department of medicine faculty meeting september 15, 2009

September 15, 2009

Department of Medicine Faculty MeetingAnnouncements, Review of ’08-’09, Goals for ’09-’10

Announcements

• BMC IT has decided not to replace Logician (GE Centricity) with an alternative product

• Clinical dashboard coming soon• Fit Testing for the N95 mask to be announced

soon• Clinical volume continues to grow (visits up over

14%, wRVU’s up 10% YTD)• BMC CEO search to interview first round of

candidates in early October• Reminder regarding importance of Influenza

Vaccine for patients and healthcare providers

Grand Rounds September 2009

Sept 18: “Clinical Problem Solving Case”, Moderator- Rob Lowe, M.D., Discussant- David Battinelli, M.D., North Shore LIJ, Health System

Sept 25: “Sudden Cardiac Death in the Young: Is it in the Genes?” Michael Ackerman, M.D., Mayo Clinic

Research Announcements

• Process to subsidize use of cores by faculty has been established • “Bill of Rights” for trainees and faculty in the

process of being drafted• Next Bridge Funding application deadline December

1, 2009• Researchers Luncheon, 12:30-1:30 pm, Tuesday,

September 22, EBRC Room 715• Paul Pilch, Ph.D. appointed Associate Director of the

Graduate Program in Molecular Medicine• BUSM Grant Writing Course October 28 and

November 4 (five participants per session) contact cornwall@bu.edu if interested

Pilot Fund Recipients

DOM:– Tracy Battaglia– Kalpana Gupta– Gustavo

Mostoslavsky– Xuemei Zhong– Michael Wolfe

Pepper Center:– Wen Guo

BU Bridge:– Doug Faller– Stephanie Lee/Amy

Rosen– Mike Hollick– Fred Little– Avi Spira/Lee

Goldstein

Evans Days: December 3-4, 2009

Abstract submission deadline October 2 at (http://www.call4abstracts.com/busm/busm09d2/ )

Wilkins Visiting Professor: David A. Flockhart, M.D., Ph.D., Chief of the Division of Clinical Pharmacology, Indiana University School of Medicine, 3:30 p.m., Thursday, December 3, 2009, Keefer Auditorium

Ingelfinger Visiting Professor: Talmadge E. King, Jr, M.D., Chair, Department of Medicine, University of California at San Francisco, 12 noon, Friday, December 4, 2009, Keefer Auditorium

Faculty Web Pages Available

The Dept. of Medicine is offering individual faculty web pages to all faculty members.

Web pages can be created by completing the online form, right, at:

bmcmedicine.info/FacultyForm.html

Contact Kate Gilbert with questions: kate.gilbert@bmc.org

Evans Center for Interdisciplinary Biomedical Research Announcements

• ARC Application Deadline: October 8, 2009 (http://www.app.bumc.bu.edu/medfunding)

• ARC celebratory event planned for February 16, 2010 (save the date)

• First Evans Center Monday Social/Science ARC hour, November 2, 2009 at 4-5:30 p.m.

• Joint CTSI/Evans Center Mini-symposium on Hypertension chaired by Dr. H. Gavras planned for April 16, 2010

Faculty Development Seminar

• Tuesday, October 20, 2009:"Academic Advancement and Promotion” Facilitator: Karen Freund, MD, MPH

September 15, 2009

Review of 2008-9 andGoals for 2009-10

(and beyond!)

Overview

• Growth in number of faculty

• Research and clinical programs grew substantially

• Transitions in Education Program

• Increasing financial constraints due to BMC’s financial situation and recession

• Increasing rate of program development, change and refinement

Leadership Appointments 2008-9

Vice Chairs– Emelia Benjamin, M.D. (Faculty Development &

Diversity)– Angela Jackson, M.D. (Education)– Rajlakshmi Krishnamurthy, M.D. (Outpatient Medicine)– Nila Radhakrishnan, M.D. (Inpatient Medicine)

Center Directors– Katya Ravid, Ph.D., D.Sc. (Evans Center for

Interdisciplinary Biomedical Research)– Joseph Mizgerd, Ph.D. (Pulmonary Center)– Maria Trojanowska, Ph.D. (Arthritis Center)

Section Chiefs– Vasan Ramachandran, M.D. (Preventive Med/Epid)– Rob Simms, M.D. (Rheumatology)

Residency Program Director– David Halle, M.D.

