October 8, 2015

VUMC poised to transform health care in region

Jeff Balser, M.D., Ph.D., started his annual State of the Medical Center Address last Thursday by affirming that many who work at Vanderbilt University Medical Center (VUMC) feel “called to do so,” often compelled by life-shaping experiences.

Jeff Balser, M.D., Ph.D., delivers the State of the Medical Center Address. (photo by Joe Howell)

Jeff Balser, M.D., Ph.D., started his annual State of the Medical Center Address last Thursday by affirming that many who work at Vanderbilt University Medical Center (VUMC) feel “called to do so,” often compelled by life-shaping experiences. He began his remarks by speaking about his own mother, who died of cancer in 1979.

“There is not a day I come to work where I don’t think about how the health care system failed her then — and whether it still would have today,” he said.

(To watch a video of the address go here. Login required)

Using his personal experience as an impetus for change, Balser provided those in attendance an outline for the Medical Center’s four major initiatives to transform health care in the Southeastern region of the country for the years ahead.

Those initiatives are: restructure our organization through the VU/VUMC transition; continue to grow our health system; make the delivery of health care more seamless; and continue to empower leaders.

Despite rapid consolidation and a tumultuous economy within the health care industry, Balser said the Medical Center’s potential to impact patients is greater than it’s ever been.

Located in the Southeast, a region with one of the lowest life expectancies of any in the developed world, VUMC is positioning itself to meaningfully impact those numbers. “I propose that’s our calling as an organization,” he said.

Vanderbilt currently cares for 800,000 to 1 million people throughout the region each year. As growth continues that number could actually double in five years.

“Large health networks can deliver better care in a more cost-effective manner, as long as services are integrated in a seamless way,” he said. “Today, Vanderbilt University Medical Center is seen as the leader in health care information technology.”

VUMC remains home to the nation’s largest biomedical informatics department that resides within an academic health system and is home to numerous health IT advancements.

During the next two years through a process called Clinical Systems 2.0, VUMC will evaluate and choose a major vendor partner to help integrate new clinical support systems throughout its hospitals and clinics.

These systems will be configured to meet the Medical Center’s unique needs, and will also create greater interoperability within VUMC and across the Vanderbilt Health Affiliated Network (VHAN).

To date, more than 750 people have been involved in the Clinical Systems 2.0 effort, providing important input into how the system should be configured for optimal success.

Currently, VUMC is undergoing the transition to a separate nonprofit entity from Vanderbilt University that will provide greater autonomy for the Medical Center to govern itself more nimbly and secure additional finances for growth. The goal is to continue to innovate to provide patient care in more effective and seamless ways across broad populations throughout the Southeast.

Last month, the Vanderbilt University Board of Trust elected an 11-member governing board for the Medical Center. Edie Carell Johnson, an attorney who led the Medical Center Affairs Committee of the Board of Trust for several years, will chair the new board.

“There is nobody who knows us so well and is as committed to our success as Edie Johnson,” Balser said.

As the population in the Mid-South swells, so does the demand for health care. In response, Vanderbilt is growing relationships with community health care partners throughout the region.

Since 2012, four new Monroe Carell Jr. Vanderbilt Children’s Hospital After Hours Clinics have opened in Brentwood, Hendersonville, Mt. Juliet and Spring Hill. The new Monroe Carell Jr. Children’s Hospital Vanderbilt at Williamson Medical Center, located in Franklin, just opened in July, while in the past few years more than 50 hospitals and health systems throughout the Southeast have joined with VHAN.

With the ongoing efforts to grow VHAN and many others, success will depend on empowering leaders. “The only way I think we grow is when we step out and try to do something that we’ve never done before,” Balser said.

“We’re going to need everybody at Vanderbilt University Medical Center to take those next steps, try the new thing and challenge the status quo and become more than we are today,” he said. “All of us have to do that in order for this to be successful.”

Balser called out the names of several role models honored for leadership this year: Five-Pillar and Credo award winners, recent faculty recruits and longtime Medical Center officials who have been elevated into new positions. Excellence and innovation are exemplified by these individuals and by Vanderbilt’s medical and nursing schools, he said.

Eighty-eight medical students were admitted this fall from a pool of nearly 7,000 applicants. Their collective GPA — 3.87 — is among the highest for medical schools in the country. The School of Nursing, distinguished in part by its advanced practice and nursing residency programs, now ranks 11th in U.S. News and World Report, up from 29 in 2003.

The new Medical Innovators Development Program is bridging the gap between technology and health care, by enabling people with Ph.D.s in technical fields like engineering, informatics and imaging to earn their M.D.

The aim is to contribute to the next generation of physician-scientists who deeply understand technology, Balser said.

Despite a national biomedical research budget that has remained virtually flat for the past decade, Vanderbilt’s research enterprise continues to grow, in part because of its emphasis on interdisciplinary science such as genetics and informatics, and its careful balance of basic and applied science.

“Our magic here is that we value both kinds of science and we invest in both kinds of science,” Balser said.

Recent high-profile grants to Vanderbilt by the federal government include one from the Centers for Medicare and Medicaid Services that would transform clinical practices in the region in ways that improve quality and hold down costs, and renewal of the National Cancer Institute grant that supports the Vanderbilt-Ingram Cancer Center.

“A third of the research that goes on every day at Vanderbilt University Medical Center is somehow related to cancer, and the infrastructure that supports it is vital to the entire research enterprise,” he said.

Vanderbilt is a world leader in personalized medicine as well. The Medical Center’s biorepository, BioVU, is one of the world’s largest, currently with 211,000 individual DNA samples linked to electronic health records. “It has really put us on the map as a center for high-level genomics research,” he said.

This research is benefiting patients at Vanderbilt in two ways. One program, PREDICT, screens patients for genetic variations that may affect their response to four commonly prescribed drugs, and adjusts their prescriptions accordingly.

Since 2010, 15,000 Vanderbilt patients have had their genomes screened in this way and hundreds have had their medications changed on this basis. The program will be expanded in December.

“We will be the leading center in this country taking care of patients in this way,” Balser said.

In the Vanderbilt-Ingram Cancer Center, patients’ tumors are now routinely DNA sequenced to identify which chemotherapy drugs are most likely to work. Moreover, MyCancerGenome, a Vanderbilt knowledge resource used on six of seven continents, matches tumor sequence to the best drug available, and shows patients and clinicians where on the globe that optimal therapy is available.

This is the “promise of discovery,” Balser said, and Vanderbilt is getting the word out — through a social media website called MySouthernHealth.com, an online feedback forum called Advise Vanderbilt and a new ad campaign that launched this week — that better health is a promise that is within reach.

In realizing the vision of offering services to a larger region, Balser also emphasized the importance of making it easier for patients to access VUMC clinicians. At the Vanderbilt Breast Center, patients now can make appointments for mammograms online, as easily as making a restaurant reservation. He indicated that online appointment capability will be expanded to many of VUMC’s clinics over the coming year.