December SOM News

Message from the Dean: The Governor's Recommended Budget

Greetings and welcome to the School of Medicine's December update.

December brought good news from Salem and Eugene.

From Salem, Governor Ted Kulongoski announced his recommended budget for the next biennium. OHSU did not suffer budget cuts, reversing the trend of the last several years.

The Governor's recommended budget includes an increase in appropriations to OHSU of about $20 million. This new funding is allocated specifically for education initiatives that will begin to help offset projected health care workforce shortages. The Governor has made education a priority.

Many people at OHSU and around the state worked diligently to communicate to our legislators and community leaders the implications of workforce shortages and the particularly harsh potential consequences to rural Oregonians and the underserved.

Specifically, the Governor's budget included funding for our planned increase of the SOM entering class size to 120 students right away and to support our efforts to expand the SOM to locations outside of Portland.

This brings me to the good news from Eugene.

Sacred Heart Hospital and PeaceHealth System, our clinical partners in the first OHSU satellite campus outside of Portland, opened the doors of the new Center for Medical Education and Research. The building is near the campus of one of our academic partners, the University of Oregon, in Eugene.

I attended the ceremony in Eugene marking this occasion. There is genuine excitement about the SOM extending its reach beyond Portland. An editorial in the Eugene newspaper noted that the program is a cost-effective "way for OHSU to increase its capacity, and OHSU's partners in Eugene - the UO and PeaceHealth Medical Center - can expect substantial benefits."

This excitement illustrates an indirect outcome of the distributed model of education. Satellite campuses provide tangible benefits - economic, academic and social - to the host communities. In turn, we gain new friends and new opportunities to both fulfill and enhance understanding of all aspects of our mission, including research and healing.

We are also making progress on establishing a second satellite campus in Corvallis in cooperation with Oregon State University and Samaritan Health Services. Eventually, our goal is to have five SOM satellites around the state. Already, we have about 25 students in clinical rotations in Eugene and if all goes well, by 2008 we could have a group of first-year medical students in Eugene.

The Governor's recommended budget is a terrific starting point. In terms of process, his proposal now will move to the full Oregon Legislature when it convenes in January. Specifically, the Ways and Means Education Subcommittee will consider OHSU's budget and then make recommendations to the House and the Senate. Both chambers have also formed special "workforce" committees for this session and OHSU's budget must additionally be deliberated and approved in these new forums.

During the legislative process, the proposed OHSU budget could change. We will learn the outcome of these deliberations this summer when the 2007 Legislative Assembly is scheduled to finalize the entire 2007-09 state budget.

My best wishes to everyone for a wonderful New Year,

HHS Secretary Leavitt at OHSU Jan 2 to discuss transparency

U.S. Department of Health & Human Services Secretary Mike Leavitt, accompanied by Governor Ted Kulongoski and OHSU President Joe Robertson, will speak at OHSU about transparency on January 2 at 11:00 am, Founders Auditorium (Room 144), School of Nursing.

Secretary Leavitt's remarks will focus on the potential transformation of the nation's health care system through the adoption of clinical outcomes and price transparency. OHSU's leadership on the issue of transparency was cited as a reason for Secretary Leavitt's visit. Business leaders from several major local employers will sign a "statement of support" for Secretary Leavitt's efforts.

Please confirm attendance with Jenny Holladay, Intergovernmental Affairs Specialist, HHS, by e-mail at jenny.holladay@hhs.gov or by phone at (206) 615-2772.

Faculty Survey results posted on new Web page

Success of the SOM strategic planning process depends both on transparency and inclusiveness. To support these aspects, the Office of the Dean has launched a dedicated Web page where relevant materials and data are posted, including the results from the recently completed Faculty Survey.

The posted survey results show average scores for each of the 44 questions and also lists general themes emerging from open-ended comments. There were 353 responses from the approximately 1,200 requests to complete the Faculty Survey. Generally, the responses trended to the positive. For instance, in response to the survey statement, "Overall, I am satisfied to be employed at OHSU," the mean response was 3.66, on a five point scale with 5 being "strongly agree." However, the results also show that there are specific areas of concern to faculty. The results will be used to inform the strategic planning efforts.

The new Web page also provides mechanisms to submit comments and ideas to help shape the strategic direction of the SOM in 2007 and beyond. Please click here to access the Web page.

In addition to the new Web page, during December, membership of the four strategic planning committees was determined and meetings began. Many faculty members volunteered to serve on the committees. The final membership was designed to maximize diversity by gender, culture, expertise and faculty rank.