Faculty Distribution by Rank, Gender, and Minority Status

5 (13) 25 (64) 39Instructor

18 (10) 75 (43) 174Asst Prof

5 (6) 33 (41) 80Assoc Prof

3 (3) 20 (22) 92Professor

31 (8) 153 (40) 383All faculty

URM (%)Women (%) TotalRank

Faculty Development Initiatives 2008-9

• Faculty Development seminars• Faculty Development grants• Creation of Faculty Development website• Enhance portfolio of faculty awards • Develop more robust faculty database• Augment mentoring available to faculty• Establish new faculty orientation• Develop faculty individual development plan tool

Faculty Development Diversity Goals 2009-10

• Improve FDD Website• FDD grants to 12 faculty not prior recipients• Continue FDD seminars• Increase diversity of DOM faculty using national

benchmarks• Target individuals at rank for >7 years to assist with

possible promotion• Develop & pilot faculty mentoring system

Promotions or New Appointments to

Professor (2008-9)

Irving Bigio, M.D.Phyllis Carr, M.D.Hyon Choi, M.D.James Collins, Ph.D.Alan Fine, M.D.Thomas Geisbert, Ph.D.

Jianlin Gong, M.D.Robert Lafyatis, M.D.Peter Merkel, M.D.Joseph Mizgerd, Ph.D.Paul Pilch, Ph.D.Philip Podrid, M.D.Susan Fried, Ph.D.

Promotion or New Appointment to Associate Professor 2008-9

Ahmed-Samer Al-Homsi, M.D.Michele David, M.D.Susan Doctrow, Ph.D.Alan Farwell, M.D.Frank Gibson, Ph.D.Kalpana Gupta, M.D.Brian Jacobson, M.D.Angela Jefferson, Ph.D.Darrell Kotton, M.D.Raj Krishnamurthy, M.D.

Paul LeLorier, M.D.Michael Paasche-Orlow, M.D.Elizabeth Pearce, M.D.Anita Raj, Ph.D.Marissa Ramirez, Ph.D.Christine Riordan, M.D.James Rosenzweig, M.D.Asish Saha, Ph.D.Jussi Saukkonen, M.D.Avi Spira, M.D.Orian Shirihai, M.D., Ph.D.

Promotions to Assistant Professor 2008-9

Laurence Beck, M.D., Ph.D.Ramon Bonegio, M.D.Yan Dai, Ph.D.Albena Halpert, M.D.Andrea Havasi, M.D.

Andrea Kronman, M.D.Raphael Lemaire, Ph.D.Daniel Mishkin, M.D.Sheng Wang, Ph.D.

New Appointments to Assistant Professor 2008-9

Uri Avissar, M.D.Ioana Bica, M.D.John Carr, M.D.Hassan Chami, M.D.Shoumita Dasgupta, Ph.D.Jean Francis, M.D.Craig Gordon, M.D.Naomi Hamburg, M.D.Amresh Hanchate, Ph.D.Jennifer Hughes, M.D.Matthew Jones, Ph.D.Alok Kapoor, M.D.Ilona Kopits, M.D.Joanne Krasnoff, Ph.D.Henri Lee, M.D.Hector Lucero, M.D.Mitchell Medow, M.D., Ph.D.James Meisel, M.D.

Gustavo Mostoslavsky, M.D., Ph.D.Jaime Murphy, M.D.Caryn Navarro, Ph.D.Leila Obeid, M.D.Yoram Puius, M.D., Ph.D.Lee Quinton, Ph.D.Timothy Radstake, M.D., Ph.D.Sandhya Rao, M.D.Bharti Rathore, M.D.Adam Rose, M.D.Alisa Rosen, M.D.Amy Rubin, Ph.D.Frank Schembri, M.D.Richard Sherva, Ph.D.Karin Sloan, M.D.Winnie Suen, M.D.Judith Tsui, M.D.Andrew Wilson, M.D.

