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May 10, 2013
Table of contents
UW Medicine retreat focuses on curriculum renewal, accountable care, precision medicine
Each spring, members of the UW Medicine senior leadership team convene for a two-day retreat to discuss some of the important priorities related to our mission of improving the health of the public. This year’s retreat included nearly 100 individuals from all UW Medicine entities. Key theme areas for discussion were: plans for medical school curriculum renewal, UW Medicine’s progress toward becoming an Accountable Care Organization (ACO) in 2014, and plans for positioning UW Medicine for leadership in precision medicine.
The curriculum renewal committee recommendations presented at the retreat included implementation of a shorter basic science phase, early clinical immersion, integration across the curriculum (within and across years), active learning, consensus-based and integrated governance, and opportunities for individual career exploration and focus in research, primary care and other areas. Two of a number of themes to be incorporated throughout the curriculum were reviewed: patient safety and quality, and interprofessional education and communication. Discussion of the proposed curriculum components and themes was lively, with considerable enthusiasm for the proposed plans. In upcoming months, the curriculum renewal committees will hold community-wide forums to obtain feedback broadly from across the WWAMI region. More information on the curriculum renewal, including committee reports, is available online.
UW Medicine has made extensive progress toward becoming an ACO, especially through ongoing strategic planning. The discussions about ACO development were active and engaged. This important transition requires a concerted system-wide focus to improve and measure the quality, safety, efficiency, access and service of healthcare programs while reducing cost.This is an ongoing process that we began more than 10 years ago with integration of our clinical, education and research activities and our focus on the single mission of improving health. We will ask for your help, ideas and leadership as we work on the triple aim of improving health care for individual patients, improving health for the populations we serve and controlling costs.
Precision medicine—a powerful research area based on optimizing individual healthcare treatment through disease-specific molecular drivers—is receiving considerable attention at UW Medicine and worldwide. Precision medicine, including genome-based guidance for prevention, diagnosis and treatment, has enormous potential to change the practice of medicine over the coming years. There are significant challenges, however, related to data management, clinical decision-making, ethical considerations and integration of precision medicine with our clinical care programs and the plans for curriculum renewal. UW Medicine education, clinical and research leaders enthusiastically discussed the potential for precision medicine and made a number of recommendations regarding how we can address the challenges.
I believe that UW Medicine is very well positioned to provide global leadership as our plans proceed for curriculum renewal, ACO transformation and precision medicine. The discussions, engagement and commitment among our senior leadership to making advances in these three areas are indications of a strong, dedicated and integrated community. Thank you to all who attended the retreat—for your contributions, enthusiasm and leadership. And thank you to our outstanding faculty, students, staff and trainees throughout UW Medicine who work hard, through science, clinical care and education, on behalf of our mission to improve the health of the public.
Paul G. Ramsey, M.D.
Randall Moon, UW professor of pharmacology, is one of two UW faculty members elected fellows of the American Academy of Arts and Sciences. The 4,000 fellows and 600 foreign honorary members of the academy include more than 250 Nobel Prize laureates and 60 Pulitzer Prize winners.
Moon, UW professor of pharmacology, is a leader in regenerative medicine research. He began studying the cell signals that transform tadpoles into frogs, later concentrating on how alterations in these Wnt signaling networks, as they are called, lead to cancer, bone density disorders and other human diseases. More recently, his lab has been enhancing this signaling to accelerate tissue repair and prod stem cells to turn into progenitors for various blood cell types. He hopes to modulate Wnt signaling to design therapies against deadly cancers, such as melanoma, and to improve recovery from brain injuries and other neurological damage. Read more about Moon’s research below.
Susan Eggers, UW professor emeritus of computer science and engineering, the other UW faculty member elected, is co-inventor of a computer processing technology that makes more efficient use of a chip’s computing power. The technology changed industry standards and was adopted by Intel, IBM and others.