The committees are charged with collecting information directly from faculty, and then articulating strategic goals that cut across and integrate SOM missions. This "charge" reflects the overarching theme emerging from SOM efforts thus far: that the greatest strengths and opportunities are found at the interface of our mission elements of learning, research and clinical care.

The SOM theme and approach to strategic planning are different than in past years. Previously, the focus was on establishing discrete goals for research, education and health care delivery. In contrast, the current goal and process focus on breaking down barriers between clinical, research and educational missions, a trend that is evident nationwide at many academic health centers.

The last SOM strategic plan was adopted in 2005. Since then, the SOM has met or exceeded some of the goals articulated in that plan, such as progress on regionalization of education. Other goals, such as enhancing the diversity of our faculty and students, require sustained effort. The new process will build on this past.

The SOM planning efforts are occurring in parallel with a university-wide strategic planning process led by President Joe Robertson. The SOM final strategic plan will both support the OHSU-wide plan and articulate a vision and goals for the SOM specifically. For information on the Presidential Strategic Planning process, please click here to visit the President's Page.

OHSU addresses "bridge" funding challenge

OHSU, like most academic medical centers around the nation, is concerned about federal and other funding threats to basic scientists. The Office of the Dean, in cooperation with other entities across OHSU, is taking steps to help lessen the impact of funding reductions.

One aspect of this is to identify ways to help temporarily sustain promising projects while investigators identify new funding sources. The Office of the Dean is working with departmental chairs to be sure that carry-forward monies are made available to help bridge funding gaps. Opportunities are also being created for basic scientists to pursue translational research as part of the new Oregon Clinical & Translational Research Institute at OHSU. Further, the Office of the Dean is helping departmental chairs optimize use of research space and thus minimize institutional overhead charges.

Recently, an important new source of bridge funding has also opened up at OHSU. This year, the Presidential Bridge Fund provided $500,000 for the exclusive purpose of supporting investigators who are threatened by an imminent lapse in research funding, but who are attempting to secure re-funding.

Twenty-two applications were received by the Office of the Vice President for Research for the Presidential Bridge Fund by the due date of December 19. Up to 10 awards will be made to a level of $50,000 each. Award notifications will be announced in January.

Approximately the same amount of funding will be available next fiscal year. However, next year, the pacing between the call for applications and deadline will be improved. This first year, an accelerated process was needed to meet a fiscal requirement that the awards be spent by June 30, 2007.

Clinician to clinician: tips for EPIC users

By James Cohen, MD, PhD, Professor of Otolaryngology, Head and Neck Surgery

It has been a little over a year now since our department (Otolaryngology/Head and Neck Surgery) went "live" with EPIC. It's been a bumpy road for me, in part because of technology and support glitches but in larger part because of my own reluctance to accept the realities of what the system could and could not do for my practice. I have been a fairly vocal critic of the system in the past and yet in reality at this point I, as a disinterested computer user and a lousy typist, would be very reluctant to go back to the way things were for me in the pre-EPIC era.

In the hopes that our experiences might help you in your EPIC transition, the Office of the Dean has asked me and others to share EPIC experiences focusing on the "tips" that make it workable. Here are the highlights from my list.

• EPIC should not be viewed as an all or none phenomenon in terms of documentation, a blend of typing and dictation are still needed. For example, the majority of visits are easily and well documented by my typed notes, supplemented with dot phrases; but some still need dictation and one needs to continue to use this modality where it is needed. My practice is made up of uncommon/complex surgical problems generally referred from outside the institution. It has been built on effective, personal and timely communication with the referring physicians, letters that serve to educate about disease processes as well as document my assessment and plans. EPIC can't generate letters of this type in a timely pattern during clinic when I am seeing new patients and so these first visit letters are still dictated, as are any complex follow up visits when I walk out of the patient's room. I am at a loss to see how I can document the nuances of the visit in a timely fashion. But even with these dictations my overall dictation volume is only a quarter of what it used to be.

• For ongoing care documentation, referring physicians and a patient's PCP may enjoy personal follow up letters but they appreciate more the incredible timeliness of a faxed copy of the progress note with an electronically signed cover letter sent at the conclusion of the patient's visit in the office as the chart is closed. Learn how to use this EPIC feature early in your experience.

