UNIVERSITY OF ROCHESTER MEDICAL CENTER
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SCHOOL OF MEDICINE AND DENTISTRY
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Advancing Orthopaedics:
Innovations in Motion
2019 VOLUME 1
On the cover Good things come in small packages, like this gumdrop-like implant that could be a game-changer for arthritis treatment. Learn more on page 23. Photo by J. Adam Fenster University of Rochester
POINT OF VIEW What’s bubbling up? These tiny spherical wells in a silicone substrate—called microbubbles— are tools in a promising study that may help regenerate salivary gland cells lost during radiation therapy for head and neck cancers. URMC researchers Danielle Benoit, Biomedical Engineering; Lisa DeLouise, Dermatology; and Catherine Ovitt, Center for Oral Biology, are using microbubbles, which are made with computer chip fabrication technology, to grow the cells and test drugs that could help patients. Photo by J. Adam Fenster University of Rochester
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F
rom its birth early in the 20th century, our academic medical center has earned a reputation for innovative education—from helping to pioneer the Flexner framework, to the biopsychosocial model which remains our hallmark, through the 1990s when we introduced the “double helix” curriculum that integrates science education and clinical medicine throughout the learning process.
Mark B. Taubman, MD CEO, University of Rochester Medical Center Dean, School of Medicine and Dentistry
Senior Vice President for Health Sciences
What do you think?
These approaches have produced generations of clinicians and researchers who are not just experts in their chosen fields, but innovative thinkers eager to find new solutions to longstanding problems. We recruit faculty members who also think outside the box, finding new ways to improve health by understanding and treating the whole patient, not just their symptoms. Our Department of Orthopaedics is a prime example, as you’ll learn in our cover story. URMC is preparing to build a new orthopaedic campus—a place that will ultimately combine clinical care, research, education, and community wellness under one roof. As we look to the future, our story explores how innovation has been part of our department’s DNA since its start, helping to drive improvements in the field that benefit patients everywhere. From a handful of physicians focused on mending broken bones and exhausted joints, orthopaedics at URMC has become a thriving, multi-faceted specialty. Our clinicians, educators and researchers collaborate to apply the latest technologies—and to invent new ones— that keep people healthy and on the move. Significant in the department’s history are renowned scientists and clinicians who have emerged from our medical school, residency and fellowship programs to prominence for their countless contributions to orthopaedic discoveries and innovations. Among them are leaders like inaugural chair C. McCollister “Mac” Evarts, who helped introduce total hip replacement surgery to the U.S., and Ed Puzas, first director of Orthopaedics research, who laid the groundwork for us to remain among the top five NIH-funded
musculoskeletal research centers for more than a decade. That vision and leadership provided momentum for Orthopaedics’ growth, allowing us to care for today’s patients while helping future generations to live longer, healthier, more active and fulfilling lives. No conversation about the future of medicine is complete without acknowledging our increased reliance on information technology to document, analyze, diagnose, discover, and even project health outcomes. In this issue, we introduce you to our Chief Information Officer, Tom Barnett. Building on a career of IT innovation at other institutions, Tom has mapped out a bold strategic vision that will leverage data to improve patient care, while making interactions with the EHR as seamless as possible for clinicians. Along with news of faculty achievements and recent highlights from across our enterprise, we hope this issue reconnects you with colleagues, fellow alumni, and a school that appreciates the part you’ve played in bringing us where we are today. As I begin my second five-year term as dean and CEO, I extend my sincerest appreciation for your support of our Medical Center and University. To be entrusted with advancing the mission of our great organization is by far the pinnacle of my four-decade career, and serving as dean of the School of Medicine and Dentistry with the support of administration, faculty, and alumni is an honor and responsibility that I treasure. I look forward to all that we can achieve in the next five years.
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Submit Class Notes RochesterMedicineMagazine@urmc.rochester.edu
CONTENTS 4
Big Smiles After a Trip to Kenya
7 Medical Rounds Cover Story 14 Keep Moving: How Orthopaedics is Addressing the Needs of a Changing Population 26 A Strategy of Solutions
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Faculty News
54 Philanthropy
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In Memoriam
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Class Notes
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Rochester Medicine is published by:
Interim Editor
The University of Rochester Medical Center,
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Dept. of Alumni Relations and Advancement
Department of Communications, in conjunction with
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for the School of Medicine and Dentistry
the Department of Alumni Relations & Advancement
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300 East River Road, Rochester, NY 14627
for the School of Medicine and Dentistry
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Big Smiles After a Trip to
Kenya
by Heather Natola (PhD ’17)
I was fortunate to travel with Daphne Pariser (MS ’17), a PhD candidate in the Immunology, Microbiology and Virology program and founder of the nonprofit Humans for Education (H4E), to Kenya last August. It was my first trip to Africa, but not Daphne’s. In 2015, she founded H4E with David Kasura, a native Kenyan and a useful ally to have on the ground while Daphne works on her PhD in Rochester. H4E began when Daphne and David connected, indirectly at first, on Daphne’s flight to Florida for a friend’s college graduation. Daphne struck up a conversation with a woman who talked about her trip to Kenya and her safari guide, David. She told Daphne about David’s efforts to install clean water filters in his son’s school. Inspired and eager to help, Daphne contacted David and together they managed not only to install filters in his son’s school, but to develop sponsorship programs, water storage containers, and filters for two additional schools as well. Denisse Vega Ocasio (MS ’18) and I were the two URBEST trainees who joined Daphne on this recent H4E trip, along with two dentists she enlisted to provide preventive and emergency dental care at Destiny Shaper School. Denisse is a PhD candidate in the Translational Biomedical Science program and I am a recent PhD graduate from the Neuroscience department. Many people are confused when they hear that a neuroscientist went to Kenya to do dental work, but being a global citizen is important to me so I jumped at the chance to travel with an organization
I believe is truly doing good. H4E is founded on the principle that education is the gateway to self-improvement and strives to decrease the barriers to a proper education by tackling health challenges. Our dental clinic was a converted second grade class room, with hair salon chairs used as dental chairs. Denisse and I served as scribes, gophers, and tables—sorting, grabbing, and holding the trays of tools for the dentists while they managed to treat 250 students and community members. The number of patients doubled our goal of 125. We survived wasp attacks, learned a little bit of Swahili (open, bite, close, and spit), and surveyed the children on their diet, education, and aspirations. Many students shared their new dreams of becoming dentists. We were only with the students at Destiny Shaper School for nine days, and while the dental care we provided undoubtedly improved their lives, the impact they had on us was just as great. The children and teachers were incredibly warm and openhearted, and we enjoyed their hospitality the entire trip. When we arrived, they performed two songs to welcome us to Kenya, and offered us traditional Maasai blankets and jewelry as thanks. When we left, we had lasting memories of a beautiful country and an amazing group of people. Due in part to the success of our trip, Daphne is planning a bigger venture for next July. For more information about Humans for Education and their 2019 dental trip, visit: humansforeducation.org/volunteerwithh4e
About URBEST URBEST is an NIH-sponsored program that aims to provide biomedical science trainees with opportunities outside of a traditional science setting. URBEST provides lectures from experts in different fields, networking opportunities, and internships for engaged graduate students and post-doctoral fellows.
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WATCH A SLIDE SHOW ABOUT HEATHER’S KENYA TRIP visit: http://bit.ly/urbestkenya
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IGNITING FIRSTS THAT LAST First steps. First graduate. First discovery. First life saved.
The University of Rochester is a proud, inspired community of leaders, thinkers, and change-makers. Thanks to you, our past is rich with firsts. And thanks to you, our future will be too. Join us May 1 for our annual Day of Giving. Your gift will ignite firsts that last for generations. Give at rochester.edu/fuelthefirst.
#FueltheFirst
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MEDICAL ROUNDS COLL A BORATION
AHA Grants Accelerate Search for Stroke Therapies In recent years, scientists have begun to develop a more complex picture of strokes and how damage to the brain can continue even after blood flow is restored. A series of new awards from the American Heart Association (AHA) to a team of researchers at the University of Rochester will focus on the development of new treatments that thwart the inflammation process that can interfere with recovery after a stroke. One of the research projects brings together experts in stroke, cardiovascular biology, platelet biology, and peptide chemistry. Marc Halterman (MS ’99, MD ’02, PhD ’02), with the URMC Center for Neurotherapeutics Discovery, Scott Cameron, MD (MS ’01, PhD ’03) and Craig Morrell, DVM, PhD, with the URMC Aab Cardiovascular Research Institute, and Bradley Nilsson, PhD, with the University of Rochester Department of Chemistry will focus on the role that platelets play in acute brain injury and inflammation during stroke.
Platelets serve an important role in protecting against blood loss and repairing injured blood vessels. However, during a stroke the inflammatory properties of platelets can interfere with the restoration of blood flow once the clot in the brain is removed, particularly in micro-vessels, which can lead to permanent damage of brain tissue. The research team will build synthetic peptides that activate platelets to study the phenomenon—which is called no-reflow—in an effort to identify specific switches within platelets that can be turned off and limit the cells’ inflammatory functions without blocking their ability to prevent bleeding. Two AHA pre-doctoral fellowship awards to Kathleen Gates and Jonathan Bartko in Halterman’s lab will support research that examines the link between an immune system response in the lungs, triggered by stroke, that can exacerbate damage in the brain, and also investigate the cellular
mechanisms that determine whether or not brain cells die following stroke. A final AHA award to the Halterman lab will seek to identify new drug targets by focusing on specific proteins activated during stroke that are suspected to play an important role in determining the survival of neurons. Collectively, the AHA Collaborative Sciences Award, Pre-Doctoral, and Innovation awards represent $1.09 million in funding.
CANCER
Study Explores Hyperbaric Oxygen for Stem-Cell Cancer Treatment With support from a $1 million National Cancer Institute grant, Omar Aljitawi, MD, is investigating whether multiple myeloma
patients who receive an autologous stem cell transplant recover faster if they’re also treated with hyperbaric oxygen therapy.
Pilot studies by Aljitawi showed that oxygen therapy was safe and effective at stimulating healthy blood production following stem cell transplantation, and the new award will allow him to continue the clinical research for three more years. In the Wilmot Cancer Institute trial, some patients who undergo the autologous transplant will be randomly assigned to the additional oxygen therapy. Aljitawi and his team are also investigating whether hyperbaric oxygen improves the recovery of natural killer (NK) cells as key components of the body’s immune system. If hyperbaric oxygen therapy boosts NK cells, he said, it has the potential to control the myeloma after the transplant. Aljitawi, an associate professor of Hematology/Oncology at Wilmot, is collaborating with hyperbaric oxygen therapy experts at URMC and Wilmot experts in the blood and marrow transplant program— which is among the largest BMT centers in New York—as well as the University of Kansas Cancer Center, where he was on faculty before coming to Rochester in 2016.
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MEDICAL ROUNDS PUBLIC HEA LTH
Childhood Obesity Study Makes Weight Loss a Family Matter URMC researchers led by Stephen Cook, MD (Flw ’03, MPH ’07) are joining those from three other organizations on one of the largest family-based childhood obesity studies ever conducted in the hopes of combating what has become a national epidemic. In the United States, one in five children and one in three adults are considered obese. The $13.9 million study, funded by the Patient-Centered Outcomes Research Institute (PCORI), encourages overweight parents to attempt to lose weight themselves in addition to assisting with their child’s nutrition and physical activity goals. In previous smaller studies, this approach has reduced obesity in children and has seen parents lose an average of 15 to 20 pounds.
