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Leading Change Through the Lens of Innovation

Eastern Virginia Medical School

PlanStrategic2015 - 2018

TABLE OF CONTENTS5 Executive Summary11 Introduction11 Background13 Strategic Planning Theme 1 – EDUCATION15 Goal E1: Establish new educational programs that generate revenue

19 Goal E2: Advance recruitment and admission practices and programs that support institutional goals

23 Goal E3: Implement Interprofessional Education (IPE) activities for the majority of EVMS students during the next two years, and possibly involve students from other institutions in subsequent years

29 Goal E4: Provide students with a comprehensive and personally rewarding medical education of the highest quality and one which optimally prepares them to excel as tomorrow’s health care providers

35 Goal E5: Create an optimal teaching and learning environment that will facilitate positive teaching/ learning interactions by upgrading two of the most frequently used learning spaces

39 Strategic Planning Theme 2 – RESEARCH41 Goal R1: Cultivate bio-repository augmentation, administration and accreditation

49 Goal R2: Coordinate and augment women’s and reproductive research at EVMS

59 Goal R3: Develop and expand capacity for health analytics and data analysis at EVMS

65 Strategic Planning Theme 3 – CLINICAL67 Goal C1: Improve EVMS Medical Group quality and patient satisfaction

75 Strategic Planning Theme 4 – PARTNERSHIPS77 Goal P1: Facilitate the development of value propositions

83 Goal P2: Increase capacity for clinical rotation placements

87 Goal P3: Establish a Student Care Center (SCC) at Booker T. Washington High School with a grant from the United Way

91 Goal P4: Strengthen clinical and academic relations between faculty, residents, student and other health-care providers working at Sentara Norfolk General Hospital and the VAMC-Hampton

95 Committee Members

Contents | Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL 3

EXECUTIVE SUMMARYThe EVMS strategic plan for FY2015-FY2018 affirms the institution’s commitment to continued excellence in its core mission areas of

Education, Research and Clinical Care. The initiatives and priorities outlined are congruent with EVMS’ mission and vision and represent an assortment of new program concepts, existing program enhancements, and operational advancements designed to better position EVMS in the uncertain economic landscape facing academic medical centers nationwide.

EVMS highly values the input of its campus community. The strategic planning process was designed to encourage transparency and participation, providing an opportunity for the institution’s faculty, staff and students to have a voice and actively participate. Throughout the proceedings, collaboration among the school’s diverse population was not only encouraged but expected, as forums were structured to solicit feedback, generate open exchange of ideas, and facilitate thoughtful discussion.

Four strategic theme areas were identified which included the three core mission areas of Education, Research and Clinical Care. The fourth strategic theme, Partnerships, is a broader area which strategically bridges the other three mission areas as our community partners are a critical component to everything we do in the areas of education, research and patient care. Subcommittees for each strategic theme were created and guiding principles were provided for development of strategic goals and objectives.

Strategic Planning — Guiding Principals1. Improve quality

2. Identify/define deliverables

3. Provide a financial/academic return on investment

4. Project/advance the national reputation of EVMS

5. Define accountability

6. Align with EVMS Mission, Vision and Diversity statements

7. Demonstrate synergistic value across multiple mission areas

The strategic planning timeline was aggressive, taking approximately seven months from start to finish and resulting in an extremely focused series of goals and objectives as outlined below.

Strategic Planning Theme 1 – EDUCATIONGoal E1: Establish new educational programs that generate revenue

EVMS’ School of Health Professions (SHP) will endeavor to develop and implement at least one new revenue-generating master’s and/or certificate program each fiscal year. Examples include Medical & Health Professions Education and Health-care Delivery Science.

Goal E2: Advance recruitment and admission practices and programs that support institutional goalsThe EVMS admissions interview process will be revised and standardized in order to improve the institution’s ability to assess candidate drive, ability to deal with pressure and adversity, maturity, flexibility, ability to work with others, leadership and communication skills.

Goal E3: Implement Interprofessional (IPE) activities for the majority of EVMS students during the next two years, and possibly involve students from other institutions in subsequent yearsEVMS will implement IPE activities in both its school of Medicine and Health Professions for the majority of EVMS students during the next two years, providing opportunities to interact with and learn from trainees, faculty, and practitioners in other disciplines. Proposed activities shall conform with the 2010 World Health Organization definition of IPE: “When students from two or more disciplines learn about, from and with each other to enable effective collaboration and improve health outcomes.”

Executive Summary | Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL 5

6 Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL | Executive Summary

Goal E4: Provide students with a comprehensive and personally rewarding medical education of the highest quality and one which optimally prepares them to excel as tomorrow’s health care providersIn 2012, EVMS began a process of redesigning the content of the curriculum and the process by which it is delivered. EVMS will continue to advance this process through the development of new courses including, Successful Transition to Effective Practice (STEP), Intersession, Service Learning, Ultrasound, and EVMS Community Interactions Anatomical & Pathological Sciences Visits.

Goal E5: Create an optimal teaching and learning environment that will facilitate positive teaching/ learning interactions by upgrading two of the most frequently used learning spacesThe emphasis on active learning and more contemporary pedagogical methods has revealed deficiencies in the EVMS physical plant that are impediments to effective delivery of the curriculum. As a result, a reconfiguration of critical learning areas will be initiated to include the installation of drop down desks on the back of chairs (to accommodate laptop computers, clickers, etc.), flat screen monitors with extra speakers, and additional seats as identified.

Strategic Planning Theme 2 – RESEARCHGoal R1: Cultivate bio-repository augmentation, administration and accreditation

The EVMS bio-repository will be advanced into a state of the art facility that will become a trusted resource which annotates, houses, and returns to research investigators samples and data that are useful in clinical and translational research, and which complies with national standards to improve bio-specimen quality and ultimately patient care. The bio-repository would function as the “trustee” or “custodian” of these resources.

Goal R2: Coordinate and augment women’s and reproductive research at EVMSBuilding a program focusing on Women’s Health and Infant Development will strengthen and integrate already strong and externally funded research programs, increase utilization of non-human primate translational models unique to EVMS, capture the clinical and clinical science expertise and patient base in Ob/Gyn, and create opportunities for medical and health professions students to be integrated into and involved in community-based/targeted research and education. These efforts will move science from lab to bedside to the community.

Goal R3: Develop and expand capacity for health analytics and data analysis at EVMSEVMS has increasing demands for research support in the areas of evidence-based medicine, translation of biomedical research, and health analytics research. To meet these demands, a Center for Health Analytics and Discovery (CHAD) will be developed under the auspices of the Office of Research. The CHAD will coordinate and centralize services for health analytics and data analysis at EVMS and enhance the capability of the Epi-Bio Core in the Graduate Program in Public Health (GPPH).

Strategic Planning Theme 3 – CLINICALGoal C1: Improve EVMS Medical Group quality and patient satisfaction

In furtherance of previously developed initiatives designed to improve the overall performance of the EVMS Medical Group, three new positions will be created in support of improving quality, patient satisfaction and value. These positions include a Referral Coordinator (who will enable navigation of EVMSMG patients within and outside of the Medical Group), a Data Analyst (who will help identify and fill in the gaps in Medical Group data and be responsible for reporting quality measures), and a Care Management Coordinator (who will develop capabilities and skills coordinated across the medical group that are necessary for a highly functioning medical practice).

Executive Summary | Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL 7

Strategic Planning Theme 4 – PARTNERSHIPS Goal P1: Facilitate the development of value propositions

To better define, quantify and communicate the value that EVMS brings to its relationships with strategic partners, EVMS will engage a consultant to develop compelling value propositions. The value propositions will focus on identifying the quantifiable value, relevancy and unique differentiators of EVMS, and more importantly, help answer “what’s in it for the partner,” therefore placing EVMS in a stronger position to negotiate mutually beneficial future agreements.

Goal P2: Increase capacity for clinical rotation placementsThe need for engaged community faculty for preceptorship of EVMS students has been recently elevated with the increase of the student population and additional planned growth for Health Professions. EVMS must strengthen its recruiting efforts and be able to assess the performance of these vital participants who help educate its student workforce. Accordingly, EVMS will work to improve the relationships within the community and foster a larger and more effective teaching environment for all students.

Goal P3: Establish a Student Care Center (SCC) at Booker T. Washington High School with a grant from the United WayIn partnership with the United Way, EVMS will develop a Student Care Center at Booker T. Washington High School in Norfolk, Va. This clinical model has been effective in other areas of the country and combines primary care, public health and education into a single clinical model. Extensive national research has shown that school-based health centers increase health care access and decrease both absenteeism and the inappropriate use of emergency rooms.

Goal P4: Strengthen clinical and academic relations between faculty, residents, students and other health-care providers working at Sentara Norfolk General Hospital and the VAMC- HamptonTo improve clinical and educational communications between the VAMC-Hampton and Eastern Virginia Medical Center health-care providers in Sentara Norfolk General, a telemedicine connection will be implemented. This will be used for the Internal Medicine residency program and will be designed to improve the learner experience and enhance morning grand rounds.

8 Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL | Executive Summary

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STRATEGIC PLAN2015 – 2018


INTRODUCTIONAchieving excellence in its core missions of education, research and clinical care while maintaining its community-based focus is

the foundation underlying the mission of Eastern Virginia Medical School (EVMS). As one of the nation’s only academic medical centers (AMC) founded and funded by its local community, this was the school’s initial vision when founded over 40 years ago. Today, EVMS serves as an integral community partner to industry organizations, academic institutions, health-care entities and area municipalities, while also being a primary economic driver and health-care workforce developer for the Hampton Roads region.

In the ever-evolving health-care environment, the future landscape for academic medicine in general is expected to be tumultuous. Despite its celebrated grassroots history and established role in the region, EVMS will not be immune to industry volatility. AMCs are under increasing pressure to reevaluate their business models and cost structures as declining research funding, reduced clinical reimbursement and increasing educational costs have, in effect, created an economic “triple whammy” to which all AMCs across the nation must respond. The progression of these market factors will greatly influence the future of academic medicine and will no doubt effect change here. EVMS’ ability to be innovative and proactive will largely determine our success in navigating the new landscape.

The development of the FY2015-FY2018 strategic plan was predicated on the core principles and collaborative community focus on which EVMS has grown over the years. While most AMCs have enormous amounts of talent and capabilities, they also are notoriously slow in reacting to environmental factors, often bound by an academic culture which supports lengthy discussion and consensus-based decision making. To the contrary, EVMS’ strength always has resided in our innovative faculty, staff and students and its ability to collectively and proactively respond to community/regional demands. As such, representatives from all campus constituencies were engaged in the strategic planning process.

BACKGROUNDThe development of a strategic plan for the four-year period FY15-FY18 began in February 2014. The planning process was focused

and accompanied by an aggressive timeline of approximately seven months. This was intended to create a targeted effort by EVMS stakeholders whereby they would identify value-based initiatives designed to advance the core missions in the face of mounting environmental pressures, while maintaining consistency with the institution’s long term financial projections and available resources.

Four “Strategic Theme” areas were identified which included Education, Research, Clinical Care and Partnerships. A Steering Committee was commissioned to lead the process and for each theme, a strategic planning subcommittee was developed and charged with developing strategic goals and supporting objectives. Each subcommittee was comprised of 20-30 members and represented materially all functional areas of the institution. They were provided the following guiding principles under which to develop their respective goals:

Principles:1. Improve quality

2. Identify/define deliverables

3. Provide a financial/academic return on investment

4. Project/advance the national reputation of EVMS

5. Define accountability

6. Align with EVMS Mission, Vision and Diversity statements

7. Demonstrate synergistic value across multiple mission areas

As is customary in the strategic planning process, a review of the institution’s current Mission Statement, Vision Statement, and Core Values was also conducted prior to launch. It was determined that the current statements/values continue to be congruent with EVMS’ core mission and strategic vision for the future and therefore remain unchanged. Additionally, they provided the foundation for developing the strategic initiatives identified in the FY2015-FY2018 plan.

Introduction | Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL 11

12 Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL | Introduction

EVMS MISSION STATEMENTEastern Virginia Medical School is an academic health center dedicated to achieving excellence in medical and health professions

education, research and patient care. We value creating and fostering a diverse and cohesive faculty, professional staff and student body as the surest way to achieve our mission. Adhering to the highest ethical standards, we will strive to improve the health of our community and to be recognized as a national center of intellectual and clinical strength in medicine.

EVMS VISION STATEMENTEastern Virginia Medical School will be recognized as the most community-oriented school of medicine and health professions in

the United States.

EVMS CORE VALUESThree core values drive our daily efforts:

n Excellence: We determine with our stakeholders what is valuable and hold ourselves to high performance standards that fulfill our promises.

n Collegiality: We serve our community and one another, building strong and mutually supportive relationships. We work as a cooperative, united team to further our purposes of education, research and patient care.

n Integrity: We strive to maintain the highest ethical standards and accept accountability for all we do and say.

EVMS DIVERSITY STATEMENTThe education, research and patient care mission of Eastern Virginia Medical School (EVMS) is shaped by many considerations: the

demographics of the surrounding communities, the significant presence of military personnel, retirees and their families, the rural and underserved communities of the Commonwealth of Virginia, and the broader national and global need to address gaps in the health workforce and the accessibility of health care.

Eastern Virginia Medical School has a unique history as one of the few institutions in the United States established by the local community to serve the local community. Indeed, its vision is to be the most community-oriented school of medicine and health professions in the nation. In fulfilling that vision, EVMS strives to attract talented students, trainees, faculty, staff and leaders who bring diverse attributes and experience to drive our collective commitment to excellence.

Eastern Virginia Medical School embraces diversity broadly defined, but places a special emphasis on recruitment of women, traditionally underrepresented minorities in medicine and the health professions (African Americans, Latinos, American Indians and Native Alaskans, and Native Hawaiians and Pacific Islanders), veterans and individuals who come from socioeconomically disadvantaged backgrounds. Acknowledging that diversity is a fluid and evolving concept, we will continually strive to be inclusive of individuals and groups in the broadest possible manner.

In careful consideration of the guiding principles established by senior leadership and the steering committee, and provided with the foundational framework of our defined Mission Statement, Vision Statement, Core Values, and Diversity Statement, the strategic planning subcommittees focused on areas where the institution could succeed quickly and efficiently.


EDUCATIONGoal E1: Establish new educational programs that generate revenue

Goal E2: Advance recruitment and admission practices and programs that support institutional goals

Goal E3: Implement Interprofessional (IPE) activities for the majority of EVMS students during the next two years, and possibly involve students from other institutions in subsequent years

Goal E4: Provide students with a comprehensive and personally rewarding medical education of the highest quality and one which optimally prepares them to excel as tomorrow’s health care providers

Goal E5: Create an optimal teaching and learning environment that will facilitate positive teaching/ learning interactions by upgrading two of the most frequently used learning spaces

Strategic Planning Theme — EDUCATIONGoal E1: Establish new educational programs that generate revenue.

n Defined objective Develop and implement at least one new revenue-generating Master’s and/or certificate programs annually (e.g., Medical & Health Professions Education, Healthcare Delivery Science).

n Implementation/ComponentsIdentify faculty and key administrators (e.g., department chairs) who will work with the leadership of the School of Health Professions (SHP) to generate ideas for new educational programs that generate revenue and are consistent with the EVMS mission.

n Feasibility/Assessment Selected individuals will generate white papers describing market opportunities and outlining key program components such as delivery mode (online, residential, hybrid, etc.), curriculum, and feasibility of program delivery based on existing faculty expertise and external faculty who could be hired to teach specific courses. The white papers will be reviewed by appropriate departmental chairs and leadership from the SHP to determine if a full business plan should be developed. Business plans will be prepared for final review by the President.

n Investment/Resources$10,000/year is estimated to support site visits, travel to EVMS by experts in existing programs, and other activities that may be required to fully explore the development of a program.

n Project leaderJeffrey Johnson, DHSc, Associate Dean of the School of Health Professions

n Performance metrics• Number of white papers developed annually

• Number of new programs initiated annually

Education | Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL 15

n Timeline & deliverables

Deliverables | Goal E1STRATEGIC PLANNING YEAR

DELIVERABLESYEAR 1 • Launch the Master’s in Laboratory Animal Sciences program

• Hire Director for the Master’s in Medical & Health Professions Education (MPHE) program *

• Develop the MPHE curriculum and market the program to prospective students.

• Identify personnel to be involved with developing new programs with emphasis on unfunded research faculty **

• Articulate a process and time frame to generate white papers and business plans for proposed programs

YEAR 2 • Launch the MPHE program

• Initiate development of at least one new Master’s degree or certificate program

YEAR 3 • Launch the program(s) developed in Year 2


YEAR 4 • Launch the program(s) developed in Year 3


*This person will also serve as Assistant Dean for Institutional Effectiveness.

**Individuals involved in developing new programs may change from year to year based on availability and recommendations from department Chairs and/or other senior officials.