This year 198 people were elected to the American Academy of Arts and Sciences, including recipients of the Nobel Prize, National Medal of Science, Lasker Award, Pulitzer Prize and MacArthur fellowships as well as Grammy, Emmy, Academy and Tony awards.
Read more in UW Today.
Randall Moon, director of the UW’s Institute for Stem Cell & Regenerative Medicine (ISCRM) and professor of pharmacology, and Jason Berndt, acting instructor of pharmacology, wrote a review in the March 22 edition of Science about the promise of manipulating Wnt pathways for disease treatment.
The Wnt signaling pathway is a network of proteins that passes signals from receptors on the surface of the cell to the cell's nucleus. It controls cell-to-cell communication in cell proliferation and differentiation during development and healing.
Wnt signaling pathways play many important roles in embryonic development and in the regulation of adult stem cells. Mutations in Wnt pathways in adults, however, play roles in cancer, bone density diseases, retinal diseases, and acute injury. In their article, Moon and Berndt discuss the findings of a recent study that showed how manipulating the way an embryonic stem cell is exposed to a Wnt signal triggers cell division and polarizes the resulting daughter cells. This enables the cells to renew into more stem cells, or to differentiate and serve different functions in the body. Since embryonic stem cells can divide into any type of somatic cell, these findings are broadly relevant to many tissues and organs.
A question in the field has been what controls daughter cells which will self-renew versus which cells will differentiate. One of the papers Moon and Berndt discuss in their review shows that a secreted protein, called Wnt3A, when attached to beads, led to different activation of a signaling protein on the side of the cell near the bead versus farther from the bead. This in turn specified which daughter cell would self-renew instead of differentiate. Both of these studies suggest Wnt pathways play a role in self-renewal of embryonic stem cells and point to areas where further research could be conducted to increase understanding of the relationship between Wnt signals and embryonic stem cells.
Wnt signaling has been studied for the past three decades, yet intriguing details about the mechanisms are still being uncovered at the molecular level and new insights into the roles of Wnt signaling in adults continue to provide surprises.
Randall Moon, who has been deeply involved in studying these Wnt signals in development and disease, notes, "There are finally a number of candidate therapeutics in clinical trials for treating a wide range of chronic and acute conditions, which is yet another demonstration that trying to understand and dissect normal biology can lead to new drugs and therapies."
Read the original article in Science.
UW Medicine’s top research awards have been listed for January through March 2013. The list draws from all awards, including those for new projects or for an additional installment to an existing project.
Awards granted during the previous quarter, October through December 2012, are also available online.
Cynthia (Cindy) Hecker has been appointed executive director for Northwest Hospital & Medical Center (NWH), effective May 6. Hecker has been serving as interim executive director at Northwest Hospital since November 2012, in preparation for the retirement of NWH President William Schneider, who will retire in June after 30 years of service.
In her new role, Hecker will provide executive leadership for Northwest and serve as a member of the senior leadership team for UW Medicine. She will report to Johnese Spisso, chief health system officer, UW Medicine, and vice president of medical affairs, and to the NWH Board of Trustees.
Hecker has more than 30 years of experience in healthcare through progressive leadership roles at UW Medicine. She began her clinical career at Harborview Medical Center as a registered nurse in acute and critical care services; she was sequentially promoted to nurse manager, assistant administrator for Patient Care Services, and chief nursing officer and associate administrator for Patient Care Services in 2000. In 2011, she was promoted to the position of UW Medicine Senior Associate Administrator for Clinical Integration, where she was responsible for key strategic initiatives for the clinical entities in UW Medicine, including NWH. Over the past eight months, Hecker has lead the operations and management of NWH under Schneider’s leadership and has gained a greater understanding of the history of the NWH campus.
Announcing the appointment, NWH Board President Peter Evans said of Hecker: “She is a dedicated and engaging leader with in-depth experience in clinical operations, business development, information technology and complex academic health systems….Cindy also brings the proven ability to develop strong working relationships with employees, medical staff and community partners, and the ability to lead system-wide change initiatives….The Board is confident she is the right person to direct the medical center’s already stellar leadership team in its future growth efforts as we all work together to improve the health of our community.”
