catalystPhilanthropy Sparks Innovation | Fall 2014

New ways of communicating help patients get the best care possible—no matter where they live

EMPATHIZING

CONNECTING

UNDERSTANDING

RESPONDING

COMMUNICATING

Connected

Inside: Special

Campaign Section

UPCOMING APPOINTMENTS

NEW MESSAGES

VIEW HEALTH RESOURCES

CHECK TEST RESULTS

GET A SECOND OPINION

c 2 catalyst | fall 2014 | powerofeveryone.org

visit powerofeveryone.org to learn more

The Power of Your Gifts

Hundreds of thousands of patients have entered Cleveland Clinic’s main campus through the Sydell and Arnold

Miller Family Pavilion since it opened in 2008. The Glickman Tower, which opened that same year, is home to the

Glickman Urological & Kidney Institute, which has more than 87,000 patient visits each year. Both buildings house

world-renowned clinical care, research and educational programs.

Philanthropy helped make these buildings and the work within them possible.

Your support has contributed to Cleveland Clinic’s No. 1 ranking in cardiology and heart surgery for 20

consecutive years in U.S. News & World Report’s list of “Best Hospitals.” The urology program was ranked No. 1 for

the second time in three years and in the top two for 15 straight years.

With your help, Cleveland Clinic is one of the top four hospitals nationwide and No. 1 in Ohio. With your help, we

will continue to lead the way in healthcare, at home and abroad.

InGr at itude

Courtesy of Cleveland Clinic

1powerofeveryone.org | catalyst | fall 2014

contentsCatalyst | fall 2014

Cover: MixAll Studio/Glow Images (doctor); (inset graphic) Naddi/iStockphoto

Philanthropy at Work5 Maltz gift makes stroke

treatment mobile

6 Samsons help transform medical education

6 Every day with sight is a gift for the Penders

7 Teresa Martinez has a new reason to race

8 Medical ethics come first for Crile Award honorees

THE POWER OF EVERY ONEFind out how you can take part in the most ambitious philanthropic campaign in Cleveland Clinic history — and one of the largest ever among nonprofit academic medical centers.

CONNECTED CARE9 Cover StoryCommunications and technology are shattering barriers and connecting patients to their caregivers. You can get the best possible care — no matter where you live.

Game Changer16 For too long, the

approach to assessing colon cancer risk has been one-size-fits-all. A new tool calculates risk at the individual level.

Medicine Chest2 Research backs the

power of art for patients

3 How crowdsourcing solves medical problems

3 Stopping cancer before it spreads

4 New findings target Alzheimer’s

4 My Story: Genetic knowledge reshapes care

2 catalyst | fall 2014 | powerofeveryone.org

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VISITORS TO CLEVELAND Clinic often speak about being impressed and moved by the diverse art collection spread throughout the campus. Now, the Arts & Medicine Institute has research to back up that highly positive anecdotal feedback.

The Institute’s Art Program surveyed 1,094 patients who had been to the main campus within the past year about the effects of the collection. Of the 826 respondents who noticed the artwork, patients with post-traumatic stress disorder (PTSD), generalized anxiety and breast cancer were more likely to say that the art collection improved their mood and lowered their stress. Eighty-one percent of PTSD patients, 75 percent of breast cancer patients and 69 percent of generalized anxiety patients said their stress levels improved because of the artwork.

Among all respondents, 61 percent said the artwork reduced their stress. For patients who were at the main campus for two to three days, 91 percent reported that the artwork improved their mood.

“Art is the one thing that can affect you on a soul level,” says Jennifer Finkel, PhD, one of the program’s curators. “There’s something very comforting about it.”

Created in 2006, the Art Program is designed to enrich, inspire and enliven visitors’ hospital experience. It has since grown to include approximately 6,000 pieces over 23 million square feet of facilities.

Cleveland Clinic is a pioneer among hospitals in embracing the arts in medicine, and the world-class collection could compete with that of many modern art museums. Landscape art long has been the standard in medical settings, but Cleveland Clinic’s collection aims for diversity of media, subject matter and artists.

Education is a key component too. Each piece is accompanied by a small descriptive label, and self-led audio tours are available in English, Spanish and Arabic, as well as docent tours.

The Institute plans a follow-up study about patients’ reaction to the art, this time interviewing patients while they’re still in the hospital. — Melanie Padgett Powers

• A R T S A N D M E D I C I N E

THE HEALING ARTSApp-etite for InfoDownload the Cleveland Clinic Today app (for Apple and Android

phones and tablets) to

get health information,

articles, tips,

infographics and more

from Cleveland Clinic’s

trusted experts.

Loris Cecchini, The

Ineffable Gardener

and the Developed

Seed, site-specific

installation, Inox

steel modules,

2013. Artwork

provided through

an estate gift to

Cleveland Clinic.

3

• D I G E S T I V E D I S E A S E S

CROWD POWER

LIKE OTHER TISSUE in the body, cancerous tumors grow and spread with the help of a rich supply of blood.

Now, Cleveland Clinic researchers have discovered a protein variant that inhibits such growth by slowing the development of new blood vessels, or angiogenesis.

New blood vessels deliver nutrients and oxygen to a tumor, allowing it to survive, expand and travel to other parts of the body. A family of proteins called vascular endothelial growth factors (VEGFs) is behind angiogenesis. One protein in particular, called VEGF-A, is the principal driver of the process.

But recently, a research team led by Paul Fox, PhD, of the Department of Cellular and Molecular Medicine and holder of The Robert Canova Endowed Chair in Inflammation Research, discovered that a variant of VEGF-A actually decreases angiogenesis.

This research has the potential to pave the way for further scientific inquiry, Dr. Fox says. It’s significant because it will open new avenues of angiogenesis and cancer research.

Patients may see benefits one day. In the long term, the research could lead to new diagnostic tools and treatments to reduce the spread of cancer, Dr. Fox says. The key is in the subtle molecular differences between VEGF-A and its more damaging counterparts.

“It is truly remarkable that a small change in a protein sequence leads not just to a protein with a different function, but one with a function completely opposite of the original,” Dr. Fox says. “In the context of cancer, the small extension changes a very ‘bad’ protein into a very ‘good’ one.”

• C A N C E R

CUTTING OFF CANCER’S GROWTH

CLAUDIO FIOCCHI, MD, who holds The Clifford and Jane Anthony Chair for Digestive Disease Research and Education, knows how much early detection matters for patients with inflammatory bowel disease.

When Dr. Fiocchi sought a new answer, he turned to the power of the crowd.

“Crowdsourcing” is common in the business and fundraising worlds, but now it’s showing promise in medicine too. In 2011, Cleveland Clinic became the first medical institution to partner with InnoCentive, a company that provides a platform for crowdsourcing medical and research problems. Physicians and scientists post their problems online, attracting creative submissions from individuals hoping to win a cash prize. To date, more than 4,000 “solvers” from around the world have participated, providing solutions to several problems.

Dr. Fiocchi’s IBD challenge is among them. The winning solution combines information about four major factors contributing to the disease: environment, genomics, immune response and intestinal bacteria. Dr. Fiocchi says he thinks that this new approach could allow for early diagnosis and help patients make lifestyle changes before damage occurs, delaying or even preventing a lifetime of painful symptoms.

