PROVING OUR WORTHOHSU will have to !nd new sources of private money to o"set government funding cutbacks. This will mean providing value for patients and insurers, undertaking new partnerships and business ventures, and enlisting donors to help bring big, world-changing ideas to reality.

HOSPITAL GROWTH RATES FALL

THE NEXT FIVE YEARS

Produced by OHSU Strategic Communications, June 11, 2012If you need printed copies stop by Baird Hall 1048 or call 503 494-8231.

National growth in hospital spending declines to lowest rate in 50 years

BIG IDEAS

Patient revenues — from private

insurance, Medicare and Medicaid

— provide almost 70 percent

of OHSU’s income. Both public

and private dollars for health care

are under new and significant

constraints. This will be a big

challenge for OHSU.

The current recession changed the

health care industry. From 2007

to 2009, ten million Americans

lost their employer-sponsored

or private insurance. Many who

remained insured elected to delay

or decline treatment for financial

reasons. Even as the economy

began to recover, consumption of

health care by consumers seems

to have declined in permanent

ways. Insurance companies and

individual patients want more

value for their money.

We are responding to that

challenge by working with private

insurers, business executives and

others who make the decisions

about what insurance plans

will cover their workers. We are

showing them why OHSU should

be part of every plan because of

the specialty care we o!er.

Most health systems believe that

they will have to become bigger

— and more e"cient — in order

to survive. OHSU’s approach to the

changing health care economy is

oriented to partnership rather than

mergers or acquisitions. We are

pursuing the Triple Aim of better

patient experiences, better health

for the entire community and

lower costs.

Source: Moody’s

Total Operating Revenue

4%

6%

8%

10%

20102009200820072006200520042003200220012000

9%

7%

5%

0

20

40

60

80

100

120

FY 2011FY 2010FY 2009

MORE ENTREPRENEURSHIPIn the past few years, OHSU has worked to become an even

better steward of our resources. We have begun to implement

new revenue-generation strategies and new thinking about

everything we do. As a result, OHSU is becoming more strategic

in its choice of investments and more creative about capturing

market opportunities and fostering innovation at all levels of the

organization. This means demonstrating our value to attract new

customers and new funding sources.

Examples of innovative strategies and new investments include:

The unique partnerships and funding sources that enabled the

construction of the Collaborative Life Sciences Building.

The FEI Living Laboratory for Cell Biology, a public-private

partnership to rapidly apply new knowledge to patient care.

The forward-thinking business plan developed by the Knight

Cancer Institute to commercialize more of its work, including

teaming up with pharmaceutical companies and making

greater use of its biolibrary.

OHSU must continue to demonstrate its value to philanthropic

partners and supporters. To do so, we must continue to

communicate the broad impact of our missions. We must build

relationships with donors across Oregon and far beyond. And

we must continue to develop a culture across our organization

that helps advance this important work.

Three years ago, OHSU, the OHSU Foundation and

Doernbecher Foundation together set an ambitious goal to

begin raising $100 million in gifts and pledges annually by

2014. During the most di"cult economic period in modern

memory, people stepped up their support to OHSU. We raised

$100 million last fiscal year and are closing in on that goal this

year. This record of success is driven by OHSU’s exceptional

faculty and the excellence of our many programs. But to

attract private donors in ways that can have a transforming

impact will require visionary thinking about what’s next. Big

ideas drive big philanthropy.

The need to demonstrate our value to patients, and to public,

private and philanthropic partners is greater than ever.

BIG IDEAS FOR PHILANTHROPY

Next up: More about e!orts to reduce expenses and improve e"ciency.

To see the whole series, search for “The Next Five Years” on the Sta! News blog.

Mill

ions

of d

olla

rs

$100.5

$78.4

$51.5

(Total excludes extraordinary $100 million gift from Phil and Penny Knight)

Gifts to OHSU climb

Totals re!ect philanthropic gifts and pledges made within the "scal year through the OHSU Foundation, Doernbecher Foundation and directly to OHSU.

DOING MORE WITH WHAT WE HAVE

Proving our worth means providing more value. With public funding

shrinking and our focus on the “big ideas” needed to ensure expanded private support, it’s more

important than ever for OHSU to be an effective steward of scarce resources.

In FY11, OHSU began a five-year effort to improve the way it operates and reduce operating costs by about $100 million each year.