Valley Medical Center (VMC) has received the American Heart Association’s Mission: Lifeline® Bronze Receiving Quality Achievement Award. The award recognizes the medical center’s commitment and success in implementing a high standard of care for heart attack patients.
Each year in the United States, nearly 300,000 people have a STEMI, (ST-segment elevation myocardial infarction), the most severe form of heart attack. A STEMI occurs when a blood clot completely blocks an artery to the heart. To prevent death, it is critical to immediately restore blood flow, either by surgically opening the blocked vessel or by giving clot-busting medication.
Hospitals involved in Mission: Lifeline ensure STEMI patients get the care they need as quickly as possible. Mission: Lifeline focuses on improving the system of care for these patients and at the same time improving care for all heart attack patients.
As a “STEMI Receiving Hospital,” VMC meets high standards of performance in quick and appropriate treatment of STEMI patients to open the blocked artery. Before they are discharged, patients are started on aggressive risk reduction therapies such as cholesterol-lowering drugs, aspirin, ACE inhibitors and beta-blockers and they receive smoking cessation counseling, if needed. Hospitals must adhere to these guidelines-based measures for a designated period of time to be eligible for the achievement awards.
“Valley is dedicated to making our cardiac unit among the best in the country, and the American Heart Association’s Mission: Lifeline program is helping us accomplish that by making it easier for our professionals to improve the outcomes of our cardiac patients,” said Elaine Lodbell, vice president, Quality Services, Valley Medical Center. “We are pleased to be recognized for our dedication and achievements in cardiac care, and I am very proud of our team.”
UW Medicine Strategic Marketing & Communications has launched an official UW Medicine Facebook page—featuring news stories, multimedia, published research, health tips and more. This Facebook presence provides an additional way to share pertinent information, news and events with the public about the work being conducted throughout UW Medicine. UW Medicine community members are invited to share news about their department or service’s latest endeavors, including research, awards and recognition, public interest stories, open house events and other relevant items, so that it may be posted on the UW Medicine fan page.
School of Medicine faculty members Rachel Klevit and Deborah Kartin have received the 2012 UW Medicine Award for Excellence in Mentoring.
Rachel Klevit is professor of biochemistry and director of the Interdisciplinary Graduate Program in Biomolecular Structure and Design. One letter of nomination summed up the qualities that set Klevit apart as a mentor: “empathy and deep interpersonal awareness, recognition of diverse perspectives, a great advocate, and providing ‘carefully measured influence.’”
Klevit's laboratory studies molecular recognition, with an emphasis on protein-protein interactions that play important roles in human disease. The Klevit laboratory uses various structural, biochemical, molecular biological, and biophysical techniques. Ongoing projects in the group include the following systems: BRCA1, the breast cancer susceptibility protein; protein ubiquitination in general; human small heat shock proteins alpha-B crystallin and HSP27; and PhoQ, a virulence factor in pathogenic bacteria.
Deborah Kartin is professor and physical therapist in the Department of Rehabilitation Medicine. She is committed to incorporating an interdisciplinary perspective in her courses that include content related to professional development, evidence-based practice, measurement, and critical analysis of the research literature. She also teaches core courses for the Ph.D. Program in Rehabilitation Science.
One of Kartin’s nominators said: “She has the capacity of being able to draw out the best in each person, helping each person define and achieve his or her dreams. She is a person who helps each of us be better than we would have been without her mentorship.”
Kartin's clinical interests include neonatal intensive care, early intervention, and pediatric developmental disabilities. Her research interests include the effects of prenatal exposure to alcohol and other drugs, the development of postural control and balance, and cerebral palsy.
The award, initially sponsored by UW Medicine's National Center for Excellence in Women's Health, recognizes the need for mentoring of women faculty. Prior award winners are Nora Disis (2003), Ed Boyko (2004), Trisha Davis (2005), Elizabeth McCauley and Anna Wald (2006), Julie Overbaugh and Catherine Otto (2007), Grace John Stewart and Lynn Schnapp (2008), Dedra Buchwald (2009), Anne Lynn and Christine Gleason (2010) and Lynne Robins (2011).