Dr. Fiocchi received many bright ideas, but this one rose to the top. The solver received a cash prize and is now working with him to design a possible clinical trial. In the long term, patients likely will benefit from many people — with the right incentive — approaching a problem with an entirely fresh perspective. — Shannon Barnes

top left: Photograph by Stephen Travarca/Cleveland Clinic; bottom: Miappv/iStockphoto; top right: T-Studio/iStockphoto and Claudia Uribe/Getty Images

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top left: Talaj/Getty Images; top right: Photograph by Tom Merce/Cleveland Clinic

When a teenage driver rear-ended and totaled her car on a Florida freeway in 2011, Kelley Douglass thought it must be one of her worst days ever. As it turned out, the accident saved her life.

Her back aching, Mrs. Douglass consulted a chiropractor, who ordered an MRI. It revealed an abnormality in her bone marrow, “just a dot, really,” she says. Next, she was referred to an oncologist. A mammogram showed suspicious tissue in her left breast. When a biopsy confirmed cancer, she had a mastectomy.

Mrs. Douglass received genetic counseling because of her young age at diagnosis. She answered a battery of questions about her family medical history, including what seemed an odd one: “I was asked if I had a hard time finding hats that fit.” When she replied, “Yes, all my life,” a blood test was ordered. It was positive for a mutation in the PTEN tumor suppressor gene. With that, she says, “Pandora’s box was opened.”

Phosphatase and tensin homolog (PTEN), a protein encoded by the PTEN gene, usually prevents cells from growing and dividing too rapidly. However, mutations can inactivate this protective effect and lead to many types of cancer. Having a defective PTEN gene also meant that Mrs. Douglass might have a rare disorder called Cowden syndrome, one of the signs of which is a larger-than-average head circumference — making it hard to find hats that fit.

Mrs. Douglass, 45, also learned that if she did have Cowden syndrome, she faced a high lifetime risk of breast, thyroid, kidney, colorectal and uterine cancer, as well as skin tumors. Wanting to be safe, she opted for preventive surgeries. She had a hysterectomy and a mastectomy of what she thought was a still-healthy breast, but it, too, was found to have cancer. At this point, a friend found research online published by the world’s top expert in Cowden syndrome, Charis Eng, MD, PhD. Mrs. Douglass made an appointment to see her at Cleveland Clinic’s Lerner Research Institute in Ohio.

In their first meeting, Dr. Eng, Chair of Cleveland Clinic’s Genomic Medicine Institute within the Lerner Research Institute, and holder of the Sondra J. and Stephen R. Hardis Endowed Chair in Cancer Genomic Medicine, positively diagnosed Cowden syndrome. On reviewing Mrs. Douglass’ chest X-rays, she also detected probable cancer atop a kidney captured in the image.

“I was shocked,” Mrs. Douglass says. Steven Campbell, MD, who holds The Eric A. Klein Chair in Urologic Oncology and Education, confirmed the assessment and diagnosed early-stage cancer. In September 2012, Dr. Campbell, of the Glickman Urological & Kidney Institute, performed surgery to remove part of her kidney.

“I am no longer just a cancer patient,” Mrs. Douglass says. “Now I know that I have a rare disease, and every medical concern must be viewed with that disease in mind.”

She also learned that although her own disease was not passed down to her because she is the first in her family to have it, her son and two daughters each have a 50 percent chance of having it. Now she, and they, can act on that information. — Elaine DeRosa Lea

• M Y S T O R Y

The Value of Genetic Knowledge

SURPRISING NEW FINDINGS about a recently discovered protein variant could lead to an entirely new area of Alzheimer’s disease research.

In 2012, scientists discovered a variant of a protein called the triggering receptor, which indicated up to a threefold increased genetic risk for Alzheimer’s. Known as TREM2, it also has been linked to other neurodegenerative diseases, including Parkinson’s. Surprisingly, TREM2 is only expressed in cells of the immune system, suggesting the immune system plays an underappreciated role in Alzheimer’s and related disorders.

“For a very long time, we’ve known that the immune system is engaged in Alzheimer’s pathology, but it has been the chicken-or-the-egg question: Is the immune system causing the problem or responding to it?” says Bruce Lamb, PhD, of Cleveland Clinic’s Lerner Research Institute. “How ever, identification of TREM2 as an Alzheimer’s risk gene suggests that the immune system somehow directly contributes to neurodegenerative disease processes.”

Researchers think amyloid plaque and brain inflammation ultimately lead to neurodegeneration and dementia. That’s where most research has been focused. However, Dr. Lamb’s team has discovered the mechanism linking TREM2 to Alzheimer’s likely is via immune cells outside the brain. That means therapies targeting TREM2 would not have to cross the blood-brain barrier. This could be an important therapeutic step because the blood-brain barrier prevents not only infections but also medications from entering the brain.

“Our studies suggest that inflammatory processes linked to Alzheimer’s may be coming not only from immune cells within the brain, but peripheral immune cells. If that’s true, it suggests a whole new therapeutic approach, as well as potential novel biomarkers,” Dr. Lamb says. — Melanie Padgett Powers

• N E U R O L O G Y

TARGET: ALZHEIMER’SKelley Douglass

5powerofeveryone.org | catalyst | fall 2014Photo courtesy of the Maltz family; mobile stroke unit Yu Kwan Lee/Cleveland Clinic

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Until three years ago, when she had a minor stroke, Tamar Maltz had never considered that she could be at risk. No one in her family ever had one. But her experience led to a lifesaving gift.

Mrs. Maltz was treated at Hillcrest Hospital and made a full recovery. Afterward, her physician, Peter Rasmussen, MD, Director of Cleveland Clinic’s Cerebrovascular Center, told her and her husband, Milton Maltz, about a new concept: a “moving emergency ward” for treating stroke. Faster delivery of treatment means a better chance of recovery, he explained, and the concept had been successfully tested in Europe.

“He said that accelerating treatment by even 10 or 15 minutes can make a tremendous difference,” Mr. Maltz says.

The couple understood the potential, and through the Maltz Family Foundation of the Jewish Federation of Cleveland, they made a $2 million gift to Cleveland Clinic. It was to be split between support for the mobile stroke unit and medical education at the Glickman Urological & Kidney Institute, where Mr. Maltz served on the leadership board.

Their gift launched one of the nation’s first mobile stroke units. In less than a month after its rollout in July, the unit already had treated 17 stroke patients. Dr. Rasmussen says he anticipates that it will treat at least another 40 patients this year in Cuyahoga County alone.

He says that the mobile stroke unit has every diagnostic modality and all the medications needed for different types of stroke. “It has a complete telemedicine unit, all the laboratory testing machines to evaluate the patient and a portable CT

Maltz Family Foundation

GIFT MAKES STROKE TREATMENT MOBILE

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scan machine,” he says. The specialized caregivers who staff the

unit can immediately diagnose the type of stroke a patient is having, then transport the patient to the most appropriate treatment facility. The process ensures the best possible care and reduces cost.

“There is no better or faster way to treat stroke,” Dr. Rasmussen says. “Mr. Maltz is truly visionary. This really is a catalyst gift — it has the potential to impact stroke treatment in other cities around the world.”