16 Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL | Education

n Financial pro-forma


EVMS

Business Plan -‐ R

evenue and

Expense Statement

EVMS STRA

TEGIC PLANNING -‐ FINAN

CIAL TEM

PLAT

EMISSION AREA:

Education

OBJECTIVE

:E1 -‐ New

Program

s

FISCAL YEA

R:2015

2016

2017

2018

Year 1

Year 2

Year 3

Year 4

Total

Revenu

e:Strategic Plan

Fun

ding

$1

0,00

0$1

0,00

0$1

0,00

0$1

0,00

0$4

0,00

0Net Patient Revenue

$0$0

$0$0

$0Other Clinical Revenue

$0$0

$0$0

$0Grant R

evenue

$0$0

$0$0

$0Co

ntractual Revenue

$0$0

$0$0

$0Inter-‐Divisio

nal Revenue

$0$0

$0$0

$0Tuition

and Fees

$0$0

$0$0

$0EV

MS Foundatio

n$0

$0$0

$0$0

Other Revenue

$0$0

$0$0

$0$10,000

$10,000

$10,000

$10,000

$40,000

Operatin

g Expenses:

Salarie

s & W

ages

$0$0

$0$0

$0Fringe Benefits

$0$0

$0$0

$0Supplies

$0$0

$0$0

$0Co

ntractual Services

$10,000

$10,000

$10,000

$10,000

$40,000

General Expenses

$0$0

$0$0

$0PP&E/De

preciatio

n$0

$0$0

$0$0

Shared Services

$0$0

$0$0

$0Indirect Cost R

ecovery

$0$0

$0$0

$0$10,000

$10,000

$10,000

$10,000

$40,000

Net Excess/(Deficit)

$0$0

$0$0

$0

Total Revenue

Total O

peratin

g Expenses

Business Plan | Revenue and Expense Statement | Goal E1


Strategic Plan Funding Milestones | Goal E1

New ProgramsTotal -‐ Strategic Plan Funding

Year 1 $ 10,000 $ 10,000

President approves program business plan and budget ✓

Year 2 $ 10,000 $ 10,000


Year 3 $ 10,000 $ 10,000


Year 4 $ 10,000 $ 10,000


Grand Total $ 40,000 $ 40,000

Eastern Virginia Medical SchoolStrategic Plan Funding Milestones

Education: New Programs

Goal E2: Advance recruitment and admission practices and programs that support institutional goals.

Background/ Rationale The medical school admissions interview is an essential component of the admission process. It is used as the measure of one’s

drive to be a physician, ability to deal with pressure and adversity. It also gauges his or her flexibility, maturity, logic, leadership, ability to work with and care about others and communication skills. Traditionally the typical admissions interview was characterized by one-on-one interviews conducted by faculty and staff. Recent trends demonstrate changes in the typical medical-school-interview process regarding the number of interviews, length and format of the interview, etc.

In the most recent years, a growing number of medical schools have adopted different processes including the holistic review as a way to standardize the process and increase the increase the diversity of their student body.

n Defined objectives1. Change the composition of the admission committee to include a higher number of full-time faculty

2. Enhance the admission process with formal training of committee members to ensure that effective and consistent methods of student recruitment are employed

3. Examine institutional advantages and opportunities in the marketplace

4. Increase engagement, retention and completion in diverse student populations

n Implementation/Components N/A

n Feasibility/Assessment N/A

n Investment/Resources Reaching these goals will require:

• Recruitment and training of full-time faculty

n Project leaders Thomas Kimble, MD, Assistant Dean for Admissions and Assistant Professor of Obstetrics and Gynecology

Donald Meyer, PhD, Associate Dean for Admissions

Mekbib Gemeda, Vice President of Diversity and Inclusion

n Performance metrics • Recruitment of students that embody the desired characteristics of the EVMS graduate



Deliverables | Goal E2

STRATEGIC PLANNING YEAR DELIVERABLESYEAR 1 Increase the composition of the Admissions Committee to include 40% full-time faculty

YEAR 2 Increase the composition of the Admissions Committee to include 50% full-time faculty





EVMS


evenue and Expense Statement

EVMS STRA


CIAL TEM

PLAT

EMISSION AREA:

OBJECTIVE

:Education

E2 -‐ Ad

missions E

nhancements

FISCAL YEA

R:2015

2016

2017

2018

Year 1

Year 2

Year 3

Year 4

Total

Revenue:

Strategic Plan

Fun

ding

$6

6,75

0$6

7,78

5$6

8,84

1$6

9,91

8$2

73,294

Net Patient Revenue

$0$0

$0$0


$0$0

$0$0

$0Grant R

evenue

$0$0

$0$0

$0Co

ntractual Revenue

$0$0

$0$0

$0Inter-‐Divisio

nal Revenue

$0$0

$0$0

$0Tuition

and Fees

$0$0

$0$0

$0EV

MS Foundatio

n$0

$0$0

$0$0

Other Revenue

$0$0

$0$0

$0$66,750

$67,785

$68,841

$69,918

$273,294

Operatin

g Expenses:

Salarie

s & W

ages

$45,000

$45,900

$46,818

$47,754

$185,472

Fringe Benefits

$6,750

$6,885

$7,023

$7,164

$27,821

Supplies

$5,000

$5,000

$5,000

$5,000

$20,000

Contractual Services

$5,000

$5,000

$5,000

$5,000

$20,000

General Expenses

$5,000

$5,000

$5,000

$5,000

$20,000

PP&E/De

preciatio

n$0

$0$0

$0$0

Shared Services

$0$0

$0$0

$0Indirect Cost R

ecovery

$0$0

$0$0

$0$66,750

$67,785

$68,841

$69,918

$273,294


$0$0

$0$0

$0

Total Revenue

Total O

peratin

g Expenses



Admission Enhancements

Total -‐ Strategic Plan Funding

Year 1 $ 66,750 $ 66,750

Identify & recruit clinical full-‐time salaried faculty for committee ✓

Year 2 $ 67,785 $ 67,785


Year 3 $ 68,841 $ 68,841


Year 4 $ 69,918 $ 69,918


Grand Total $ 273,294 $ 273,294


Education: Admission Enhancements

Identify and recruit clinical full-time salaried faculty for committee




Goal E3: Implement Interprofessional Education (IPE) activities for the majority of EVMS students during the next two years, and possibly involved students from other institutions in subsequent years.

Proposed activities shall conform with the 2010 World Health Organization definition of IPE: “When students from two or more disciplines learn about, from and with each other to enable effective collaboration and improve health outcomes.”

As with many programs hosted by academic health centers, our students are generally educated in professional silos that provide few or no structured opportunities to interact with and learn from trainees, faculty and practitioners in other disciplines. Accreditation requirements, substantial curricular differences, scheduling logistics and the understandable tendency for programs to adopt changes in small incremental steps have all contributed to the prolonged status quo of disciplinary isolation.

Implementing IPE for students in the School of Medicine and School of Health Professions supports the teaching of team-oriented health care delivery and encourages the inclusion of diverse experiences and perspectives among program participants.

School of Health Professions Interprofessional Education

In growing recognition that a safe, effective and value-driven health-care delivery system must emphasize teams of professionals working in unison to benefit patients and improve outcomes, the School of Health Professions (SHP) is developing a 1-credit-hour Interprofessional Collaborative Education (ICE) course that will be implemented during the 2014-15 academic year. About 200 students will be enrolled in the course, with the majority being in the first year of their respective program.

n Defined objectiveIn FY15, EVMS will implement a 1-credit-hour IPE course for students from seven EVMS programs.

n Implementation/ComponentsThe course will consist of 6 didactic sessions, 2 hours each; 5 of the sessions will be case-based learning and will include 20 breakout groups of 10 students each. Faculty development training pertaining to TeamSTEPPS and facilitating small groups will occur for salaried faculty in the School of Health Professions, and possibly others depending on interest and availability.

n Feasibility/Assessment The days and times of all sessions are identified in the course syllabus and have been conveyed well in advance to all participating Program Directors and students. Some students (particularly in the Master of Public Health Program) may be unable to participate in some or any sessions because of geographic and/or work conflicts. Conflicts will be handled on a case-by-case basis.

n Investment/ResourcesThe course requires essentially no new spending. Key resources are faculty presenters, faculty facilitators and classroom space in Lester Hall.

n Project leaderJeffrey Johnson, DHSc, Associate Dean of the School of Health Professions

n Performance metricsStudents will complete:

• A pre- and post-test pertaining to knowledge about IPE

• A quiz about all EVMS degree-granting programs

• An evaluation of each of the six sessions

• A brief summative evaluation about the overall course and experience





STRATEGIC PLANNING YEAR DELIVERABLESYEAR 1 Successful delivery and assessment of the course, followed by discussions among faculty and administrative

leadership about potential changes and/or expansion of the course in Year 2.

YEAR 2 Expand the course to include all M1 students, thus bringing total student participants to approximately 350. Discussions will also occur about developing an IPE component (online and/or residential) during the 2015 Fall Orientation for incoming students.

Selected training sites will be identified where IPE competencies can be practiced, observed, and evaluated (e.g., HOPES Clinic).

Comprehensive assessment will occur after the expanded course is implemented and evaluated, concluding with recommended changes for subsequent years.

YEAR 3 Determine feasibility of including students from Old Dominion University (disciplines to be decided) in the course and/or in elected training sites.

Logistical considerations may be considerable, and if necessary may need to seek grant funding for staffing support. (At this point, it is simply too soon to speculate on feasibility, complications, or possible funding needs.)

YEAR 4 Determine feasibility of including students from other local institutions (e.g., Norfolk State University, Hampton University) in the course and/or in selected training sites.

(At this point, it is much too early to speculate about the ability to support an initiative that could involve many hundreds of students from multiple schools and disciplines.)

School of Medicine Interprofessional Education

In growing recognition that a safe, effective, and value-driven health-care delivery system must emphasize teams of professionals working in unison to benefit patients and improve outcomes, the School of Medicine (MD) program is developing an integrated experience that will be implemented during the 2015-2016 academic year. All MD students (~148) will participate in strategically placed experiences within their existing courses and experiences.

n Defined objectivesIn an effort to foster collaborative learning and to improve health outcomes, students will learn about, from and with practitioners and students of other health care disciplines.

n Implementation/ComponentsThe experience will consist of experiences in orientation, an online course for M1, case logging experiences for Longitudinal Generalist Mentorship (LGM) in M1 and M2, students self-select from a menu of experiences for M2, case logging of interprofessional experiences during the clerkships in M3 and possible HRSA grant supported activities in M4 with case logging.

n Feasibility/AssessmentThe days and times of all sessions will be identified in all course syllabi will be conveyed well in advance to all participating Program Directors and students. Some students (particularly in the Master of Public Health Program) may be unable to participate in some or any sessions because of geographic and/or work conflicts. Conflicts will be handled on a case-by-case basis.


n Investment/ResourcesThe course requires development time for subject matter experts, instructional designers and course developers. Faculty development is necessary to bring all participating faculty to consensus on IPE and how to facilitate student development in IPE. Key resources are faculty presenters, faculty facilitators, instructional designers, videographer and graphic artists. E*Value (an electronic software package) will need to be expanded to include M1-4 case logging.

n Project leadersBruce Britton, MD, Professor of Family and Community Medicine and Director of the Family Medicine Clerkship Tom Parish, DHSc, PA-C, Director of the Master of Physician Assistant Program

n Performance metricsStudents will complete the following:

• A pretest about IPE knowledge

• Evaluation of community impact day

• Quizzes in M1 online course

• Reflection journal entries in M1 online course

• Reflection journal entries in M2 experiences in THOM2

• Case logging in M1-4 E*Value system

n Timeline & deliverables• 2014/2015: Pilot volunteer MD students in SHP-ICE program, M3 case logging in E*Value, faculty development for IPE.

• 2015/2016: The deliverables in Year 2 (FY16) include faculty development sessions, new student orientation, the ICE online course for M1, case logging experiences for Longitudinal Generalist Mentorship (LGM) in M1 and M2 and students’ self-selection of service-learning opportunities from a menu of experiences for M2.

• 2016/2017: The deliverables in Year 3 (FY17) include continuing faculty development sessions, new student orientation, the ICE online course for M1, case logging experiences for Longitudinal Generalist Mentorship (LGM) in M1 and M2 and students’ self-selection of service-learning opportunities from a menu of experiences for M2. New additions for FY17 include case logging of inter-professional experiences during the clerkships in M3 and possible HRSA grant-supported activities in M4 with case logging. EVMS will determine the feasibility of including students from Old Dominion University (disciplines to be decided) in the course and/or in elected training sites. Logistical considerations may be considerable, and, if necessary, EVMS may need to seek grant funding for staffing support. At this point, it is simply too soon to speculate on feasibility, complications or possible funding needs.

• 2017/2018: EVMS will determine the feasibility of including students from other local institutions (e.g., Norfolk State University, Hampton University) in the course and/or in selected training sites. As with Year 3, it is much too early to speculate about the ability to support an initiative that could involve many hundreds of students from multiple schools and disciplines.

STRA

TEGI

C PL

ANNI

NG

YEAR

DELIVE

RABL

ES

M1

M2

M3

M4

Facu

lty D

evel

opm

ent

YEAR

110

Vol

unte

er M

D st

uden

ts p

artic

ipat

e in

SH

P-IC

E Se

pt 14

to M

ar15

(not

sure

if th

ey

will

be

M1s

or M

2s o

r bot

h)

10 V

olun

teer

MD

stud

ents

par

ticip

ate

in S

HP-

ICE

Sept

14 to

Mar

15 (n

ot su

re if

they

will

be

M1s

or M

2s o

r bot

h)

Brie

f tra

nsiti

onal

trai

ning

ab

out I

PE fo

llow

ed b

y lo

ggin

g IP

E ex

perie

nces

in

E*Va

lue

STEP

PS tr

aini

ng

April

201

5•

Janu

ary 2

015

onlin

e an

d fa

ce-to

-face

tra

inin

g fo

r IPE

and

its

impl

emen

tatio

n

• Us

e th

e ex

istin

g IT

P te

ams a

nd te

am le

ader

s to

bec

ome

facil

itato

rs

for 4

year

ly te

am

mee

tings

YEAR

2•

Orie

ntat

ion

• In

tro to

IPE

• Bl

ackb

oard

IPE

Cour

se to

pics

1. Va

lues

/Eth

ics IP

pra

ctice

2.

Role

s/Re

spon

sibili

ties

3.

IP co

mm

unica

tion

4.

Team

s and

Team

wor

k*C

onfli

ct re

solu

tion

com

pone

nt th

roug

hout

• 4

Mod

ules

(eac

h fo

llow

ed b

y IPE

te

am m

eetin

g fa

cilita

ted

by IT

P te

am

lead

ers)

Augu

st-O

ctob

erNo

vem

ber-J

anua

ryFe

brua

ry-A

pril

May

-July

• St

uden

ts w

ill lo

g cli

nica

l IPE

enco

unte

rs in

thei

r Lon

g te

rm

gene

ralis

t men

tors

hip

(LGM

) pro

gram

• In

terp

rofe

ssio

nal C

olla

bora

tive

Educ

atio

ns

(ICE)

• Al

l MD

and

SHP

Stud

ents

• 6

Sess

ions

Sep

t to

Mar

ch

• TE

AM S

TEPP

S Tr

aini

ng

• Ca

se S

essio

ns w

ith P

E Te

ams

• M

enu

of S

ervi

ce Le

arni

ng O

ppor

tuni

ties

linke

d to

serv

ice le

arni

ng fo

r stu

dent

s to

choo

se fr

om th

at in

clude

IPE

oppo

rtuni

ties.

Stud

ents

will

log

IPE

enco

unte

rs in

SL e

xper

ienc

es in

E*Va

lue

• St

uden

ts w

ill lo

g cli

nica

l IPE

enco

unte

rs

in th

eir L

ong

term

gen

eral

ist m

ento

rshi

p (L

GM) p

rogr

am

Log

clin

ical

IPE

and

en

coun

ters

in E

*Val

ueST

EPPS

in A

pril

HRS

A G

rant

Su

ppor

ted

Activ

ities

Stud

ents

will

lo

g en

coun

ters

in

E*V

alue

YEAR

3Sa

me

as p

revi

ous y

ear w

ith e

xpan

ded

Serv

ice Le

arni

ng (S

L) o

ppor

tuni

ties

Sam

e as

pre

viou

s yea

r with

exp

ande

d SL

op

portu

nitie

sLo

g cli

nica

l IPE

and

enco

unte

rs in

E*Va

lue

Sam

e as

pre

viou

s ye

ar w

ith

expa

nded

HRS

A op

portu

nitie

s

YEAR

4Sa

me

as p

revi

ous y

ear w

ith e

xpan

ded

SL

oppo

rtuni

ties

Sam

e as

pre

viou

s yea

r with

exp

ande

d SL

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portu

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g cli

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l IPE

and

enco

unte

rs in

E*Va

lue

Sam

e as

pre

viou

s ye

ar w

ith

expa

nded

HRS

A op

portu

nitie

s



n Financial pro-formaNo funding requested for this initiative (Redirecting existing faculty time and effort as well as existing institutional resources)

Goal E4: To provide students with a comprehensive and personally rewarding medical education of the highest quality and one which optimally prepares them to excel as tomorrow’s health care providers.

Background/ Rationale Medical schools across the country are undergoing a process of curricular change in order to prepare trainees to be leaders in a

health-care delivery and discovery environment that is rapidly changing. New curricula embrace innovative teaching methods and emphasize skills related to health care quality, interprofessional education and teamwork, technology, service learning and more.