The award selection committee is the Dean's Standing Committee on Issues of Women Faculty; committee members are not eligible for the award.
MEDEX Northwest, the UW School of Medicine’s physician assistant (PA) training program, has announced it will discontinue classroom teaching in Yakima this fall and consolidate that training in Spokane, Seattle and Tacoma. The September 2013 entering class of 16 Yakima PA students will be divided among the three campuses, with four students attending classes at UW-Tacoma, one at UW-Seattle, 10 at the Spokane Riverpoint campus, part of the UW School of Medicine’s WWAMI Spokane partnership program with Washington State University, and one taking a deferment for one year.
The two-year PA training program educates healthcare professionals to practice medicine with physician supervision. Current Yakima classes of PA students in their first or second year of training will not be impacted, and MEDEX will maintain a Yakima field office to support current students, recruit future students, and maintain an active clinical presence with longstanding community partners throughout the Yakima Valley.
The re-focusing of the educational model in Yakima is part of a larger effort by MEDEX to centralize PA classroom training sites while, at the same time, decentralizing PA clinical training in local underserved communities that are part of the UW School of Medicine’s five-state WWAMI region (Washington, Wyoming, Alaska, Montana and Idaho). In addition to Seattle, Tacoma and Spokane, MEDEX has a training site in Anchorage, Alaska.
Following their classroom training, students from rural and small-town areas return to their home communities—where the shortage of primary care professionals is greatest—to complete clinical training and seek future employment opportunities.
“While the challenges of recruiting and retaining PA faculty have made it necessary to centralize our classroom training sites, we remain strongly committed to our mission of educating students from rural and underserved communities so they can become skilled providers of healthcare services for those same communities,” said MEDEX Director Ruth Ballweg.
The first MEDEX class at the UW School of Medicine convened in 1969 with the goal of training health care providers who would practice primary care in medically underserved and rural areas of the northwest service region. Today, most of the nearly 1,900 MEDEX graduates work in the WWAMI region.
“Of all the PA programs in the country, we are seen as the number one champion for physician assistant training among experienced healthcare workers,” Ballweg said. She noted that the MEDEX program and the UW School of Medicine remain strongly committed to serving the Yakima community. Clinical placements of PA students will continue in the Yakima Valley, facilitated by the field office in Yakima.
Learn more about the MEDEX training program on its new website.
While West Virginia, Kentucky and other Appalachian states have recently managed to turn the tide of mounting prescription drug abuse, it is on the rise in Washington, Oregon, Colorado and Idaho. These western states now form the newest hub for the highest rates of painkiller abuse, according to data released earlier this year by the Substance Abuse and Mental Health Services Administration.
“We have been confronting this epidemic of opioid abuse by broadening the scope of our educational content about best practice care of chronic pain and extending our outreach by making our expertise available to family practitioners and other primary care providers,” said David Tauben, medical director of the UW Medicine Center for Pain Relief and interim chief of its Division of Pain Medicine.
Part of this ongoing effort is a new web-based course, COPE-REMS (Collaborative Opioid Prescribing Education-Risk Evaluation and Mitigation Strategy), a continuing medical education course from UW Medicine. COPE-REMS is specifically aimed at improving the safety of prescribing painkiller medications, or opioids.
Last year, the Food and Drug Administration issued a Risk Evaluation and Mitigation Strategy (REMS) for long-acting, extended-release painkillers, a response in part to the alarming death rate of nearly 16,000 prescription drug overdose deaths per year in the U.S. The FDA REMS requires opioid manufacturers to educate providers on ways to reduce risks associated with chronic opioid therapy.