The Maltzes have made other gifts that have resulted in tangible outcomes. “For example, we developed a biopsy-based test for prostate cancer,” says Eric Klein, MD, Chairman of the Glickman Urological & Kidney Institute and holder of the Andrew C. Novick, MD, Distinguished Chair in Urology. “Their funding helped to support this research.”

The couple has a longtime relationship with Dr. Klein. “We’re proud to support his work,” Mr. Maltz says.

Their new gift to the institute will help develop a $10 million endowment to offset costs for education, equipment, salary support and attendance at medical conferences.

“We need philanthropy to help extend what we do because operating dollars can’t be used for education,” Dr. Klein says. “The Maltzes believe in our mission.” — Jill Stefancin

“ The Maltzes

believe in our

mission.”

— Eric Klein, MD

6 catalyst | fall 2014 | powerofeveryone.org

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Courtesy of Cleveland Clinic

SIGHT-SAVING SURGERY,VISIONARY GIFT

Eric and Sheila Samson of Johannesburg, South Africa, are helping to transform medical education at Cleveland Clinic.

Their $10 million gift in 2010 launched the Samson Global Leadership Academy at Cleveland Clinic, providing a two-week, reality-based intensive learning experience for clinicians and healthcare executives from around the globe.

The couple says that they are proud of the progress made by the Global Leadership Academy, which has had 80 participants from 23 countries since its inception. “It is growing, and communities outside of the U.S. are benefiting from the teachings,” Mr. Samson says.

Now, the couple is making a $20 million gift toward a new health education campus for students of Cleveland Clinic’s Lerner College of Medicine and the Case Western Reserve University School of Medicine.

“The new health education campus will bring in a new era of teaching,” Mr. Samson says. “We have to look

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EDUCATION — A GIFT TO THE WORLD

to the future, new technology and an updated way of imparting knowledge. The collaboration between Cleveland Clinic and Case Western Reserve University will certainly make this campus the best teaching facility available to students.”

Mr. Samson, a steel company executive, had successful heart surgery performed by Toby Cosgrove, MD, now CEO and President of Cleveland Clinic. Mrs. Samson also is a patient.

“We have both experienced firsthand the excellent care and attention given to patients, and we feel honored to be part of the future growth of Cleveland Clinic,” Mr. Samson says.

Funded entirely by philanthropic support, the innovative health education campus will be located at Cleveland Clinic. Curriculum will focus on leadership skills, practice management, quality outcomes and value-based medicine. Classrooms will feature several interactive screens that simultaneously can show lectures by faculty members in remote locations, simulated or real patients, and a virtual medical library.

“We are deeply grateful to Mr. and Mrs. Samson for their vision and generosity in supporting the planned health education campus,” says James B. Young, MD, Executive Dean of the Lerner College of Medicine and holder of the George M. and Linda H. Kaufman Endowed Chair.

“With their significant gift, they are helping to address an urgent need, both here and abroad, for highly trained physician investigators,” Dr. Young says. “This is an ambitious goal that could not be met without philanthropy.”

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Jim Pender is grateful every day for what he can see: the face of a loved one, a sunset, his grandchildren in action.

“I never experienced the inability to see,” he says. “I did, however, get a life-changing hint of the consequences of losing one’s vision.”

So did his wife.“It would be dusk, and we would be

going somewhere with Jim driving,” Kathy Pender says. “I would relax for a short while, but soon discovered that Jim could not see the signs, or that the lights were creating such a glare that he seemed blinded. I asked him how long this had been going on. It seems it had for some time, but I just did not know.”

She advised her husband to have his eyes checked. At Cleveland Clinic’s Cole Eye Institute, he was diagnosed with Fuchs endothelial corneal dystrophy, a condition in which the innermost cell layer of the cornea fails and the cornea becomes swollen and cloudy, causing light scattering, glare, and loss of visual contrast and color definition. He had a cornea transplant in his right eye.

Two years later, he developed similar problems in his left eye and had another transplant. “By replacing the dysfunctional cell layer, the transplants reversed the visual effects of the disease,” says his surgeon, William Dupps, MD, PhD.

Mr. Pender says he is “humbled” by the fact that he now has normal vision. “This is due to generous organ donors and the

ALL STORIES BY ELAINE DEROSA LE A

7powerofeveryone.org | catalyst | fall 2014Courtesy of Cleveland Clinic; top right: Courtesy of Teresa Martinez

SIGHT-SAVING SURGERY,VISIONARY GIFT

Jim and Kathy Pender

skills of the staff at the Cole Eye Institute.”Dr. Dupps underscores the importance

of organ donation. “Taking the step of becoming an organ donor is a selfless act of generosity that has the potential to dramatically improve the life of another person in need,” he says. “It is an incredible living legacy to pass on to another human being.”

To thank Dr. Dupps and Cleveland Clinic, the Penders have established an ophthalmology research fund in their name. It supports the work of Dr. Dupps and his team in the Ocular Biomechanics and Imaging Laboratory at the Cole Eye Institute. They are developing customized surgical planning tools to predict and improve the outcome for each patient.

“Through the Penders’ generosity, we will be able to accelerate these efforts and bring this approach to clinical trials,” Dr. Dupps says.

Mr. Pender is grateful not only for his restored vision, but also his improved quality of life.

“I have always valued my health and certainly have never taken my eyesight for granted,” he says. “However, it is a far different matter to actually experience a partial loss of vision and get hints of the potential inability to perform routine tasks. I was there, but thanks to the Cole Eye Institute, I am not dealing with such limitations now.”

THE RACE OF A LIFETIMETeresa Martinez will never forget the 2009 half-marathon in Indiana, not because it was the country’s largest, but because she nearly died crossing the finish line.

She was struck by sudden, piercing head pain. “I couldn’t see or move,” she says. “Then, everything went black.” Awakening hours later in a hospital, she learned that she’d had a heart attack.

Thirty-five and athletic, Ms. Martinez was shocked to find that hypertrophic cardiomyopathy (HCM), a rare hereditary heart condition, and the same one that took her mother’s life eight years before, was the cause. She checked herself out the next day and went to see renowned HCM expert Harry Lever, MD, at Cleveland Clinic.

“If I was going to beat the odds of HCM taking my life, there was no other option for me,” she says.

Heart surgery came next. “Everyone told me it would save my life, but I knew that it also would change it,” she says. “I was told that I would never run again. It took me a year after that to move beyond losing my old life and creating a new one.”

Ms. Martinez began taking part in half-marathons noncompetitively, using a combination of running and walking. And she took on a new challenge, founding an organization to help half-marathoners build a new, healthy lifestyle. “If I could prevent someone else from experiencing what I had gone through, then I had to do that,” she says.

Through a Personal Fundraising page on Cleveland Clinic’s website, Ms. Martinez raised $12,000 to support HCM research and train others for the May 2014 Indy Mini, in which she also participated.

“The race was fantastic and a great way to get closure to what happened in 2009,” she says. “And this was my 33rd half-marathon — 28th after being told I would never run again. My time was two hours, 32 minutes, but I’ve proven that Race Day isn’t about time. It’s about honoring the best version of yourself so that you can see the finish line — your finish line.”

To learn more about Ms. Martinez, go to: http://giving.ccf.org/goto/teresamartinez

“ The transplant

reversed the

visual effects

of the disease.”