• Ordering tests yourself in EPIC takes longer than when you circled things on a sheet of paper and then sent the patient to the front desk, however the accuracy is vastly improved. Much of the frustration of ordering these tests can be avoided by building "smart sets" - electronic lists of common diagnoses, lab tests and imaging for each of the most common types of problems you see in your practice. These allow you to complete the ordering process quickly and efficiently by simply checking things off a list. Spend your pre-EPIC time building these "smart sets" rather than worrying as much about dot phrases and templates - it will save you significant time and frustration.

•Rather than trying to build templates for documenting complete patient visits, start with a small number of personal dot phrases that reflect fairly short pieces of dictation that you find yourself repeating over and over in your day to day practice. These will prove far more useful than longer template types of dot phrases that never quite fit any patient in their entirety. Commit to reviewing these periodically, renaming them as necessary in a manner that becomes logical as you come to see how you use EPIC. Despite my previous impressions, the reality of patient encounters is that 75 percent of their content is routine and only 25 percent is individual.

•As a tool for chart review and for receiving, reviewing and acting upon lab results, EPIC is much more powerful than any system we have had before. Establish early with your support personnel/clinic who will be responsible for the actions that these results cause you to generate - how you will communicate and follow up (result notes? messages? telephone encounters?). It is unfortunately possible to create parallel tracts of responsibility with each group thinking the other is responsible if you are not careful.

More than anything else, remember there is a long learning curve to this transition; start simple by incorporating only those things that are needed to get through your clinic day and keeping everything else the same. Add new things slowly and keep an open mind. Our experience shows that EPIC is a powerful tool that can make things better for your patients and for you.

(Please click here to share your own "tips" for EPIC users and we will publish them in this newsletter periodically.)

Media coverage climbs

By Liana Haywood, Senior Media Coordinator, OHSU News and Publications

Third quarter media mentions of OHSU increased nearly 40 percent over second quarter to 1,811 mentions in all media formats. The majority of that coverage (72 percent) was in newspapers. More than half of all media coverage was within the state of Oregon.

The business of OHSU represented the largest amount of media coverage locally (42 percent) and regionally (33 percent), including the expansion to the South Waterfront, the tram, medical malpractice and tort claim issues, and the presidential search.

The "green" aspects of new buildings were of particular interest to media locally and nationally. The Basic Research Building and the Center for Health & Healing were described in a USA Today article about green building and in numerous Oregonian articles.

The naming of Joe Robertson, M.D., M.B.A., as president and subsequent coverage of his trips across the state continue to be covered widely, representing 8 percent of third quarter media mentions. An Oregonian reporter accompanied President Robertson on a three-day trip to eastern Oregon, resulting in a front-page feature profile.

Nationally, the majority of media coverage (43 percent) featured OHSU experts, most of whom are SOM faculty, commenting on various health and science topics. OHSU experts appeared in publications including The New York Times, Chicago Tribune, USA Today, U.S. News and World Report, and Washington Post, among many others.

CTSA "Pilot Project" funding applications under review

Momentum is building now that the organizational framework for the CTSA grant has been established with the designation of the Oregon Clinical & Translational Research Institute, or OCTRI. OCTRI launched a Web site in December (www.octri.org).

A first round of Pilot Project funds applications are under review; sixty applications were received for the two awards. Additional Pilot Project funding will be available in 2007 and beyond. Pilot Projects are primarily for new investigators or for those extending their research in multidisciplinary or translational directions.

OCTRI is currently accepting fellowship applications for the OSLER program (short for Oregon Students Learn and Explore Research) for predoctoral students. The application deadline is January 31, 2007. For additional information, refer to the OSLER Web site click here.

Center for Health & Healing holds open house, tram enters operational training phase

The Center for Health & Healing held an open house for employees and the public in early December. As of the close of December, 95 percent of the building was occupied. Each of OHSU's missions of teaching, research and clinical care are represented in the building.

Eight levels of the 16-floor, 400,000 square-foot building are devoted to clinical services and four levels are dedicated to educational and research activities, including laboratory space for the biomedical engineering program. The other floors house the School of Nursing's March Wellness Center and retail space.

The Portland Aerial Tram began an Operational Training Phase on December 15. This is the period when loading, unloading and other operational procedures will be refined to make it ready for public use. Work on the Tram terminals is still underway. Because the tram technically remains a construction site, only OHSU employees with an OHSU badge are permitted to ride during the Operational Training Phase. As of the third week of December, the tram has carried about 11,000 riders. The tram will open to the general public in late January.

Nominations for OHSU-sponsored MBA programs sought

The OHSU MBA Sponsorship Program, launched last fall, is accepting nominations for candidates. The program pays the tuition costs of a few high-potential leaders from OHSU to attend a local MBA program of their choice. Three employees were selected last fall to participate and are already on their way to earning their MBA degrees.