UW Medicine’s COPE-REMS course is one of the first of its kind nationally to respond to this need and to be fully compliant with the FDA REMS. The course is based on an earlier continuing medical education course called simply COPE. The new course is rich with guidance about when it is appropriate to prescribe, to change a dose level, or to discontinue opioid prescribing. It offers videos of case-based scenarios to help providers model ways to handle difficult situations.
“Our course aims to increase knowledge of opioid medications and of communication skills among primary healthcare providers so they can better navigate the often challenging waters associated with treating patients who experience chronic pain,” said Mark Sullivan, a psychiatrist with the UW Medicine Center for Pain Relief, professor in the UW Department of Psychiatry and Behavioral Sciences, and a widely-published expert in pain management.
The course stresses constructive dialogue between provider and patient, and emphasizes collaborative goal setting with patients to better address their needs over the long haul.
Visit the COPE-REMS course website to learn more.
On April 19 Wyoming WWAMI first-year medical students joined with family, friends, University of Wyoming leadership and the Wyoming medical community to celebrate the receipt of their white coats and the anticipated conclusion of their first year of medical education.
Mark McKenna, a 2006 graduate of the Wyoming WWAMI program, who now practices orthopedic surgery in Laramie, Wyo., was the keynote speaker for the event. He discussed the importance of a quality basic science education that integrates with clinical knowledge.
"The white coat emphasizes and denotes the transition from classroom learning to clinical medicine and patient care," McKenna said. This was McKenna's first year as a preceptor for Wyoming students after returning to practice orthopedic surgery in Wyoming two years ago. Sixty-five percent of Wyoming WWAMI graduates return to practice medicine in Wyoming.
Twenty first-year students were presented white coats by their physician preceptors. Each student spends approximately one half-day per week during the majority of the first year with a physician preceptor. In their work with preceptors, the students learn about patient care, clinical medicine, and gain important insights into the culture of medicine. During the presentation, preceptors emphasized the teamwork demonstrated by the class, and the outstanding medical knowledge they exhibit. One preceptor noted that, "The Introduction to Clinical Medicine course, does an outstanding job of preparing students to work in our offices."
Matt McEchron, first -year director for Wyoming WWAMI at the University of Wyoming, moderated the program. He thanked the families, preceptors and basic science faculty for their outstanding work during the year. A reception followed the ceremony. This summer, seven of the Wyoming WWAMI students will participate in the Rural /Underserved Opportunities Program (RUOP) in Wyoming, nine will participate in research projects, and two will spend time in Peru pursuing projects in global health.
Photos: Above left, Wyoming WWAMI first-year medical students. Above right, First-year medical student Alexander Colgan celebrates the white coat ceremony with his parents.
The following events may be of interest to the UW Medicine community:
22nd Annual Visiting Scholar in Cardiothoracic Surgery Lecture, May 10
A New Paradigm in Transplantation: Personalized Medicine for the Organ, 3:30 to 4:30 p.m., Friday, May 10, Health Sciences Building, Room K-069. Shaf Keshavjee, director of the Toronto Lung Transplant Program and surgeon-in-chief of the University Health Network, University of Toronto, will speak. The lecture is presented by the UW Division of Cardiothoracic Surgery. Reception follows. Contact Kelsey Hobbs at firstname.lastname@example.org or 206.543.3093 for more information.
20th Annual Buehler Memorial Visiting Professorship in Plastic Surgery Lecture, May 15
Reconstructive Microsurgery at Chang Gung, 6:30 to 7:30 a.m., Wednesday, May 15, Health Sciences Building, Room K-069. Fu-Chan Wei, professor of surgery in the Division of Plastic Surgery at Chinese Medical University, Taipei Medical University, and Chang Gung Memorial Hospital & Medical College in Taiwan. Wei will discuss recent developments in reconstructive microsurgery, workhorse flaps for various reconstructions, and the functional results and complications from reconstructive microsurgery. Contact Diane Kennedy at Dianek6@uw.edu or 206.543.3680 for more information.