– William Dupps, MD, PhD

8 catalyst | fall 2014 | powerofeveryone.org

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Photograph by Tom Merce/Cleveland Clinic

CRILE AWARD HONOREES SUPPORT MEDICAL PROFESSIONALISM

Shortly before he passed away on May 15, 2014, Bertram Lefkowich and his wife, Alice, made a gift that launched the Professionalism in Medicine Program at Cleveland Clinic’s Lerner College of Medicine.

This was the most recent of the couple’s contributions. Longtime Cleveland Clinic supporters, married 64 years, they had made multiple types of gifts to a variety of areas for more than two decades. For their commitment, including Mrs. Lefkowich’s service on the Leadership Board of the Arts & Medicine Institute, they were honored with the 2014 George W. Crile Sr. Award.

The award, presented to Mrs. Lefkowich at the annual Partners in Philanthropy event on June 24, is named for Dr. Crile, one of the four founding physicians of Cleveland Clinic. It was established in 2003 to recognize a Pyramid Legacy Society member for longstanding service, extraordinary commitment and contributions of time, talent and resources to the mission and people of Cleveland Clinic. Pyramid Legacy Society members have made planned gifts supporting Cleveland Clinic.

Mr. and Mrs. Lefkowich chose to help the Professionalism in Medicine program because of their passionate belief that future physicians should be trained in the humanities and medical ethics. The gift furthers the work of their family physician, J. Harry Isaacson, MD, the Associate Dean for Clinical Education, who will lead the program.

Mrs. Lefkowich says that she and her husband, both from Cleveland, shared a “great appreciation” of Cleveland Clinic. They fully immersed themselves in helping to create the program in the hope that it would produce compassionate physicians like Dr. Isaacson, who, she says, “goes above and beyond” in caring for his patients.

The inaugural Alice & Bert Lefkowich Celebration in Humanism in Medicine took place Oct. 1. It featured Jon Hallberg, MD, creator and host of the Hippocrates Cafe at the University of Minnesota Medical School.

“As medicine evolves in the 21st century, nothing is more important than a renewed emphasis on professionalism to create an environment that sustains physicians and allows patients to receive the best care possible,” Dr. Isaacson says. “Our Professionalism in Medicine Program has a vision to integrate the art and science of medicine to train and sustain physicians in providing compassionate care. Alice and Bert Lefkowich’s generous support of our program will help us achieve our vision.”

Mrs. Lefkowich says that she and her husband learned of their selection for the Crile Award before his passing and were honored to be chosen. For her part, she says, the feeling is mutual. “I’d like to thank Cleveland Clinic for being so wonderful to us over the years.” — Elaine DeRosa Lea

“ I’d like to thank Cleveland Clinic for being so wonderful to us over the years.”

— Alice Lefkowich

J. Harry Isaacson, MD, and Alice Lefkowich

Courtesy of Cleveland Clinic

2 The Power of Every One | powerofeveryone.org

Giving back to the community is so important. This isn’t only an institution, it’s giving back to patients in Northeast Ohio and all over the world through care, innovation, research, education and, most important, by putting the patient first.

— Larry Pollock, Campaign Co-Chair, Board of Directors

We are excited to present to you our $2 billion philanthropic campaign, The Power

of Every One. The campaign, named to recognize the power of each and every

gift, will continue until Cleveland Clinic’s 100th anniversary in 2021.

The Power of Every One is the most ambitious philanthropic campaign in

Cleveland Clinic history and one of the largest ever among nonprofit academic

medical centers. A challenging goal, yes — but one that will help bridge the gap

between what we can afford to do and what we desire to do as we continue to

invent the future of healthcare. We already have raised more than $600 million.

With your help, we will meet our goal.

We publicly kicked off our campaign on June 9 with an event attended

by more than 500 supporters and featuring inspiring presentations by

Toby Cosgrove, MD, Cleveland Clinic’s CEO and President, and members

of Cleveland Clinic’s medical staff. It was the celebration of work begun by

Cleveland Clinic’s founders — Frank E. Bunts, MD; George Crile Sr., MD;

William E. Lower, MD; and John Phillips, MD — and of nearly a century of

innovative, lifesaving patient care, medical education and research.

We’d like to thank Campaign Distinguished Chair Norma Lerner and Emeritus

Chair Bob Rich for their wisdom, energy and passion, which contributed to the

success of the last campaign and will help propel this one into our centennial

year, as well as the Campaign Cabinet members, whose commitment to Cleveland

Clinic is unequalled. Their names are highlighted on Cleveland Clinic’s website at

powerofeveryone.org on the “About the Campaign” page.

And we’d like to thank you for all that you do on behalf of Cleveland Clinic

and the patients of today and tomorrow, here and around the world. You will be

hearing from us again in the months and years to come.

PHILANTHROPY POWERS INNOVATION

I’m convinced that this is the moment for Cleveland Clinic. This is the moment when we build on our fantastic 100-year heritage and take a quantum leap. We have the right people, the right processes, reputation and brand. It’s all here.

— Stewart Kohl, Campaign Co-Chair, Board of Trustees

Larry Pollock Stewart Kohl

Courtesy of Cleveland Clinic

3powerofeveryone.org | Cleveland Clinic

C

PHILANTHROPY POWERS INNOVATION AN UNPRECEDENTED CAMPAIGN

TO CONTINUE LEADING

THE TRANSFORMATION

OF HEALTHCARE, WE

HAVE IDENTIFIED FOUR

STRATEGIC AREAS:

leveland Clinic’s caregivers and researchers

have had a profound effect on healthcare and

on millions of lives. Because we know we have

much more to do, we have embarked on The

Power of Every One Centennial Campaign.

With a goal of $2 billion, it is the most

ambitious philanthropic effort in our history,

one that will help Cleveland Clinic remain at the

forefront of healthcare.

Our founders — four physicians inspired

by the teamwork and efficiency of military

medicine — bucked tradition to adhere to a

then-radical principle: Patients First. Their

unwavering focus on patients, coupled with

a culture of innovation, changed the way

healthcare was delivered. They created what has

become an extraordinary and internationally

respected academic medical center.

Today, we continue to build on that legacy of

healing, promoting innovation and teaching

empathy.

Cleveland Clinic is leading the shift in

America from “sick care” to “well care.” We

have the unique opportunity to be an example

of effective, efficient healthcare for the nation

and the world. But we can’t do this alone.

With federal and corporate funding on a steep

decline — coupled with increasing regulation

and rising healthcare delivery costs —

philanthropy is more crucial than ever.

Vinod Labhasetwar, PhD, Biomedical Engineering, Lerner Research Institute

Cleveland Clinic has been providing, reimagining and reshaping healthcare for almost 100 years. Now, our centennial campaign will set our course for the next century.

Photography by Russell Lee

4 The Power of Every One | powerofeveryone.org

Cleveland Clinic stands alone in patient care, always putting the patient first. Here, humanity is side by side with science. This is a place to come to get well.

— Robert E. Rich Jr., Board Chair, Campaign Emeritus Chair

Cleveland Clinic is universally acknowledged to be

among the top hospitals in the world. We treat more

complex cases than any other U.S. hospital and more

patients who are denied treatment elsewhere because

of frailty or age.

Providing superb medical care is just the beginning.

We want the entire patient experience to rise to the

level of our clinical care. Cleveland Clinic was the first

major academic medical center to make the patient

experience a strategic goal, the first to appoint a Chief

Experience Officer, and one of the first to establish an

Office of Patient Experience.