Initial Appointment as Instructor 2008-9

Sonia Ananthakrishnan, M.D.Anthony Annese, M.D.Aaron Bartoo, Ph.D.Wanda Blanton, M.D.Xueping Fan, M.D., Ph.D.Vandana Gupta, M.D.

Peter Hoffmeister, M.D.Won Lee, M.D.Sara Pietras, M.D.Andres Solorza, M.D.Lisa Usdan, M.D.Steven Vlad, M.D.Jean Yeung, M.D.

September 15, 2009

Research Program

Research Initiatives 2008-9

• Bridge (10) and Pilot (22) Funding• Nanomedicine initiative• Instrumentation cores (analytical, imaging, animal

phenotyping, Immunohistochemistry, HTS)• Clinical research core (with CTSI)• First Step grant internal grant review• Researchers’ luncheons• Research space review• Evans Junior Faculty Merit Award (E. Pearce, J Lu, M Zang) and

Evans Scholar Award (R Cohen, D Felson)• Research symposia (Obesity, Stem Cells, Nanomedicine)

Evans Junior Faculty Research Merit Awardees 2009

Tuhina Neogi, M.D., Ph.D.Ravi Jasuja, Ph.D.Gerald Denis, Ph.D.

Department of Medicine Research Funding 2006-9 (in millions $, excludes NEIDL, VA, Roger Williams)

30

40

50

60

70

80

90

100

110

2006 2007 2008 2009

BUSM

BMC

Total

Research Goals 2009-10

• Enhance Faculty success in securing research support

• Improve IT support of research• Refine and further develop research cores• Develop strategic space allocation plan to

promote programmatic affiliations• Refine pilot, bridge, and Award programs• Improve mentoring and faculty development

initiatives

Research Goals 2009-10

• Enhance translational and interdisciplinary research

• Enhance the research and training ambiance• Increase efficiency of research program• Enhance impact of research program in

vulnerable patient populations• Enhance capacity to derive and analyze

biological material for diagnostic, prognostic and therapeutic uses

• Improve impact of preventive health interventions

September 15, 2009

Clinical Program

Clinical Initiatives 2008-9

• Increase number of clinical faculty (22) and clinical faculty ftee (7.5%)

• Improve access for new patients (23%)• Increase clinical volume• Patient satisfaction• Increase productivity expectations of clinicians• Department (Quality Council) and Section specific quality

improvement• Increase communication at transitions of care• Conversion to new billing company, electronic billing system

and use of EMR on inpatient service• Develop new and enhancing existing clinical programs• Increase primary care services

Sections Receiving Incentive Payments based on 08-9 Performance

New Patient Access

– Hematology-OncologyNew Patient Volume Increase

– Gastroenterology– General Internal Medicine– Geriatrics– Pulmonary

Total Clinical Volume

0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

FY 2005 FY 2006 FY 2007 FY 2008 FY 2009

wRVU's

Ambulatory VisitsDepartment of Medicine

100000

120000

140000

160000

180000

200000

220000

240000

260000

FY 2007 FY 2008 FY 2009

12000

12500

13000

13500

14000

14500

15000

15500

16000

FY 2008 FY 2009

Discharges Medical Service

Boston AMC’s Inpatient Volume(FY 2009, 9 mo’s)

11.46 14,379 Tufts

2.20 22,274 BMC

-3.28 30,612 BID

0.87 38,180 MGH

1.83 39,951 BWH

% Increase YTD Discharges Hospital

Average Length of Stay (Days) Medical Service

4.5

4.6

4.7

4.8

4.9

5

5.1

5.2

5.3

5.4

5.5

2006 2007 2008 2009

Clinical Collections

2008/Jul 2008/Aug 2008/Sep 2008/Oct 2008/Nov 2008/Dec 2009/Jan 2009/Feb 2009/Mar 2009/Apr 2009/May 2009/Jun

Rolling 12 Months $1,589,644 $1,961,296 $1,657,605 $2,030,098 $2,110,705 $2,335,879 $2,071,940 $1,963,911 $2,588,018 $2,767,721 $2,819,894 $2,254,359