The chart below outlines some of the major components of that effort, which is requiring difficult changes across the institution.

The goal is not just saving money, but putting in place the structures that will allow OHSU to thrive in an era of reform.

SPENDING LESS,CHANGING MORE

the next five years

Produced by OHSU Strategic Communications, June 21, 2012If you need printed copies stop by Baird Hall 1048 or call 503 494-8231.

How much we’ll save with productivity and process redesign

WORKING SMARTER

More than $13 million a year in expected savings comes from

improving the way we purchase supplies. The team charged

with leading that effort compared OHSU’s costs for all kinds of

supplies to other academic health centers and prioritized a list

of 37 opportunities.

Most of these required changes not just in purchasing, but

also in culture. Reducing the number of vendors for some

surgical implants from six to two meant dramatically improved

pricing—but also that medical students could learn on fewer

examples. Buying reprocessed operating room products—

sterilized and tested by an outside vendor—cut costs in

half, but also required changing workflows and developing

confidence in product quality. To date, with more than a full

fiscal year to go in the project, the effort has saved more than

$11.8 million.$0

$20

$40

$60

$80

$100

FY 15FY 14FY 13FY 12($20)

$(6)$5$3

$15

$8

$(8)

$12

$7

$30

$16

$(10)

$25

$11

$30

$16

$(10)

$39

$15

$30

$16Throughput & Revenue Cycle

Uniform Processes and Purchasing

Faculty Research & Productivity

Other Initiatives

Ongoing Investments

Mill

ions

of d

olla

rs

INVESTING TO MAKE WORK MORE EFFICIENTJuly 5 marks the official launch of O2, OHSU’s

new intranet. Improvements to our 14-year-

old intranet—recommended by external

analysts and OHSU community members—

make it easier for everyone at OHSU to do

their jobs. In just one example, more than

350 pages of content for Facilities & Logistics

has been organized and trimmed to less

than half that, and many OHSU business

services are now offering easy online access.

Search tools, which didn’t exist on OHSU’s

old intranet, make it simple to quickly find

information instead of hunting it down

through multiple phone calls.

If O2 saves half of OHSU’s employees five

minutes a day, it will return more than $1.5

million every year in otherwise wasted

time—more than six times the value of

investments made in the project.

OHSU’s faculty and staff are engaged and entrepreneurial: Faced

with a goal of using resources more efficiently, everyone wants

to know what they can do to help. The fact is, everyone can help.

School of Medicine employees dealing with a confusing array of

human resources forms, for example, decided to standardize their

paperwork—just one of the “uniform processes” needed to help

OHSU work smarter. The single standard form they developed by

collaborating with their Human Resources business partners is

now being used across OHSU — reducing frustration and saving

time and money every day.

“Stewardship” is an old-fashioned term, but it will remain OHSU’s

touchstone in the years ahead. Philanthropic partners, employers,

investors and public funders are all looking for more value, and

OHSU is providing it: We are doing more by working smarter,

innovating in everything we do.

WHAT CAN THE OHSU COMMUNITY DO?

To see the whole series, search for “The Next Five Years” on the Staff News blog.

finding solutions THE PERS CHALLENGEWorking smarter doesn’t just mean saving money. it means

putting in place structures that will allow oHsu to thrive in an era of reform. We must be able to control and predict our costs so we can sustain and grow our missions.

PERS — the state’s Public Employees Retirement System — presents two challenges to public employers like OHSU. The cost of PERS is growing substantially, and it is a cost that is out of OHSU’s control. Beginning in FY11, OHSU has taken on an additional $20 million per year in PERS-related expenses. PERS costs play a significant role in OHSU’s bottom line.

Another way to look at how much PERS rates have grown is to compare how much OHSU must pay as a percentage of each person’s salary for retirement. Under OHSU’s University Pension Plan, OHSU pays 12 percent of each UPP employee’s pay for retirement. OHSU controls that amount. OHSU can’t control PERS rates, however. By 2015, OHSU will pay an amount to PERS equal to nearly 24 percent of the salary of each employee enrolled in a PERS plan.

THE bALLooNiNG CoST of PERS

UPP* PERS

OHSU retirement contribution per employee as a percent of pay *OHSU reserves the right to change the UPP rate, but it plans no change in the next five years.