Attendant to the charge from the Dean of the School of Medicine in 2012, EVMS began a process of redesigning the content of the curriculum and the process by which it is delivered. Progress has been made to enhance students’ learning of the foundational sciences and clinical learning opportunities across the curriculum. There has been increased integration, both horizontal and vertical, with more emphasis on learner-centered rather than content-centered instruction. By leveraging new technologies to support efficient delivery of the curriculum, it has been possible to limit formal course work and total contact time. Promotion and development of additional active-learning activities have been accommodated by a 15% reduction in contact hours for M1 in Academic Year 2015 (AY15) with a goal to reduce contact hours in M2 by 20% for AY16.

After completing an in-depth review of the existing curriculum, reviewing the medical education literature and conducting discussions with our faculty and trainees, several new courses have been identified.

1. Successful Transition to Effective Practice (STEP)Over the past several years, Program Directors have increasingly expressed concern that some medical school graduates are not prepared to begin residency. In 2013, the ACGME and ABMS (American Board of Medical Specialties) initiated the Milestone Project to define progressive levels of performance for residents. Building upon these efforts, a drafting panel convened by the Association of American Medical Colleges (AAMC) has developed the “Reference List of General Physician Competencies.” The 13 activities in the core Entrustable Professional Activities (EPA) are the first standardized set of guidelines defining what activities a medical school graduate should be able to perform without direct supervision on their first day of residency, regardless of his or her specialty.

Concurrent with this initiative of the AAMC is the development of the STEP course at EVMS. This new course will address all13 EPAs and additional activities designed to facilitate transition into Graduate Medical Education and enhance patient safety. Embedded within this month will be the capstone project which represents the culmination of a service-learning project that students will participate in longitudinally beginning in the M1 year. The first offering will be in April 2015 as an elective and all students will be required to complete the course in April 2016.

A Course Director and administrative support will be required to effectively deliver the curriculum.

2. IntersessionDesigned to facilitate transition from the classroom into the clinical setting, a new course — intersession — was implemented June 2014. A variety of didactic and hands-on experiences were provided to help prepare students for their core clerkships.

3. Service learningAs part of curriculum reform at EVMS, service learning has been incorporated to not only enhance the health of the community but also to provide EVMS graduates with the skills and experience necessary to distinguish them as strong candidates for residency-training programs. This will be accomplished by completion of projects and studies conferring a nationally recognized certificate or other form of distinction.

For AY15, two service-learning programs have been developed for implementation:

• Spanish Bilingual Clinician Certificate and Longitudinal Service Learning Program – deigned to provide medical Spanish education and certification through National Institutes of Health (NIH) recognized curriculum and testing



• Bystander CPR – designed to improve bystander CPR rates in the local community by integrating EVMS medical students into the chain of survival

• New service-learning curricula introduced sequentially with the ultimate goal of having all medical students engage in a longitudinal service-learning project in their initial year with culmination in a capstone project incorporated into the M4 STEP course

4. UltrasoundUltrasound imaging enhances a clinician’s ability to evaluate, diagnose and treat patients. There has recently been an explosion in point-of-care ultrasound technology making ultrasound accessible across the breadth of medicine. Ultrasound has the potential to revolutionize undergraduate medical education by enhancing better understanding of anatomy, physiology, pathology and the physical examination. Ultrasound education better equips future physicians to make more accurate diagnoses and appropriate treatment plans.

In AY13, Eastern Virginia Medical School (EVMS) became one of the first medical schools in the country to fully integrate ultrasound into its undergraduate medical curriculum. Since then, EVMS has become a nationally recognized leader in ultrasound education.

Attracting more competitive students

• 25% (n=36) of current M1 students surveyed identified the undergraduate ultrasound curriculum as one of the reasons they chose to attend EVMS

Enhancing undergraduate medical education

• 95% of EVMS M1 students surveyed (n= 248) felt the overall educational experience in ultrasound enhanced their undergraduate medical education

• 93% of EVMS M1 students (n=266) would like to see more ultrasound included their four-year undergraduate medical curriculum

5. EVMS community interactions (anatomical & pathological sciences visits)EVMS has a long history of interacting with public and home-schooled students in Hampton Roads. This health education is in the spirit of EVMS’ community-focused vision. Fostering a relationship with the children and their families also supports institutional awareness, provides fundraising opportunities and presents a natural venue for development of potential service-learning projects. These visits are only for students from grade 9 through 12.

Visits: The visits can be coordinated into two sessions of up to 100 students each per day. Each visit would be 3 hours long with a morning visit from 9 to 12 and an afternoon visit from 12:30 to 3:30. The visit would start with an introduction and campus tour followed by a pre-visit survey and information sheet. The tour would end in the anatomy lab discussing the human body, diseases affecting the community and the health care system.

Timing and Scalability: The EVMS visits would be scheduled in advance to take place on the first three business days following the winter exam period and on three business days of Medical Spring Break (dates to be solidified by committee and with teacher input). If program growth is needed in the future based on early successes there is the possibility to expand to add the first three days following Health professions school final exams or MD program final exams. Visits would be coordinated centrally through the office of community interactions and with EVMS Pathology and Anatomy. The scalability of the program would allow for interactions ranging from 600 students per year to 1200 students per year without significant cost or operational impacts.


n Defined objectives1. Prepare students to begin their residency training regardless of chosen specialty using the 13 standardized set of

guidelines (Entrustable Activities, EPAs) as defined by the American Association of Medical Education( AAMC)

2. Facilitate transition from the classroom into the clinical setting

3. Engage students in longitudinal activities to acquire the skills and knowledge necessary to better serve patients and community as well as to promote long-term community partnerships

4. Enhance students’ ability to make more accurate diagnoses and their ability to treat patients utilizing ultrasound technology

n Implementation/Components • Complete a comprehensive review of the current curriculum to identify gaps and opportunities

• Involve faculty, students and other stakeholders in the design of the new initiatives

• Identify and provide faculty development opportunities

• Develop a robust program evaluation to ensure achievement of goals and monitor closely the implementation process

n Feasibility/Assessment • Identify faculty with specific expertise to lead the initiatives

• Coordination of faculty from different departments


• Faculty’s time to design, implement and assess

• Increased operating expenses

• Increased teaching load as many of the courses require teaching in small groups or one-to-one

• A course director and administrative support for the successful implementation of the STEP curriculum

n Project leader

Ronald Flenner, MD, Vice Dean of Academic Affairs

n Performance metrics • Evaluation data from faculty and students

• LCME accreditation

• Increased community engagement

• Increased research opportunities for students and faculty

• Better applicants

• Better residency match results

• Innovative curricula that will enhance the national reputation of EVMS

STRATEGIC PLANNING YEAR DELIVERABLESYEAR 1 • Implementation of STEP program as an elective

• Implementation of intersession for all M2 students (mandatory)

• Implementation of service-learning certificate program – Medical Spanish

• Development and design of service-learning program – Bystander CPR

YEAR 2 • Implementation of STEP program as a required course with capstone project in M4 year

• Hire new faculty to oversee fully maturated Ultrasound course

• Implementation of Bystander CPR

• Development and design of Food is Medicine service-learning program

• Development and design of Crisis Intervention service-learning program

• First group of certified Medical Spanish students

• Medical Spanish available to other EVMS students and affiliates

YEAR 3 • Implementation of Food is Medicine service-learning program

• Implementation of Crisis Intervention service-learning program

• Development and design of remaining service-learning programs

• Second cohort of certified Medical Spanish students and affiliates

YEAR 4 • Implementation of final service-learning programs

• Assessment of new programs

• AAMC presentation on EVMS service-learning programs







EVMS



EVMS STRA


CIAL TEM

PLAT

EMISSION AREA:

OBJECTIVE

:Education

E4 -‐ MD Curriculum

n Revision/Com

prehensive M

edical Educatio

n

FISCAL YEA

R:2015

2016

2017

2018

Year 1

Year 2

Year 3

Year 4

Total

Revenue:

Strategic Plan

Fun

ding

-‐ One

Tim

e$8

0,50

0$8

2,11

0$8

3,75

2$8

5,42

8$3

31,790

Strategic Plan

Fun

ding

-‐ Re

curring

$238

,893

$225

,153

$228

,273

$231

,455

$923

,774

Net Patient Revenue

$0$0

$0$0


$0$0

$0$0

$0Grant R

evenue

$0$0

$0$0

$0Co

ntractual Revenue

$0$0

$0$0

$0Inter-‐Divisio

nal Revenue

$0$0

$0$0

$0Tuition

and Fees

$0$0

$0$0

$0EV

MS Foundatio

n$8,000

$8,000

$8,000

$8,000

$32,000

Other Revenue

$0$0

$0$0

$0$327,393

$315,263

$320,025

$324,883

$1,287,564

Operatin

g Expenses:

Salarie

s & W

ages

$215,003

$219,063

$223,204

$227,428

$884,699

Fringe Benefits

$30,890

$31,499

$32,121

$32,754

$127,265

Supplies

$40,500

$23,700

$23,700

$23,700

$111,600


$25,000

$25,000

$25,000

$25,000

$100,000

General Expenses

$16,000

$16,000

$16,000

$16,000

$64,000

PP&E/De

preciatio

n$0

$0$0

$0$0

Shared Services

$0$0

$0$0

$0Indirect Cost R

ecovery

$0$0

$0$0

$0$327,393

$315,263

$320,025

$324,883

$1,287,564


($0)

$0$0

$0$0

Total Revenue

Total O

peratin

g Expenses



New Courses Less: Other Revenue


Year 1 $ 327,393 $ (8,000) $ 319,393

MEC approval of course content ✓

Approved job description for ultrasound director ✓

Implement STEP & Intersession ✓

✓Approved business plan for service-learning project

Year 2 $ 315,263 $ (8,000) $ 307,263

✓

$ 320,025 $ (8,000) $ 312,025

✓

$ 324,883 $ (8,000) $ 316,883

Approved business plan for service-learning project

Year 3

Approved business plan for service-learning project

Year 4

Approved business plan for service-learning project ✓

Grand Total $ 1,287,564 $ (32,000) $ 1,255,564


Education: New Courses

Goal E5: To create an optimal teaching and learning environment that will facilitate positive teaching/ learning interactions by upgrading two of the most frequently used learning spaces.

Background/RationaleAttendant to the charge from the Dean of the School of Medicine in 2012, EVMS began a process of redesigning the content of the

curriculum and the process by which it is delivered. Progress has been made to enhance students’ learning of the foundational sciences and clinical learning opportunities across the curriculum. There has been increased integration, both horizontal and vertical, with more emphasis on learner-centered rather than content-centered instruction. By leveraging new technologies to support efficient delivery of the curriculum, it has been possible to limit formal course work and total contact time. Promotion and development of additional active learning activities have been accommodated by a 15% reduction in contact hours for M1 in AY15 with a goal to reduce contact hours in M2 by 20% for AY16.

The emphasis on active learning and more contemporary pedagogical methods has revealed deficiencies in the physical plant that are impediments to effective delivery of the curriculum. Research on the teaching and learning environment has shown that the physical arrangement can affect the behavior of both students and teachers and that a well-structured classroom tends to improve student academic and behavioral outcomes. In addition, the classroom environment acts as a symbol to learners and others regarding what teachers value in behavior and learning.

n Defined objectives1. Provide the most effective learning environment based on desired pedagogy

2. Form an environment designed to enhance students’ ability to participate in active learning

3. Design a learning space that is comfortable for learners and faculty as well as durable, reliable and easy to maintain and upgrade

n Implementation/Components • Engage appropriate level of expertise in terms of engineering and computer sciences

• Identify appropriate time period to complete the work



McCombs Auditorium

1. Installation of drop-down desks on the back of chairs to accommodate laptop computers, clickers, etc.

2. Installation of flat screen monitors in the rear of the room with extra speakers

3. Installation of additional seats in the back of the room with renovation of the AV storage space

Lester Hall – Room 104

1. Revision of the standard configuration including installation of additional outlets so that each table will have access to power, a wireless microphone system and a flat screen monitor

n Project leader Ronald Flenner, MD, Vice Dean for Academic Affairs



n Performance metrics • Successful completion of the project

• Evaluation data from teachers and students



STRATEGIC PLANNING YEAR DELIVERABLESYEAR 1 Vendor design, engineering review, and quote delivery

YEAR 2 • Four to six weeks for internal review and if necessary, request changes of the vendor

• Six to eight weeks from quote acceptance to generation of purchase order to installation

• McCombs – Install larger desktop spaces to accommodate laptop computers. Install monitors for back of room viewing. Expand seating into the AV space

• Lester 104 – Electricity reconfiguration, monitors in back of room, microphone purchase, reconfiguration of tables to accommodate active learning in groups




EVMS



EVMS STRA


CIAL TEM

PLAT

EMISSION AREA:

9/8/14

OBJECTIVE

:Education

E5 -‐ Facilities U

pgrades

FISCAL YEA

R:2015

2016

2017

2018

Year 1

Year 2

Year 3

Year 4

Total

Revenue:

Strategic Plan

Fun

ding

$6

25,000

$0$0

$0$6

25,000

Net Patient Revenue

$0$0

$0$0


$0$0

$0$0

$0Grant R

evenue

$0$0

$0$0

$0Co

ntractual Revenue

$0$0

$0$0

$0Inter-‐Divisio

nal Revenue

$0$0

$0$0

$0Tuition

and Fees

$0$0

$0$0

$0EV

MS Foundatio

n$0

$0$0

$0$0

Other Revenue

$0$0

$0$0

$0$625,000

$0$0

$0$625,000

Operatin

g Expenses:

Salarie

s & W

ages

$0$0

$0$0

$0Fringe Benefits

$0$0

$0$0

$0Supplies

$0$0

$0$0

$0Co

ntractual Services

$0$0

$0$0

$0Ge

neral Expenses

$0$0

$0$0

$0PP&E/De

preciatio

n$625,000

$0$0

$0$625,000

Shared Services

$0$0

$0$0

$0Indirect Cost R

ecovery

$0$0

$0$0

$0$625,000

$0$0

$0$625,000


$0$0

$0$0

$0

Total Revenue

Total O

peratin

g Expenses



Facilities Upgrades


Year 1 $ 625,000 $ 625,000

Approved vendor quotes & renovation timeline ✓

Year 2 $ -‐

Year 3 $ -‐

Year 4 $ -‐

Grand Total $ 625,000 $ 625,000

Eastern Virginia Medical SchoolStrategic Plan Funding MilestonesEducation: Facilities Upgrades

Facilities Upgrades


Year 1 $ 625,000 $ 625,000

Approved vendor quotes & renovation timeline ✓

Year 2 $ -‐

Year 3 $ -‐

Year 4 $ -‐

Grand Total $ 625,000 $ 625,000

Eastern Virginia Medical SchoolStrategic Plan Funding MilestonesEducation: Facilities Upgrades


RESEARCH

Goal R1: Cultivate biorepository augmentation, administration and accreditation

Goal R2: Coordinate and augment women’s and reproductive research at EVMS

Goal R3: Develop and expand capacity for health analytics and data analysis at EVMS

Strategic Planning Theme 2 — RESEARCHGoal R1: Cultivate biorepository augmentation, administration and accreditation.

The biorepository is the EVMS infrastructure that provides for the procurement, identification, collection, storage and distribution of biospecimens in compliance with regulatory guidelines. Augmentation of the repository to include non-neoplastic tissues, such as placenta, and standardization of protocols will increase translational opportunities for EVMS faculty and open up opportunities for partnerships. Funding from research organizations requiring compliance with NIH guidelines will be more likely. The College of American Pathologists has developed biorepository accreditation standards to ensure best practices are followed and misleading data and incorrect analysis is minimized. Pathologists are physicians with expertise in laboratory medicine and, by training, are knowledgeable about standards to comply with national accreditation standards. It is noted, however, that research programs and grants are protocol driven, making accreditation more a baseline than a ceiling.

VisionThe vision for this plan is to augment the EVMS biorepository into a state-of-the-art facility that, both through perception and

reality, is a trusted resource that annotates, houses and returns to investigators samples and data that are useful in clinical and translational research that complies with national standards to improve biospecimen quality and, ultimately, patient care. The biorepository would function as the “trustee” or “custodian” of these resources.

Background and Rationale: The Hampton Roads region is rich in clinical material. A high quality, well-annotated biorepository, defined as the infrastructure where biospecimens, e.g. blood, urine, tissues (frozen and formalin fixed paraffin tissue) are identified, collected, stored and distributed (Arch Pathol Lab Med 2012;136:668-678). A biorepository provides resources for both investigator-initiated research and fruitful collaborations and partnerships. A high-quality biorepository is an entity that adheres to standard operating procedures and best-established procedures (Arch Pathol Lab Med 2012;136:668-678).

Inherent in the biorepository infrastructure is a database of clinical and demographic data that is link to archived material. Protocols that minimize tissue deterioration as well as control for numerous preanalytical variables during the collection process are critical to ensure biospecimen quality. Physical storage (freezers, storage of paraffin blocks, other) under a controlled environment is also required. Processes and facilities that enable prompt distribution of samples to qualified investigators are also important. Oversight by the institution as well and guidelines for use of biorepository material are integral to protect patients while insuring compliance with regulatory constraints and meeting the needs of funding agencies as well as meeting the requirements of editorial boards.