“While tracking the child’s behavior, we also work on setting goals for the parents as well,” says Cook, associate professor of Pediatrics at URMC. “When father and daughter, or mother and son, are working together toward the same goal— eating more fruits and vegetables together, exercising together—they tend to have much more success.” The study also includes researchers at Washington University School of Medicine in St. Louis, which is serving as the lead institution; the LSU Pennington Biomedical Research Center in Baton Rouge, La.; and the
PATIENT CARE
Specialty Programs Named to Best Hospitals List Strong Memorial’s ENT and Nephrology, Highland’s Gynecology Earn Top 50 Rankings Three UR Medicine specialties ranked among the nation’s best, and Strong Memorial again captured the spot as the No. 1 hospital in the Rochester Metro area, according to the U.S. News & World Report 2018-19 rankings of America’s Best Hospitals. Strong Memorial’s Otolaryngology specialty program ranked 43rd among the nation’s hospitals, up from 53 last year, and Nephrology ranked 44th, up from 65 last year. Highland Hospital’s Gynecology specialty program ranked 45th in the nation, up from 71. Seven other programs are included among the 12 specialty areas ranked by U.S. News. All achieved “high performing” 8
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status, which means they scored in the top 10 percent among all hospitals analyzed but are not nationally ranked. Those programs include Diabetes and Endocrinology, Gastroenterology and GI Surgery, Geriatrics, Neurology and Neurosurgery, Orthopaedics, Pulmonology, and Urology. U.S. News evaluated more than 4,500 hospitals nationwide for its Best Hospitals rankings this year. Results are based on measures such as risk-adjusted survival and readmission rates, volume, reputation, patient experience, patient safety, and quality of nursing, among other indicators. A total of 158 hospitals were nationally ranked in at least one specialty. Margo M. Benoit, MD, cares for a young patient in UR Medicine’s pediatric ENT clinic.
American Academy of Pediatrics Institute for Healthy Childhood Weight in Itasca, Ill. In total, the study aims to enroll 1,296 parent-child pairs nationally. For its part, URMC will receive $3.1 million and expects to enroll 432 families in the Rochester area.
NEUROLOGY
National Initiative Focuses on New Treatments for Lewy Body Dementia Lewy Body Dementia (LBD) is a notoriously difficult disease to diagnose and treat and is frequently mistaken for Parkinson’s or Alzheimer’s disease. The Medical Center is joining a new national network of centers of excellence that will seek to raise awareness and advance research for this complex disorder. “Lewy Body Dementia is a challenging, multifaceted disease and research to find new diagnostic tools and treatments is still in its infancy,” says URMC neurologist Irene Richard, MD (Res ’95, Flw ’97) who will serve as director of the URMC Lewy Body Dementia Association Research Center of Excellence. “This new network will create an infrastructure of clinician researchers who understand the disease, are able to identify patients to participate in research, and have experience participating in multi-site clinical trials.” LBD is a progressive brain disorder marked by abnormal protein deposits— called Lewy Bodies—in areas of the brain important for behavior, cognition, and motor control. This complex disease gives rise to a range of symptoms, including cognitive impairment, sleep disturbances, hallucinations, difficulty with blood pressure regulation, and problems with movement and
balance. Individuals with the disease will often experience marked fluctuations in their levels of alertness and clarity of thought. Many patients with the disorder will often go years before it is diagnosed. Once identified, the disease is difficult to treat as many of the drugs available to address specific symptoms—such as those enhancing dopamine for movement and anti-psychotic drugs for hallucinations and behavioral problems—have side effects that can make other features of the disease worse. The Clinical Research Centers of Excellence program, which was created
by the Lewy Body Dementia Association and consists of 33 leading academic medical centers, will provide a centralized, coordinated research resource to support government, industry, and foundation-supported clinical studies investigating new ways to identify and treat the disease. The program will also serve as an educational resource for providers to improve care for patients and their families. The centers were chosen for their clinical expertise in LBD and experience conducting clinical research trials in related conditions.
UROLOGY
Simple Post-Surgery Step Reduces Bladder Cancer Recurrence
One of the most difficult challenges for patients with low-grade bladder cancer is the return of the cancer within a couple years after surgery. The good news is European and Canadian scientists have been using a treatment strategy that reduces recurrences
that has met with notable success. Now a major clinical study in the U.S. supports using the same strategy here. The strategy, which involves washing the bladder with the chemotherapy drug gemcitabine within three hours after surgery, was part of clinical study led by Edward M. Messing, MD, that was deemed “practicechanging” by an editorial in the Journal of the American Medical Association (JAMA) in May 2018. The nationwide trial was funded by the National Cancer Institute. “The real importance of this study is that we now have a readily available drug that’s fairly inexpensive, well-tolerated, and effective,” said Messing, a professor of Urology, Oncology, and Pathology at the University of Rochester Medical Cancer and the Wilmot Cancer Institute. “I know some patients who’ve undergone four
surgeries in a year, and if we can cut down on these recurrences, we will save a lot of people a lot of pain, money, and time lost to recovery.” Researchers followed all patients for four years—the time period when most bladder cancers return—seeking to discover which treatment strategy worked better. The results were clear: A 34 percent reduction in the risk of recurrence for patients receiving the gemcitabine infusion. Sixty-seven patients in the gemcitabine group, or 35 percent, experienced a recurrence, compared with 91 patients in the saline group, or 47 percent. A former president of the Society of Urologic Oncology, Messing also received the American Urological Association (AUA) Ramon Guiteras Award, honoring 35 years of accomplishments that have improved care for patients with urologic cancers. ROCHESTER MEDICINE | 2019– V1
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MEDICAL ROUNDS
YMCA, UR Medicine Announce Exclusive Collaboration 11-year agreement increases access to UR Medicine programs, services at 17 YMCA locations
UR Medicine and the YMCA of Greater Rochester are partnering to improve community health and wellness. From left: University of Rochester President Richard Feldman, UR Medicine CEO Mark Taubman, MD, YMCA CEO George Romell, and YMCA Board Chair Erik Grimm.
Area residents will have greater access to UR Medicine wellness programs and clinical services at 17 YMCA of Greater Rochester locations, under terms of a collaboration agreement announced in May 2018. The agreement expands upon, and formalizes, the pilot collaboration launched in 2014 between the YMCA and UR Medicine. The original partnership, initiated to improve community health, is the largest, most comprehensive collaboration of its kind in the Northeast. This exclusive agreement, which begins now and extends through 2029, will make a range of health services available at YMCA locations across the region, meeting the increased needs of the communities served by both organizations. Specific programming will include clinical programs for managing chronic diseases, sports performance and injury-prevention clinics, dental health screenings, pediatric telemedicine care, and expanded prevention and education services such as influenza clinics and wellness screenings.
As part of the agreement, several UR Medicine physician practices will be located within YMCA branches. UR Medicine Heart and Vascular’s Rochester Cardiopulmonary Group (RCPG), for example, is launching a practice at the Eastside YMCA branch in Penfield to treat cardiology patients. “The goal of UR Medicine is to improve the health of communities we serve across upstate New York, and we achieve it by providing people easy access to preventive services and high-quality clinical care,” said Mark B. Taubman, MD, CEO of UR Medicine. “The YMCA of Greater Rochester is a great community partner already, and with this agreement we will expand the reach of our services to more convenient locations.” The expanded services will be provided by multiple units within URMC, including the School of Nursing’s Employee Wellness Program; the Center for Community Health and Prevention; the Orthopaedics and Sports Medicine department; Golisano Children’s Hospital; and Eastman Dental Center.
BREAKTHROUGH
Brain Injury Blood Test Receives FDA Approval Diagnosing brain injury has always involved guesswork, with physicians weighing subjective patient-reported symptoms such as headaches, nausea, or light sensitivity to determine which individuals might have brain trauma and require a head CT scan. Although they’re commonly used to evaluate individuals who come to the emergency department following a sports concussion or car accident, research shows that around 90 percent of head CTs don’t show any brain bleeding or bruising. A major clinical trial led by Jeffrey J. Bazarian (MD ’87, MPH ’02)
brings a new and long-awaited tool to the emergency physician’s toolbox: an accurate and objective blood test
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to help rule out the need for a head CT. Called the Banyan Brain Trauma Indicator®, the test could eliminate needless radiation, allow people to get in and out of the emergency room faster, and lower health care costs. Studied in more than 2,000 individuals presenting with a head injury to emergency departments in the U.S. and Europe, the test detects two brain proteins that are present in the blood soon after a hit to the head. The results, published in The Lancet Neurology in July 2018, show that if the test is negative (meaning that the brain proteins aren’t present) it is highly unlikely that a traumatic intracranial injury exists and that a head CT scan can be safely avoided. If the test is positive, a brain injury may be present and the patient should receive a head CT scan to further assess the damage and guide treatment. “Many concussion patients don’t seek medical care for their injury, a decision due in part to the perception that emergency departments have nothing to offer in terms
of diagnosis,” says Bazarian, a professor of Emergency Medicine. “This study shows that we now have something to offer—a brain biomarker blood test. The ability of this test to predict traumatic injuries on head CT scan will soon allow emergency physicians to provide patients with an unbiased report on the status of their brain.” In February 2018, the U.S. Food and Drug Administration approved the test for use in individuals 18 years and older as part of a fast track program to get breakthrough technologies to patients more quickly. The test is effective up to 12 hours following injury and picks up the presence of the brain proteins UCH-L1 and GFAP. Bazarian says these are useful markers because they aren’t elevated when someone gets hit outside the head, such as the shoulder or abdomen. He believes the test will be valuable for emergency room physicians and reassuring for concerned patients and families.
NEUROLOGY
NIH Extends URMC’s Role in Network to Advance Neurological Care
A national initiative created by NIH to accelerate the process of bringing new treatments to market for neurological disorders is being extended after the successful launch of Phase II trials for nine experimental drugs. The Medical Center— which has been a part of the Network for Excellence in Neuroscience Clinical Trials, or NeuroNEXT, since its inception—has played a critical role in the initiative’s vitality and achievements. “Neurological diseases are some of the most challenging in all of medicine and the process of translating promising discoveries into new treatments requires building partnerships across many institutions in order to create the infrastructure necessary to recruit patients and run multi-site clinical trials,” says Robert Holloway, MD (MPH ’96, Res ’93, Flw ’96), professor and Edward A. and Alma Vollertsen Rykenboer Chair of the Department of Neurology and principal investigator of the URMC NeuroNEXT site. “The Medical Center has a long history in the field of experimental therapeutics and we are proud to be a part of NeuroNEXT and to
URMC was one of the original 25 institutions selected by the National Institute of Neurological Disorders and Stroke to participate in NeuroNEXT support efforts that will make clinical research better, faster, and more efficient in the quest to aid patients and families affected by neurological disease.” In 2011, URMC was one of the original 25 institutions selected by the National Institute of Neurological Disorders and Stroke to participate in NeuroNEXT. The network was created to streamline the operations of neuroscience clinical trials and help increase the number of new treatments that get into clinical practice. The program is designed to encourage collaborations between academic centers, disease foundations, and industry and support efforts to train the teams of researchers and administrators necessary to conduct clinical research. Over several years, URMC has been involved in NeuroNEXT studies involving the testing of new drugs for myasthenia gravis, multiple sclerosis, Huntington’s disease, stroke, brain cancer, and neuropathy. URMC neurologist Andrew Goodman, MD, served on the national steering
committee of a clinical trial evaluating the drug ibudilast for multiple sclerosis. The results of the study, which showed that the drug was effective in slowing the progression of the disease, were published in September in the New England Journal of Medicine. URMC is the dominant provider of comprehensive neurological care in upstate New York with growing referral networks that have a regional, national, and international reach. This breadth of geographic reach and specialization of services has resulted in the Medical Center being one of the network’s leading performers in terms of clinical trial recruitment and performance. “The complexity of neurological diseases and the ever-evolving nature of scientific innovation in this field mean that we must look always to the future and build the teams that turn new discoveries into new ways to diagnose, treat, and prevent these diseases,” says Jonathan Mink, MD, PhD, the Frederick A. Horner, MD Endowed Professor in Pediatric Neurology, and co-investigator on the grant who is leading Rochester’s training of its investigators.