PERS costs are rising and uncontrollable by OHSU

0

5

10

15

20

25

2016-20172014-10152012-20132010-2011

Perc

enta

ge o

f Pay

12% 12% 12% 12%

9%

14%

19%

24%

Produced by OHSU Strategic Communications, June 28, 2012If you need printed copies stop by Baird Hall 1048 or call 503 494-8231.

EmPLoyEE CHoiCESThe University Pension Plan was created more than 16 years ago to give OHSU employees a choice in retirement plans. Employees who are eligible to participate in a retirement plan can choose the University Pension Plan, or the current PERS plan. The state Legislature has changed PERS several times

during the past years, so OHSU employees may be in PERS Tier One, PERS Tier Two or the newest offering, OPSRP. About 54 percent of OHSU eligible employees are in one of the PERS plans, and about 46 percent are in the University Pension Plan. Here’s how the plans differ:

Next up: How health reform will change our healthcare mission.To see the whole series, search for “The Next Five Years” on the Staff News blog.

If OHSU does nothing to address the rising costs, our payment to PERS will be unsustainable. We must make changes so we can protect our missions while still offering employees a choice between our two retirement programs — PERS and the University Pension Plan.

Both PERS and the University Pension Plan are generous plans compared to the market. OHSU leaders understand that faculty members, researchers, nurses and other staff members are the university’s most important asset. Wages and benefits

must remain competitive, even as we find ways to control unsustainable costs. Solving the PERS puzzle is a crucial, mutual challenge for protecting our missions in the coming years.

OHSU’s contributions to employee retirement plans

OHSU employees who are eligible to participate in a retirement savings plan have two choices:

University Pension Plan Public Employees Retirement System (PERS)

UPP retirement accounts have two components: PERS retirement accounts have two components:

Paid by OHSU

Contribution set by OHSU

Paid by OHSU

Contribution set by OHSU

Paid by OHSU

Contribution set by State at 6%

Paid by OHSU

Contribution set by State every

two years

EmPLoyEE ACCouNT EmPLoyER ACCouNT EmPLoyEE ACCouNT EmPLoyER ACCouNT

As the nation’s health care system is transformed, the way OHSU educates new health care professionals is changing, too. We are

redesigning our educational programs, finding exciting ways to ensure Oregon’s future health care workforce excels in this new era.

HeAltH refOrm And edUcAtiOn

THE fuTurE workforcE

Produced by OHSU Strategic Communications, July 19, 2012.If you need printed copies stop by Baird Hall 1048 or call 503 494-8231.

Seventh

Interprofessional education is essential to meet our goal of transforming the na-tion’s health care system. When students from different disciplines are educated together, they are more likely to work together effectively in patient-centered health care teams. If scientists and health care professionals of all types learn side-

by-side from day one, they can more rapidly identify and solve the complex health care challenges of the future.

OHSU is developing interprofessional education across all our schools and programs – and with other university

partners – to improve the quality of patient care. We will deploy dynamic and cutting-edge educational models, includ-ing simulation, team-based learning, distance learning and more.

We are educating more students than ever

Gro

wth

in s

tude

nt e

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HSU

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1990 1995 2000 2005 2010 2011

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1,000

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0

INTErProfESSIoNAL EDucATIoN IS kEY

Health care reform will bring big changes to the systems that provide care. Ore-gon’s Coordinated Care Organizations are one example of how health care reform will change the way care is delivered. Physicians, nurses, dentists, pharmacists, mental health providers and other profes-sionals will join forces to provide integrat-ed patient care, emphasizing preventive care, wellness and population health.

Transforming OHSU’s educational pro-grams is challenging – and there’s hard work ahead of us. We will educate more students than ever to meet the health care workforce needs of Oregon and beyond. OHSU is acting now to remain a competitive, nationally ranked university for years to come.

Ensuring excellence in our education mission is crucial to OHSU’s future success. Doing so will require us to not only develop dynamic new teaching models and methods, but also to offer exceptional education value to each of our students.

DEPLoYING TEcHNoLoGY: THErE’S AN APP for THAT!

GooD EDucATIoNAL VALuE

Information technology – from the electronic health record to the smart phone to telemedicine – has fundamentally transformed the way we access and share information, both for providers and patients. As part of our redesign of educational programs, we are developing innovative new ways to deploy advanced information technology. Our educational programs will train students to become experts at processing and interpreting rapidly changing and evolving health data and information on behalf of, and in partnership with, patients and communities.