Alignment with EVMS Mission EVMS has three core missions: Education, research and patient care.

• Medical school: Liaison Committee on Medical Education (LCME) standard 7.3 Scientific Method/Clinical/Translational Research states that the faculty of a medical school ensure that the medical curriculum includes instruction in the scientific method (including hands-on or simulated exercises in which medical students collect or use data to test and/or verify hypotheses or address questions about biomedical phenomena) and in the basic scientific and ethical principles of clinical and translational research (including the ways in which such research is conducted, evaluated, explained to patients and applied to patient care). Functions and Structure of a Medical School March 2014 LCME standards also require the curriculum to provide students time for active independent learning which includes opportunities for research. Opportunities for basic science research are a component of medical education (undergraduate and graduate). LCME and Accreditation Council for Graduate Medical Education (ACGME) standards outline that research opportunities are available in their respective curricula. Development of a rigorous research program provides students opportunities for basic-science research as well as alternatives for post-sophomore fellowships. EVMS’ biorepository provides a vehicle to comply with these standards. The repository would also enhance EVMS’ reputation and be a potential factor on applicants choosing EVMS over other programs and increasing applications to EVMS Undergraduate Medical Education and Graduate Medical Education and health-professions programs.

Research | Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL 41

42 Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL | Research

• Graduate School: EVMS offers several Master’s/PhD programs (Master’s in Biotechnology, Master’s/PhD in Biomedical Sciences). Knowledge of the functions and regulatory issues regarding biorepositories as well as opportunities to intern in the repository is a component that can augment EVMS’ educational programs and become a part of the program’s curriculum. Facilitation with the elements of the biorepository may provide job opportunities for our graduates.

• Research: Agencies that fund research increasingly emphasize the application of various “omics” approaches to disease by directly assaying well-annotated human specimens. While by no means eliminating in vivo and in vitro models, the “omics” technologies have allowed for discovery and identification of prognostic and therapeutic targets in human samples. This is an opportunity for EVMS to compete with well-resourced academic medical centers in translational research. Well-endowed as they may be, academic tertiary centers of care frequently lack access to large numbers of samples that encompass pre-diagnostic (e.g. screening), diagnostic and treatment/post-treatment samples. EVMS may find it challenging to directly compete on broad fronts of biomedical research requiring ongoing heavy investments in technology and expertise. However, through a biorepository, it can manage valuable resources that enable EVMS investigators to both initiate research and develop collaborations and partnerships that leverage the expertise, talents and resources of this community. Recent literature suggests that funding agencies will demand test accuracy and compliance with standards before funding research protocols while journal editorial boards demand documentation of proper biospecimen handling before accepting manuscripts. (Arch Pathol Lab Med 2014;138:452).

• Patient Care: Ultimately, teaching students and facilitating research will lead to enhanced patient care. As primary care is rendered more often by physician assistants and nurse practitioners, physicians will take on new roles in personalized medicine and clinical and translational research.

ApplicationThe long-term goal is development of a biorepository that identifies EVMS as a trustee of resources for translational research.

With appropriate annotation of clinical data elements and ongoing follow-up data, the biorepository can also provide resources for outcomes research. Intimately linked to this objective is the need to enhance and cultivate the relationships of EVMS with key clinical partners, including Sentara, CHKD and Bon Secours. It is critical that the biorepository be perceived as an accessible, trusted third party that is dedicated to the custodianship of clinical data and samples. The biorepository thus has responsibility for securely housing, distributing and disposing of biorepository specimens and data.

Managing Expectations A basic biorepository as outlined in this strategic planning document can provide key components of biorepository storage

and distribution to programs at EVMS, collaborators and partners. Prospective sample collection requires consent, data entry and negotiations with clinicians, clinics and programs.

Obtaining Institutional Review Board (IRB) approval and consent of prospectively sampled subjects demands staff time and resources. In other words, future significant expansion of the biorepository will require an analysis and expansion of staff and resources. The histology functions of the biorepository can be leveraged to support routine histology needs of investigators in the institution. However, digitization, image analysis and morphometry, such as might be encountered in an imaging core, require a larger commitment of staff and resources.

In addition, the quality of the database will determine the level at which epidemiological and outcomes research can be conducted. Some programs may require only basic annotation of clinical data elements. However, at the higher end of the spectrum of data richness and data quality, more focus and resources must be given to data management, which includes quality control.

The depth, quality and updating of data will determine the degree to which the database is acceptable to an epidemiologist. This also means that not all data within the database may be suitable for clinical “outcomes” research. Therefore, the extent to which the biorepository database can function as a robust resource for epidemiological research will be determined by the quality of data that goes in. This would require epidemiological input up front for each program that participates should the goal for that program be a robust database suitable for epidemiological research. The transfer of clinical data to the biorepository database to populate desired clinical data elements naturally also requires that personnel (typically a Clinical Research Associate, RN) have appropriate access to electronic health records or paper records. This requires negotiation with prospective partners.


n Defined objectives1. Augment the EVMS biorepository for translational research and consolidation into one centralized system

2. Designate EVMS Pathology and Anatomy as custodian of the biorepository

3. Align the biorepository and support elements (histology, immunohistochemistry and imaging) under EVMS Pathology and Anatomy

4. Obtain accreditation for EVMS biorepository to ensure compliance with national standards

n Implementation/Components EVMS’ biorepository is currently housed in the Leroy T. Canoles Jr. Cancer Research Center. Its primary focus has been on banking cancer-related specimens. Pathology involvement is limited to a single board-certified pathologist. Several studies and research funding agencies required a minimum of two pathologists to review diagnostic material to ensure diagnostic accuracy and necessitated ad-hoc collaboration. All studies using archived material are based on the assumption that a correct diagnosis is rendered. Movement of the biorepository under EVMS Pathology and Anatomy will provide critically needed direct pathologist oversight as well as provide additional board-certified pathologists to augment the center. The department will maintain oversight and ensure standards are met. Use of the facility by EVMS faculty and partners is an institutional issue. As part of the biorepository administration, an advisory board should be established. It is recommended that the Vice Dean for Research appoint several faculty as an advisory group to outline policies on access and use of the facility while the pathology department ensures compliance with national operational standards. The mission of the repository should expand to include other tissue samples from infectious diseases, metabolic disorders, neurologic disorders and other non-neoplastic entities. As part of the strategic plan, an interest in placental research has surfaced. Nationally, this is a high-yield venue of research, which should attract national funding over the next several years. (New York Times, July 14, 2014, “The mysterious tree of a newborn’s life. The push to understand the placenta.”) While most biorepositories have focused on cancer biospecimens, biobanking placenta would distinguish EVMS from other biorepositories. Based on the research interests of EVMS faculty, the biorepository can accommodate other IRB approved research protocols.

n Feasibility/AssessmentThe existing biorepository housed in the Canoles Cancer Research Center has sound and productive work flows in place for sample procurement, storage and annotation. This includes bar coding for liquid samples such as serum, plasma, and urine. For selected programs (GU Oncology and ENT), these well-established procedures include identification and consent of subjects; sample procurement and archiving; and data entry (e.g. annotation). The IRB approval processes have been highly regarded. They can serve as a model for future developments and collaborations. It is critical that this valuable experience and institutional knowledge be preserved and conveyed to current and newly engaged EVMS and collaborating investigators. Good working relationships exist with Sentara Norfolk General Hospital, Urology of Virginia and Bon Secours for prospective procurement of samples.

In today’s environment, security of the database is a paramount responsibility of the trustee (e.g. EVMS and the biorepository). This security does not translate into inaccessibility by collaborators and investigators as the degree of access can be apportioned according to needs. Furthermore, reports can be generated that are stripped of identifiers. Thus, EVMS and the biorepository are trustees of clinical data, but have a simultaneous responsibility to make appropriate data readily available to investigators. Centralization of databases within institutions is recognized as an important step toward securely housing clinical data and is a requirement for accreditation. A set of policies and procedures exists that could be a template for the proposed institution-wide biorepository. Managing this and other partnerships will require the attention of upper-level leadership at EVMS.

n Investment/Resources • Dedicated personnel for hardware and software management; biorepository procurement, data entry, reporting,

and regulatory tasks; and distribution and histology tasks and functions

• Additional personnel and equipment, beyond those available in the Canoles Cancer Research Center, for expanded biorepository functions such as database management, immunohistochemistry and imaging/digitizing functions


Personnel needs

• Consulting pathologists

• Departmental secretary

• Biorepository supervisor

• Repository technician

Equipment needs

• NanoZoomer scanning system with 210 slide capacity with fluorescence units. Obtain in Year 3

• Automated Tissue Microarray. Obtain in Year 1-2

• Freezers: Two new -85°C freezers initially and others to be provided by departments providing specimens

• Cryostat

• Bar Scanner (The current repository has bar code annotating and scanning equipment)

• Microtome

• Computer and hardware (a mirrored server that allows access to Urology of Virginia and also serves as a backup)

• Miscellaneous (alarms, thermometers, battery backup for freezers)

Accreditation Fees

• Application fee: $1,000

• Accreditation fee: $4,000/year

• Departmental administrative expenses (supplies, marketing and meetings)

Database management

A core requirement for the biorepository is a useful, user friendly, and secure database for annotation of specimens with clinical data elements that can be continually updated with treatment and outcomes information. This database requires support such as servers, software, and even networking capabilities to ease access while maintaining appropriate security.

The existing cancer center biorepository database is housed in Caisis, an open-source data-management system. Hardware and software components may require assessment and evaluation for scalability, updating, etc. While developed for cancer biorepositories, it is reasonable to explore the feasibility of using Caisis in other settings. Other databases may be brought forward as well, but multiple systems can quickly overwhelm available financial and staffing resources.

Implementation of a barcode system standard in laboratories to track specimens is needed.

Quality histological sections are required. Diagnostic accuracy is essential. Many biorepositories have moved to a system where glass slides are scanned and consulting pathologists at different sites can view the slides, rendering a diagnosis and annotating the areas of interest for the researcher and preparation of the tissue arrays. An additional microtome is needed and potentially a slide scanner.

Additional IT support, software and hardware may be needed for accreditation. Additional equipment to include alarms, thermometers and other equipment needed for accreditation may be needed.

n Project leadersRichard Conran, PhD, Professor and Chair of Pathology and Anatomy Dean Troyer, MD, Professor of Microbiology and Molecular Cell Biology

n Performance metrics• Increased grant applications using the biorepository


• Expansion of biorepository to non-cancer principal investigators

• Increased manuscripts based on research using archived specimens

• Increased partnerships for use of the repository with non-EVMS personnel

• Increased research opportunities for students

• Increased indirect costs to EVMS for research using biorepository assets

• Increased revenue to repository from fees and indirect costs

Return on Investment: There are different forms of “payment” that can accrue to a biorepository. Diagnostic companies are realistic in their budgeting and will seek out reasonably priced samples. Over the past five years, funded projects have been performed with the following diagnostics companies: Aureon, Exosome Diagnostics, MDx, Oncomethylome (predecessor to MDx) and IRIS.

National funding: The biorepository currently receives support as a sub-site within the National Cancer Institute (NCI) Cooperative Human Tissues Network, and EVMS-affiliated investigators have received support from the NCI for development of bioreposiotry improvements in Caisis. In some instances, a biorepository will facilitate the funding of academic grants. Submitted grant budgets can include part-time technician or other personnel salaries. Per-sample costs also can be included in budgets.

A broader question to be considered is, if national accreditation becomes a future requirement by research funding agencies in 5-10 years and EVMS is not accredited, what will be the impact on EVMS? Will EVMS revenue and partnerships be compromised?

n Future initiatives• Expansion of histology services

• Provide quality service currently unavailable such as Immunohistochemistry of Tissue Microarrays and expand histology service line outside of EVMS to generate more revenue

• Housing in EVMS Pathology and Anatomy will provide for continual oversight and training of personnel by pathologists

• Realignment of histology and immunohistochemistry to EVMS Pathology and Anatomy will provide researchers with in-house pathology consultation

• Addition of a Master’s program for pathology assistants will provide part of the salary for a biorepository supervisor; repository functions will be a component of the Pathology Assistant Master’s program

STRATEGIC PLANNING YEAR DELIVERABLESYEAR 1 • Appoint advisory group

• Realign biorepository to EVMS Pathology and Anatomy

• Acquire CAP biorepository checklist

• Identify areas where EVMS is not in compliance with national standards

• Purchase equipment as outlined above

• Promote the biorepository to EVMS and regional partners

• Survey EVMS faculty, departments, centers and institutes in conjunction with the EVMS IRB office to identify existing biorepositories

• Develop and promote plan to centralize EVMS campus biorepository activities

• Identify resources and personnel that can provide Quality Assurance for data in the biorepository

• Seek opportunities with EVMS Development to solicit donations to fund the biorepository

YEAR 2 • Continue to bring repository in compliance with College of American Pathologists (CAP) accreditation standards

• Continue promotion of biorepository to EVMS and the Hampton Roads area

• Centralize EVMS biorepositories

• Seek opportunities with EVMS Development to solicit donations to fund biorepository

YEAR 3 • Continue to bring repository in compliance with CAP accreditation standards

• Apply for accreditation

• Continue promotion of biorepository to EVMS and the Hampton Roads area

• Centralize EVMS biorepositories


YEAR 4 • Maintain accreditation

• Continue promotion of biorepository to EVMS and Hampton Roads area


• Continue to expand repository




Deliverables | Goal R1


Business Plan | Revenue and Expense Statement | Goal R1

EVMS



EVMS STRA


CIAL TEM

PLAT

EMISSION AREA:

OBJECTIVE

:Research

R1 -‐ Bioreposito

ry augmentatio

n, adm

inistration and accredita

tion

FISCAL YEA

R:2015

2016

2017

2018

Year 1

Year 2

Year 3

Year 4

Total

Revenue:

Strategic Plan

Fun

ding

-‐ One

Tim

e$2

81,071

$113

,925

$260

,205

$0$6

55,201

Strategic Plan

Fun

ding

-‐ Re

curring

$98,40

0$1

78,900

$0$0

$277

,300

Net Patient Revenue

$0$0

$0$0


$0$0

$0$0

$0Grant R

evenue

$0$100,000

$250,000

$250,000

$600,000

Indirect Cost R

ecovery

$0$46,500

$116,250

$116,250

$279,000

Contractual Revenue

$0$15,000

$30,000

$50,000

$95,000

Inter-‐Divisio

nal Revenue

$5,000

$10,000

$15,000

$20,000

$50,000

Tuition

and Fees

$0$0

$100,000

$200,000

$300,000

EVMS Foundatio

n$0

$0$0

$0$0

Other Revenue

$0$0

$0$0

$0$384,471

$464,325

$771,455

$636,250

$2,256,501

Operatin

g Expenses:

Salarie

s & W

ages

$82,500

$170,000

$172,400

$174,848

$599,748

Fringe Benefits

$9,900

$26,400

$26,928

$27,467

$90,695

Supplies

$45,000

$10,000

$10,000

$10,000

$75,000


$0$0

$0$0

$0Ge

neral Expenses

$6,000

$4,000

$4,000

$4,000

$18,000

Additio

nal G

rant Dire

ct Costs

$0$100,000

$250,000

$250,000

$600,000

Add'l. Education Prog. Expense

$0$40,000

$44,000

$122,000

$206,000

PP&E

$241,071

$113,925

$260,205

$0$615,201

Shared Services

$0$0

$0$0

$0$384,471

$464,325

$767,533

$588,315

$2,204,644


$0$0

$3,922

$47,935

$51,857

Total Revenue

Total O

peratin

g Expenses


Strategic Plan Funding Milestones | Goal R1Equipm

ent

Director

Lab

Supervisor

Position

Technician

Position

Adm

in

Position

Office

Furnishings

and

Computers

Accreditation

Fees

Path Assist.

start up

costs/

Marketing

Misc supp

lies

and general

expenses

Less: Other

Revenue

Total -‐

Strategic Plan

Fund

ing

Year

1

$ 241,071 $ 37,500

$ 36,600 $ 18,300

$ -‐ $ 35,000

$1,000

$-‐ $ 15,000 $ (5,000) $ 379,471

•Appointment o

f advisory group

✓✓

✓✓

✓✓

•Realignm

ent o

f Biorepository to

EVM

S Pathology

and

Ana

tom

y✓

✓✓

✓✓

✓•Acquire CAP Bioreposito

ry checklist

✓✓

✓✓

✓✓

✓•Survey EVM

S faculty, departm

ents, centers and institu

tes in

conjunction with

the EV

MS IRB office to identify existin

g bioreposito

ries

✓✓

✓✓

•Hire

Lab Supervisor

✓✓

✓•Develop and promote plan to

centralize EV

MS campus

bioreposito

ry activities

✓

•Identify areas where not in com

pliance with

national standards

✓•Identify resources and personnel that can serve to

Quality

Assure data in th

e bioreposito

ry

✓

•Prom

ote the bioreposito

ry to

EVM

S and regional partners

✓Year 2

$ 113,925 $ 50,000

$ 73,200 $ 36,600

$ 36,600

$-‐ $

4,000

$ 40,000 $ 10,000 $ (71,500) $ 292,825

•Receive approval fo

r Pathology Assistant Program

for FY17

program start

✓✓

✓

•Establish biorerpository interdivisional billing mechanism

(recharge center)

✓

•Centralize EV

MS bioreposito

ries

✓•Report on number of grant proposals submitted using biorepository

✓•Co

ntinue to

bring reposito

ry in com

pliance with

CAP accreditatio

nstandards

✓✓

✓

•Prom

ote the bioreposito

ry to

EVM


✓✓

Year 3

$ 260,205 $ 50,000

$ 74,664 $ 37,332

$ 37,332

$-‐ $

4,000

$ 10,000 $ (213,328)

$ 260,205

•Apply for accreditatio

n✓

✓•Matriculate Pathology Assistant students

(target: 4 students)

✓•Report on number of grant proposals submitted using biorepository

✓•Prom

ote the bioreposito

ry to

EVM


✓✓

•Perform services for external organizations and invoice for services

✓Year 4

$-‐ $ -‐ $

-‐ $

-‐ $ -‐ $

-‐ $

-‐ $

-‐ $

-‐ $

-‐

•Co

ntinue promotion of biorepository to

EVM

S an

d the

Ham

pton Roads

area

•Perform services for external organizations and invoice for services

Grand Total

$ 932,501

Eastern Virginia Medical Schoo

lStrategic Plan Fun

ding M

ileston

esResearch: Biorepository

Goal R2: Coordinate and augment women’s and reproductive research at EVMS.