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MEDICAL ROUNDS RESEARCH
Excellence in Parkinson’s Research Bolstered by $9.2 Million Award URMC was named a Morris K. Udall Center of Excellence in Parkinson’s Disease Research by the National Institute of Neurological Disorders and Stroke (NINDS), earning a $9.2 million award that will fuel development of digital tools to enhance understanding of the disease, engage broad populations in research, and accelerate progress toward new treatments. “We are in the midst of a Parkinson’s pandemic,” says URMC neurologist Ray Dorsey, MD, the Robert J. Joynt Professor in Neurology and director of the Center for Health + Technology (CHeT) and principal investigator of the center. “From 1990 to 2015, the number of individuals with Parkinson’s disease globally has doubled and, absent change, will double again in the coming generation. The status quo is not working. The medical community must develop new approaches to better understand this complex disease, expand access to specialized care, and increase the speed and efficiency in how we bring new treatments to the market.” “This designation is a testament to the leadership that the Department of Neurology and CHeT have demonstrated in building the international networks of scientists and
research infrastructure necessary to conduct multi-center clinical trials for Parkinson’s disease,” says URMC CEO Mark Taubman, MD. “It places us among an elite group of eight academic medical centers that will accelerate the search for new ways to treat this disease.” CHeT is a unique academic-based research organization with decades of experience working with industry, foundations, and government researchers in bringing new therapies to market. Over the last 25 years, CHeT has helped conduct pivotal trials leading to seven FDA-approved treatments, including four for Parkinson’s disease. “The Udall Center will develop new and innovative approaches to solving the challenges faced in Parkinson’s disease, strengthened by the resources of the award and the academic and industry partnerships that will be formed,” says neurologist Erika Augustine (MD ’03, Flw ’10), the Robert J. Joynt Professor in Neurology and associate director of CHeT, a flagship research program working with the URMC Del Monte Institute for Neuroscience. The Center will bring together industry and academic researchers with expertise in Parkinson’s, genetic testing, engineering, biostatistics, and computer science. Its
funding will support four research programs that develop advanced machine learning tools to predict the progression of the disease and response to potential treatments; identify and follow patients with a rarer, inherited form of the disease; develop a successor to the mPower app, which enables patients and researchers to track the progression of the disease on their phones; and develop remote monitoring and wearable technologies to better understand how the disease impacts people in their daily lives. “The URMC Udall Center will be at the forefront of efforts to develop the new tools that will deepen our understanding of the disease, break down the geographic barriers to participation in research, and apply new approaches to conducting research that will apply to Parkinson’s disease and many other neurological conditions from autism to Alzheimer’s disease,” says Robert Holloway, MD (Res ’93, MPH ’96, Flw ’96), Professor and Edward A. and Alma Vollersten Rykenboer Chair of the Department of Neurology. The NINDS Parkinson’s Disease Research Centers of Excellence program was developed in honor of the late Arizona Congressman Morris K. Udall, who was diagnosed with Parkinson’s in 1979.
RESEARCH
The Bugs in Your Gut Could Make You Weak in the Knees A Fiber Supplement May Protect Against Osteoarthritis by Altering the Obese Microbiome Scientists have long thought that osteoarthritis in people who are obese was a consequence of excess wear and tear on joints, but URMC researchers recently showed that bacteria in the gut, called the microbiome, might be to blame. Their study, published in JCI Insight shows that a high-fat diet (like the Western diet) can alter gut microbes, increase inflammation throughout the body, and speed deterioration of joints. An interesting twist: a common dietary supplement overturned these effects in mice. What a Western, High-Fat Diet Can Do The team, led by Michael Zuscik (MS ’89, PhD ’93), former associate professor of Orthopaedics in URMC’s Center for Musculoskeletal Research, Robert Mooney, PhD, professor of Pathology and Laboratory Medicine at URMC, Steven Gill, PhD, associate professor of Microbiology and Immunology at URMC, fed mice a high-fat diet akin to a Western ‘cheeseburger and milkshake’ diet.
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TECHNOLOGY
Mobile Apps Could Hold the Key to Parkinson’s Research, Care One of the most powerful new tools to study and treat Parkinson’s disease may already reside in our pockets. URMC neurologists, who were part of a team that developed the first iPhone app to track the disease, have shown that the data that is collected from software and other smartphone technologies can accurately track the severity and symptoms of people with Parkinson’s disease. “This study demonstrates that we can create both an objective measure of the progression of Parkinson’s and one that provides a richer picture of the daily lived experience of the disease,” said URMC neurologist Ray Dorsey, MD, the David M. Levy Professor of Neurology and a co-author of the study. One of the difficulties in managing Parkinson’s is that symptoms of the disease can fluctuate widely on a daily basis. This makes the process of tracking the progression of the disease and adjusting treatment a challenge for physicians who may only get a snapshot of a patient’s condition once every several months when they visit the clinic. This variation also limits the insight that researchers can gather on the effectiveness of experimental treatments. Researchers recruited 129 individuals who remotely completed a series of tasks on
a smartphone application. The Android app called HopkinsPD, which was originally developed by Max Little, PhD, an associate professor of Mathematics at Aston University in the U.K., consists of a series of tasks which measure voice fluctuations, the speed of finger tapping, walking speed, and balance. The study was led by Suchi Saria, PhD, an assistant professor of Computer Science at Johns Hopkins University, and was funded with support from the Michael J. Fox Foundation and the National Institute of Neurological Disorders and Stroke. The Android app is a predecessor to the mPower iPhone app which was developed by Little, Dorsey, and Sage Bionetworks and has been downloaded more than 15,000 times from Apple’s App Store since its introduction in 2015.
Just 12 weeks of the high-fat diet made mice obese and diabetic, with guts dominated by pro-inflammatory bacteria and almost completely lacking beneficial Bifidobacteria, the probiotic bacteria often added to yogurt. The obese mice had more inflammation throughout their bodies and their osteoarthritis (induced with a common meniscal tear) progressed much more quickly than their lean-diet counterparts. Can You Eat Your Cake and Protect Your Joints, Too? Surprisingly, a common prebiotic fiber, called olligofructose, completely prevented the negative effects of the high-fat diet. Adding the fiber to the high-fat diet normalized gut bacteria, reduced inflammation, and slowed osteoarthritis in the obese mice. The key, the researchers think, is that prebiotics like oligofructose cannot be digested by rodents or humans, but are a welcome treat for certain types of beneficial gut bacteria, like Bifidobacteria. Feeding mice oligofructose might help good bacteria grow and crowd out bad,
As a part of the study, the researchers also conducted in-person visits with 50 individuals with Parkinson’s disease and controls in the clinic at URMC. Participants were asked to complete the tasks on the app and were also seen by a neurologist and scored using a standard clinical evaluation tool for the disease. They found that the measurements collected by the app corresponded with what was observed by physicians in the clinic. The smartphone data collected from the larger group of participants was then analyzed using a machine-learning algorithm which the researchers used to generate a mobile Parkinson disease score (mPDS) that uses a scale of 1-100—with a higher number indicating a greater severity of symptoms. “The ability to remotely monitor patients on a much more frequent basis, more accurately track the symptoms and progression of the disease, and monitor the impact of exercise, sleep, and medications and their side effects holds the potential to transform how we treat Parkinson’s disease,” said URMC neurologist Christopher Tarolli, MD (Res ’16, Flw ’18), a co-author of the study.
pro-inflammatory bacteria—preventing them from causing negative effects downstream. Before You Head to the Vitamin Shop Though there are parallels between mouse and human microbiomes, the bacteria that protected mice from obesity-related osteoarthritis may differ from the bacteria that could help humans. Zuscik, Mooney and Gill aim to collaborate with researchers in the Military and Veteran Microbiome: Consortium for Research and Education at the U.S. Department of Veterans Affairs to move this research into humans. The team hopes to compare veterans who have obesity-related osteoarthritis to those who don’t, to further identify the connections between gut microbes and joint health. They also hope to test whether prebiotic or probiotic supplements that shape the gut microbiome can have similar effects in osteoarthritic veterans as they did in mice.
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Cover Story
KEEP MOVING
How Orthopaedics is Addressing the Needs of a Changing Population
by Barbara Ficarra
A
body in motion stays in motion. It’s the first law of physics and the unspoken force behind the University of Rochester’s Department of Orthopaedics, whose mission has always been to help patients with musculoskeletal problems get well and get back in action. But now, a department that has been in a constant state of change since its origins in 1926 is doing a lot more than staying on the move. It’s building momentum.
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A specialty that started small—as a division of surgery with just a handful of providers— is now a vast and diverse enterprise, with approximately 60 clinical faculty and 600 staff. Together they cover 240,000 annual visits for patients from Rochester, the Western New York region, and the Northeast. A look at the Clinton Crossings outpatient facility may render the keenest snapshot of the Orthopaedic department’s pace and personality. Physically expansive at more than 100,000 square feet, it is as robust and multifaceted in its clinical offerings, with space for each of the department’s 14 divisions. At any hour of the workday, every clinic room is full, but staff and care providers help patients move smoothly through their visits at a speed of nearly 17,000 a month. Running at this intensity, it would be hard to see how Orthopaedics could get any bigger or move any faster. But it will, because slowing down isn’t an option. It’s not just the growing number of patients and rising demand for specialized services that are pushing URMC Orthopaedics forward. And it’s not just the onward trajectory of a department that prides itself on its entrepreneurial spirit and competitive fire. “The urgency comes from socioeconomic and health trends that are already in force, building speed, and poised to impact millions of Americans now and in the decades ahead,” says Mark Taubman, MD, CEO of the University of Rochester Medical Center and dean of the School of Medicine and Dentistry. “Like its counterparts across the country, the Department of Orthopaedics is seeing musculoskeletal issues in patients of all ages that prior generations of providers never encountered,” Taubman adds. “Baby Boomers living into their 90s who need arthritis care and joint replacements—that’s just one source of our explosive volume growth. The entire Orthopaedics enterprise is focused on meeting patients’ needs now and building for the changes coming its way, so it can help future generations live longer, healthier, more active lives.”