Qualified employees are those who possess a high potential for success in executive leadership, demonstrate a long-term commitment to OHSU, already exceed performance expectations, and have the internal drive to complete an MBA program. Candidates may be nominated to start a program for the spring, summer or fall semesters. An employee who was nominated in the last round but was not selected is eligible to be considered again. For details and an application, click here.

Surgery and art: History of Medicine lecture, Jan 8

The OHSU History of Medicine Society will host a guest lecture by J. Patrick O'Leary, MD, FACS, Professor and Chairman, Department of Surgery, Louisiana State University School of Medicine on January 8. Dr O'Leary will present a lecture titled: Surgery's Entry into its Modern Era Depicted by the Art of the Times. The lecture is in the Old Library Auditorium. Refreshments will be served at 12:00 noon and the lecture begins at 12:15 pm.

OHSU receives Business Journal award, research cited

The Oregon business community named OHSU the Most Admired Health Care Company in Oregon in 2006. This is the second year in a row that OHSU has earned this distinction. The group named Doernbecher Children's Hospital as the fourth most admired in the health care field. The health care category includes both hospitals and insurers.

According to the Business Journal, "With its dramatic South Waterfront expansion and recent presidential succession, OHSU has made lots of headlines this year. That – along with the health care organization's ambitious health research program – likely pushed it to the top spot as the most admired health care company for the second year."

Sharon Anderson, MD, appointed to NIH study section

Sharon Anderson, MD, Professor of Medicine, Division of Nephrology & Hypertension, and Associate Dean for Faculty Development and Affairs has been appointed to the National Institutes of Health, Pathobiology of Kidney Disease Study Section. Dr. Anderson's term begins immediately and ends June 30, 2010. Study section members are selected on the basis of their demonstrated competence and achievement in their scientific discipline as evidenced by the quality of research accomplishments, publications in scientific journals and other significant activities, achievements and honors, according to the NIH.

ORCATECH receives $7 million NIH grant

The National Institute on Aging of the National Institutes of Health awarded a five-year, $7 million Bioengineering Research Partnership (BRP) grant to OHSU's Oregon Center for Aging and Technology, or ORCATECH. Formed in 2004, ORCATECH studies and develops enabling technologies to assess elders for memory changes. Jeffrey Kaye, MD, Professor of Neurology in the OHSU School of Medicine and Biomedical Engineering in the School of Science & Engineering, is the director of ORCATECH.

The pilot phase of the BRP is already underway with 13 monitored homes throughout the Portland area. The BRP also will fund a second phase, which will monitor up to 250 elders ages 80 and older over three years.

Oregon Brain Institute Fellowships awarded

The OHSU Brain Institute (OBI) awarded its first round of fellowships this fall to support graduate students (PhD or MD/PhD) interested in research relevant to the study of the neurobiology of disease. The awardees were selected by OBI Co-Chairs Dennis Bourdette, MD, Professor and Chair of Neurology and Gary Westbrook, MD, Professor of Neurology and Professor of Physiology & Pharmacology.

Congratulations to the following awardees:

1) Jeff Iliff for the Neurobiology of Disease Fellowship

2) Anna Barsoukova for the Neurodegenerative Disease Fellowship

3) Brenda Poltster for the Pediatric Neurobiology of Disease Fellowship

4) Marnie Preston for the Multiple Sclerosis Fellowship

There were 26 applicants for the four awards for the 2006-2007 academic year. The work of the OBI fellows will be featured at the first annual OBI meeting which will coincide with the Neuroscience Town Hall and the Oregon Chapter, Society for Neuroscience meeting next spring.

SOM appoints new Director of Communications

Kathleen McFall has joined the Office of the Dean as Director of Communications. Jennifer Boyd, PhD, prior Director of Communications, is now working with the Office of the President. Kathleen previously was Senior Communications/Crisis Specialist for OHSU News and Publications. In that role, she worked directly to inform and educate the media, community representatives and internal OHSU audiences on issues important to the School of Medicine and OHSU. Please share your ideas and news with Kathleen at 494-9892 or mcfallka@ohsu.edu.

Welcome to new SOM faculty

A warm welcome to the following faculty members who joined the School of Medicine in November 2006.

Rebecca Armour, MD, Assistant Professor, Ophthalmology; Phillip Wilmarth, PhD, Research Assistant Professor, Biochemistry & Molecular Biology; Randall Woltier, MD, Assistant Professor, Pathology.