Two initiatives support achievement of this goal:

• To enhance Women’s Health and Infant Research that will advance EVMS in research as well as education, health care and community outreach.

• To help expand CONRAD’s portfolio and funding base and enhance its competitiveness in future funding competitions

Initiative 1: To enhance women’s health and infant research that will advance EVMS in research as well as education, health care and community outreach.

RationaleA gender-specific prevalence of disease and clinical disorders (e.g. breast cancer, osteoporosis, bone fractures, diabetes and

cardiovascular disease associated with the onset of menopause) occurs in women. In the U.S., there is an alarmingly high rate of infertility and complications of pregnancy (e.g., hypertension/preeclampsia, diabetes, and premature birth) that compromise fetal growth and development and increase the incidence of infant mortality and risk for newborns to develop diseases in adulthood (e.g. diabetes, hypertension, neurologic disorders) as well as compromise maternal well-being not only during the pregnancy but later in life. This makes women’s health and infant development a critically important area of medical care and a targeted area of the NIH. Emphasizing this area also support EVMS’ mission by seeking to address health disparities in the community it serves.

Alignment with EVMS’ overall missionBuilding a program focusing on women’s health and infant development will strengthen and integrate already strong and

externally funded research programs, increase utilization of non-human primate translational models unique to EVMS, capture the clinical and clinical-science expertise and patient base in OB/GYN, create opportunities for medical and health-professions students to be integrated into and involved in community-based/targeted research and education. These efforts will move science from lab to bedside to the community.

Achievement in this targeted area also is expected to advance the education, patient care and research missions as well as bring many benefits to EVMS, its hospital partners and the community. These benefits include raising the academic stature and visibility of EVMS nationally and internationally, and improving our ranking in benchmarks established by the Association of American Medical Colleges; advancing the national profiles of teaching hospitals affiliated with EVMS, including Sentara Healthcare and Children’s Hospital of The King’s Daughters; attracting nationally and internationally recognized physicians and scientists to the EVMS faculty, and, thus, enhancing our educational and patient-care programs; increasing our competitiveness in recruiting medical students, residents, graduate students, postdoctoral candidates and clinical fellows to our educational programs; distinguishing the clinical-care programs at EVMS and affiliated teaching hospitals; strengthening the bond between EVMS and the community it serves; and increasing the role of biomedical research in the local economy.

The first focus area to research is the placenta. The National Institutes of Health (NIH) has announced its intent to fund placenta research and EVMS has the resources and intellectual assets on hand to be successful in this area of discovery. By utilizing EVMS’ established areas of excellence in women’s and infant health and allowing for collaboration among departments, EVMS is poised to be competitive in this type of research. By securing seed funding, investigators from various departments can collaborate to maximize EVMS’ existing assets and become competitive in this market. Existing assets include:

1. The science is in the realm of that already in place in the research laboratory of Gerald Pepe, PhD, EVMS Foundation Chair in Biomedical Sciences and Chair of Physiological Sciences, which has NIH funds (NIDDK 93950; 5/1/13-4/31/17) to support study of the role of estrogen on placental development and impact on the fetus including development of insulin resistance in adulthood. Studies are conducted with the lab of Jerry Nadler, MD, Harry H. Mansbach Chair in Internal Medicine, Vice Dean for Research and Chair of Internal Medicine.

2. The clinical expertise, ultrasound technology and ability to do 3D reconstruction (Alfred Abuhamad, MD, Mason C. Andrews Chair in Obstetrics and Gynecology, Vice Dean for Clinical Affairs and Chair of Obstetrics and Gynecology) and the patient population are already in place in the Maternal Fetal Medicine program at EVMS.



3. EVMS Pediatrics has the expertise and infrastructure to perform follow-up studies of adolescents born to high-risk pregnant mothers.

4. The topic addresses an important clinical area as the incidence of infant mortality, high-risk pregnancy are particularly high in the Hampton Roads communities; the educational program will be easy to market and have considerable appeal to the local communities.

5. Expertise in outcomes research is a strength of the faculty in the Master of Public Health program/EVMS Epi-Bio core and EVMS Pediatrics.

6. Understanding and performing stress analysis is a significant strength of faculty in EVMS Psychiatry and Behavioral Sciences.

7. Community outreach is a strength and goal of EVMS.

8. The potential to expand this expertise nationally and internationally exists through the M. Foscue Brock Institute for Community and Global Health here at EVMS.

9. Facilitate and utilize a state of the art biorepository.

Justification for placenta research

Epidemiologic evidence shows that various endogenous and environmental factors can affect placental function and impact maternal well-being, fetal growth and development of disease(s) in adulthood. Findings from animal models emphasize the need for further research in this arena, and human studies have shown that cognitive and behavioral development can be impaired by maternal health factors.

n Defined objectives1. Establish a dialogue using open forums initiated by team leaders from EVMS OB/GYN and Physiological Sciences

with other basic- and clinical-research investigators, the Brock Institute, CHKD and local colleges and universities

2. Solicit concept papers from EVMS faculty and other scientists that would support and augment women’s research at EVMS incorporating the existing assets previously referenced (A minimum of two EVMS departments must be included in the concept paper to nurture cross-departmental collaboration. Highest priority will be given to papers that incorporate community outreach, student involvement and probability of future external funding.)

3. Establish a Scientific Review Committee (including EVMS Research and team leaders) to evaluate and award the projects

4. Provide awards to the best proposals

5. Investigators receiving awards submit proposals for external funding

6. Conduct workshops and make awards annually over three years

n Implementation/Components• Develop required proposal formats and timelines and organize the workshop to discuss potential projects and

themes

• Identify the Scientific Review Committee and seek reviewers for the solicited concept papers in collaboration with the EVMS Research Advisory Committee

• Award projects with highest priority going to those that incorporate community outreach, utilization of EVMS’ existing assets (i.e. MFM, non-human primate colony, ultrasound program, Jones Institute, Brock Institute, etc.), student involvement and probability of external funding

• Workshops and awards will occur annually over three years

• Investigators awarded projects expected to submit proposals for external funding

• Monitor project status, external funding proposals and publications generated from the seed funding


n Feasibility/Assessment• Seed funding for these projects will likely generate additional external funding and provide a mechanism to nurture

interdepartmental collaboration. As noted, the NIH has already expressed an interest in this area.

• Potential risks include the fact that the identified projects may not have successful outcomes nor be unique enough to be funded due to the competition for research support.

• Barriers to implementation are minimal since the objective utilizes existing EVMS faculty, staff and resources such as laboratory space.

• Competition for the pilot projects would not be a problem since everyone is seeking new ideas and funding. However, future funding is problematic based on the uniqueness of the project and its successful completion within the defined timeline of two to three years.

• There are no obvious legal/regulatory issues, or relevant accreditation factors to be considered.

• Marketing and support of a broad-based research endeavor focused on women and children is relevant and important in the long range planning for a Women’s Health and Infant Research Center at EVMS. Identification of local foundations or individuals interested in supporting such a program would be important.

n Investment/Resources• Seed funding to be awarded by the Scientific Review Committee under the direction of EVMS Research

• Annual support for workshops to facilitate discussion and collaboration between departments (i.e. William & Mary model)

n Project leaders Gerald Pepe, PhD, Chair and Professor of Physiological Sciences and the EVMS Foundation Chair in Biomedical Sciences Alfred Abuhamad, MD, Chair and Professor of Obstetrics and Gynecology and the Mason C. Andrews Chair of Obstetrics and Gynecology

n Performance metrics• Number of grant proposals

• Number of awards

• Number of manuscripts

• Number of presentations

• Number of research projects in collaboration with Sentara, ODU and other partners

• Community outreach results

• Increased regional and national recognition as a leader in placenta and reproductive research



Deliverables | Goal R2 | Initiative 1

STRATEGIC PLANNING YEAR DELIVERABLESYEAR 1 • Schedule workshop to generate project ideas

• Appoint Scientific Review Committee

• Solicit concept papers

• Make Year 1 awards

YEAR 2 • Team leaders and EVMS Research review Year 1 awards including monitoring status and project results

• Year 1 investigators submit proposals to external funding agencies

• Investigators present and publish findings

• Schedule workshop to generate project ideas for Year 2 awards



YEAR 3 • Review Year 1 and Year 2 awards including monitoring status and project results (Team leaders and EVMS Research)

• Submit proposals to external funding agencies (Year 1 and 2 investigators)

• Present and publish findings (Investigators)

• Schedule workshop to generate project ideas for Year 3 awards



YEAR 4 • Continue to monitor results for all awards (Team leaders and EVMS Research)

• Submit proposals to external funding agencies (Investigators)

• Present and publish findings (Investigators)

n Financial pro-forma See page 56.

Initiative 2: To enhance the competitiveness of CONRAD in future funding competitions.Rationale/Justification

CONRAD is the most successful research enterprise in the history of EVMS having received more than $400M in project funding and associated indirect costs (IDC). These IDC have significantly benefitted EVMS as a whole. Last year, CONRAD was able to secure more than $80M in funding. That said, this funding is narrowly focused on topical prevention of HIV acquisition. Very little funding is currently available to other areas of priority research and CONRAD’s expertise such as contraception, STI prevention and reproductive/maternal health. Expanding CONRAD’s R&D portfolio would lead to a wider funding base and the possibility of new funding sources. CONRAD has an extensive track record of successful grantsmanship, which in combination with new, innovative data from pilot projects in the above mentioned areas can lead to increased and more competitive funding applications, ultimately expanding EVMS’s total research budget.

n Defined objectives• Establish a dialogue using open forums initiated by CONRAD with other Basic and Clinical Research Investigators at

EVMS and local colleges and universities.

EVMS has strong research interests in virology/ immunology within EVMS Microbiology and Molecular Cell Biology and significant research in reproduction within EVMS Physiological Sciences and EVMS Obstetrics and Gynecology. CONRAD should take the lead in developing a meeting of interested parties within EVMS and from local colleges and universities to enhance and encourage interaction between the groups with a goal to developing research projects that would expand CONRAD’s portfolio and funding base and enhance its competitiveness for future grants/contracts. This meeting would allow each investigator or group to present background information on their research and then allow time for an open discussion of how this activity would interact with the other investigators programs. The meeting output would be the identification of two to three broad areas that would address potential interaction and synergism with CONRAD.

• EVMS would provide pilot funding for 3 years for two or three of the concept papers.

The need for funding of pilot programs is important. Current CONRAD funding is totally committed to specific programs and projects. The selected projects could have differential funding but would not exceed the total cap. The projects would have clearly identified sources for future funding based on anticipated outcomes. The plan would be to provide funding to enhance indirect dollar return already provided by the school.

• CONRAD in collaboration with EVMS Research will solicit concept papers from the EVMS faculty and other scientists that would support and augment CONRAD areas of R&D.

CONRAD would assist EVMS Research in establishing a Scientific Review Committee composed of faculty and administrators from EVMS. This committee would be charged with soliciting concept papers from EVMS and local colleges and universities. These concept papers would be reviewed and scored by scientists selected by the committee relative to unique or innovative ideas, which support or improve existing CONRAD research, can have significant results within 2-3 years, have a theme that is within the CONRAD mission and have a clearly defined future funding source.

n Implementation/Components1. Identify an individual (Director or Project Leaders) tasked with moving the project forward, who is approved by Vice

Dean of Research Jerry Nadler, MD, and CONRAD Executive Director Gustavo Doncel, MD, PhD, in consultation with Chair of Obstetrics and Gynecology Alfred Abuhamad, MD.

2. The Director will lead an advisory committee to develop the goals and timelines as well as organize the initial meetings to discuss potential projects and themes.

3. The Director will identify and help establish the Scientific Review Committee, and seek reviewers for the solicited concept papers in collaboration with the Research Advisory Committee of the School.

4. The Director will oversee the progress of the selected studies, and will provide semi-annual progress reports to the Director of CONRAD and the EVMS Vice Dean for Research.



n Feasibility/Assessment• The environment is conducive to develop synergisms within the local research community. CONRAD is funded and

has a successful track record while EVMS scientists have well established and proven research activities. There is a need to enhance communication and collaboration between these individuals and entities.

• Potential risks include the fact that the identified projects may not have successful outcomes nor be unique enough to be funded due to the competition for research support.

• Barriers to implementation are minimal since the concept utilizes existing EVMS Faculty, Staff, and resources such as laboratory space.

• Competition for the pilot projects would not be a problem since everyone is seeking new ideas and funding. However, future funding is problematic based on the uniqueness of the project and its successful completion within the defined timeline of two to three years.

• There are no obvious legal/regulatory issues, or relevant accreditation factors to be considered.

• Marketing and support of a broad based research endeavor focused on women and children is relevant and important in the long-range planning for a Women’s and Infant Health Research Center at EVMS. Identification of local foundations or individuals interested in supporting such a program would be important.

• The important relevant items are the enthusiasm of the investigator and the uniqueness or innovation in the project, with its relevance directly linked to the CONRAD mission.

n Investment/Resources• The personnel for the project exist within CONRAD, EVMS, and local Colleges and Universities.

• The space exists in the EVMS laboratories and clinical facilities and those of surrounding local colleges, and university. No new space would be required rather existing space could be modified if needed.

• IT hardware such as computers may be needed; while there are existing IT facilities in place at EVMS.

• Equipment and supplies would be contingent upon the solicited scientific proposals.