Our emphasis on patient experience pays off in

faster healing and better adherence to follow-up

recommendations. And when our patients are

discharged, they’re less likely to need to come back.

Cleveland Clinic further enhances patient care in the

clinical setting through the Arts & Medicine Institute.

We’ve seen firsthand — and our recent research proves

— the positive effects of displaying art in the hospital,

rehabilitating stroke patients with the help of music

therapy, providing art therapy for cancer patients,

and arranging musical performances for patients and

visitors.

Achieving this campaign goal will help us continue

to be a magnet for outstanding physicians, scientists

and nurses with a passion for quality, innovation

and patient care. It will ensure that we continue to

advance clinical care on behalf of patients everywhere,

putting their health and well-being above every

other consideration. One specific initiative, the

construction of a new outpatient cancer building, will

house all of our comprehensive, multidisciplinary

oncology programs and will be dedicated to providing

exceptional patient-centered care and innovative

treatment.

PROMOTING HEALTH

Priority goal: $800 million

Courtesy of Cleveland Clinic

5powerofeveryone.org | Cleveland Clinic

AADVANCING DISCOVERY

t Cleveland Clinic, the science drives the care. Research

supports healthcare delivery systems and the care a

patient receives now and in the future. Philanthropy

today will advance the most promising research,

technology and business ideas that otherwise would

not have a chance to benefit humanity.

Stanley Hazen, MD, PhD, a cardiologist, biochemist

and cell biologist, doesn’t specialize in digestive

research but boldly followed where his research led

him: to exploring a connection between dietary fat,

intestinal bacteria and heart disease. His work is

furthered by The Jan Bleeksma Chair in Vascular Cell

Biology and Atherosclerosis and The Leonard Krieger

Chair in Preventive Cardiology.

Dr. Hazen and his colleagues at the Lerner Research

Institute exemplify Cleveland Clinic’s approach to

discovery: Cross-disciplinary and driven by creativity

and curiosity. Entrepreneurial and unafraid to pursue

commercialization. Focused on the greatest healthcare

needs. And, perhaps most important, willing to follow

the science.

Cleveland Clinic’s Lerner Research Institute is

home to 200 of the world’s most respected physicians

and scientists. Discoveries and firsts include the

development of coronary angiography, the first coronary

artery bypass, isolation and naming of serotonin,

regeneration of brain cells, the first successful laryngeal

transplant, the first resection of intestine from a single

incision, and the first nearly full face transplant.

RESEARCH NOW UNDERWAY HAS THE POTENTIAL TO:

• Cure type 1 diabetes using stem cell-derived insulin-producing cells

• Invent tools for personalizing healthcare based on an individual’s unique genetic signature

• Discover causes of and treatment for Alzheimer’s disease and other brain disorders

Every day, Cleveland Clinic is meeting new opportunities

and breaking new ground in patient care delivery

models, technology and personalized therapies.

Electronic medical records give doctors and patients

ready access to all of their medical data. Robots deliver

supplies throughout the hospital and assist with

surgery. IBM’s Watson, of Jeopardy! fame, is now in our

medical school, working with physicians to provide

fast, efficient access to relevant knowledge buried in

huge volumes of unstructured data.

Cleveland Clinic’s Center for Personalized

Healthcare is showing the value of customized patient

data in diagnosing more accurately and treating more

effectively — for example, being able to anticipate

and prevent serious health events in families whose

members are at risk of developing a hereditary disease.

IN THE NEAR FUTURE, WE WILL SEE INNOVATIONS IN:

• Technology to improve healthcare delivery and lower costs. We envision devices that can wirelessly transmit a person’s blood glucose levels to a healthcare provider, eliminating finger sticks and making it easier for patients to manage their illnesses and avoid ER visits and hospitalizations.

• Micro-electrical Mechanical Systems (MEMS). Cell-sized machines soon may rove through the vascular system, trawling for cholesterol or hunting down cancer cells. Our BioMEMS lab is working on tiny biochips that will perform pressure sensing, imaging, drug delivery and tissue sampling from the tip of a catheter.

• Breath analysis. Diseases of the lung, liver, kidney and heart all leave traces in the breath. Devices now are being tested at Cleveland Clinic to detect lung cancer, asthma and other conditions through a patient’s breath.

TRANSFORMING CARE

Priority goal: $100 millionPriority goal: $700 million

Courtesy of Cleveland Clinic

6 The Power of Every One | powerofeveryone.org

Al loved Cleveland Clinic. He always said that he couldn’t be a doctor. But what he could do with this program was really give back to humanity.

— Norma Lerner, Cleveland Clinic Board of Directors member and Campaign Distinguished Chair

Our campus is home to the Cleveland Clinic Lerner

College of Medicine, established in 2002 by Alfred and

Norma Lerner. The curriculum prepares clinicians for a

career in research and patient care. Students also take

arts and humanities courses to develop values such as

mindful reflection on what it means to be a doctor and

awareness of the rich context of caregiving.

Our five-year program — one year longer than most

medical schools — makes an enormous difference

in the education of doctors who graduate, allowing

them to move into residency training programs at the

country’s most prestigious academic medical centers,

including Cleveland Clinic. Generous donations

could help offset the cost of providing a full-tuition

TRAINING CAREGIVERS

Priority goal: $400 million

scholarship to each student. Each year, the Lerner

College of Medicine receives nearly 1,700 applications

for 32 available positions.

We also are partnering with Ohio University to open

an extension of its osteopathic medical school, which

will help address the serious shortage of primary

care physicians in Ohio and the nation. And, with

philanthropic support, we will build a new health

education campus in partnership with Case Western

Reserve University. The new facility, located in the

heart of our 167-acre main campus, will be a hub for

international medical education and faculty training.

Cleveland Clinic also offers extraordinary medical

education for interns, residents and fellows. Ours is the

fourth-largest graduate medical education program in

the United States, training more than 800 residents,

fellows and advanced fellows annually. Worldwide,

nearly 9,000 Cleveland Clinic alumni are practicing

medicine. And more than 96,000 medical professionals

participate annually in Cleveland Clinic’s continuing

medical education programs, with 10 percent attending

from outside the United States.

The new health education campus will be shared in partnership by the Lerner College of Medicine and Case Western Reserve University School of Medicine (rendering courtesy of Foster + Partners).

Courtesy of Cleveland Clinic

7powerofeveryone.org | Cleveland Clinic

We see the course ahead. With the help of our friends and supporters, Cleveland Clinic will lead the way to a new era in healthcare for America and the world.

— Toby Cosgrove, MD, CEO and President

T CAMPAIGN CO-CHAIRS OFFER EXPERIENCE, COMMITMENT

Larry Pollock and Stewart Kohl bring

many years of leadership experience to their new roles as

Co-Chairs of The Power of Every One Centennial Campaign.

Mr. Pollock is Managing Partner of Lucky Stars Partners LLC, a

private investment firm, and serves on the Board of Directors of

Cardinal Commerce Corp. and Safeguard Properties LLC. From

2000 to 2004, he was President, Chief Executive Officer and a

Director of the Cole National Corp.

Mr. Kohl is Co-Chief Executive Officer of The Riverside

Company, a private equity firm. Prior to that, he was a Vice

President of Citicorp Venture Capital Ltd., the private equity arm

of Citibank.

