March 10, 2011

Zutter to lead efforts to integrate diagnostic testing

Zutter to lead efforts to integrate diagnostic testing

Mary Zutter, M.D., has been appointed assistant vice chancellor for Integrative Diagnostics at Vanderbilt University Medical Center.

In her newly created role, she will guide efforts to apply and integrate the latest advances in biomedical science and technology and emerging diagnostic tests and procedures. The major goal of these efforts is to improve patient care.

Mary Zutter, M.D.

Mary Zutter, M.D.

Diagnostic testing has become increasingly complex. By correlating and integrating test results in an easily accessible way, pathologists can help clinicians make quick and accurate diagnoses, determine the most appropriate therapy and avoid unnecessary and costly tests.

“We really think we can transform medicine and pathology,” said Zutter, who also has been named to the newly endowed Louise B. McGavock Chair in Pathology, Cancer Biology and Microbiology & Immunology.

“Vanderbilt is committed to an aggressive program of bringing personalized medicine into reality,” said Gordon Bernard, M.D., associate vice chancellor for Research who will oversee the effort. “This new position is designed to optimize that process.”

Zutter, who will continue to direct the Division of Hematopathology, said “integrative diagnostics” emerged from discussions she had last year with Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of Vanderbilt University School of Medicine.

At the time, she was leading development of a “diagnostic management team” (DMT) in Hematology/Oncology to guide clinical decision-making in diagnosing and treating leukemias and lymphomas.

With the help of Bill Stead, M.D., the medical center's Chief Strategy and Information Officer, and Mia Levy, M.D., Ph.D., assistant professor of Biomedical Informatics, Zutter's team developed a computerized “dashboard” and patient “flow chart” to keep track of the tests used in diagnosis and monitoring treatment and have begun to issue comprehensive hematopathology reports.

The program launched Feb. 14. “When a patient comes into the clinic, all the data are there to understand patient history and laboratory tests and to direct ordering of additional ancillary tests,” Zutter said.

The comprehensive, electronic patient reports generated by the DMT link to up-to-date references and appropriate clinical trials. “We're trying to make this easy to do. I hope and think this will dramatically improve patient care,” she said.

“While we are convinced that this is the right thing to do and the best thing to do for patient care,” Zutter continued, “it will also be cost effective. If we can work out the very best way to diagnose and monitor patients with these difficult diseases, this would be valuable not only to Vanderbilt but to the rest of the country … That I find really exciting.”

This effort built on the success of the coagulation DMT effort led by Michael Laposata, M.D., Ph.D., the Edward and Nancy Fody Professor and executive vice chair of Pathology.

Last summer, Laposata and other experts in coagulation began reviewing the electronic medical records of patients with clotting or bleeding problems, using efficient testing algorithms and issuing interpretive reports to help doctors make quicker and more accurate diagnoses, avoid unnecessary testing, and improve the treatment success rate.

Members of the new Hematology/Oncology diagnostic management team include (foreground, from left) Adam Seegmiller, M.D., Ph.D., Megan Smith, M.D., and (background, from left) David Head, M.D., and Eric Gehrie, M.D. (photo by Susan Urmy)

Members of the new Hematology/Oncology diagnostic management team include (foreground, from left) Adam Seegmiller, M.D., Ph.D., Megan Smith, M.D., and (background, from left) David Head, M.D., and Eric Gehrie, M.D. (photo by Susan Urmy)

“Feedback from physicians … has been uniformly positive,” Laposata said. “We have learned that the coagulation DMT … is improving patient outcomes while greatly reducing the costs associated with patients who have bleeding or thrombotic disorders.”

To support the hematology/oncology effort and DMTs that will be organized for other complex diseases, Zutter will help establish a “translational” laboratory. It will develop and validate new diagnostic tests and procedures prior to moving them into the clinical labs.

Zutter, who is scientific director of the Human Tissue Acquisition and Pathology Shared Resource in the Vanderbilt-Ingram Cancer Center, also will help “optimize” tissue-based research at the medical center. “There are multiple banks of tissue here at Vanderbilt,” she said. “Part of my goal will be to help 'virtually' link those together.”

Zutter said several people were instrumental in developing the DMT, especially Kristy Sinkfield and Hershell Pollard in Strategy Development, and fellow hematopathologists Annette Kim, M.D., Ph.D., Claudio Mosse, M.D., Ph.D., Adam Seegmiller, M.D., Ph.D., and Mary Ann Arildsen, M.D., Ph.D.

“I work with the most incredibly wonderful team of hematopathologists. We've actually had so much fun working on this project together,” she laughed. “It's just been a riot doing this.”

Medical center administration, including C. Wright Pinson, MBA, M.D., and John Manning, Ph.D., also has been very supportive of the whole “integrative diagnostics” concept, she added.

“The best part of Vanderbilt is it's not limiting,” said Zutter, who joined the faculty in 2003. “If you have a good idea, someone will help you figure out how to move it forward. That's been so true for me in everything I've done here.”