• Departments at EVMS would be supported for supplies and personnel costs related to the activity.

n Project leader David Archer, MD, Director of the CONRAD Clinical Research Center Gustavo Doncel, MD, PhD, Executive Director of CONRAD

n Performance metrics• Appointment of the project director and establishment the advisory committee including key external advisors

• Scheduling and implementation of two meetings between CONRAD and the local scientific community to identify and develop themes for the program

• Solicitation of concept papers to be reviewed by the Scientific Review Committee

• Identification and appointment of the members of the Scientific Review Committee

• Evaluation and Selection of concept projects for further development and submission for evaluation by the Scientific Review Committee

• Selection of the most promising research projects that can be accomplished within the budget and timelines proposed

• Semiannual progress reports on the funded projects

• Submission of grant/contract applications to funding agencies (local, regional and national) based on data from the funded projects

• Presentation of the work in progress at national and international meetings

• Submission of and acceptance of manuscripts related to the funded research to peer-reviewed journals



Deliverables | Goal R2 | Initiative 2

STRATEGIC PLANNING YEAR DELIVERABLESYEAR 1 • Appoint project director and establish advisory committee

• Organize meetings between CONRAD and local scientific community

• Identify and appoint members of the Scientific Review Committee

• Identify local foundations or individuals to support program


• Select and fund 2-3 worthy projects

YEAR 2 • Semi-annual progress report on funded projects reviewed by Scientific Review Committee to determine if another round of funding is warranted

YEAR 3 • Semi-annual progress report of funded projects reviewed by Scientific Review Committee

• Publication of results

• Submission of new grants/contracts

YEAR 4 • Assist CONRAD with competitive renewal process with USAID or new sponsors/agencies identified based on the research track

• Publication of results

• Submission of new grants/contracts

• Semi-annual progress report of funded projects reviewed by Scientific Review Committee (if projects are not completed)


56 Strategic Plan FY 2015 – FY 2018 • EASTERN VIRGINIA MEDICAL SCHOOL | Research


EVMS


evenue and

Expense Statement

EVMS STRA


CIAL TEM

PLAT

EMISSION AREA:

OBJECTIVE

:Research

R2 -‐ To coo

rdinate and augm

ent W

omen's and Reproductive Research at EVM

S

FISCAL YEA

R:2015

2016

2017

2018

Year 1

Year 2

Year 3

Year 4

Total

Revenu

e:Strategic Plan

Fun

ding

-‐ One

Tim

e$2

20,000

$220

,000

$220

,000

$0$6

60,000

Strategic Plan

Fun

ding

-‐ Re

curring

$0$0

$0$0

$0Net Patient Revenue

$0$0

$0$0


$0$0

$0$0

$0Grant R

evenue

$0$0

$0$250,000

$250,000

Indirect Cost R

ecovery

$0$0

$0$79,352

$79,352

Contractual Revenue

$0$0

$0$0

$0Inter-‐Divisio

nal Revenue

$0$0

$0$0

$0Tuition

and Fees

$0$0

$0$0

$0EV

MS Foundatio

n$0

$0$0

$0$0

Other Revenue

$0$0

$0$0

$0$220,000

$220,000

$220,000

$329,352

$989,352

Operatin

g Expenses:

Salarie

s & W

ages

$0$0

$0$0

$0Fringe Benefits

$0$0

$0$0

$0Supplies

$0$0

$0$0

$0Co

ntractual Services

$0$0

$0$0

$0Ge

neral Expenses

$220,000

$220,000

$220,000

$0$660,000

Additio

nal G

rant Dire

ct Costs

$0$0

$0$250,000

$250,000

PP&E/De

preciatio

n$0

$0$0

$0$0

Shared Services

$0$0

$0$0

$0$220,000

$220,000

$220,000

$250,000

$910,000


$0$0

$0$79,352

$79,352

Total Revenue

Total O

peratin

g Expenses


Strategic Plan Funding Milestones | Goal R2

Aug

ust 2

9, 201

4

Wom

en's

Research

Worksho

p

Wom

en's

Research

Seed Fun

dsCO

NRA

D

Worksho

pCO

NRA

D

Seed Fun

dsLess: Other

Revenue

Total -‐

Strategic Plan

Fund

ing

Year 1

$ 10,000

$ 100,000 $ 10,000

$ 100,000 $ -‐ $ 220,000

App

ointmen

t of a

dvisor

y/scientific review

com

mitt

ee✓

✓✓

✓Sc

hedu

le w

orksho

ps and

mee

tings to

excha

nge idea

s an

d de

velop co

llabo

ratio

n plan

s✓

✓✓

✓

Solic

it co

ncep

t pap

ers to be ev

alua

ted an

d aw

arde

d by

scientific review

com

mitt

ee✓

✓

Year 2

$ 10,000

$ 100,000 $ 10,000

$ 100,000 $ -‐ $ 220,000

Sche

dule w

orksho

ps and

mee

tings to

excha

nge idea

s an

d de

velop co

llabo

ratio

n plan

s✓

✓✓

✓

Mon

itor resu

lts of Y

ear 1 aw

ards

and

review

progres

s repo

rts

✓✓

Repo

rt on nu

mbe

r of fa

culty

sub

mitt

ing gran

t propo

sals,

pres

entin

g an

d pu

blishing

find

ings bas

ed on stud

y resu

lts✓

✓✓

✓

Solic

it co

ncep

t pap

ers to be ev

alua

ted an

d aw

arde

d by

scientific review

com

mitt

ee✓

✓

Year 3

$ 10,00

0 $ 1

00,000

$ 10,00

0 $ 1

00,000

$ -‐

$ 2

20,000

Sc

hedu

le w

orksho

ps and

mee

tings to

excha

nge idea

s an

d de

velop co

llabo

ratio

n plan

s✓

✓✓

✓

Mon

itor resu

lts of Y

ear 1, 2 awards

and

review

progres

s repo

rts

✓✓

Repo

rt on nu

mbe

r of fa

culty

sub

mitt

ing gran

t propo

sals,

pres

entin

g an

d pu

blishing

find

ings bas

ed on stud

y resu

lts✓

✓✓

✓

Solic

it co

ncep

t pap

ers to be ev

alua

ted an

d aw

arde

d by

scientific review

com

mitt

ee✓

✓

Year 4

$ -‐ $ -‐ $ -‐ $ -‐ $ -‐ $ -‐

Mon

itor resu

lts of a

ll aw

ards

and

review

progres

s repo

rts if

ongo

ing

Assist C

ONRA

D w

ith com

petit

ive rene

wal proce

ss or othe

r prop

osals ba

sed on

rese

arch

resu

lts

Grand Total

660,000

$

Eastern Virginia Medical Schoo

lStrategic Plan Fun

ding M

ileston

esResearch: Wom

en's Health and Reprod

uctive Research

Goal R3: Develop and expand capacity for health analytics and data analysis at EVMS.

n Defined objectives1. To establish the Center for Health Analytics and Discovery (CHAD) in the EVMS Research office to coordinate and

centralize services for health analytics and data analysis at EVMS

2. To enhance the capability of the Epi-Bio Core in the join EVMS-ODU Graduate Program in Public Health (GPPH)

n RationaleEVMS has increasing demands for research support in the areas of evidence-based medicine, translation of biomedical research and health-analytics research. Skills in biostatistics, epidemiology and research design are indispensable for the success of research in different disciplines, and there has been a proliferation of units that provide this expertise within academic health centers nationally.

The Epi-Bio Core is integral to the GPPH and is essential for managing and growing the program, which includes both teaching and research functions. Faculty in the MPH Program are tasked with supporting the Epi-Bio Core, and such shared resources allow for the Program to meet Council on Education for Public Health (CEPH) accreditation requirements. Enhancing the Epi-Bio Core will allow the MPH Program to continue to meet its accreditation requirements, educational mission and statistical-service activities across campus.

The functions of the Epi-Bio Core include:

• Study design (experimental or observational)

• Data analysis

• Database development and data management

• Evaluation methods

• Survey research

• Qualitative research (e.g., focus groups and structured interviews)

• Community engagement strategies

• Writing section(s) of grant proposal

• Preparation of appropriate grant and manuscript sections

• Software usability or task analysis

• Other services, as needed

However, there is a lack of coordination of these services across EVMS that limits collective planning for large projects and planning for growth. EVMS Pediatrics also has developed a robust program in Epi-Bio that has served the needs of faculty, students and residents. In addition, other departments, including EVMS Internal Medicine, the Brock Institute and EVMS Family and Community Medicine, have programs supporting their faculty and resident research design and/or statistical analysis needs.

n Implementation/ComponentsReaching the goal and objectives will require additional personnel and other resources — primarily in the establishment of the CHAD and in enhancing the coordination and capabilities of the Epi-Bio Core with other sites of Epi-Bio research expertise on campus. Ideally, hiring of a Director/researcher and recruitment of additional faculty and staff should be completed in 12-18 months.



n Feasibility/AssessmentResearch demands at EVMS continue to outpace research infrastructure resources. Expansion of health analytics and data analysis at EVMS will allow for continuation of current service capacity while providing research support for faculty to seek funding from external (e.g., PCORI) and private (e.g., Sentara) sources.

CHAD will coordinate expertise and services, when available, from EVMS departments that have personnel providing statistical analysis and assistance with research design. The CHAD will help set the stage for “Big Data” set analysis at EVMS so the school can better partner with area health-care systems.

EVMS has several biostatistics and epidemiology personnel aligned with various educational or clinical programs. These individuals will participate in CHAD, depending upon their commitments to other assigned duties. Dedicated personnel to provide research analysis and design support for faculty desiring to conduct research in these areas, and to apply for grants to agencies like PCORI, AHRQ and NIH, is severely limited.

Regionally, EVMS is well positioned to expand its health-analytics research to the surrounding patient populations, to expand its partnership with Sentara and other health-care systems and to utilize the pool of student talent that to contribute to research projects.

CHAD is a new research infrastructure initiative that will be based in EVMS Research office and will be under the oversight of the Vice Dean for Research. The faculty will have academic appointments in the Graduate Program in Public Health and other EVMS faculty and staff currently based in the different departments will remain based in their home departments.

n Investment/ResourcesCHAD

Establishing CHAD will require hiring:

• 1 PhD Biostatistician Director/researcher at 65% effort in CHAD. The remaining 35% effort will be funded through the Graduate Program in Public Health, where this faculty member will be appointed.

• 1 PhD Biostatistician at 65% effort in CHAD and 35% in the Graduate Program in Public Health. This position will be 100% funded by CHAD.

• 1 PhD Epidemiologist with health-analytics experience at 33% effort in the CHAD. This position will be 33% funded by CHAD and 67% by the GPPH.

• 1 Master’s-prepared (MPH or statistics) Research Associate II position at 100% effort and funding in CHAD.

Additional IT hardware, IT software, and supply expenses will be required.

Epi-Bio Core

To enhance the Epi-Bio Core functions, the PhD Epidemiology position will be upgraded. This position will continue at 67% effort in the Graduate Program in Public Health, where the faculty member appointment will reside. Funding for the position will be 67% GPPH and 33% CHAD.

n Project leaderTina Cunningham, PhD Biostatistics, would be appointed Director of CHAD.


n Performance metricsPerformance metrics for the Center include:

1. Consultation• Time spent on consulting activities

• Number of projects and investigators

2. Collaboration

• Number of grants, manuscripts, abstracts and presentations

• Number of study teams

3. Education• Number of lectures and workshops

• Time to prepare to teach and grade

• Number of students mentored and evaluated

4. Partnership• Number of research projects with Sentara, ODU, William & Mary and VCU

• Community


Deliverables | Goal R3

STRATEGIC PLANNING YEAR DELIVERABLES YEAR 1 • Hire Director/researcher by October 2014

• Hire Research Associate II position by April 2015

• Begin search for new PhD in Biostatistics

• Purchase computers with software as faculty/staff are hired

• Purchase necessary supplies

• Continue ongoing research activities

• Expand research activities

YEAR 2 • Upgrade existing PhD Epidemiology position effective July 2015

• Hire PhD in Biostatistics position by July 2015

• Purchase necessary supplies/computers

• Expand research activities

• Market services internally to EVMS research community and externally to hospital partners, educational partners and other organizations that require data expertise

YEAR 3 • Continue to expand research activities

• Continue to market services internally and externally

YEAR 4 • Continue to expand research activities

• Continue to market services internally and externally




EVMS



EVMS STRA


CIAL TEM

PLAT

EMISSION AREA:

OBJECTIVE

:Research

R3 -‐ De

velop and expand capacity fo

r health

analytics a

nd data analysis

FISCAL YEA

R:2015

2016

2017

2018

Year 1

Year 2

Year 3

Year 4

Total

Revenue:

Strategic Plan

Fun

ding

-‐ One

Tim

e$5

0,00

0$0

$0$0

$50,00

0Strategic Plan

Fun

ding

-‐ Re

curring

$105

,695

$323

,752

$278

,584

$260

,355

$968

,386

Net Patient Revenue

$0$0

$0$0


$0$0

$0$0

$0Grant R

evenue -‐ T&

E Reimbursem

ent

$12,614

$75,501

$80,744

$86,166

$255,025

Grant R

evenue -‐ New

Grants

$0$50,000

$200,000

$250,000

$500,000

Indirect Cost R

ecovery

$3,784

$37,650

$84,223

$100,850

$226,507

Contractual Revenue

$0$5,000

$10,000

$15,000

$30,000

Inter-‐Divisio

nal Revenue

$0$0

$0$0

$0Tuition

and Fees

$0$0

$0$0

$0EV

MS Foundatio

n$0

$0$0

$0$0

Other Revenue

$0$0

$0$0

$0$172,094

$491,903

$653,551

$712,372

$2,029,918

Operatin

g Expenses:

Salarie

s & W

ages

$88,125

$372,350

$379,797

$387,393

$1,227,665

Fringe Benefits

$14,269

$60,053

$61,254

$62,479

$198,053

Supplies

$36,700

$6,500

$6,500

$6,500

$56,200


$0$0

$0$0

$0Ge

neral Expenses

$33,000

$3,000

$6,000

$6,000

$48,000

Additio

nal G

rant Dire

ct Expense

$0$50,000

$200,000

$250,000

$500,000

PP&E/De

preciatio

n$0

$0$0

$0$0

Shared Services

$0$0

$0$0

$0$172,094

$491,903

$653,551

$712,372

$2,029,918


$0$0

$0$0

$0

Total Revenue

Total O

peratin

g Expenses


Strategic Plan Funding Milestones | Goal R3

Aug

ust 2

9, 2

014

Direc

tor

Position

(n

et o

f gra

nt

fund

ing)

Rese

arch

Ass

ocia

te II

Po

sition

(net

of

gra

nt

fund

ing)

PhD P

ositio

n (n

et o

f gra

nt

fund

ing)

PhD P

ositio

n (n

et o

f gra

nt

fund

ing)

Recr

uitm

ent

Office

Furn

ishi

ngs

and

Com

pute

rs

Misc su

pplie

s an

d ge

nera

l ex

pens

esLe

ss:

Oth

er

Reve

nue

Tota

l -‐

Stra

tegi

c Pl

an Fun

ding

$ 71

,480

$

1

8,30

0 $

-‐ $

-‐ $

3

0,00

0 $

3

0,20

0 $

9

,500

$

(

3,78

5)15

5,69

5$

✓✓

✓✓

✓ $

91

,494

$

6

9,54

0 $

1

56,4

00

$ 39

,468

$

-‐ $

9

,500

$

(4

2,65

0)32

3,75

2$

Year

1App

oint

Dire

ctor

Hire

Rese

arch

Ass

ocia

te II

pos

ition

Begi

n re

crui

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hD p

ositi

ons

Year

2M

arke

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tern

ally

to E

VMS

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arch

com

mun

ity

and

exte

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ly to

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✓

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✓Hire

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✓✓

Year

3 $

93

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$

6

7,19

8 $

1

59,5

28

$ 40

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a Ana

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✓ ✓ ✓


CLINICAL

Goal C1: Improve EVMS Medical Group quality and patient satisfaction

Strategic Planning Theme — CLINICALGoal C1: Improve EVMS Medical Group quality and patient satisfaction.

The 2001 Institute of Medicine’s report on “Crossing the Quality Chasm” challenged the health-care system to undertake fundamental changes based on six core needs of health-care delivery — to be efficient, effective, timely, safe, patient-centered and equitable. In response, in 2004 EVMS Medical Group adopted patient-centered quality- focused Mission, Vision and Value statements to frame our service delivery system. That same year, the EVMS Medical Group implemented an electronic health record (EHR) as a seminal tool to reinvent clinical operations. The following year, the position of Chief Quality Officer was created to define, measure and eventually report the quality of care delivered. That same year, EVMS Medical Group created a marketing program, “Achieving Service Excellence” aligned with the quality program to include patient satisfaction at each practice and customer service training and recognition of employees who demonstrated the patient-centered mission.

This framework positioned the medical group to meet the requirements and become certified Patient-Centered Medical Homes (PCMH) in our primary care practices in 2009. By 2013, providers in twelve practices attested successfully for Meaningful Use. EVMS Medical Group has demonstrated success by measuring:

• PCP Continuity Reports which led to improvement in workflow processes

• PCMH weekly reports tracking and coordinating care

• Identifying high-risk populations

• Evaluating cost savings and population health measures specifically through generic prescribing and influenza immunization documentation

• Analytic documentation allowing Meaningful Use attestation

• PQRS (Physician Quality Reporting System) claims reporting for Program Years 2007 and 2008

• PQRS Certified Registry in Program Years 2009-2011

• PQRS Data Submission Vendor in Program Year 2012

• PQRS Group Practice Reporting (GPRO) Certified Registry reporting three diabetes measures for Program Year 2013

• Program Year 2014 the Medical Group will submit nine clinical quality measures, expand internal quality reporting and the practice wide report care that includes quality measures reported to the board of the directors.

The committee felt that to meet the strategic goal of improving quality and patient satisfaction in today’s rapidly evolving health care environment that places and emphasis on quality, value and patient experience, three key positions are required:

1. Referral Coordinator

2. Data Analyst

3. Care Management Coordinator

n Defined objectivesThe Referral Coordinator will enable navigation of EVMS patients within and outside of the Medical Group. Currently departments within the medical group have limited awareness of the programs available to meet the needs of their patient population. Similarly, physician and hospital entities outside the Medical Group often find it difficult to properly access EVMS clinical programs and individual faculty. A dedicated Referral Coordinator will:

• Serve as a resource to enhance physician and public awareness of the medical services available within the Medical Group

• Develop mechanisms to enhance quality and document patient satisfaction through surveys with clinical services provided by EVMS as well as to monitor the performance and benefit of the referral-coordination process

• Responsible for developing best practices and establishing and monitoring feedback to practices around the referral/consultation process

Clinical | Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL 67

68 Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL | Clinical

• Develop an information/communication tree along with referral guidelines between the Referral Coordinator and each department within EVMS Medical Group to facilitate and coordinate patient care services

The Data Analyst will help identify and fill in the gaps in Medical Group data and be responsible for reporting quality measures. The dedicated Data Analyst will:

• Evaluate internal and external patient satisfaction tools such as patient advisory councils, CAHPS

• Enhance the Medical Group’s ability to meet the quality metrics established for our primary care providers and specialists

• Establish and disseminate evidence-based guidelines within various Medical Group specialties to improve clinical care, improve quality and reduce costs across the clinical practice.