At Risk: Growing Numbers of Aging, Inactive Patients “Like our colleagues across the country, UR Orthopaedics is caring for patients facing multiple, complex medical challenges,” adds Paul T. Rubery, MD (Flw ’94), Marjorie Strong Wehle Professor in Orthopaedics and chair of the Department of Orthopaedics. “America’s population is aging, obesity is at epidemic levels, and youths and adults are experiencing higher levels of anxiety and depression. We are seeing the impact of this throughout the Medical Center, particularly in our orthopaedics patients.” The numbers back that up. The Population Reference Bureau reports that the number of Americans over age 65 is expected to double from roughly 50 million today to nearly 100 million by 2060. According to the Centers for Disease Control (CDC), only 1 in 5 Americans meets the baseline for recommended physical activity, and nearly 40 percent of American adults—about 94 million—are obese. It’s an epidemic that brings with it chronic health conditions in adults and children. “Understandably, much of the focus has been on how these lifestyle factors contribute to heart disease and cancer, but they also have a profoundly negative impact on musculoskeletal health,” Rubery says. “Obesity places tremendous mechanical force on knees and hips, so patients are having joint problems earlier in life. We are even seeing obesity affecting bone health in children. Inactivity is a factor in lower bone density as people age, so we’re seeing more adult patients requiring arthritis care, joint replacement, and treatment for osteoporosis and fragility fractures.” Pointing out that many of these conditions could be mitigated or even prevented with proactive care, Rubery argues that as the population ages, the need for orthopaedic care will rise. He says health systems will be called upon to deliver well-designed treatment facilities, well-trained providers and care teams, and “breakthrough research that leads to innovative treatment approaches.”
At left, Kostantinos Vasalos guides a participant through a video-capture fitness assessment. Center photo: Gregg Nicandri, MD, and David Mitten, MD, review the patient’s results. ROCHESTER MEDICINE | 2019– V1
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Cover Story: Keep Moving: UR Orthopaedics & Rehabilitation
Catherine Humphrey, MD (third from right) reviews the surgical instruments for hip fracture repair with residents (from left) Caitlin Orner (MD ’16), Michelle Smith, MD, Linda Zhang, MD, Serena Liu, MD, and Brittany Haws, MD.
Researching New Cures, Training Next-Generation Providers In addition to expanding its clinical reach, UR’s Orthopaedic research and medical education efforts are preparing the department for the future. Orthopaedics is home to research faculty who drive innovation and exploration at the Center for Musculoskeletal Research (CMSR), one of the nation’s preeminent, top-funded musculoskeletal research enterprises. The Center integrates faculty from Orthopaedics and Rehabilitation, Pathology and Laboratory Medicine, Biomedical Engineering, and
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Medicine (Rheumatology and Endocrinology). Some 25 faculty members have individual labs supporting over 75 scientists focused on research programs that include Bone Biology and Disease, Cartilage Biology and Arthritis, Musculoskeletal Stem Cell Biology, Musculoskeletal Repair and Maintenance, Musculoskeletal Development, and Bone Cancer Biology. CMSR has consistently placed in the top tier of NIH research funding and serves as a fertile training ground for the next generation of orthopaedic research leaders at UR and across the nation. Last year three new centers for musculoskeletal research opened
at major U.S. universities and launched national searches for their inaugural directors. All three positions were filled by former CMSR faculty: Michael Zuscik at the University of Colorado, Hicham Drissi at Emory University, and John Elfar at Penn State. As the U.S. faces a shortage of orthopaedic providers, UR’s Orthopaedic residency training program is growing and evolving its training to prepare surgeons for next-generation medicine. (Full story in Rochester Medicine Volume 1, 2018.)
Building on a Solid Foundation: Biopsychosocial Medicine The challenges ahead may be daunting, but the Department of Orthopaedics seems to have an answer that is deeply rooted in the University of Rochester’s past. Its vision is not only to grow and expand capacity, but to carry forward a tradition of orthopaedic innovation, guided by UR’s legacy of biopsychosocial medicine. According to Rubery, responding to America’s changing health needs is as much about the perception of the discipline as it is about growth. “As we prepare for the next evolution, Orthopaedics will have to fundamentally redefine its role in the delivery of clinical care, research, and physician education,” Rubery says. To understand why Orthopaedics is forging a new direction, consider the old-saw stereotype it’s up against. As the International Journal of Surgery puts it, the traditional view of orthopaedics is a profession dense with “old boys’ clubs, rugby jocks, and an unthinking, nonholistic approach to patient care.” To a casual observer in decades past, the specialty sometimes looked like a sideline business not integrated with the field of medicine as a whole—more a piecework, body-part repair shop. “If orthopaedics was ever that, it isn’t anymore. And especially not here,” says David J. Mitten (BS ’88, MD ’92, Res ’97), professor of Orthopaedics and director of the UR Health Lab, which explores new uses for technology in medicine. “This department passionately believes in biopsychosocial medicine, a philosophy that sees the patient as a whole person—body, mind, and spirit—within the context of a family unit and a social environment that profoundly affect health and well-being. Our physicians, clinical staff, researchers, and students closely collaborate to explore new technologies, new treatments, and new ways to deliver health care to a population that sorely needs it—at a time when patient demand already outstrips provider supply.” To that end, the department’s professionals work in close partnership with other specialties at the Medical Center,
Department of Orthopaedics Chair Paul T. Rubery, MD (Flw ’98), left, with fellow spine surgeon Emmanuel N. Menga (MD ’09).
and in collaboration with primary care practices and schools in the community. Just as important, they recognize the value of what they do—restoring and preserving movement—to an individual’s overall health, emotional outlook, and ability to contribute to their family, workplace, and community. Michael D. Maloney, MD (Res ’97), division chief of Sports Medicine, treats athletes of all ages, as well as patients he calls “occupational athletes”—adults who may never have picked up a bat or struck a soccer ball, but who battle arthritis or injury to stay in the larger, more essential game of life. “People need to move to stay healthy, to make a living, to function in their families and the community,” Maloney says. “My colleagues in other divisions, and our entire Sports Medicine team, are seeing people of all ages challenged by musculoskeletal issues—from young people who are specializing in one sport and sustaining preventable injuries they’ll carry with them all their lives, to older adults who want to stay active and push their bodies and bones to the limit, to people living into their 90s whose joints wear out and need to stay mobile to preserve their health.”
Carrying on the Traditions of Innovation The Department of Orthopaedics has been prolific and creative in developing new approaches that focus on promoting wellness, preventing injury, and positively impacting population health. In just the last five years, it has claimed global leadership in using the Patient-Reported Outcomes Measurement Information System (PROMIS) tool to improve patient-provider communication and deliver better, more cost-effective care. It’s explored a new avenue for helping at-risk student athletes by pairing traditional performance training with life-skills coaching, nutritional counseling, and academic support. It has tested the potential of biologic treatments to foster healing and promote joint health. And it has researched and delivered a new option for end-stage arthritis, making URMC the first in the nation to offer synthetic cartilage for the most common form of foot arthritis, and one of five academic medical centers to test the device’s efficacy in treating thumb arthritis.
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URMC Pioneers
When Orthopaedics set off as a division of Surgery in 1926, its first leader, R. Plato Schwartz, founded the Myodynamics Laboratory to study the basics of human locomotion. He aimed to accurately record and define parameters for normal and abnormal gait. From that preliminary study of walking, the department’s physicians and researchers have forged a steady path for new and better approaches to patient care. In their hands, what were then new and untested ideas, such as the Harrington Instrumentation to treat adolescent scoliosis, arthroscopic surgery to repair torn cartilage and ligaments, and total joint replacement to restore mobility to patients with end-stage arthritis, have become common and indispensable tools to treat musculoskeletal conditions. These pioneers have inspired modernday counterparts to explore today’s new and little-known possibilities, including biologic treatments for joint health, artificial intelligence to facilitate research, and population health strategies to make care more effective, accessible, and affordable for future generations. Here are some examples of how one era of discoveries can inspire next-generation physicians’ work and progress. Illustrations by Michael Osadciw, University of Rochester
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O’Keefe
Baumhauer
Even in a department rich with clinician-researchers, former chair/ CMSR director Regis O’Keefe, MD (Flw ’88, Res ’92, PhD ’00), and Judith F. Baumhauer, MD (MPH ’09, Flw ’09), are standouts. O’Keefe is nationally recognized for advancing musculoskeletal research, particularly with respect to bone disease, and Baumhauer led the seven-year study that brought synthetic cartilage implants to the U.S.
Evarts
Gorczyca
C. McCollister (“Mac”) Evarts (’57 MD, Res ’59, Res ’64), is renowned for his leadership as the department’s first chair, and for mentoring generations of trainees, many of whom rose to national leadership. John T. Gorczyca, MD, the Dr. C. McCollister Evarts Professor in Orthopaedics and residency program director, guides the program’s continued growth and embrace of high-tech training and work-life balance to recruit the nation’s top talent.
DeHaven
Maloney
A passion for helping their fellow athletes recover and return to the game inspired these Sports Medicine physicians to explore new paths of care. Kenneth E. DeHaven, MD, popularized arthroscopic surgery for joint repair in the U.S. in the 1970s. Today Michael D. Maloney, MD (Res ’97), is testing the potential of biologics to accelerate healing, and building a holistic approach to athletes’ training, mindset, and lifelong health with Fitness Science.
Burton
Mitten
Richard I. Burton, MD (Res ’64), and David J. Mitten (BS ’88, MD ’92, Res ’97), share a specialty—hand surgery—and a knack for crafting new solutions to long-standing problems. Burton invented a procedure for hand arthritis that has become the world standard. Mitten is exploring how technology—such as machine learning—can facilitate research and patient care.
Goldstein
Mesfin
Louis A. Goldstein (MD ’32, Res ’37), changed the landscape for care of adolescent idiopathic scoliosis with Harrington Instrumentation, the first widely used internal fixation system. Addisu Mesfin, MD, associate professor of Orthopaedics/Public Health Sciences/Neurosurgery and Rosier Schwarz Spinal Fellowship Director, has earned several international fellowships that are bringing world-leading surgical approaches to URMC. One example is en bloc spondylectomy, which he introduced to physicians URMC’s Orthopaedics research grew from nonexistent to the national and patients in Western New York. forefront thanks to its first director Edward Puzas (MS ’73, PhD ’76); Randy N. Rosier (MS ’76, MD ’78, PhD ’79), who established the Center for Musculoskeletal Research; and its current director Edward Schwarz, PhD, the Richard and Margaret Burton Distinguished Professor in Orthopaedics whose leadership has kept CMSR among the top five NIH-funded centers for more than a decade.