Annual Science in Medicine Lecture, May 22
The Sleep Gap: Why is it Growing? 1 to 2 p.m., Wednesday, May 22, Health Sciences Bldg., Turner Auditorium, Room D-209. Charles Czeisler, professor of sleep medicine and director of the Division of Sleep Medicine at Harvard Medical School, will give the lecture. Czeisler’s translational research is on the physiology of the human circadian timing system, its relationship to the sleep-wake cycle and its application to occupational medicine and health policy. The lecture will be televised at several locations. For a listing and more information, visit the Science in Medicine website or contact Heather Hawley at email@example.com or 206.221.5807.
Neurological Surgery Grand Rounds: The Robert Goodkin, M.D. Endowed Lectureship, May 29
Reflections on 57 Years of Spine Surgery, 7 to 9 p.m., Wednesday, May 29, Harborview Medical Center, Research and Training Bldg., 1st floor auditorium, 300 Ninth Ave. John Jane, professor of neurological surgery and director of the Neurological Training Program at the University of Virginia School of Medicine in Charlottesville, will give the lecture. An icon in the field of neurological surgery, Jane was professor and chair of the Department of Neurosurgery at the University of Virginia School of Medicine for more than 30 years. Jane’s clinical interests include cranial and spine surgery, pediatric neurosurgery, with a special interest in craniofacial surgery. He is also the editor of the Journal of Neurosurgery. Contact Mary Gilbert, at firstname.lastname@example.org or 206.744.9356 for more information.
Graduate Medical Education Grand Rounds, May 30
Debt Management and Repayment Strategies, 5:30 to 7:00 p.m., Thursday, May 30, UW Health Sciences Building, Room T-733.Medical residents and fellows are invited to learn how to manage student debt and learn strategies for repayment. The presenter will be Julie Fresne, director of student and resident financial services, Association of American Medical Colleges. A light dinner will be served at 5:30 p.m. Register online. Contact Shawn Banta at email@example.com or 206.616.8286 for more information.
2013-2014 Teaching Scholars Program applications due, June 28
Faculty in the health sciences professions are invited to apply to the 2013-2014 Teaching Scholars. The program, offered by the UW Department of Biomedical Informatics and Medical Education, prepares faculty to become leaders in all aspects of health professional education. Teaching Scholars is a 10-month, part-time, certificate program consisting of integrative seminars, scholarly projects, and a professional peer group. To be considered to participate in the 2013-2014 program, applicants must be nominated by their department chair and complete the application by June 28. Apply to the program online; click “Register Now” for Teaching Scholars 2013-2014. Complete the survey and submit electronically. For more information, contact Lynne Robins at firstname.lastname@example.org or 206.616.9874, Stephanie Habben, program coordinator at email@example.com or 206.616.9875, or visit the UW Teaching Scholars website.
Continuing Medical Education
Visit Continuing Medical Education for information on upcoming classes.
UW surgeon using crowdfunding to fund research
Michael Mulligan, professor of surgery in the Division of Cardiothoracic Surgery, is using the new online crowdfunding website Consano to raise funds to advance his research in lung transplantation. Consano, a non-profit, aims to use small donations to fund important scientific research by bringing crowd-funding to the world of medical research. Mulligan is raising funds to perfect a technique using bacteria to render bacteria-infected donor lungs suitable for transplant. KING 5 TV.
Spring UW Medicine magazine available online
The spring issue of UW Medicine is now available online. Read about the new UW Palliative Care Center of Excellence, which is taking care of people at the most vulnerable times in their lives, and ENCODE, the ground-breaking study that is mapping the living genome, and more.
UW Medicine health and wellness initiative on the air and online
UW Medicine’s new multi-media health and wellness initiative provides consumers with health and wellness information and the latest treatments and medical breakthroughs at UW Medicine. Look for the new UW Medicine Health website, and regular television and radio spots on Fisher Communication’s KOMO News, KOMO News Radio and STAR 101.5. Contact UW Medicine Strategic Marketing & Communications at 206.543.3620.
UW Medicine Brand Resources website (UW NetID required)