Both are committed supporters of Cleveland Clinic.

Mr. Pollock and his wife, Julia, have made significant gifts

to Cleveland Clinic. Mr. Pollock has served on Cleveland

Clinic’s Board of Directors since 2008. He also is Chair of the

Philanthropy Committee and serves on the Governance and

Government and Community Relations Committees.

Mr. Pollock holds additional trustee positions with The

Cleveland Foundation; Musical Arts Association, which

operates the Cleveland Orchestra; ideastream (WVIZ / PBS and

90.3 WCPN); Kent State University; University School; Bellefaire

JCB; Maltz Museum of Jewish Heritage; and The Mt. Sinai Health

Care Foundation.

In 2013, Mr. Kohl and his wife, Donna, provided a major gift

that launched a communitywide cycling initiative, VeloSano

(“swift cure”), to support cancer research at Cleveland Clinic.

The first VeloSano event in July 2014 attracted 800 riders from

21 states, Canada and Abu Dhabi, as well as 700 volunteers, and

it raised almost $2 million from more than 10,000 supporters in

all 50 states and 23 countries, over 90 percent of whom had not

given to Cleveland Clinic previously.

Mr. Kohl serves as the Event Chair of VeloSano and is a member

of Cleveland Clinic’s Board of Trustees and the Wellness Institute

Leadership Board. He also serves on the boards of Oberlin College

and the Museum of Contemporary Art Cleveland, where he is

Co-Chair. He previously served as Co-Chair of the Building for

Hope Capital Campaign of the Center for Families and Children.

he Power of Every One is the power of shared vision, generosity and effort. Philanthropic support helps Cleveland Clinic save lives and shape the future of medicine. Future gifts will help us invest in capital, research, education and patient care to answer the pressing needs of society. They will help us continue to be a leader in healthcare delivery to benefit patients today and tomorrow.

THE IMPORTANCE OF PHILANTHROPY

For more information about The Power of Every One Centennial Campaign, please visit powerofeveryone.org.

For gift planning options, please visit giving.clevelandclinic.org/giving/gift-planning.

Courtesy of Cleveland Clinic

The Power of Every One | powerofeveryone.org

Cleveland Clinic CEO and

President Toby Cosgrove, MD,

announced the launch of The

Power of Every One Centennial

Campaign, explaining the critical

need for philanthropic support

and the strategic priorities.

Also presenting were

Campaign Co-Chairs Larry

Pollock and Stewart Kohl; James

Young, MD, Executive Dean,

Cleveland Clinic Lerner College

of Medicine, and Thomas

Graham, MD, Chief of Cleveland

Clinic Innovations, who, with

his wife, CeCe, told the story of

the lifesaving care he received at

Cleveland Clinic. The program,

which included a stirring video

about the campaign, concluded

with a life-size holographic

projection of campaign leaders

and Cleveland Clinic staff

members, illustrating the

importance of each individual to

the success of the campaign.

A reception followed in the

Great Hall.

To watch the campaign video, visit: giving.clevelandclinic.org/campaign/about-campaign.

KICKING OFF THE CAMPAIGNCleveland Clinic launched its historic $2 billion campaign on June 9 at the InterContinental Hotel.

Courtesy of Cleveland Clinic

9powerofeveryone.org | catalyst | fall 2014

CONNECTED CARE: : : : : : : : :

By Elizabet h Lear

EMPATH I Z ING RESPOND ING COMMUN ICAT ING UNDERSTAND ING

THROUGH INGENUITY AND A PATIENT-CENTERED APPROACH, CLEVELAND CLINIC IS HELPING PEOPLE CONNECTWITH THE BEST POSSIBLE MEDICAL CARE, NO MATTER WHERE THEY LIVE, THROUGH NEW WAYS OF COMMUNICATING.

10 catalyst | fall 2014 | powerofeveryone.org page 9: Sorendls/Getty Images; page 11: Photography by Julia Lynn

IT TOOK A FAMILY CAR ACCIDENT to reveal William Einziger’s kidney cancer.

After the accident, Mr. Einziger, his wife and daughter

were cleared of traumatic injury at the local hospital in

Florence, S.C., but a CT scan happened to reveal a growth on

one of Mr. Einziger’s kidneys. Although he experienced no

symptoms, his physicians determined that the tumor almost

certainly was cancerous. They advised that he have the kidney

removed.

“I felt confused and overwhelmed by my surgeon’s

recommendations,” Mr. Einziger says. “Only days before

that, I had no idea I had cancer. Now, I was faced with the

choice of losing a whole kidney.”

He wanted the peace of mind of a second opinion, but he

didn’t know where to turn — until he took geography out

of the equation. It so happened that his employer, General

Electric, offered a long-distance second opinion option

through Cleveland Clinic’s MyConsultTM online program.

Mr. Einziger completed the online questionnaires,

submitted his physician’s reports and imaging, and was

able to obtain a thorough case review in just a few days

from urological surgeon Robert Stein, MD, in Cleveland —

all without leaving South Carolina. Dr. Stein called him

personally to share his recommendation: He was a candidate

for partial kidney removal. Mr. Einziger decided to travel to

Cleveland Clinic to receive the specialized surgery, which

wasn’t available in his region, and has remained cancer free

and happy with his choice for two years.

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11powerofeveryone.org | catalyst | fall 2014

12 catalyst | fall 2014 | powerofeveryone.org

AS MEDICAL EXPERTISE BECOMES AN INCREASINGLY VIRTUAL KNOWLEDGE BASE, PHYSICIANS ARE FINDING WAYS TO BYPASS TRADITIONAL BOUNDARIES OF THE PHYSICAL WORLD — NAMELY, THE CONFINES OF SPACE AND TIME. MYCONSULT IS JUST ONE EXAMPLE AMONG MANY.

“I can’t tell that I don’t have all of my kidney. There are no effects,” he says.

Mr. Einziger is in good company. Cleveland Clinic’s MyConsult online second opinion program is provided as a health benefit by more than 35 corporations. More than 13 million employees of these companies have access to the service, and other patients also can enroll directly. Most MyConsult patients come from distances of 180 miles or more, and more than a quarter are international. The secure, online program provides second opinions from specialists for more than 1,200 life-threatening and life-changing diagnoses.

Cleveland Clinic has a global patient base, but traveling to Northeast Ohio for a second opinion is not always feasible — or even necessary. Approximately 1,200 diagnoses can be evaluated through the MyConsult online service. Some conditions do require an in-person exam, but in many cases, the patient’s medical records and imaging files provide the detail needed for a thorough evaluation, says Jonathan Schaffer, MD, Managing Director, MyConsult.

Participants gather and supply the needed medical records, including imaging files and the original diagnoses and treatment plans. In return,

they receive a detailed written report and, in many cases, a phone call from the reviewing physician. Patients also have phone access to a dedicated team of nurses who can address their questions at any point in the process, providing a high-tech and high-touch environment. In three-quarters of cases, Cleveland Clinic physicians agree with the original diagnosis. Half the time, they recommend minor or moderate changes to the treatment plan. In 16 percent of cases, they offer what would be considered major changes to the treatment plan.