With its open settings, state-of-the-art technology and new simulation labs, the Collaborative Life Sciences Building under construction in South Waterfront will provide a venue where students – and faculty – will learn together in a collaborative, interprofessional setting.

THE coLLABorATIVE LIfE ScIENcES BuILDING

Student debt load – at OHSU and across the nation – has grown to unacceptable levels. Concern about debt discourages talented students from choosing health care as a profession. It also may influence new graduates to not choose the professions or communities where

workforce shortages or critical needs are greatest.

As OHSU works hard to transform our educational programs in this new era, we will ensure excellence and provide exceptional value to our students.

Learn more about OHSU’s vision for the future: http://www.ohsu.edu/xd/about/vision/

the triple aim MEETING THE GOAL OF HEALTH REFORM

Produced by OHSU Strategic Communications, September 7, 2012If you need printed copies stop by Baird Hall 1048 or call 503 494-8231.

BETTER OUTCOMES

LOWER COST

BETTER EXPERIENCES

Achieving the Triple Aim is a lofty goal. First, let’s look at cost. By 2020, health care will make up 20 percent of the total cost of goods and services in the United States. That is the highest percentage in the world, and the rate at which health care costs are growing in America is faster than in nearly every other country. Now let’s look at outcomes. Despite our high level of spending, the U.S. lags behind on important measures like infant mortality and life expectancy.

We can, and must, do better.

Achieving broad improvements in health outcomes requires redesigning entire systems. Oregon is beginning to transform the way we provide care for Medicaid recipients, through the use of coordinated care organizations (CCOs). The nation is watching. If Oregon is successful, this approach — emphasizing shared decision-making and coordination between providers — could influence reform in a big way. OHSU is helping lead Oregon’s transformation, but it means rethinking every aspect of how we deliver care.

health reform is about getting better health outcomes for our communities, improving access and experiences for our patients, and lowering costs. this is the triple aim – the goal that OhSU and others who care about the health care system want to achieve.

INTEGRATED SYSTEMSAchieving the Triple Aim requires consistency, standardization and integration across our own organization. In some ways, that goes against the grain of OHSU’s culture of entrepreneurialism and independence. But none of us works in isolation. We must find ways to organize complex systems and the work of hundreds of people so that we provide better experiences, better outcomes and lower costs for patients. In just one example, OHSU is streamlining care for the highest risk patients — before they are even

admitted to the hospital. Identifying these patients and managing their care effectively requires a common understanding of the risks they face medically and in their environment. Using the electronic medical record effectively to provide shared understanding of the patient’s situation, and ensuring smooth communication between the faculty and staff who serve the patient during hospital stays or outpatient visits is essential. It’s work worth doing, but it requires us to retool and rethink old habits.

Next up: The role of research in health care reform.To see the whole series, search for “The Next Five Years” on the Staff News blog.

EFFECTIVE PARTNERSHIPSHealth reform isn’t just about how OHSU does its work. It’s also about how we work with others. Our responsibility for patients will be measured not by the treatments they receive, but by the health outcomes they achieve. Our relationship with patients won’t be limited to office visits and hospital stays, but will span a continuum that begins in homes and ends in hospice.

As the state’s only comprehensive academic health center, OHSU’s role in Oregon’s health care system is irreplaceable. But achieving the Triple Aim means having effective relationships with all other parts of the health care system. To accomplish that, OHSU is building links with home health agencies and hospice providers, skilled nursing facilities and primary care clinics, and with healthcare organizations from The

Dalles to Astoria and from Vancouver to Medford. OHSU is also a partner in Health Share of Oregon, a coordinated care organization designed to change the way we provide services to Portland-area Medicaid patients. Health Share of Oregon is all about partnerships; organizations historically seen as competitors are working together to improve the system.

RAPID CHANGEOHSU adopted eight essential principles for health care reform in 2008, and has taken part in the conversation leading up to this time of change. The next five years will transform our health care system. The organizations that thrive will be those that excel in managing change.