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The Promise of Patient Data Analysis
In the national drive to improve health care quality and value, the University of Rochester is seeking input from one group of experts who haven’t weighed in yet: the patients themselves. Surveys of patient experiences are not new to health care. Providers have long used them to assess the quality of care they deliver, but they had limitations. They were rendered sporadically, and only after the care was complete. Facing those challenges, Northwestern University made a leap forward in 2009 by developing the PROMIS patient reported outcome tool, with funding from the National Institutes of Health. PROMIS (Patient-Reported Outcomes Measurement Information System) is a computer-driven survey that uses adaptive technology and item-response theory for highly detailed, accurate results. The technology was powerful and had great potential, but presented a new challenge for health care systems: How to efficiently gather information from large numbers of patients in a clinical setting, so the wealth of data would be easily accessible and usable by clinicians. The Department of Orthopaedics devised a solution that has quickly built its reputation as a leader in implementing patient-reported outcomes, according to the Northwestern researcher who led the creation of PROMIS. “There are a handful of organizations that made the kind of ‘all-in’ commitment it takes to succeed in re-engineering a system as large and complex as health care,” says David Cella, PhD, chair of
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the Department of Medical Sciences at Northwestern University. “It is clear that the University of Rochester system is indeed at the forefront of innovation in health care. They have figured out how to truly integrate the patient perspective into their evaluation of clinical outcomes across the system.” What’s different about the way University of Rochester uses PROMIS? In 2014, a team led by Orthopaedics professors David J. Mitten (BS ’88, MD ’92, Res ’97); Judith F. Baumhauer, MD (MPH ’09, Flw ’09); and PROMIS IT Project Director Chris Dasilva replaced the PROMIS hardware with a custom-built solution linked to the University of Rochester Medical Center’s own technology enterprise. The new technology and collection process—dubbed UR VOICE—instantly collects patient-reported PROMIS data and makes it available for viewing in eRecord, URMC’s electronic health record system. It is clear that the University of Rochester
“
system is indeed at the forefront of innovation in health care.”
–David Cella, Northwestern University, who led the creation of PROMIS
The UR VOICE team then built a process to collect assessments on iPads that patients get at check-in. While they sit in the waiting room, patients tap their answers to questions about pain, function, and mood. Physicians can view patient responses instantly and go over the results with the patient during their visit. Patients get a vivid picture of their progress: the URMC-designed interface displays their cumulative pain, mood, and physical function scores as line charts. Physicians use the data to spark conversations with patients and engage them in shared decision-making on their care. As medical director of PROMIS and patient derived data for URMC, Baumhauer works with clinical areas to help them adopt the technology for their use; to date,
more than 40 clinical departments and divisions have followed Orthopaedics’ lead in offering it to their patients. Patients’ input on what worked for them—and what didn’t—is creating a kind of health care “trip advisor” for providers as they seek the best care pathways for future patients. “This information has real clinical value—as a physician, it can change how we practice,” says Baumhauer. When Baumhauer looked at aggregate data on Brostrom lateral ligament reconstruction for chronic ankle sprains, which she and her fellow foot and ankle surgeons have performed for years, she discovered that the most expensive variation of the procedure, using a fiber tape augmentation, was also the least effective. This is just one example of hundreds that have been assessed with the patient front and center in the judgment of the treatment. PROMIS also encourages shared decision making between provider and patient. “This program is the ultimate in paying it forward,” Baumhauer adds. “It puts the patient front and center in health care and ensures that their voice is heard. For the first time, the patient’s own perspectives on their care are part of their permanent health record, right alongside the doctor’s.” As of September, the University of Rochester has collected 2 million patient assessments in just three years. The nine-member UR VOICE team is in high demand at international conferences to present its findings; New England Journal of Medicine Catalyst invited Baumhauer to deliver a TED-style talk in Los Angeles in January 2019. She and clinical faculty have published perspectives about the value of PROMIS—and UR’s leadership in implementing it and using the data—in NEJM and other journals. “We see this becoming the standard of care, something that happens at every visit, the same way you would take a patient’s blood pressure,” Mitten says. “We want to be the first medical system in the United States that collects data on every patient who comes through the door.”
East High School students who participated in Fitness Science trials have advanced physically and academically thanks to the program’s unique combination of athletic training, nutrition, and mindset skill development. Leaders of the initiative include, from left, Michael Maloney, MD (Res ’97), Calvin Cole, PhD, research assistant professor, and Shaun Nelms (EdD ’13, MS ’04), associate professor, East High Educational Partnership Organization superintendent, and William & Sheila Konar Director of the Center for Urban Education Success at East High School.
WATCH TO SEE A VIDEO ABOUT FITNESS SCIENCE, visit: http://bit.ly/ urfitnessscience
Fitness Science
Athletic performance specialists Cameron Apt and Emmalyn Osterling guide Fitness Science athletes through a workout.
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Cover Story: Keep Moving: UR Orthopaedics & Rehabilitation
Using Technology to Predict and Prevent Injury Technology, paired with principles of biopsychosocial medicine, can be a powerful tool in addressing modifiable health risks. It can also automate clinical tasks, identify opportunities to improve health care quality, and improve cost-efficiency of care. One example that’s already making a difference: Workplace Health, an Orthopaedics-led technology and business venture to prevent workplace injury, estimated as a
$1 billion weekly expense for U.S. employers. The effort began as a pilot by Rubery and Kostantinos Vasalos, director of rehabilitation services and chief of sports and spine rehabilitation, who showed that exercise and nutrition interventions could help prevent injury and promote health among URMC nurses. Building on those findings, Vasalos, Mitten, and Gregg Nicandri, MD, associate professor of Orthopaedics, built a high-tech system that employs video-capture technology, physical and behavioral health
screenings, and patient health surveys to gather data. Custom-written software interprets the data and identifies who’s at risk of a health issue that could trigger a workplace injury claim. At-risk workers get a customized intervention—which can include nutrition counseling, physical therapy, athletic training, behavioral health, pain management—to promote their health and safety. After a 3-year pilot of 4,000 URMC staff, the program cut claims costs by 37 percent and the team is selling the solution to large Rochester-area employers.
Hand surgeon Constantinos Ketonis, MD, PhD (left), and research scientist Alayna Loiselle (PhD ’09) are researching ways to improve flexor tendon healing in the human hand; artificial intelligence and machine learning help by automating analysis of ultrasound images.
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From the Cover
Synthetic Cartilage Offers New Solutions for Arthritis Care Judith F. Baumhauer, MD, MPH, helped bring synthetic cartilage as a treatment for arthritis to the U.S. She led research to demonstrate its safety and efficacy and performed the nation’s first implant.
When it comes to managing arthritis, there hasn’t been much movement in recent years. Physicians and their patients had a time-tested but limited range of treatments: from anti-inflammatory and pain medications, to cortisone or hyaluronic acid injections, and for end-stage, bone-on-bone sufferers joint fusion or total joint replacement. But Judith F. Baumhauer, MD (MPH ’09, Flw ’09) says new research is showing a promising option—and it is proving to be a game changer. Baumhauer was principal investigator on a study to test synthetic cartilage as a new treatment for arthritis. Baumhauer, an orthopaedic surgeon specializing in foot and ankle surgery, professor, and associate chair of academic affairs in Orthopaedics, led a seven-year, multi-center study in Canada and the United Kingdom. The MOTION study compared joint fusion surgery patients with those who received synthetic cartilage implants to treat severe great toe arthritis. The most common form of arthritis in the foot, great toe arthritis affects one in 40 individuals over age 50. The promise of a new type of treatment is significant. Osteoarthritis is the leading cause of disability in the U.S., affecting
54 million people and driving $140 billion in health care costs every year. Baumhauer’s research could be offering patients and physicians an important next step. “Until now, the best treatment for severe great toe arthritis has been to fuse the toe, leaving it stiff but with the pain being markedly less,” she says. “But patients often want to retain their motion. Previous generations of implants have been shown to cause some bone destruction and wear debris that make treating the toe, if the implant fails, much more difficult.” Baumhauer notes that the results from previous types of implants have often shown to be less beneficial than traditional fusion. That is what makes this new implant so exciting. Baumhauer and her fellow researchers in the MOTION study determined that the synthetic cartilage implant manufactured by CartivaTM, a medical device company out of Alpharetta, Ga., was effective in providing pain relief and was superior in preserving range of motion. Days after the FDA approval came, Baumhauer was the first U.S. surgeon to implant the device in a patient. The small, translucent implant looks and feels like a gumdrop, but is able to cushion a joint that takes 300 percent of a person’s body weight with each step, for thousands of steps a day. Some 17,000 U.S. patients have had the implant since Baumhauer’s first case, and follow-up on the MOTION patients is promising. The synthetic cartilage device seems to be holding up, even in the busiest single joint in the body. Since that first procedure, Baumhauer says the interest in the implant has exploded. “We have people flying in from all over the
world just to see if they’re candidates for this,” she notes. Baumhauer presented 5.8-year results on the initial study of the participants in July 2018. “It’s a 90 percent win with only one out of 10 implant patients experiencing continued pain at two years,” Baumhauer notes. “We saw a slight drop-off to 85 percent at 5.8 years, and for the 10 percent of cases that did not respond well at two years, the implant can be removed with no adverse reactions. The surgeon can then fuse the toe as would have done prior to the Cartiva, so when you remove the implant and you fuse it, you don’t lose any ground in the pain relief. Unfortunately, you do lose the motion.” Implant patients also expressed high levels of satisfaction. Ninety-three percent said they would have the procedure again. Patients reported a 97 percent median reduction in pain, 25 percent improvement in range of motion, and 176 percent median improvement in sporting activities. “The study demonstrated that the Cartiva implant was as effective as fusion for pain and function and yet it improved range of motion of the toe, ” Baumhauer says. “I anticipate that it will become a very common procedure, and I’m gratified that the initial results have continued as the procedure has expanded to other centers and physicians across the country.” The next step for synthetic cartilage will be testing its potential for other joints in the body. Led by Warren Hammert, MD, Chief of the Hand and Wrist Division, the University of Rochester is one of five U.S. academic medical centers to trial the implants to treat thumb arthritis—the most common form of arthritis in the hand. Thumb arthritis affects one in four post-menopausal women, which is one reason the Cartiva implant is being tested for improved motion and pain relief. Hammert performed the center’s first hand procedure using Cartiva in June 2018.
“America’s population is aging, obesity is at epidemic levels, and youths and adults are experiencing higher levels of anxiety and depression. We are seeing the impact of this throughout the Medical Center, particularly in our orthopaedics patients.” – Paul T. Rubery, MD ROCHESTER MEDICINE | 2019– V1
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Ilya Voloshin, MD (Res ’03), performs rotator cuff repair using arthroscopic surgery. Arthroscopic surgery was popularized nationally at URMC; it revolutionized patient care by repairing soft tissues through minimally invasive procedures.
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Collaboration yields clinical excellence: Brian Giordano, MD (Res ’09), and P. Christopher Cook, MD, FRCS(c), FAOA, are co-directors of the Hip Preservation Program, a specialty service that is a leader in the region.
“We can predict who will file a claim in the next three years with 76 percent accuracy,” Vasalos says, “and if you can predict it, you can help prevent it.” “Workplace injury represents a significant portion of the patients we see in our clinics. It’s also one of the highest operating costs that businesses have,” says Nicandri. “We’ve identified risk factors for these injuries— physical fitness, weight, and biopsychosocial factors like social networks and depression. Preventing injuries by helping workers achieve healthier lifestyles gives them higher quality of life and saves employers needless expenses so they can invest elsewhere in their business. This approach also reduces unnecessary use of the nation’s finite health
care resources. It’s an example of how taking a biopsychosocial view of a health problem can change an individual’s life, and an entire society’s.”
Next Steps: Plans For An Orthopaedics Campus After many years of planning, Orthopaedics is poised to announce plans for an orthopaedics campus that ultimately will bring together clinical care, research, education, and community wellness in one location. To see why, look no further than Clinton Crossings—which is consistently at top capacity and won’t accommodate the larger patient volumes the department expects in five years’ time.