The Care Manager Coordinator will develop capabilities and skills coordinated across the medical group that are necessary for a highly functioning medical practice in line with the principles of the patient-centered medical home, the patient-centered specialty practice and the patient-centered neighborhood. Currently the medical group has individual divisions that have started to develop some care management capabilities. It is important that these capabilities and skills are coordinated across all practices if the medical group is to achieve the best patient outcomes and provide an optimal educational environment for our learners. These skills are even more important for an academic medical group that provides the training ground for future physicians; particularly since the recently published IOM report “Graduate Medical Education That Meets the Nation’s Health Needs” points out that current residency graduates do not receive adequate education in these critical practice population-health skills.

The following capabilities and skills will meet patient needs, coordinate transitions of care, improve quality metrics and reduce waste and duplication of services through care management, team care and registry function:

1. Assessing the medical group patient population using registry data to identify gaps in care and/or complex or vulnerable patients requiring additional support and care management.

• Identifying the unmet needs of patients in the medical practice and working within the health-care system to meet those needs is critical if the medical is to be successful in a rapidly transforming health-care system where high quality, lower cost and patient experience are the defined measures of success.

• Developing team skills in the practices that enable team members to work the registry and fill care gaps, identifying vulnerable and complex populations that need extra support and care management and providing resources that encourage patient self-management are all important aspects of population health.

2. Coordination of care management capabilities with entities outside of EVMS Medical Group is a critical component of this objective.

• Care management capabilities are being developed at the hospital system and at the newly formed clinically integrated network. All payers have internal care management/coordination capabilities. It will be critical to coordinate practice care management and the data available in the medical group patient registries with these health system partners in the local health-care system if EVMS Medical Group is to provide the most effective patient care for its population of patients.

n Implementation/ComponentsReferral Coordinator: Job description must be created, position must be posted and hire must be made. Orientation with and support from medical group administration and physician leadership will be critical to success.

Data Analyst: Position has been hired by the medical group and employee is interfacing with medical group IT, electronic health record and quality programs.


Care Manager Coordinator: To accomplish these objectives, EVMS will need coordination of care management, team building and role definition and registry data across all of the medical group practices. Integration with the Quality Team and the Electronic Health Record Team also will be critical. Individual practices within the medical group will need training, common goals around performance improvement and care coordination and centralized leadership and coordination of services. The hiring of an EVMS Medical Group advanced practice nurse/care coordinator will be a key component to achieving these objectives.

n Feasibility/AssessmentReferral Coordinator: There appear to be no discernible barriers to implementation of the Referral Coordinator position. For successful implementation, however, strict adherence to referral guidelines including timeliness of appointments, feedback to referring physicians, open access to appointment scheduling and cooperation amongst the various primary care and specialty services will be necessary. This position will monitor all these activities and provide reports to EVMS Medical Group for review. The coordinator also will recommend process modification to optimize patient flow and satisfaction. This proposed position will not generate direct revenue and therefore viability will need to be determined and assessed based upon identifiable improvements in patient access and increased patient volume, along with improvements in clinical quality and patient satisfaction.

Data Analyst: Position has been hired by the medical group.

Care Manager Coordinator: Success in meeting these objectives will be dependent on each practice recognizing the importance of developing these critical skills in population health. Leadership in individual divisions and leadership at the medical group level will need to recognize that practice transformation is a priority and set expectations that common goals related to quality improvement and care-management capabilities are important and that achieving these goals is critical for success. The Care Manager Coordinator will need to be empowered by the medical group to help individual divisions and practices achieve these skills and capabilities. This position will be able to generate some direct revenue to partially support the position over the long term, but viability of the position will need to be determined and assessed based upon identifiable improvements in quality measures and a decrease in unnecessary utilization that results in cost savings. Improved quality and reduced costs will result in revenue related to incentive programs and fees for care coordination and care management. It will be particularly important to negotiate future payer contracts that take into account care-management capabilities and improved performance measures with the medical group.

n Investment/ResourcesReferral Coordinator: Development and implementation of the Referral Coordinator position will require:

• Hiring of a qualified individual with a background in marketing and business development

• Development of appropriate office space to house the program

• Collaboration of all clinical departments to share data, provide rapid access and respond to feedback from both referring physicians and patients

• Implementation of evidenced-based protocols to improve management of specific disease processes across the Medical Group while improving quality

• Development of internal as well as external metrics to assess physician as well as patient satisfaction

Data Analyst: Position budgeted and hired by EVMS Medical Group

Care Manager Coordinator: Development and implementation of the Care Manager Coordinator position will require:

• Hiring of a qualified Advanced Practice RN with a background in care management

• Development of appropriate space to house the program

• Collaboration with clinical departments and practices to develop patient registries, build team skills within the practices and develop care-management capabilities across the medical group

• Collaboration with the quality program and the electronic health record team at EVMS Medical Group


• Implementation of evidence-based protocols to improve management of specific disease processes across the medical group while improving quality

• Development of internal and external metrics to assess the success of gap analysis, performance improvement and care coordination and management

• Appropriate hardware, IT software and supplies will be required

n Project leaders Jim Lind, CEO of EVMS Medical Group Stephen Deutsch, MD, PhD, Anne Armistead Robinson Chair in Psychiatry, Chairman and Professor of EVMS Psychiatry, and EVMS Medical Group Medical Director Rick Bikowski, MD, Professor of Family and Community Medicine and EVMS Medical Group Quality Director

n Performance metricsReferral Coordinator

• Time from request to patient appointment

• Increase in patient volumes in specific clinical areas

• Feedback from referring physicians and EVMS Medical Group regarding ease of access and communication.

• Internal and external assessment tools related to patient satisfaction

• Improved performance to meet meaningful-use targets and additional quality metrics

• Collaborations with hospital partners/community physicians to increase and improve patient access

• Number of referrals processed each quarter

Data Analyst

• Submission of reports

Care Manager Coordinator

• Quality scorecard: Quality measures related to Medicare PQRS, Sentara Quality Care Network and other quality initiatives in which the medical group participates

• Measures of utilization including hospital readmissions, avoidable hospital admissions, ER utilization, avoidable high-end imaging and generic prescribing

• Process measures around transitions of care, hospital discharge follow-up appointments, care management calls and patient interactions and number of Medicare wellness visits.

• Internal and external assessment tools related to patient satisfaction

• Collaborations with hospital partners/community physicians to increase and improve patient coordination care management

• Measures of resident and student experience in the care management and multidisciplinary-team environment (Both evaluations from the student/resident and number of experiences could be tracked)


Deliverables | Goal C1

STRATEGIC PLANNING YEAR DELIVERABLES YEAR 1 Quarter 1

Referral Coordinator/Care Manager Coordinator• Job descriptions developed in cooperation with EVMS Human Resources

• Positions posted and recruitment begins

• Successful candidates assume positions and begin orientation

Referral Coordinator• Meet with Department Chairs and Practice Administrators to develop guidelines, establish referral

communication process and develop metrics for patient satisfaction

Care Manager Coordinator • Orientation to practices, registries and analytics

Data Analyst• Become proficient in analytics

Quarter 2Referral Coordinator

• Begin to serve as direct resource for internal as well as external patient referrals

Data Analyst • Begin submitting reports

Care Manager Coordinator • Begin to see patients and assessing the medical-group patient population

• Begins to develop team skills required to support population health


• Utilize evidence-based guidelines to enhance patient quality and satisfaction

• Patient satisfaction and physician satisfaction survey developed and implemented.

• Data analyzed and area(s) of improvement discussed with individual departments and faculty

Data Analyst• Refine reports to provide information for actionable intervention

Care Manager Coordinator • Working with the Data Analyst, Referral Coordinator, clinical practices and Quality Team, develop goals

and training programs for performance improvement and care coordination


• Collaborate with hospital partners to increase awareness of EVMS Medical Group programs in support of enhanced patient volume

Data Analyst

• Continue to refine reports with input from EVMSMG Board, clinicians, Referral Coordinator and Care Manager Coordinator to provide information for actionable intervention

Care Manager Coordinator

• Implement training programs for performance improvement and coordination


EVMS



EVMS STRA


CIAL TEM

PLAT

EMISSION AREA:

OBJECTIVE

:Clinical

C1 -‐ Patie

nt Satisfaction Quality and Im

provem

ent

FISCAL YEA

R:2015

2016

2017

2018

Year 1

Year 2

Year 3

Year 4

Total

Revenue:

Strategic Plan

Fun

ding

$1

02,866

$68,18

9$4

2,28

8$1

3,65

8$2

27,001

Net Patient Revenue

$84,293

$124,587

$158,321

$195,271

$562,472

Other Clinical Revenue

$0$0

$0$0

$0Grant R

evenue

$0$0

$0$0

$0Co

ntractual Revenue

$0$0

$0$0

$0Inter-‐Divisio

nal Revenue

$0$0

$0$0

$0Tuition

and Fees

$0$0

$0$0

$0EV

MS Foundatio

n$0

$0$0

$0$0

Other Revenue

$0$0

$0$0

$0$187,159

$192,776

$200,609

$208,929

$789,473

Operatin

g Expenses:

Salarie

s & W

ages

$130,000

$132,600

$135,252

$137,957

$535,809

Fringe Benefits

$39,000

$39,780

$40,576

$41,387

$160,743

Supplies

$5,000

$2,000

$2,000

$2,000

$11,000


$0$0

$0$0

$0Ge

neral Expenses

$2,200

$2,200

$2,200

$2,200

$8,800

PP&E/De

preciatio

n$0

$0$0

$0$0

Shared Services

$10,958

$16,196

$20,582

$25,385

$73,121

Indirect Cost R

ecovery

$0$0

$0$0

$0$187,158

$192,776

$200,609

$208,929

$789,473


$0($0)

($0)

($0)

$0

Total Revenue

Total O

peratin

g Expenses


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PARTNERSHIPS

Goal P1: Facilitate the development of key value propositions

Goal P2: Increase capacity for clinical rotation placements

Goal P3: Establish a Student Care Center (SCC) at Booker T. Washington High School with a grant from the United Way

Goal P4: Strengthen clinical and academic relations between faculty, residents, students and other health-care providers working at Sentara Norfolk General Hospital and the VAMC- Hampton

Strategic Planning Theme — PARTNERSHIPSGoal P1: Facilitate the development of value propositions.

EVMS relies on strong partnerships to achieve its various endeavors. However, EVMS often perceives itself as undervalued by existing partners and the Commonwealth. While EVMS administrators, faculty and staff often can speak of why the school needs more funding or certain services, EVMS has been less successful at identifying why that is of benefit to our partner organizations. To that end, EVMS should engage a consultant to develop value propositions targeted at critical audiences.

A well-crafted value proposition includes three key elements:

Quantified value

• How relevant is the metric to your audience?

• What are you comparing yourself against?

Relevance

• Is the value relevant to the audience you are targeting?

• Is the proposition tuned appropriately for the targeted audience?

Unique differentiator

• Can competitors make the same claim as you?

Value propositions consider not just what is important to EVMS, but also what is important to the intended partner. Understanding these synergies allows EVMS to answer “what’s in it for the partner” and places the school in a stronger position to negotiate new partnership agreements and/or procure greater resources.

n Defined objectiveTo develop compelling value propositions that allow EVMS to form stronger, mutually beneficial relationships with key partners

n Implementation/ComponentsBy their nature, value propositions are specific to the particular audience/partner. Given time and resource constraints, a small number of audiences/partners will be targeted initially with an additional value proposition to be developed in-house building upon the work provided by outside consultants. The subcommittee developed a list of existing or potential partners (see listing on page 80).

From those possibilities, five ranked priorities were identified:

1. Sentara: The current affiliation agreement with EVMS’ primary academic hospital partner will expire Dec. 31, 2015, requiring renegotiation

2. Community Faculty (Preceptor Candidates): EVMS is experiencing a critical need for preceptors to meet existing and expanding enrollment needs

3. Commonwealth of Virginia: The state legislature continues to be a high priority as a source of funding increases

4. Bon Secours: One of our principal academic hospital partners

5. Children’s Hospital of The King’s Daughters: One of our principal academic hospital partners

After additional deliberation, the subcommittee recommended moving the Commonwealth lower on the list for a

Partnerships | Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL 77

78 Strategic Plan 2015 – 2018 • EASTERN VIRGINIA MEDICAL SCHOOL | Partnerships

variety of reasons. The other priorities are audiences located within our immediate region and keep our scope within a more compact geographical location. Additionally, legislators and government officials can be particularly difficult to schedule interviews/meetings with. Finally, EVMS can build upon the work done by an outside consultant and develop the state-focused value proposition using the knowledge and experiences of our senior leadership and lobbying consultants.

An outside consultant will be hired to oversee the process and develop the identified value propositions. This process will include getting to know EVMS (reviewing a variety of existing information and interviewing key EVMS personnel), conducting research about our various target audiences, conducting interviews with key leaders within each of those audiences and creating the appropriate deliverables (white papers, executive summaries, talking points, etc.). Progress meetings with an EVMS steering committee will occur along the way and final presentations to key EVMS personnel will present the finished products and discuss how best to use them.

n Feasibility/AssessmentThe subcommittee considered two options to fulfill this recommendation — hiring an outside consultant and hiring a temporary employee to complete the work. In the end, hiring an outside consultant to facilitate the process and develop compelling value propositions seems the most viable option for a variety of reasons:

• An outside consultant is often seen as a more neutral participant and target audiences are more likely to be honest with an outside party.

• Limited internal resources exist to support rapid development of multiple value propositions without curtailing existing services and eliminating existing priorities.

It should be possible to hire a vendor located within this region (the state of Virginia or Washington, DC) thereby limiting any incurred travel expenses.

It will be important to align the consultant’s efforts with the timeline of need for each particular value proposition (for example, timing delivery of the Sentara value proposition delivery in advance of the start of negotiations with Sentara regarding the next affiliation agreement). An additional challenge for the consultant will be conducting the necessary interviews with senior leaders in various organizations given these leaders’ busy schedules.

n Investment/ResourcesThis effort is projected to incur a one-time cost of $75,000. No recurring monies are required. Once the initial value propositions have been developed, EVMS would look to build upon that work using existing internal resources (Marketing & Communications staff working with various administrators, faculty and staff across campus) by developing additional value propositions for other existing or potential partners. (See list of existing or potential partners on page 80).

Part of this effort requires the outside consultant take time to learn about EVMS. Marketing & Communications will compile a variety of information for use by the consultants.

n Project leaderVincent Rhodes, PhD, Director of Marketing & Communications, will lead these efforts and serve as liaison with outside vendor chairing a committee comprised of Richard Homan, MD, President and Provost of EVMS and Dean of the School of Medicine; C. Donald Combs, PhD, Vice President of EVMS and Dean of the School of Health Profession; Elza Mylona, PhD, Vice Dean for Faculty Affairs and Professional Development; Ron Flenner, MD, Vice Dean for Medical Education; Linda Archer, PhD, Associate Dean for Graduate Medical Education; and Dan Thibodeau, MHP, PA-C, Director, Clinical Education Recruitment and Support and Associate Professor.


n Performance metricsIt is difficult to measure the direct impact of the development of strong value propositions as there is not a one-to-one relationship to follow. Having an appropriately focused value proposition greatly enhances the ability to negotiate with potential or existing partners, but it is only one tool among many.

While having a strong value proposition will not guarantee any particular outcome, its impact can be seen. For example, are all EVMS representatives conveying the same key messages from the value proposition? Do the partnership agreements that are executed include the mutually beneficial elements identified in the value propositions? Are partnerships successfully brokered resulting in greater support and/or funding for EVMS?

n Timeline & deliverables The anticipated timeframe is 6 months for 4 of the 5 deliverables. This does not include the time required to find and hire the outside consultant.