OHSU is at the leading edge of some of those changes. OHSU has developed

unique expertise in comparing the effectiveness of different treatments and developing standard, evidence-based practices for improving outcomes. As an early adopter of sophisticated systems for managing patients’ electronic health records, OHSU is beginning to use this kind of research and other data to achieve better health outcomes and reduce costs. And as the state’s leader in

telehealth, OHSU is connecting Oregon’s providers in a virtual network that keeps care close to home for patients.

Remaining at the leading edge of reform will require more innovations just like these. Achieving excellence, however, means developing deep skill in matching the potential of innovation to the imperatives of the Triple Aim

the vital role

of research

Produced by OHSU Strategic Communications, October 5, 2012.If you need printed copies stop by Baird Hall 1048 or call 503 494-8231.

OHSU is poised to lead. Our research strength is reflected in numerous ways: publications in top-tier research journals, the support of visionary philanthropists like Phil and Penny Knight, and in our merit-based awards. Last year, our faculty and research staff were awarded $359 million in competitive grant funding, up $1 million from the previous year.

This figure is notable because of the expected drop off in American Recovery and Reinvestment Act funding, which resulted in OHSU’s ARRA funding dropping from $32.7 million awarded in fiscal year 2011 to $4.4 million awarded in fiscal year 2012. In other words, the non-ARRA research base went up roughly 9 percent in the last year, a tribute to the productivity of OHSU investigators.

Maintaining that impressive record will be a challenge, since federal funding for the National Institutes of Health will likely shrink. OHSU is actively working to diversify our funding portfolio – to expand relationships with other federal agencies, broaden our philanthropic partnerships, and work with industry in innovative ways to create joint research and training programs.

as health reform moves toward the triple aim goals of increased access, improved patient experience and lower costs, ohsU’s research mission will have a vital role to play. research breakthroughs offer hope for less expensive treatments, more efficient delivery of care and the translation of new discoveries to prevent disease.

0

50

100

150

200

250

300

350

400

FY 2012FY 2011FY 2010FY 2009FY 2008

$237 $238 $255 $251 $276

$62$66

$67

$74 $79

$70$33

$4

$4

$299 $307

$392

$358 $359

Non-federalARRAFederal

Research awards of the last five years, in millions

Strengthening the BaSeOHSU is noted for its research in neuroscience, cardiology and cancer, among other disciplines. These strengths lie on a solid foundation of basic science discovery by our excellent faculty. The next five years will require us to continue to support these outstanding scientists — as well as to recruit new faculty.

We have made important infrastructure investments. One example: we’ve invested in multiple imaging tools that will revolutionize our ability to see how disease works at a molecular level. These tools will be used to

understand the causes of cancer, as well as cardiovascular, neurologic and developmental disorders.

We’ve also made a critical investment in a new data center to house the computational infrastructure for supporting the research, patient and educational activities of the future. Managing “Big Data” is necessary to effectively mine the massive amounts of information we’re gathering. Breakthroughs will come from how well we can define key patterns and understand connections.

Next up: Outreach and conclusions. To see the whole series, search for “The Next Five Years” on the Staff News blog.

PerSonalized MedicineThe Knight Cancer Institute continues to recruit top scientists who conduct cutting-edge research on how cancer cells grow and personalized cancer treatments. These treatments target abnormalities in an individual’s cancer cells to stop the disease, while leaving healthy cells alone. OHSU is a national leader in this line of research.

The new OHSU Knight Biolibrary and the Knight Diagnostic Laboratories will be crucial resources for this work, allowing research on thousands of tumor and tissue samples, and developing effective tests for these cancer-causing molecules.

Personalized medicine is evolving rapidly. Already, we are discovering that

research must go beyond identifying changes to known genes in a patient’s DNA. We must now study other, less well understood segments of our DNA, as well as how gene function can be modified by the environment, diet and lifestyle. This field is called epigenetics, and many areas of investigation will be influenced by its discoveries.

the reSearch gaPThe next five years will see a new effort to bridge a knowledge gap identified by health reform — namely, understanding and dismantling the barriers to implementing research findings in clinical practice. OHSU has significant resources to bring to bear on this problem — resources in translational research, health systems effectiveness,

evidence to inform clinical practice, and evidence to inform policy discussions.In the next five years, the social and economic pressures of an aging population will require research into everything from how to improve oral health in patients with dementia to containing costs — and respecting patient wishes — at the end of life.