Clinton Crossings was a breakthrough idea, for its time: a convenient, easily accessible space with complementary clinical services—diagnostic imaging, physical and occupational therapy, prosthetics and bracing—all under one roof to better serve patients. When it opened in 2000, it was state of the art. Since then, it has succeeded beyond all expectations and the department’s growth is a direct result of this concept’s success. “Orthopaedics’ role in URMC’s health care delivery has steadily grown over the past several decades and it will play an increasingly important part in our plans to be a regional provider of advanced health care services in the years ahead,” says Taubman. continued on page 64 ROCHESTER MEDICINE | 2019– V1
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Feature Story
A STRATEGY OF
SOLUTIONS by Kate Rivera
“There is no health care event without an IT response.” - Tom L. Barnett, URMC chief information officerr
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W
ith a passion for moonshots and a penchant for organization, University of Rochester Medical Center chief information officer Tom L. Barnett has delivered a vision for the future of the academic medical center. It’s a strategy for technology that meets at the intersection of information and innovation, and one that helps everyday users better understand how data will continue to transform medicine and patient care. Most importantly, it’s a vision that strategy for technology helps increase academic medicine’s ability to analyze, diagnose, treat, study, and discover in an increasingly tech-driven world.
Supporting a Vision URMC requires considerable support to keep the flow of information moving along to what can seem like countless destinations. As the organization experiences how technology is influencing and reshaping everything from core clinical functions to regulatory requirements, a new chief information officer (CIO) came to lead the Information
Systems Division—a core team of more than 500 employees who maintain continuous operations of the institution’s facilities, faculty and staff—with a vision to modernize IT and set a path for the future. Change was in the air when Barnett joined the Medical Center’s executive leadership team in 2016. Mark Taubman MD, CEO of URMC and Dean of the School of Medicine
and Dentistry, was unveiling his strategic vision for URMC to thrive financially and become Upstate New York’s premier health network. His vision also included URMC becoming known as a leading biomedical education and research institution that attracts top-level faculty, staff, and students. The new CIO’s arrival at URMC came at a pivotal moment. Not only was the strategic
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Vision (n.) - The act or power of anticipating that which will or may come to be
focus of the organization sharpening, but a transformational expansion of the electronic health record system was on the verge of integrating clinical and revenue cycle management. This watershed would be key to Barnett’s vision for taking the enterprise into the future of information-infused health care. A seasoned expert in planning and deploying technology to meet the needs of a modern health care environment, Barnett is fond of employing a phrase, “There is no health care event without an IT response.” From his vantage point, information technology (IT) is a coordinated yang to every yin in patient care or research, from the instructions patients receive to be ready for a procedure they’ve scheduled, to the way scientists track and analyze information from clinical trials.
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Technology in Focus Barnett is no stranger to the challenges of health care technology. In leadership roles at academic medical centers in Michigan and Illinois, he deployed and managed the tools of the IT trade to navigate some of the most important driving forces in health care—population health management, government regulations, and risk stratification. But he points out that marrying these overarching priorities with the unique needs of each specialty and unit at URMC is a major planning challenge, especially when you’re the new face at the head table. “I was not so naïve to think I could walk in and declare how things should be done,” Barnett says. “I knew I needed to learn from my new colleagues just as I did in my previous positions.” Barnett’s first year at URMC consisted of many hours spent simply listening. “I met with leaders from all missions, and with the
members of my own staff to understand how IT is meeting URMC’s needs and where we have gaps to address,” he says. “We have a tremendous amount of talent and expertise across the organization and much activity depending on IT support. It’s my job to create a vision that brings health care IT together with the desires and needs of the faculty and staff.” Barnett says the call for more IT support was loud and clear, with requests ranging from increased development to reduce the EHR workload for providers, to more services in specialty areas and improved support for academic education and research. According to Barnett, developing a unified vision of URMC’s future IT structure that aligned with the Medical Center’s strategic plan was critical, particularly in the way a strategic plan can guide the path of an institution. He warns that decisions about technology around individual initiatives
might fill immediate needs, but those individual initiatives can sometimes make an institution go in unplanned directions. “If the destination for IT isn’t tapped into the GPS of our leadership,” Barnett notes, “we’re certain to veer off course.” Many argue that chief among URMC’s broader organizational goals is building a foundation of scientific discoveries that drive improvements in patient health and outcomes. The logic then follows that from those outcomes, the institution can attract patients and thus fuel the financial resources that fund more research, more treatments, more outcomes, and so on. At the outset, the strategic vision for technology is focused on clinical care: using information derived from patients and their interactions with URMC’s health care services to become stewards of clean, clear patient data.
Building Better Relationships to Achieve Better Outcomes In the health care field, much of the work focuses on the relationship between the patient and the provider. It’s that relationship which is the foundation for URMC’s growth, and it is the centerpiece of Barnett’s IT strategic plan. The vision behind the plan is simple: enable providers to have engaged and informed relationships with their patients for more individualized care and better clinical outcomes. Those goals are achieved through the collection, storage, and analysis of huge amounts of data. What starts as information captured in a patient’s electronic health record (EHR) becomes the roadmap for more personalized care. The better the data that
goes in, the more benefit it provides to the patient’s current and future care. Based on these concepts, the IT strategic plan aims to transform seven aspects of clinical care.
Provider Experience: A Transparent EHR Diagnostic documentation, orders, referrals, and clinical notes are all part of the first crucial milestone in the Medical Center’s technology plan. This interaction with the EHR captures the details of a patient’s health and treatment that, when aggregated, can open up vast opportunities. One challenge is that EHR systems have been cast as barriers to providing quality care. Barnett says there is a solution. “It’s imperative that we invest in making the providers’ interaction with EHRs as seamless and invisible as we possibly can,” he says. “When the technology is transparent, that’s when it’s most effective.” According to
Illustration by John Cammarosano/K2
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“When you can integrate the technology and workflows to almost become part of your DNA, then the technology becomes an accelerator for the care you’re able to provide to patients.” - Tom Barnett
Barnett, efforts to streamline workflows and improve provider experiences with EHR are a key focus moving forward. “We must become more intimate in the partnership with our clinicians to understand how they work in the EHR to find the opportunities they need us to improve.”
Revenue Cycle: Integrating the Financial Picture According to Barnett, a financial picture is needed to complete a data profile. He recalled, “Earlier this year, URMC drastically expanded the EHR system, and eRecord, to go beyond clinical care. It now helps us manage scheduling, registration, and insurance, including claims and billing activities.” Barnett says this provides URMC a complete, integrated view of our patients that follows their journey, and their cost, of care.
Data Warehouse: Enriching What We Know Having a well-structured and secure facility for storing and managing the data gathered through patient interactions is every bit as important as collecting the data itself. Much like the hub for an airline carrier, the Enterprise Data Warehouse is the place where data is received, exchanged, enriched, and analyzed—a pivotal point to enable it to arrive at its ultimate destination as information that can positively transform the patient-provider relationship.
Predictive Analytics: Knowing Our Population Information pulled from the warehouse reflects the landscape of health care, from data that helps increase operational efficiency to trends that help characterize a patient population with its particular risks and its priorities for care management. One example is the ability to peer into the utilization of certain health services and compare that information with geographic locations to determine where clinics might be opened or established.
Predictive Analytics: Optimizing Providers’ Time Understanding the provider’s experience of utilizing the data available in an EHR helps the health system focus on improving how the physician interacts with the health record system. Analytics offer insight into the length of time physicians work beyond their standard hours, and provide statistics on how much time is spent on certain functions, such as reviewing test results. With that information, IT support teams can help optimize how the provider is using the EHR tool through customizations and recommendations on how to navigate in the system. The changes often result in improvements to the delivery of care.
Patient Engagement: Increasing Convenience and Value Health care is becoming more transparent, consumer-friendly and accessible. Enabling patients to manage appointments, request medication refills, and pay bills from their favorite device anytime, anywhere is a key component of growing their relationships with providers. “As we become more
“None of the data analytics mean anything unless you
can inject it back into physicians’ workflows at the point they need it. A report isn’t enough and doesn’t fortify the relationship with the patient.” - Tom Barnett
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Data Warehouse (n.) - centralized repository for data that enables organizations to store, share, integrate, recall, and analyze information
knowledgeable about the population of patients served by the health system, we can learn where we may apply services and technology to enhance the experience of coming to UR Medicine,” says Barnett. “Through MyChart, the eRecord EHR’s patient portal, we not only capture data but create a resource full of their personal information and the opportunity to become partners in their care. “Getting this right means reasserting the patient at the forefront of our mission and allowing ourselves to break all the traditional bonds of interacting with them. We have to optimize our processes and meet them on their technology so our relationships are sticky with convenience and quality of care.”
Exponential Medicine: Achieving Next-level Care One of the ultimate goals of data analytics is the ability to predict health outcomes and provide decision support at the precise point of care where it can be the most effective. Detailed data on a patient’s pathology can identify markers that predict the success of a therapy when compared to diagnoses, treatments, and outcomes of similar patient data. “When our data warehouse can extract that information and serve it to the provider during a patient encounter, that is where we have the opportunity to exponentially reduce costs and optimize care,” said Barnett. “This is the ultimate destination and it’s coming fast!”
IT @ URMC
Building URMC’s Data Warehouse Establishing the hub of the technology vision is top priority for the Information Systems Division (ISD) and its head of Data and Analytics, Kevin Moran. Taking a broad view of the organization’s current state, Moran acknowledges much has been done within URMC to build repositories of data and take advantage of shared information, particularly with the EHR. “We’re assessing the data that’s available to us,” Moran says. “The quality and completeness of that data, and the technology we have to manage it will be important as we architect a more all-encompassing approach that will have benefits for researchers and our clinical endeavors.” Getting a warehouse strategy right means looking at the entire data supply chain and ensuring each is resourced and functioning to fulfill the institution’s requirements. Step 1: Check URMC’s pockets for sources of data. Since 2011, URMC’s EHR has been the primary generator of clinical data. Starting in early 2018, insurance and cost data has been integrated, making it easy to access demographics, diagnoses and treatment information. Other data sources within programs and departments should be invited into the enterprise solution to create the most comprehensive picture possible of patient interaction with the health system. “Data in one place allows us to look within for operational efficiencies and growth opportunities. It also exposes our gaps where data isn’t available or hasn’t been captured in a consistent manner,” says Barnett. Step 2: Create roadways for data to get to the warehouse. The more automated the process becomes to merge data sources into one pool, the more capacity URMC creates to focus on what can be pulled from the data. “Currently, data analysts could spend up to 80 percent of their time finding, finessing, and merging outputs from various sources,” says Moran.
203 locations 504 specialty practices 700 applications
supported by IT services
7 PB* digital information stored and managed
15,000+ eRecord users 2.9 million
patient interactions documented through eRecord EHR at Strong and Highland hospitals
(discharges, emergency visits, outpatient surgeries and office visits)
500+ IT staff * How big is a Petabyte? Most people are now accustomed to Gigabytes (GB), which is how computer hard drive storage and other consumer-grade digital devices are measured. A Petabyte (PB) = 1 million GB. That’s still hard to grasp, so think about those fancy, top-of-the-line smartphones, which can store up to 256GB — you’d be carrying nearly 4,000 of them.
