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IU School of Medicine dean presents vision for school at public forum

May 8, 2014

The new leader of the country's second-largest medical school recently outlined his vision for the IU School of Medicine during a presentation to medical, business and community leaders in Indianapolis.

Jay L. Hess, M.D., Ph.D., dean of the IU School of Medicine and IU vice president for university clinical affairs, presented a BioCrossroads Frameworx Session on April 16 at the Chase Tower in downtown Indianapolis. The 45-minute presentation, which is available on YouTube, presented plans for the school in physician training, research leadership and patient care.

Jay Hess

Jay L. Hess, M.D., Ph.D., dean of the IU School of Medicine and IU vice president for university clinical affairs

"When you think about our footprint across the state, we're really positioned to influence health care patterns across the entire state of Indiana," Dr. Hess said. "We train the majority of the physicians in Indiana; more than half of our graduates will go on to practice within the state. We have a big role to play."

But the challenges are great. The United States expends more than twice per capita on health care than the next closest country, but it comes in last in overall health outcomes among industrialized nations. Indiana ranks 41st overall in health care status among the states, including poor metrics in areas such as infant mortality. An aging population, rising medical school debt and shifts in medical care reimbursement models also present serious challenges. 

"The Affordable Care Act was really designed to try to address all three aspects of the 'Triple Aim,'" Dr. Hess said. "We have to improve the health of populations, improve the experience of being a patient and drive down the per-capita cost of care. So everything we do at the School of Medicine, we're trying to work on these three axes."

To address these challenges, Dr. Hess presented six "Pillars of Success" for the school:

Pillar 1: Population health

"I truly believe that IU can be a leader in the nation in population health management, which is the idea that rather than waiting for people to develop a chronic disease … you manage a group of patients and keep them healthy," Dr. Hess said.

The School of Medicine's strengths in this area include the recently established Center for Health Innovation and Implementation Science, which embeds experts on improving health care processes at IU Health University Hospital, Riley Hospital for Children at IU Health, Eskenazi Health and the Richard L. Roudebush VA Hospital; and the Regenstrief Institute, an international leader in medical informatics and electronic medical records closely affiliated with the IU School of Medicine.

He also pointed to such unique areas of strength as the Rural Health Program at the IU School of Medicine-Terre Haute, which represents "one of the most successful models for keeping physicians in rural areas," and the Academic Model for Providing Access to Healthcare, or AMPATH, a School of Medicine-led HIV/AIDS treatment program that has "saved millions of lives" since it was founded in 1989.

According to Dr. Hess, AMPATH's success at engaging the Kenyan community may potentially serve as a model for a new "Grand Challenges"-style project in population health from the school designed to impact citizens "right in our own backyard."

Pillar 2: Focusing on strengths

The three strategic research strengths outlined in the jointly funded $150 million IU School of Medicine-IU Health Strategic Research Initiative -- cancer, cardiovascular disease and neuroscience -- provide the base for this pillar. But Dr. Hess aims to dig deeper into these topics to focus on specific "areas where we can really make a difference … where we're truly leading the country." 

"If federal research funding is only going to fund the top 5 or 10 percent of grants, we need to find a way to be in that top 5 and 10 percent," he said. "We need to pick a few areas where we've got strengths and really build on them so we can be competitive."

Also part of this goal is crafting a competitive faculty recruitment strategy to attract pre-existing teams of scientists who can fill the gaps in expertise required to propel the school into the top ranks of its selected areas.

Pillar 3: Speed clinical translation

A key aspect of this goal is the Indiana Clinical and Translational Sciences Institute, a National Institutes of Health-funded partnership between IU, Purdue and Notre Dame. Indiana CTSI aims to speed "bench to bedside" research across Indiana through partnerships with the state's universities and health care providers, especially the 18 IU Health hospitals in Indiana, as well as the private sector, state government and community groups.

Dr. Hess cited Indiana CTSI-led projects such as project development teams to assist researchers at any stage of the translational research process; a partnership with Covance to increase industry-sponsored phase 1 clinical trials at the school; speeding internal processes, such as Internal Review Board approvals for human subjects research, which make the school more attractive to private partners; and the alignment of molecular therapeutics resources across IU, Purdue and Notre Dame.

Also supporting this goal is the Physician Scientist Initiative, funded by a $60 million grant from the Lilly Endowment, which aims to boost the school's recruitment of faculty with both M.D. and Ph.D. degrees. 

Pillar 4: Train the providers of the future

The expansion of four years of medical education to all eight IU School of Medicine regional medical education centers forms the foundation of this pillar. The expansion is also a key factor behind the school's ongoing curriculum reform process, which will standardize instruction across the medical education centers, including a stronger emphasis on active learning, such as small work groups and discussions, with the majority of lecture-based education delivered electronically.

Dr. Hess also pointed to the school's recipience of one of only 11 $1 million American Medical Association grants promoting innovative curriculum development. The School of Medicine's project will focus on training medical students to manage patient care based on real electronic medical records, including the ability to see the financial impact of their treatment decisions.

Pillar 5: Faculty and staff vitality 

This pillar aims to improve on faculty and staff support structures, such as providing training to smooth changes in expectations related to research funding and curriculum reform, as well as developing more effective and targeted professional mentor relationships.

Also in progress are projects to improve recruitment challenges such as fostering workplace flexibility and collaborating with the private sector to find jobs for new faculty members' spouses.

Pillar 6: Silos to a system

This pillar encompasses goals such as aligning expertise across the state and organizing clinicians and lab scientists by discipline, not department, such as the recent re-grouping of neurosurgery, psychiatry and physical medicine and rehabilitation science in the new IU Health Neuroscience Center and IU School of Medicine Neurosciences Research Building.

"It's all about collaboration -- deeper and more meaningful collaborations -- whether they're between health science schools or whole universities," Dr. Hess said. "We don't want to just go out and invest in the same equipment and compete for the same talent but to pool our expertise in a way in which we collectively, as a state, become one of the top programs in the country."

Building projects 

In addition, Dr. Hess provided an overview of major building projects at the school, including the anticipated fall opening of the IUSM Neurosciences Research Building and the construction of a 26-acre, $200-million-or more complex that will occupy the former site of the old Wishard Hospital -- acquired in a land swap with IU upon the opening of the new Sidney and Lois Eskenazi Hospital and Eskenazi Health campus.

Projects slated for the new Health Sciences Park include:

  • A new site for the Regenstrief Institute, which will design and construct its own building on the site.
  • An interprofessional health education building for all nine of the health science schools on the IUPUI campus. The building will house programs designed to train students from these disciplines in working collaboratively and include not only shared classrooms and a simulation center but common areas and a library.
  • A Center for Chemical Biology and Drug Development, a 120,000-square-foot facility with lab space focused on advancing projects related to drug discovery. The site, which will be constructed in part with state funds, may serve as permanent or temporary space for the Indiana Biomedical Research Institute, a collaboration of Indiana research companies and universities officially launched by Gov. Mike Pence in May 2013.
  • New homes for the IU School of Dentistry and Richard M. Fairbanks School of Public Health.
  • The IU Research and Technology Corp., which will relocate to the site from its current location to the northeast of campus.

Dr. Hess also noted that about half a million square feet of heavily outdated facilities will be removed as part of the construction process.

"We realize that this needs to be a vibrant health sciences campus with amenities and good parking and access to all," said Dr. Hess, who cited lessons from his previous role helping create the University of Michigan North Campus Research Complex, which comprises 2.1 million square feet acquired from Pfizer after the drug company's departure from the region.

"You're going to see a lot going on over the next several years on this part of the IUPUI campus."

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