“We’re removing the geographic, time and communication barriers to care,” Dr. Schaffer says. Getting a second opinion can provide peace of mind and more thorough understanding of the original diagnosis and treatment plan, he adds. It also offers perspective when there are multiple treatment options.

ACCESS AND EFFICIENCY As medical experts increasingly rely on a virtual knowledge base, they are finding ways to bypass traditional boundaries of the physical world — namely, the confines of space and time. MyConsult is just one example among many.

In 2010, Cleveland Clinic was the first hospital system nationwide to launch same-day appointments. The goal: to eliminate the wait for care across all specialties and ease patients’ concerns about everything from skin rashes to heart disease.

Accomplishing this required some major logistical overhauls: Centralized schedulers offer every caller a same-day appointment. More than 96 percent of callers take up the offer, resulting in more than 1 million same-day visits across the region each year.

Same-day appointments are part of a renewed focus on the idea that physicians are here, first and foremost, to take care of patients, says James Merlino, MD, Chief Experience Officer. Hospital leaders wanted to address a misconception that it was very difficult to get into Cleveland Clinic, that a person “had to know somebody, have a referral or be wealthy.” The broadly marketed same-day appointment program dispelled this myth, spurring a 20 percent increase in new-patient visits in the first year.

Issues with wait time extended beyond everyday appointments too. They also were a constraint in

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THE TELEFUTURETeleporting patients to a hospital remains in the realm of science fiction, but the virtual office visit is fast approaching the mainstream. Camera-ready medical kiosks and real-time technology soon will allow people to connect with caregivers via virtual interface James Merlino, MD, anticipates. Beyond telemedicine, most electronic health records now include the option of communicating with caregivers and scheduling appointments by text message or email. Ultimately, he sees a progression toward active patient engagement — using communications tools that people already use every day.

As for telemedicine and virtual kiosks, Adrienne Boissy, MD, MA, already is examining how such interfaces will affect patient-physician communication. “I’m very interested in making sure our ability to communicate over a virtual interface provides the same relational value that we’re able to provide in physical presence,” she says.

obtaining high-quality care in the surgery consult-to-procedure cycle. Surgeon Allan Siperstein, MD, saw this in his own endocrine surgery practice. To try to fix it, he and colleagues borrowed process-improvement principles from just-in-time auto manufacturing to help curb cancellations and step up productivity.

With guidance from Cleveland Clinic’s process-improvement engineers — experts whose backgrounds are in manufacturing rather than healthcare — the team collectively discussed every individual’s role, from front-desk managers and medical secretaries to nurses and physicians.

“It allows you to sit down and really reflect and think about what you are doing, get best practices from other people and put together a uniform practice,” Dr. Siperstein says. “That’s how you create a better product or experience for patients.”

As a result, physicians agreed on standardized protocols for gathering and reviewing appropriate medical records before a patient’s first visit. This made it easier for any team member to perform the initial patient evaluation within 10 days, which streamlined the process and reduced the patient’s wait time.

The team also reduced the time from consult to procedure date by tentatively scheduling surgery — even before the initial consult — when it appears likely an individual will need it. Pre-admission testing can take place during the initial appointment, saving patients another trip to the medical campus and freeing physicians to see more new patients.

The team tracks progress with weekly reports. Cancellations dropped from 28 to 17 percent, and the team was able to increase total consults from 31 to 52 per month. The department’s consult-to-surgery time span decreased from 39 days to as few as 15 days for low-risk patients.

Although the details are specific to endocrine surgery, Dr. Siperstein notes that this process could apply to almost any medical or surgical department. In fact, his team has performed similar projects to improve the time and cost efficiency of the operating room.

The department’s six surgeons discussed and agreed upon consistent best practices for the preoperative preparation, the instruments used, setup, conduct within the operating room and

postoperative care. Recently, they expanded to a multidisciplinary approach, with standardized anesthesia and nursing practices and assigned teams, reducing already-efficient operating times by 10 to 15 percent.

MEANINGFUL CONVERSATIONSIt may be less clear-cut than time and geography, but ineffective communication presents a major barrier to excellent care. That’s why many of Dr. Siperstein’s productivity improvements rely on open, empathetic communication.

Recognizing the importance of effective communication and its impact on the patient, the provider, compliance, safety, trust and outcomes,

For information on

MyConsult, visit:

eclevelandclinic.org/

myConsultHome

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14 catalyst | fall 2014 | powerofeveryone.org MixAll Studio/Glow Images

Cleveland Clinic launched an enterprisewide education program to harness the value of relationship-centered communication. Adrienne Boissy, MD, MA, Medical Director, Cleveland Clinic Center of Excellence in Healthcare Communication (CEHC), and her team designed an experiential program to engage practicing clinicians in communication skills work.

“The idea of training talented, seasoned clinicians in communication skills was a bit daunting,” Dr. Boissy says. “And yet, we realized we all had moments we wish had gone differently or where we got stuck for one reason or another. We all have blind spots with respect to how we communicate and are perceived. If that’s true for our team, it has to be true for other clinicians.”

Consider this: The last time most physicians received formal feedback on their communication skills was in medical school, if even then.

To address the need, the CEHC team developed a one-day, peer-facilitated course and trained 3,000 physicians and house staff in just six months. Four hundred advanced care providers also have completed the course. Sixty peer facilitators have been trained to lead the courses, and they facilitate groups of 10 to 12 participants. The peer-to-peer format creates a space for open dialogue, shared experiences, communications skills practice and feedback.

“This learning has to be experiential, engaging and relevant,” Dr. Boissy says. To that end, the course simply meets learners where they are. Cases are adjusted to their practice in the moment, built around their challenges, and focus on an individual’s goals. Recognizing that relationships built with effective communication can be therapeutic for both parties, the team developed a framework for a skill set called the REDE model: Relationship, Establishment, Development and Engagement.

“We’re not asking people to be friends with their patients,” Dr. Boissy notes. “We’re asking them to reflect on the words they use for a given purpose and to employ evidence-based skills that will make them more effective, empathetic and efficient in providing great care.”

Often it’s as simple as overcoming assumptions. Many physicians believe that their patients already know they care and forget to state it.

Alternatively, instead of telling patients to quit smoking, the clinician might start with

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“WE’RE NOT ASKING PEOPLE TO BE FRIENDS WITH THEIR PATIENTS,” DR. BOISSY NOTES. “WE’RE ASKING THEM TO EMPLOY SKILLS THAT WILL MAKE THEM MORE EFFECTIVE IN PROVIDING GREAT CARE.”

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15powerofeveryone.org | catalyst | fall 2014Courtesy of Cleveland Clinic

NEW CANCER BUILDING DESIGNED WITH THE PATIENT IN MIND Cleveland Clinic’s Patients First culture prioritizes efficient, communicative care focusing on the entire scope of patients’ needs. A new cancer outpatient facility, planned to open in 2017, was designed to give patients an even better, team-based approach to their care.

The 377,000-square-foot building will house all of Cleveland Clinic’s comprehensive, multidisciplinary cancer programs. Patients will receive their care conveniently in one location, including all support services.

“The new Cleveland Clinic cancer building will allow us to centralize the cancer care we provide, creating a seamless, personalized experience for patients,” says Brian J. Bolwell, MD, Chair of Cleveland Clinic’s Taussig Cancer Institute and holder of the M. Frank Rudy and Margaret Domiter Rudy Institute Chair in Translational Cancer Research.