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Feature Story: A Strategy of Solutions A common pool filled with more complete and consistent data will free up those resources to invest more energy into extracting information and analyzing it for the benefit of researchers, patients and the organization.” Step 3: Integrate other key data sources. URMC’s EHR vendor, Epic, makes data from other customer organizations available for benchmarking. There are also other shared warehouses, including regional health information organizations, statewide planning and research cooperatives, and regulatory and quality assurance sources. “By sharing and comparing data from academic medical center peers, we can utilize benchmarks and best practices with proven outcomes to inform our initiatives,” Barnett says. Step 4: Extract information through analytics. This is how the warehouse turns into a distribution center and where learning through data occurs. Through data analysis, more informed decisions can be made, such as where to open a new specialty clinic based on concentrations of certain disease conditions. Potential study participants for URMC researchers may be identified, and health care’s biggest challenges such as readmission rates can be dissected for common markers that affect outcomes. “We’re starting this journey with analytics and developing our competency, which is critical to bending the cost needle for URMC to thrive in a value-based care model, and for our strategic growth objectives. A data-driven approach is vital to URMC’s future,” Moran says.
Get to Know the CIO A twice-transplanted Detroit native with 20 years of experience in information technology, Tom Barnett has pushed himself beyond his professional and personal comfort zones. Joined URMC: October 2016 Previous Experience: NorthShore University HealthSystem’s Vice President of Healthcare Information Technology Henry Ford Health System’s Vice President of Application Services and IT Operations Education: BS, Management Information Systems MBA, Healthcare Administration Oakland University (Rochester, Mich.) Current residence: Fairport, N.Y.
“When you’re working with cuttingedge technology, don’t lose sight of what matters to engaging
Favorite Activity: Walking his two Jack Russell terriers: Sparky and Gabby
patients. You can offer Bluetooth
Interest: Big band drumming
alter the ability to capture data
integrated devices that radically
in the patient’s record, but what Fun Fact: Completed Second City Improv the patient really wants is training in Chicago; performed with simple and basic: make it easy to classmates to sold-out house. “When the house lights go down and schedule an appointment and get you’re going to make everything up for the prescriptions refilled.” next hour based on audience suggestions, it’s a blast.” Publications: “Taking your first steps in digital health (or, here’s the best way to eat an elephant)” — CIO (September 2016) “Digital health: Just what are we talking about?” — CIO (July 2016) “Top 10 IT mistakes to avoid in a merger and acquisition” (January 2012) “IT explained in 9 simple words” — Computerworld (July 2010) “Avoiding death by e-mail” — CIO (October 2009) “What IT can learn from the railroad business” — Computerworld (June 2007)
Recommended Reads: The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age by Robert Wachter Why Hospitals Should Fly: The Ultimate Flight Plan to Patient Safety and Quality Care by John J. Nance Getting Things Done by David Allen
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Optimization (n.) - act or methodology of making a system or process as fully perfect, functional or effective as possible
EHR: A Tool for Transformation Overcoming EHR fatigue is sometimes complicated in health care. Many providers are challenged by changing workflows as new requirements and software enhancements often affect how the tool is used. Many of those responsible for entering information and patient data find themselves spending time outside of the exam room, surgical space, or on the unit to keep up with messages, documentation, and follow ups. Barnett says he frequently hears the complaint that, “the EHR is working me, I’m not working the EHR.” For Barnett, the criticism is an opportunity for troubleshooting. “What I typically ask when I hear that is, ‘How are you practicing? What can you tell me about your workflow?’ That’s where we begin to understand where to improve the experience, make the technology less visible to the provider, and lessen the demand on a physician outside of work.” The panacea for modern health care is the point where the EHR is a welcome and informative member of the care team, not a barrier between provider and patient. For most, the transition from paper to electronic
charting is complete. Recent graduates have never experienced the “old world” of thick charts pulled from shelves, filled with transcriptions that were dictated into recorders. Helping clinicians refine their techniques and improve their information entries will help ensure that the necessary data is concisely and accurately put in place. Achieving transparency with technology begins with listening for where EHR workflows are impeding providers while understanding the technical capabilities of the system. For several years, physician architects or clinical informaticists have taken to learning the ins and outs of the EHR to identify and improve clinical workflows. However, Barnett says a new approach is needed. “We must free clinicians from the chore and disruption of working in the EHR,” he notes. “That takes focus. It’s now the ISD Optimization Team’s responsibility to make the improvements that will benefit physicians throughout our health system.” Initiated in November 2017, the dedicated eRecord Optimization Team applies experience in clinical workflows, project management, lean process improvement, training, and EHR programming to address challenges with the amount of time providers
spend working in the system. “The team is ranking the physicians’ pain points and then working through all of the various details with stakeholders to resolve them,” Barnett says. “We want our faculty, advanced practice providers, residents, and fellows to know we are working diligently to improve their experience. We are working to make our EHR less intrusive while they’re working with their patients.”
Every Mouse-Click Matters
Within the last 13 months, the eRecord Optimization Team closed out more than two dozen requests aimed at reducing time and clicks, most notably within inbox messaging and documentation. Tackling more complicated processes is on the agenda for the team in 2019. Lisa Nelson, ISD’s senior director responsible for the clinical applications in the EHR, oversees the team that’s delivering meaningful change. “One of the most dissatisfying aspects of working in an EHR is the interruption from an advisory notice,” Nelson says. “It’s also one of the most widely used tools to ensure patient safety and can be incredibly helpful— when they’re used at the right time and for the right purpose.” The team is beginning the
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Feature Story: A Strategy of Solutions
Prepare for Takeoff
“I see the EHR as the physician’s cockpit. You have your controls and your instrument panel and it’s all timed to provide information at the precise moment it’s needed. That’s where we’re going with patient records: serving up information at the point a provider needs it to identify a more successful course of treatment based on the patient’s unique traits and comparative outcomes.” - Tom Barnett work to identify, categorize and evaluate all of the pop-up advisories to ensure the speed bumps are purposeful and effective. “We’re responding daily to the needs of our provider groups, working with representatives from across UR Medicine’s specialties and hospitals to invest our attention where it will have the most significance for them,” Nelson says. “With every extraneous click and inbox message we eliminate, we’re alleviating a burden, increasing job satisfaction, and promoting a more balanced experience that improves well-being.” In Barnett’s vision, this is key to transforming the EHR from a record of data to an informational partner.
Managing Change Through Governance How do we better align IT to the needs of the Medical Center? Common goals supported across all of the organization’s missions is the first step. The next critical step involves governance and process. “When interest in developing the tools we currently have and adding new technology to support the needs of the Medical Center’s growth and expansion were pouring in through every door and window, URMC realized it needed a process,” Barnett notes. “It needed a system to bring ideas and suggestions forward in a way that they were accounted for, reviewed, compared to other
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activities and capacity, and decided upon by an integrated team representing the key areas of the entire enterprise, not just the IT department.” In 2016, in an effort to help address that need for an integrated team, Shawn Newlands, MD, PhD, MBA, members of the Medical Faculty Group leadership, and a representative team of clinical faculty took the first leap into IT governance with the Physician Advisory Team. The group formed the original steering committee that made recommendations for EHR enhancements that were derived from clinician feedback, clinical EHR experts, and the physician wellness group. As the governance concept developed further, additional advisory councils and review boards began to form to address clinical needs, as well as analytics (business and clinical reporting), revenue cycle, IT architecture, research, academic education, and other business needs. Each council or review board pairs subject matter experts with URMC and IT leaders to evaluate and respond to requests. “Some move forward and some don’t,” Barnett says. “What’s key is that we have the right people, well-versed in each area, making a unified decision that allows IT to focus our resources on fulfilling those requests on time while keeping the systems and applications we rely on available every day.”
Health Care as Easy as Uber? Talking to Barnett about an IT strategic plan is not just about new information systems to be implemented or how to enhance existing systems. His passion lies in what’s possible, so sometimes the plans are about the rungs in the ladder that are needed to get to the good stuff. It is no secret that technology is transforming health care. Convenience, speed and quality were drivers of early change. Interoperability pushed later waves, integrating the EHR with tools of the trade. Today, the advent of handheld technology has bitten both provider and patient. In the not-too-distant future, it might be difficult to find a physician who’s viewed an imaging exam on actual film. As technology changes, an integrated architecture helps ensure information from one location or system flows seamlessly to another. It’s Chief Technology Officer Jim Forrester’s job to turn patient information into meaningful data across multiple systems. “The key to successful interaction with patients relies on the information getting to the device quickly, consistently, and reliably no matter where it originates within UR Medicine’s enterprise,” Forrester notes. “Staying up to date and in sync across our technology foundation makes the data and our patient interactions flow smoothly.” Barnett says there is a common thread to many of the technology changes. “Health
care is moving in the ease of use direction,” he says. “Look how quickly you can get a ride now—just four taps on the Uber app. Patients are starting to demand that same level of service and convenience to make appointments, refill prescriptions, and communicate with their care team.” For Barnett and his team, it means reassessing— and sometimes reinventing—some of the most common interactions between patients and providers. “It’s up to us to streamline our processes to enable that new type of interaction” Barnett says. “For instance, we need to understand what information is a ‘must’ to make an appointment electronically and what can wait until a pre-visit phone call or for the patient to check in at the office. Today’s consumer wants to be part of the team, but also wants to make those transactions anytime and anywhere.”
Star Trek Comes to the Exam Room
What really piques Barnett’s interest is the technology that is turning fantasy into reality. “Remember Star Trek’s McCoy and the tricorder?” he asks. “It’s happening! There’s a real device out there that’s capable of diagnosing 13 medical conditions and continuously monitoring five vital signs in a way that resembles a tricorder.” In addition, Barnett says there is also a breast examination glove being developed that acts like a tricorder, which uses diagnostic technology to enhance a routine exam. “Robots are being used to perform complex procedures with the surgeon halfway around the world from the patient,” he says. “It’s remarkable. And it’s game changing.” According to Barnett, the goal of technology development isn’t to remove the physician from the equation but to make gathering the data and other important information easier and more comprehensive. “Technology is a tool to enable better care,” he says. “A diagnostic scanner, an electronic health record, an app on a patient’s phone—these are all to help facilitate the relationship. It’s similar to when delivery truck transmissions changed from manual to automatic. It wasn’t about replacing the driver. The goal was to remove certain tasks so the driver could focus elsewhere. The industry is automating where it needs to in order to put providers, and their creativity, in the driver’s seat. That freedom will take us to
the next level of refining our science in order to better serve our patients.” It’s important to note that development and disruption are about more than gadgetry or the pursuit of the next greatest app. Rather, it’s about understanding and analyzing enormous amounts of data for everything from improved office efficiencies to personalized patient care. For example, artificial intelligence applied to vast stores of data from medical journals and diagnostic imaging can compare and validate patient data from symptoms to lab results. That can make it possible to show the probability of diagnoses and treatment recommendations. This constructive disruption to the doctor/ patient relationship could have a radical effect on the cost of treating conditions by empirically identifying more successful approaches.
Keeping Data Secure Data is powerful and, in some cases, lucrative. Being proper and mindful stewards in an era of hacking and ransomware attacks is vital. The Medical Center’s research work and clinical patient information require careful warehousing with all the necessary safeguards that would be found in the financial industry. “Our duty is to ‘protect and serve’ no matter how sophisticated or clever the threats become,” says Barnett. “As the risks evolve, we’re challenged to keep our technologies secure and employ diverse tools and strategies to shield our systems and information.” The stakes are always high and the consequences of inadequate security can be severe. “Retaining the trust of our patients by protecting their information is of the utmost importance,” Barnett says. “In health care we’re often accountable to government entities that can levy a range of fines and penalties for security breaches.” Barnett says that the adage about an ounce of prevention absolutely applies to data protection. “It’s to everyone’s benefit that we employ tools like two-factor authentication and other technologies that ensure we let the right people in, and keep the wrong ones out.” Data is also valuable—especially when you have large amounts of it. Google and Facebook have cast doubt on who deserves access to information. “Sharing data in the
right way with the appropriate partners is an important part of delivering on precision medicine and transforming patient care relationships,” Barnett says. “Our stewardship and protection extend to those essential pathways and partnerships.”