OHSU is poised to lead, but challenges remain. Rapid deployment of science into the clinic will require new partnerships among our schools, institutes and centers, and our hospital and clinics. OHSU’s clinical settings, research infrastructure and overall culture will need to become more connected and team-oriented to meet these goals.

OHSU’S

Produced by OHSU Strategic Communications, Nov. 30, 2012.If you need printed copies stop by Baird Hall 1048 or call 503 494-8231.

OHSU is moving into a new era, defined by health reform and declining public resources. The era of reform will challenge our missions of education, research and patient care. But OHSU also has a fourth mission — outreach, an expression of our commitment to healing, teaching and discovery applied to the 96,000 square miles of Oregon.

SqUare mile campUS

NET COMMUNITY BENEFIT:

$307.6 million

FrOm EntErpriSE tO COOS Bay, pOrtland tO KlamatH FallSAs the state’s major comprehensive academic health center, OHSU is committed to Oregon and has unique resources to bring to bear to improve the health and well being of Oregonians.

We are partners in more than 200 community health care programs, reaching out to vulnerable groups in urban areas as well as underserved rural communities throughout the state. These programs span our missions and provide a breadth of services that no other entity in the state can match. To cite just a few:

• The Office of Rural Health helps rural communities recruit and retain primary care providers and administers several tax credit programs that help keep rural health care systems viable.

• The Oregon Rural Practice-Based Research Network is a statewide clinical research network that extends medical research opportunities to rural communities. Recently named a Center of Excellence by the Agency for Healthcare Research and Quality, network members include 158 clinicians at 46 practices across Oregon, providing care to more than 235,000 patients.

• The Oregon Center for Children and Youth with Special Health Needs helps build the capacity of families, providers and communities caring for children with special needs through training programs, multidisciplinary clinics, public health agencies and community planning activities.

Other programs offered by OHSU include: Traveling pediatric subspecialty clinics, workforce “pipeline” programs to develop the health care leaders of tomorrow, information resources for providers, including a physician consult service and access to OHSU library materials on-line, and information resources for members of the public, including expertise on poisons and chemicals in the workplace and environment.

To see the whole series, search the ohsu.edu site for “OHSU Vision” or for “The Next Five Years” on the Staff News blog.

tHE impliCatiOnS OF rEFOrmHealth reform will also challenge our outreach mission. The demand for everything OHSU does — patient care, education, research, community service — is expanding as public funding is contracting.

Universal access through federal health reform creates additional demands on the workforce. More providers will be needed to see newly covered patients. OHSU is

developing innovative ways to train the next generation of health professionals. Part of that process includes working with our statewide partners to help identify additional training sites for the expanded class sizes made possible by the construction of the Collaborative Life Sciences Building.

Other evolving needs include the study of populations beyond the metro area

to inform and validate our efforts in the areas of translational research, health systems effectiveness, and evidence-based medicine. Finally, OHSU must be part of the effort to reduce systemic costs of health care. Expanding telemedicine links and clinical affiliations can help save resources by keeping patients close to home whenever possible and clinically appropriate.

COllaBOratiOn iS tHE KEyCollaboration makes the most out of limited resources. That’s why it’s embedded in our strategic vision: “OHSU will partner to make Oregon a national leader in health and science innovation for the purpose of improving the health and well-being of all Oregonians.”

We’ve seen the importance of collaboration for years in our outreach mission, with program partnerships that touch all 36 Oregon counties. In this new era, the best way to meet the growing need for services in a resource-scarce environment is to build on existing partnerships while developing new collaborations to meet changing needs.

OHSU will evolve to meet the challenges of the next five years. The 96,000 square mile span of our campus will serve not as a strain on our resources but as the source of our strength, connecting us with partners and the Oregonians we serve.

The chart above outlines the cost of OHSU’s community services for fiscal year 2011 (July 2010 through June 2011).

NET COMMUNITY BENEFIT:

$307.6 million

$106 million — Charity care and unreimbursed cost of public health care programs

$161.6 million — Medical education costs not covered by tuition, scholarship and public support

$34.5 million — Research costs not covered by grants and gifts

$3.8 million — Community health improvement services

$1.5 million — Community education and outreach

$155.8 thousand — Assistance to rural hospitals

$71.5 thousand — Tracking and reporting