Patient-centered features of the new space will include: • A first floor dedicated to support services such as art and

music therapy, patient navigation, social work, a wig salon and cosmetology services, relaxation therapies and meditation;

• Ample natural light and outdoor views, with infusion rooms with windows so that patients can see outside during treatment;

• Treatment spaces and appointment rooms located in the same areas, clustered by cancer type.

understanding the reasons why they smoke, why they might consider quitting, what smoking means to them, and how ready they are to move toward quitting. These explorations generate a completely different conversation, grounded in the concept that each person has a valuable perspective. Another relationship-building gesture is to negotiate a “shared agenda” for patient visits, remembering that patients may have particular needs that differ from what the doctor envisions.

The course also lauds the power of silence. When a physician has bad news to deliver, the tendency is to fill the space with talking. However, even more powerful is sitting quietly with that person in the emotion of the moment, Dr. Boissy says.

“If you think about the difference between curing and healing, curing being ‘I’ve returned you to your normal state’ and healing being ‘I’m going to meet you wherever you are and be there with you,’ then these skills take on additional meaning for both parties,” she says.

In 2008, before the healthcare communication course began, Cleveland Clinic ranked below the 10th percentile in physician communication on patient surveys. It now hovers around the 70th percentile and outperforms peer organizations. Significant improvements have been noted in preliminary data on validated scales of empathy, burnout, self confidence in skills and patient perception.

Dr. Boissy’s team since has taken the concept further. They have developed advanced communications courses delving into topics such as how to talk to people about bad news, how to talk about the end of life, how to process strong emotions and how to help people change.

Now, the team is planning on creating interprofessional, leadership and nursing-specific REDE model communication programs. And in a nod to another barrier — geography — the courses and consultation sources are offered externally, as other hospitals have noticed the positive results at Cleveland Clinic.

One facilitator, Mary Beth Modic, described the course’s impact: “While it is essential to listen, it’s also important to find the words that illustrate that the caregiver is truly bearing witness to the suffering, trauma and chaos that may be occurring in the patient’s life.”

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16 catalyst | fall 2014 | powerofeveryone.org

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WHAT IS YOUR risk of having colorectal cancer? If you are approaching or have passed your 50th birthday, your doctor probably has advised you to have colorectal cancer screening to determine that.

And that’s the problem.

Since the late 20th century, this one-size-fits-all advice has been standard because there has been no other reliable way of predicting a specific individual’s risk of developing this deadly disease. That’s why our team at Cleveland Clinic’s Lerner Research Institute has invented a tool more fitting for 21st century medicine: an online calculator to help physicians decide when patients truly need colorectal screenings.

We call this the CRC-PRO, for Colorectal Cancer Predicted Risk Online. It allows physicians to determine an individual patient’s likelihood of developing colorectal cancer quickly and accurately.

Our team analyzed about a decade’s worth of data on more than 180,000 patients and identified strong links between certain risk factors and colorectal cancer. We produced separate calculators for men and women. In addition, we took into account differences among racial groups, for which the risks differ dramatically. This was important because, until now, research into

CALCULATING CANCER RISK

a Stage IV Hodgkin’s lymphoma diagnosis while I was beginning work on my doctorate — I have been driven to help find a better way of predicting cancer risk as well as outcomes, and using that information to develop a personalized prevention or management strategy. I learned firsthand how inaccurate existing cancer staging systems were at the time of my diagnosis.

Staging systems are based on physical exams, imaging procedures, lab tests, and pathology and surgical reports that help doctors determine the cancer’s severity. I soon recognized the need to have personalized predictions through calculators. And I changed my career path from financial prediction to healthcare outcomes.

Developing risk prediction calculators like the CRC-PRO is vital for improving

colorectal cancer risk mainly focused on Caucasians.

A calculator that accounts for multiple factors provides clinicians with a more accurate way of predicting risk than relying on a single risk factor, such as age. Clinicians using this calculator can decide to screen high-risk patients before age 50, for instance, while delaying or forgoing screening in low-risk individuals, regardless of their age. This approach is much safer for patients who might not need the procedure and can be lifesaving for younger patients who ordinarily would not have the screening until years later, when it might be too late. Also important: Accurate prediction helps improve the efficiency of screening while lowering healthcare costs by reducing unnecessary testing.

Our research results, which showed that the tool is accurate and user-friendly, were published in the Journal of the American Board of Family Medicine.

As someone who has had cancer — I received

By Michael Kattan, PhD

medical decision-making. Our research team is creating a number of such online tools for other diseases, including heart disease and cancers of the breast, prostate and thyroid. We also are working on software to integrate these tools for automatic calculation in a patient’s electronic health record, making it even easier for physicians to devise an effective treatment plan.

To advance our work, we need philanthropic support for website development, data collection, biostatistical analysis, and outcomes research. Support would help us answer questions and improve prediction, helping patients across the globe now

and in the future.

Michael Kattan, PhD, is Chair of the Department of Quantitative Health Sciences in Cleveland Clinic’s Lerner Research Institute.

Illustration by Glenn Pierce

c3powerofeveryone.org | catalyst | fall 2014

I nnovat ion

Imagine feeling the softness of a pet’s fur or the smoothness of a silk sheet as easily with an artificial hand as a

living one.

Paul Marasco, PhD, of the Department of Biomedical Engineering in Cleveland Clinic’s Lerner Research

Institute, has long considered just how much is lost when a limb is amputated. He is working to develop

prosthetic devices that provide a real sense of touch. “There are more than 770,000 traumatic upper-limb

amputees in the United States, most of whom are young and active and could benefit substantially from more

functional artificial arms,” he says.

Without sensory feedback from touch, amputees rely on vision. “This makes it difficult to engage in any

other tasks because they must closely watch the movement and placement of their prosthesis at all times.”

In addition, touch and cognition coincide, and disruptions to these systems seem to affect health when the

impression of connectedness with the limbs is lost, he says.

Philanthropic support would help advance understanding of how sensory channels organize and integrate,

Dr. Marasco says. “We want to help patients establish a cognitive sense of self.”

visit powerofeveryone.org to learn more

Photograph by Tom Merce/Cleveland Clinic

Getting in Touch

The Cleveland Clinic Foundation

The Philanthropy Institute/DV3

3050 Science Park Drive, AC/322, Beachwood OH 44122

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Cleveland Clinic Catalyst is published by the Philanthropy Institute for friends and benefactors of Cleveland Clinic.

Cleveland Clinic, founded in 1921, integrates clinical and hospital care with research and education in a private, nonprofit group practice. Cleveland Clinic depends on the generosity of individuals, families, corporations and foundations to ensure its continued excellence in patient care, medical research and education.

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catalystVolume 12 | Issue 2 Fall 2014

Kathryn DeLong, Director, Development Communications

Elaine DeRosa Lea, Communications Manager

Chris Blose, Managing Editor

Amy Stephenson Fabbri, Project Manager

Glenn Pierce, Art Director

Caroline E. Couig, Photo Editor

Allison Leopold, Copy Editor

Brenda M. Waugh, Production Artist

Editorial, Design and Project Management by McMURRY/TMG, LLC

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Photograph by Steve Travarca/Cleveland Clinic

Art is everywhere at Cleveland Clinic, and patients benefit. Read more on page 2.