Deliverables for each target audience include:

• Value proposition (white paper)

• Executive summary

• Talking points

• Presentation from vendor delivering and explaining information

Deliverables | Goal P1

STRATEGIC PLANNING YEAR DELIVERABLES YEAR 1 Hire Consultant to prepare value propositions

• Value Proposition for Sentara

• Value Proposition community faculty/preceptors

• Value Proposition for CHKD

• Value Proposition for Bon Secours

YEAR 2 Value proposition for state legislators. This work to be developed in-house at no additional cost by existing staff (Marketing & Communications and various administrators, faculty and staff) building on work delivered by outside consultants


List of existing and potential partners | Goal P1

Educational organizations/Partners• Community Faculty (Preceptors)*• Faculty (Prospective)• Hampton University• Norfolk State University• Old Dominion University• Public School Systems• Regent University• Residency Programs (GME, non-EVMS locations)• Residents (Prospective)• Staff (Prospective)• Students (Prospective, MD & HP)• Tidewater Community College• University of Virginia (Medical School)• Virginia Commonwealth University (Medical School)• Virginia Wesleyan College• William & Mary (College of)

Hospital/Medical Organizations/Partners• Bon Secours*• Chesapeake Regional Medical Center• Children’s Hospital of The King’s Daughters*• Disease-Related Organizations • Health-Based Coalitions• Kaiser Permanente (Northern Virginia)• Medical Societies (local, state)• Naval Medical Center• Riverside Regional Medical Center• Sentara*• Veterans Administration (VA)

Government Organizations/Partners• Commonwealth of Virginia (General Assembly, Governor, State Agencies)**• Hampton Roads Cities• Military• Planning District Commissions

Research and others• Alumni• Clinical Trial Participants• Community (at large)• Donors• Large Corporations• Northrup Grumman• Patients• Small Businesses • LifeNet• ModSim Partners Listing presented in alpha, not rank order

*To be developed by outside consultants

**To be developed in-house by existing staff


Business Plan | Revenue and Expense Statement | Goal P1

EVMS

Busin

ess P

lan -‐ R

evenue and

Expense Statement

EVMS STRA

TEGIC PLAN

NING -‐ FINAN

CIAL TEM

PLAT

EMISSION AREA:

OBJECTIVE

:PA

RTNERSH

IPS

P1 -‐ VA

LUE PR

OPO

SITION

FISCAL YEA

R:2015

2016

2017

2018

Year 1

Year 2

Year 3

Year 4

Total

Revenu

e:Strategic P

lan Fund

ing

$0$0

$0$0

$0Strategic P

lan Fund

ing -‐ o

ne time

$75,00

0$0

$0$0

$75,00

0Ne

t Patient Revenue

$0$0

$0$0


$0$0

$0$0

$0Grant R

evenue

$0$0

$0$0

$0Co

ntractual Revenue

$0$0

$0$0

$0Inter-‐Divisio

nal Revenue

$0$0

$0$0

$0Tuition

and Fees

$0$0

$0$0

$0EV

MS Foundatio

n$0

$0$0

$0$0

Other Revenue

$0$0

$0$0

$0$75,000

$0$0

$0$75,000

Operatin

g Expenses:

Salarie

s & W

ages

$0$0

$0$0

$0Fringe Benefits

$0$0

$0$0

$0Supplies

$0$0

$0$0

$0Co

ntractual Services

$75,000

$0$0

$0$75,000

General Expenses

$0$0

$0$0

$0PP&E/De

preciatio

n$0

$0$0

$0$0

Shared Services

$0$0

$0$0

$0Indirect Cost R

ecovery

$0$0

$0$0

$0$75,000

$0$0

$0$75,000


$0$0

$0$0

$0

Total Revenue

Total O

peratin

g Expenses



Strategic Plan Funding Milestones | Goal P1

ConsultingTotal -‐ Strategic Plan Funding

$ 75,000 $ 75,000 ✓

Year 1Identify consultant with agreement and scope of work. Delivery of value propositions.

Grand Total $ 75,000

Eastern Virginia Medical SchoolStrategic Plan Funding MilestonesPartnerships: Value Proposition

Goal P2: EVMS will work to improve the relationships within the community and foster a larger and more effective teaching environment for all students. We will also work towards creating a robust support structure to those practices and facilities that teach our students.

Vibrant, engaged community faculty members are essential to EVMS’ academic programs. This need has recently become more pressing with the recent increase in student population and the planned increased growth for health professions programs. EVMS must strengthen its community faculty and recruiting efforts and be able to assess the performance of these vital participants that educate our student workforce. Additionally, expanding the number and variety of available clinical sites will ensure that EVMS students are exposed to a diverse range of clinicians, patients and practice settings, thereby deepening students’ understanding of the factors contributing to health outcomes as well as improving their cultural competency.

n Defined objective

• By 2017, EVMS will obtain adequate clinical educations sites for all disciplines to meet the needs of the expanded student workforce as well as the standards of our accrediting bodies

n Implementation/Components• Create a new office that will consolidate all clinical site recruitment, as well as establish and maintain community

educator support between clinical sites and the school

• Create and maintain an aggressive recruiting system through this newly created office to add more clinical sites across all programs and recruit effective preceptors

• Consolidate all clinical rotation scheduling to improve better utilization of clinical resources

• Create a support structure directed at creating a sustainable relationship with all clinical education sites

• Develop a Community Clinician Educator Advisory Board to meet on an annual or biannual basis

• Establish long-term affiliation agreements with the possibility of exclusivity

n Feasibility/Assessment• Investment of financial resources and time to both EVMS as well as the medical community will be required

• Establish adequate support systems to meet the needs of educators and medical facilities to teach our students

n Investment/Resources• Convene a focus group of local clinicians to determine how to improve clinical sites and community relationships

• Working with EVMS Faculty Affairs and Professional Development to improve relationships and to foster improved quality of teaching within the community

• Improve continuing medical education opportunities to clinicians related to effectively teaching and mentoring students

n Project leader• Daniel Thibodeau, MHP, PA-C, Director of Clinical Education Recruitment and Support and Associate Professor

n Performance metrics• Determination of the appropriate student-to-educator ratio within each type of clinical focus (i.e. general surgery,

internal medicine, pediatrics, etc.)

• Ability to schedule all students in clinical rotations in an adequate time in preparation for clinical year

• Limitations on gaps in scheduling for any students

• Sustainable numbers of educators that provide the ability for prevention of educator burnout





STRATEGIC PLANNING YEAR DELIVERABLES YEAR 1 Assess clinical sites for all curricula (MD, PA, SA, ATC).

• Initiate gap analysis and determine needs

• Determine overall support services for clinical rotation sites

• Hire clinician engagement personnel

YEAR 2 Merging all programs into central scheduling office.

• Phase out individual scheduling and clerkship office scheduling

• Develop robust support service for community clinical sites (including a community clinician educator advisory board)

• Develop improved interaction with Faculty Affairs and Professional Development

YEAR 3 Coordinate scheduling for all students

• Coordinate and evaluate all rotations and sites

• Have a central support system in place for all community clinical sites

YEAR 4 Review and assess new office structure




EVMS


evenue and

Expense Statement

EVMS STRA


CIAL TEM

PLAT

EMISSION AREA:

OBJECTIVE

:PA

RTNERSH

IPS

P2 -‐ RESTRU

CTURE CLINICAL ROTA

TION PLACEMEN

TS

FISCAL YEA

R:2015

2016

2017

2018

Year 1

Year 2

Year 3

Year 4

Total

Revenu

e:Strategic Plan

Fun

ding

$8

,400

$9,200

$10,10

0$1

0,10

0$3

7,80

0Strategic Plan

Fun

ding

-‐ on

e tim

e$6

1,51

5$6

3,50

6$4

2,10

3$0

$167

,124

Net Patient Revenue

$0$0

$0$0


$0$0

$0$0

$0Grant R

evenue

$0$0

$0$0

$0Co

ntractual Revenue

$0$0

$0$0

$0Inter-‐Divisio

nal Revenue

$0$0

$0$0

$0Tuition

and Fees

$0$0

$0$0

$0EV

MS Foundatio

n$0

$0$0

$0$0

Other Revenue

$0$0

$0$0

$0$69,915

$72,706

$52,203

$10,100

$204,924

Operatin

g Expenses:

Salarie

s & W

ages

$47,072

$53,653

$36,246

$0$136,971

Fringe Benefits

$8,443

$9,853

$5,857

$0$24,153

Supplies

$9,500

$3,900

$4,300

$4,300

$22,000


$0$0

$0$0

$0Ge

neral Expenses

$4,900

$5,300

$5,800

$5,800

$21,800

PP&E/De

preciatio

n$0

$0$0

$0$0

Shared Services

$0$0

$0$0

$0Indirect Cost R

ecovery

$0$0

$0$0

$0$69,914

$72,706

$52,203

$10,100

$204,924


$0$0

($0)

$0($0)

Total Revenue

Total O

peratin

g Expenses



Director Time

Clinician Engagement

Personnel

Office Furnishings

and Computers

Misc supplies and general expenses

Total -‐ Strategic Plan

Funding

Year 1 $ 33,554 $ 21,960 $ -‐ $ 14,400 $ 69,914 Initiate gap analysis and determine needs ✓Determine overall support services for clinical rotation sites ✓Hire clinician engagement personnel ✓ ✓ ✓

Year 2 $ 34,226 $ 29,280 $ 6,000 $ 3,200 $ 72,706 Scheduled move to new offices ✓ ✓Phase out inidividual scheduling and clerkship office scheduling ✓Develop robust support service for community clinical sites ✓ ✓Develop improved interaction with Faculy Affairs and Professional Development ✓

Year 3 $ 34,783 $ 7,320 $ -‐ $ 10,100 $ 52,203 Coordinate and evaluate all rotation sites ✓Have a central support system in place for all community clinical sites ✓ ✓

Year 4 $ -‐ $ -‐ $ -‐ $ 10,100 $ 10,100 Review and assess new office structure


Eastern Virginia Medical SchoolStrategic Plan Funding MilestonesPartnerships: Clinical Placements

✓

✓

✓

Goal P3: Establish a Student Care Center (SCC) at Booker T. Washington High School with a grant from the United Way.

n Defined objectiveTo educate students about healthy behaviors, enhance student’s health and carry out the important goal of providing preventative care for all students

n Implementation/ComponentsHire NP/PA and identify EVMS Family Medicine faculty to oversee staff

n Feasibility/AssessmentThree-year pilot project to assess feasibility

n Investment/ResourcesUnited Way grant of $560,000 to seed pilot project and $60,000 of EVMS one-time funds to establish NP/PA practice

n Project leaderChristine Matson, MD, Chair and Director of Family and Community Medicine and the Glenn R. Mitchell Chair in Generalist Medicine

n Performance metrics• Number of new medical homes (decreased ER visits)

• Number of completed consent and health forms

• Number of student visits accessing SCC services

• Student and parent satisfaction





STRATEGIC PLANNING YEAR DELIVERABLES YEAR 1 • Hire NP/PA

• Hire administrative support

• Open Student Care Center

• Daily access to NP/PA

• Norfolk Public Health - Immunizations

YEAR 2 • Daily access to NP/PA

• School and sports physicals

• United Way vision care

• United Way dental care

• Data analysis of first-year outcomes

YEAR 3 • Expansion of care to family members

• Longitudinal data analysis




EVMS

Business Plan -‐ Revenue and Expense Statement

EVMS STRATEGIC PLANNING -‐ FINANCIAL TEMPLATE

MISSION AREA:

OBJECTIVE:

Partnerships

P3 -‐ BTW Student Care Ctr

FISCAL YEA

R:2015

2016

2017

2018

Year 1

Year 2

Year 3

Year 4

Total

Revenue:

Strategic P

lan Fund

ing

34,500

23

,000

11

,500

-‐

$69,00

0Net Patient Revenue

$0$0

$0$0


$0$0

$0$0

$0Grant R

evenue

$0$0

$0$0

$0Co

ntractual Revenue

$0$0

$0$0

$0Inter-‐Divisio

nal Revenue

$0$0

$0$0

$0Tuition

and Fees

$0$0

$0$0

$0EV

MS Foundatio

n$0

$0$0

$0$0

Other Revenue

$0$0

$0$0

$0$34,500

$23,000

$11,500

$0$69,000

Operating Expenses:

Salarie

s & W

ages

$30,000

$20,000

$10,000

$0$60,000

Fringe Benefits

$4,500

$3,000

$1,500

$0$9,000

Supplies

$0$0

$0$0

$0Co

ntractual Services

$0$0

$0$0

$0Ge

neral Expenses

$0$0

$0$0

$0PP&E/De

preciatio

n$0

$0$0

$0$0

Shared Services

$0$0

$0$0

$0Indirect Cost R

ecovery

$0$0

$0$0

$0$34,500

$23,000

$11,500

$0$69,000

Department/Project Net Excess/(Deficit)

$0$0

$0$0

$0

Total Revenue

Total O

peratin

g Expenses



PersonnelTotal -‐ Strategic Plan Funding

Year 1 $ 34,500 $ 34,500 Obtain United Way grant ✓

$ 23,000 $ 23,000

Year 3 $ 11,500 $ 11,500

Year 4 $ -‐ $ -‐



Partnerships: BTW Student Care Center

Hire NP/PA ✓Year 2Continued employment of NP/PA

Continued employment of NP/PA

✓

✓

Goal P4: To strengthen clinical and academic relations between faculty, residents, students and other health-care providers working at Sentara Norfolk General Hospital and the VAMC-Hampton.

n Defined objectiveTo improve clinical and educational communications between the VAMC-Hampton and Eastern Virginia Medical School health-care providers in Sentara Norfolk General

n Implementation/ComponentsPurchase and install video conferencing equipment for EVMS Internal Medicine residency conference room in SNGH


n Investment/Resources:

One-time equipment purchase: $6,000

n Project leaderMitchell Goodman, MD, Assistant Professor of Medicine and Internal Medicine Residency Director

n Performance metrics• Morning rounds/grand rounds attendance

• Improved Learner’s Satisfaction Survey results



STRATEGIC PLANNING YEAR DELIVERABLES YEAR 1 • Equipment purchase and installation

• Improved morning/grand rounds attendance

• Improved Learner’s Satisfaction Survey results

• Improved communication with faculty and residents



Business Plan | Revenue and Expense Statement | Goal P4n Financial pro-forma

EVMS

Busin

ess P

lan -‐ R

evenue and

Expense Statement

EVMS STRA

TEGIC PLAN

NING -‐ FINAN

CIAL TEM

PLAT

EMISSION AREA:

OBJECTIVE

:Partnerships

P4 -‐ VA

MC Tel-‐a-‐Con

ferencing

FISCAL YEA

R:2015

2016

2017

2018

Year 1

Year 2

Year 3

Year 4

Total

Revenu

e:Strategic P

lan Fund

ing

$6,000

$0$0

$0$6

,000

Net P

atient Revenue

$0$0

$0$0


$0$0

$0$0

$0Grant R

evenue

$0$0

$0$0

$0Co

ntractual Revenue

$0$0

$0$0

$0Inter-‐Divisio

nal Revenue

$0$0

$0$0

$0Tuition

and Fees

$0$0

$0$0

$0EV

MS Foundatio

n$0

$0$0

$0$0

Other Revenue

$0$0

$0$0

$0$6,000

$0$0

$0$6,000

Operatin

g Expenses:

Salarie

s & W

ages

$0$0

$0$0

$0Fringe Benefits

$0$0

$0$0

$0Supplies

$6,000

$0$0

$0$6,000


$0$0

$0$0

$0Ge

neral Expenses

$0$0

$0$0

$0PP&E/De

preciatio

n$0

$0$0

$0$0

Shared Services

$0$0

$0$0

$0Indirect Cost R

ecovery

$0$0

$0$0

$0$6,000

$0$0

$0$6,000

Department/Project N

et Excess/(Deficit)

$0$0

$0$0

$0

Total Revenue

Total O

peratin

g Expenses



EquipmentTotal -‐ Strategic

Plan Funding $ 6,000 $ 6,000

✓Year 1Identified location and vendor with quote

Grand Total $ 6,000


Partnerships: VAMC Teleconferencing

EquipmentTotal -‐ Strategic

Plan Funding $ 6,000 $ 6,000

✓Year 1Identified location and vendor with quote

Grand Total $ 6,000


Partnerships: VAMC Teleconferencing


COMMITTEE MEMBERS


Strategic Planning Steering CommitteeCo-chairs:C. Donald CombsElza Mylona

Members:Alfred AbuhamadLinda ArcherMark BabashanianL.D. BrittBrant CoxRonald FlennerRichard Homan (ex-officio)Connie McKenzieMekbib GemedaC.W. GowenAntoinette HoodJerry Nadler

Stacy PurcellMary RobertsWard RobinetteTommy RuegerAnne ShumadineDebbie TaylorStephanie TroyBill WasilenkoBrittany Weber Wayne WilbanksDaniel Young

Education CommitteeCo-chairs:Ronald FlennerJeff Johnson

Members:Linda ArcherJack BeasleyCourtney BoveeAnne CampbellMichele CatalanoKaren CliffordRichard ConranFrank CounselmanDebbie DamonKimberly DempseyCraig GoodmurphyDavid HubandTom Hubbard

Lester JohnsonJulie KerryThomas KimbleAllison KnightJoshua LeskoJudith MercerShelly Mishoe Dan Ramirez Helena RussellJoel RydelDan ShumanChris SturgesGail Williams

Committee Members(In alphabetical order. Credentials not included)

Research CommitteeCo-chairs:Neel KrishnaJerry NadlerBill Wasilenko

Members:David ArcherDaniel Cohen Brant CoxTina CunninghamKenji CunnionYolanda DemoryDiane DuffyDoug GardnerTroy GleasonRichard HellerHelen HeseliusBrian Martin

Jennifer MellorDavid NashJulius NyalwidheLee OuyangGerald PepeLarry SanfordAgatha Parks-SavageMatthew SchenkJohn SemmesHarry TillmanEmily Webb

Clinical Care CommitteeCo-chairs:Alfred AbuhamadBarry Strasnick

Members:Serena AmersonRick BikowskiRebecca BrittBruce Britton Ersell CarrowAngela ConradSandra Deane Stephen DeutschJim DixonValerie HarveyBlair Holloway

Travis KirbySteven LeeWilliam LemleyJim LindChristine MatsonAntonio Quidgley-NevaresDrucie PapafilMark SinesiMike SmithRyan Tomberg

Partnerships CommitteeCo-chairs:C. Donald CombsMekbib Gemeda

Members:Christine BoswickTammy ChrismanCole Combs Clinton CrewsCraig DerkayGriffin EverhartKaethe FergusonJeff Goodwin C.W. GowenJason GrahameTanya Kearney

Kerry Kruk Melissa LangTom LynchShannon McColeKurt McCammonConnie McKenzieSerina NeumannVincent RhodesDon Richardson Ed Robey Dan Thibodeau


Notes


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