Previous 12 Months $1,920,993 $1,931,716 $1,879,565 $2,073,948 $2,032,879 $2,021,549 $2,138,419 $1,993,452 $2,015,558 $2,187,155 $1,638,786 $1,922,170

Variance -$331,350 $29,580 -$221,959 -$43,850 $77,826 $314,330 -$66,478 -$29,541 $572,459 $580,566 $1,181,108 $332,188

$0

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

$3,000,000

Rolling 12 Months vs. Previous 12 Months - Payments Trending

Payments increased 10% or $2.4m from the same time prior year.

Charge Lag

2009/Jan 2009/Feb 2009/Mar 2009/Apr 2009/May 2009/Jun

> 30 Days $2,792,298.00 $2,392,609.00 $1,921,808.00 $1,155,432.00 $674,577.00 $1,074,096.00

15 - 28 Days $2,584,924.00 $3,028,315.00 $3,037,860.00 $2,874,536.00 $2,435,182.00 $2,561,767.00

< 15 Days $2,668,160.00 $3,230,894.00 $4,544,995.00 $4,987,890.00 $5,828,724.00 $5,743,524.00

$0.00

$1,000,000.00

$2,000,000.00

$3,000,000.00

$4,000,000.00

$5,000,000.00

$6,000,000.00

$7,000,000.00

$8,000,000.00

$9,000,000.00

$10,000,000.00

Charge Lag Trend - Service Date to Posting Date

Clinical Goals for 2009-10

• Improve patient access• Increase clinical volume• Improve communication among internal and external

providers at transitions of care• Enhance quality of care and patient safety• Improve financial performance • Enhance provider and patient satisfaction• Promote integrity of the clinical practice• Disseminate results of clinical innovation

September 15, 2009

Education Program

Medical Student Education 2008-9

• Established Evans Student Educator positions • Tom Barber, M.D. hired to direct ambulatory

medicine clerkship• Ambulatory medicine clerkship moving to fourth

year• Student satisfaction on medicine rotation

improved

Residency Program 2008-9Two new Associate Program Directors:

Subha Ramani, M.D.Charlene Weigel, M.D.– EBM curriculum establishedEvans Educators appointed:

Adam Segal, M.D.Julie Crosson, M.D.Renee McKinney, M.D.Tuhina Neogi, M.D.Steve Vlad, M.D.Rob Lowe, M.D.Elaine Hylek, M.D.Craig Gordon, M.D.

Residency Program 2008-9

Excellent match results:• 60 positions (41 cat, 14 prelim, 5 primary

care)• 32/60 women• 9/60 under-represented minorities

Primary Care Training Program awarded three year grant from HRSA Title VII ($1.01 m)

Fellowship Programs 2008-9

• Fellowship curriculum committee being established

• Following programs received full accreditation following RRC site visit

– Infectious Disease– Nephrology– Hematology-Oncology

Education Goals for 2009-10

• Develop and evaluate a rigorous residency program curriculum

• Foster a spirit of inquiry and scholarship• Expand training and modeling in professionalism and

communication • Aggressively recruit best and diverse candidates• Develop externships at international sites• Develop central resources for fellowship training• Develop faculty skills in teaching and curriculum

development• Integrate doctoral training in DOM• Enhance and evaluate medical student education• Enhance Graduate Program in Molecular Medicine

Administrative Goals 2009-10

• Improve timeliness and ease of use of all financial transactions and controls

• Improve accuracy and usefulness of the budgeting process

• Enhance staff development• Augment information technology resources• Reduce expenses

September 15, 2009

Final Thoughts

Evans Center for Interdisciplinary Biomedical Research Examples of Pre-ARC’s

• CV consequences of Metabolic Disease• Biomarkers of Disease• Protein Trafficking and Neurodegenerative Diseases:

Alzheimer Disease as a first model system• Sex differences in adipose tissue remodeling:

mechanisms and role in disease risk• Regenerative Medicine• Mitochondria: one organelle, multiple organs• Immunobiology of trauma• Blood microbiome