Download - 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)
Cultural Diversity and Cultural Diversity and Medical School EducationMedical School Education
“Increasing the diversity of the physician workforce will improve access to health care for underserved populations.”
Cultural Diversity and Cultural Diversity and Medical School EducationMedical School Education
“Increasing the diversity of the research workforce will accelerate advances in medical and public health research.”
Road Map To the FutureRoad Map To the Future
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.
Road Map To the FutureRoad Map To the Future ResearchResearch
How Should We Perform?
Road Map To the FutureRoad Map To the Future ResearchResearch
We Should Be #1
In
Number Of Grants Per Faculty
Road Map To the FutureRoad Map To the Future ResearchResearch
What Do We Need To Do To Be #1?
Road Map To the FutureRoad Map To the Future ResearchResearch
To Climb to #1
85more grants 4 new grants per department 1 new grant / department / year over 4
years
Road Map To the FutureRoad Map To the Future ResearchResearch
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.
Road Map To the FutureRoad Map To the Future
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
Road Map To the FutureRoad Map To the Future
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.
Road Map To the FutureRoad Map To the Future
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