Fundamental Intelligence for New Payment Models Know your costs. Know your patients. Know your physicians. These are the fundamentals of the IT vision for URMC, and they are the hallmarks of value-based care. “When it comes to dealing with large patient populations in a declining reimbursement model, it comes right down to answering those three questions,” Barnett says. “Do you know your costs, your patients and your physicians?” The value of analytics, for clinical practice, comes from knowing these answers systemically. URMC can pool its clinical, revenue, and patient data, then compare it to other institutions in order to understand who has the best outcomes and which cost structures yield the best price points. “Physicians and health systems need to know this information before undertaking bundled procedures for a fixed price,” Barnett notes. “With this level of intelligence, we can set a course to succeed within the new payment models.”
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Convocation September 6, 2018
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White Coat Ceremony August 17, 2018
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Honoring Dean Emeritus Marshall Lichtman Friends gathered in October to recognize the distinguished career of Professor Emeritus Marshall A. Lichtman, MD (Res ’66), who served as the School of Medicine and Dentistry’s sixth dean, from 1990 through 1995. Highlights of his tenure include the launch of a long-range plan for the school, appointment of key leaders and more than 200 faculty members, establishment of three new academic departments, execution of the highly successful “Fund for the 90s” campaign, and negotiation of several formal affiliations. Among those honoring Lichtman were URMC CEO and SMD Dean Mark B. Taubman, MD, Aram F. Hezel, MD, John and Ethel Heselden Professor of Medicine and chief of Hematology/Oncology; Jonathan W. Friedberg, MD, Samuel E. Durand Chair in Medicine and director of the Wilmot Cancer Institute; and Paul C. Levy, MD (Res ’86, Flw ’89), Charles Ayrault Dewey Professor of Medicine and chair of the Department of Medicine. Marshall A. Lichtman, MD, and his wife Alice Jo.
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Calling all School of Medicine and Dentistry alumni whose class years end in a 4 or 9…
SAV E T H E DAT E
YOUR REUNION OCTOBER 3 - 6, 2019
Reconnect. Reminisce. Rediscover.
URMC.Education
Come back to campus for Meliora Weekend, October 3-6, 2019! Enjoy world-class entertainment, lectures, music, celebrity guests, and special Reunion events.
urmceducation URochesterMed
L E A R N M O R E AT U R M C.R O C H E S T E R.E D U/S M D/A LU M N I ROCHESTER MEDICINE | 2019– V1
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FACULTY NEWS
Mark Taubman Reappointed Dean of School of Medicine and Dentistry University President Richard Feldman has announced the appointment of Mark B. Taubman, MD, to a new term as dean of the School of Medicine and Dentistry, effective July 1, 2019. The Board of Trustees approved this deanship renewal at its October meeting. Taubman will also continue his joint responsibilities as University senior vice president for Health Sciences, and CEO of the University of Rochester Medical Center (URMC) and UR Medicine, the University’s health care network. Taubman has served as CEO since January 1, 2015 and as dean since March 2010. He is the first person in the history of the Medical Center to serve this dual role. “Mark is a leader with great integrity and experience who has devoted a tremendous amount of work to ensuring that our School of Medicine and Dentistry remains among the best and most selective medical schools in the country,” said Feldman. “He spearheaded a strategy that guides the actions essential to sustaining our academic excellence, and these efforts have greatly enhanced the global profile of both the school and the University as destinations for top medical students and faculty. I am very pleased that Mark will continue as dean, in addition to the other key leadership positions in which he serves.” Since being named CEO, Taubman and his leadership team have refined and executed a strategic plan that re-invigorated the institution’s core missions of patient care, research, and education, while improving its culture and establishing financial agility. Under Taubman’s leadership, the Medical Center has experienced unprecedented growth in clinical faculty and programs, along with the development of strategic affiliations and alliances with other health care providers. Today, UR Medicine encompasses six hospitals, eight urgent care centers, more than 225 outpatient sites, and through its accountable care network, AHP, now
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provides care to more than half a million patients. It is the sole Upstate New York provider of liver and heart transplants, as well as care and treatments for many pediatric subspecialties; with 11 locations, the Wilmot Cancer Institute is Upstate’s largest cancer center. The strategic plan coalesced the Medical Center’s research portfolio into 15 multi-disciplinary “Programs of Excellence” supported by newly reinforced cores. Taubman has also taken steps to diversify the sources of financial support that sustain URMC’s research. Within education, URMC has emerged as a national leader in interprofessional education and an innovator in the training of resident physicians. Meanwhile, Taubman has put in place an infrastructure to improve the Medical Center’s efforts around diversity and inclusion. The Medical Center has adopted a new, integrated financial reporting model and is implementing changes to funds flow to foster cohesiveness and transparency, while incenting greater collaboration among its divisions. “I’m honored to have the support of administrative and faculty leaders at the Medical Center and University that has enabled our success during my first
term, and I look forward to all that we can achieve in the next five years,” Taubman said. “I’m also grateful for the confidence of the University trustees and the URMC board as we aim to become Upstate’s premier academic medical center and health system.” A board-certified cardiologist, Taubman came to the Medical Center as chief of the Cardiology Unit and Paul N. Yu Professor in Cardiology in February 2003. He became chair of the Department of Medicine and Charles E. Dewey Professor of Medicine in May 2007, and served in that role until being named as dean. He briefly served as acting CEO in 2010 while former CEO Bradford Berk, MD, recovered from an injury. Taubman graduated from the New York University School of Medicine and interned at Peter Bent Brigham Hospital in Boston before completing his residency and cardiology fellowship training at Brigham & Women’s Hospital. He held academic appointments at Harvard Medical School, Children’s Hospital Boston, and Mt. Sinai School of Medicine. Prior to being recruited to the University of Rochester, he was director of cardiovascular research at Mt. Sinai.
Taubman Tapped to Chair AMSNY Mark Taubman, MD, CEO of the University of Rochester Medical Center, has been selected as chair of the Board of Trustees of the Associated Medical Schools of New York (AMSNY). The consortium represents the New York’s medical schools, which collectively are responsible for training more physicians than any other state in the nation. “AMSNY is an important voice in Albany and Washington in support of medical education, health care, and biomedical research,” says Taubman. “The collaboration and dialogue that the organization fosters among the deans of medical schools is essential and is one of the reasons why New York State is leading the way in scientific innovation, high quality and cost-efficient care, and producing the next generation of physicians trained in team-based medicine.” “Medical education is facing significant pressure from changes in state and federal policy, the escalation of health care costs and
the rapid pace of technological development,” says Jo Wiederhorn, president and CEO of AMSNY. “At the same time, we’re in the midst of major advances in biomedical research and the ability to treat and cure complex diseases. The medical education community needs to ensure we are educating and training the best physicians to treat diverse populations and researchers to drive innovation. Dr. Taubman’s deep knowledge of and commitment to education and science will ably guide AMSNY’s priorities over the coming years.” AMSNY is a consortium of the 16 public and private medical schools in New York State, which collectively enroll 10,743 medical students and receive more than $2 billion in annual research funding from the National Institutes of Health. New York State is home to the largest number of medical schools in the U.S. and trains approximately 11 percent of the nation’s medical students and 16
percent of its residents. AMSNY plays a critical advocacy role in state and federal health policy. The organization’s list of legislative and policy priorities includes universal access to health care, funding for graduate medical education, medical education debt forgiveness, and biomedical research. AMSNY was instrumental in the creation of the Empire State Stem Cell Program (NYSTEM), continued funding for the Spinal Cord Injury Research Program, and the state’s recent decision to invest $320 million in capital funding to support life sciences, a portion of which is specifically targeted to recruit and retain scientists in bioscience research labs and academic medical centers. AMSNY also played a leading role in the creation of the Diversity in Medicine Program, which provides a pathway for middle school, high school and college students to careers in the health professions.
Bringing Mindfulness and Machine Learning to Tough Conversations on Prognosis Ronald M. Epstein, MD, professor of Family Medicine, Psychiatry, Oncology and Medicine (Palliative Care) and director of the Center for Communication and Disparities Research
For patients with advanced, incurable cancer and their doctors, conversations about prognosis are among the most difficult. Patients often come away from them with a very different understanding of the course of their disease. Some will still believe that their cancers are curable, and a majority will have unrealistic beliefs about how long they will survive. “The consequences are large,” says Ronald M. Epstein, MD, professor of Family
Medicine, Psychiatry, Oncology and Medicine (Palliative Care). “Patients get treatments they later regret. Families feel upset and abandoned. For doctors, these conversations are difficult too.” Epstein has studied these conversations for decades with the goal of improving communication between patients and doctors. In order for patients to make informed choices and maximize their quality of life, he says, doctors and patients must have shared understanding and expectations about prognosis and care. His latest research will focus on who patients turn to after learning of their prognosis, including family, friends, clergy and others. Epstein, who directs the Center for Communication and Disparities Research, will also continue to study mindfulness—being conscious and aware of one’s own feelings, thoughts and reactions—as a strategy for patients and doctors to improve their communication, especially regarding difficult
topics like prognosis. These efforts will be supported by the American Cancer Society’s most prestigious award, the Clinical Research Professorship, which Epstein received in 2018. ACS awards only two of these professorships each year. These grants to mid-career professionals provide up to $80,000 a year for five years and are renewable once. Epstein is also partnering with M. Ehsan Hoque, PhD, who serves as the Asaro Biggar Family Fellow in Data Science, to incorporate machine learning into data analysis and communication coaching for doctors and patients. With Hoque, who leads the Rochester Human-Computer Interaction Group, Epstein will explore the use of avatars that can read facial expressions and other emotional cues to help patients and physicians practice for important conversations. The avatars are intended to augment, rather than substitute for, in-person practice, Epstein says.
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Children’s Hospital Chief to Lead International Research Conference Patrick Brophy, MD, the William H. Eilinger Chair of Pediatrics at URMC and physicianin-chief at UR Medicine’s Golisano Children’s Hospital, has been named Program Committee Chair for the 2020 and the 2021 Pediatric Academic Societies (PAS) Meeting, the preeminent pediatric research conference in North America. The meeting is a partnership between four pediatric organizations: the American Pediatric Society, the Society for Pediatric Research, the Academic Pediatric Association, and the American Academy of Pediatrics, and draws several thousand pediatricians from across the continent each year. As Program Committee Chair, Brophy will coordinate efforts from all four organizations
to showcase basic, translational, and clinical research, and to maximize the conference’s impact and educational offerings. His appointment began in June 2018, and he will spend the first year shadowing the 2019 Program Committee Chair, Thomas P. Shanley, MD. before stepping in to the lead for the subsequent two meetings. The 8th chair of the Department of Pediatrics, Brophy is a board-certified pediatric nephrologist, and is president of the American Society of Pediatric Nephrology, where he also previously served as program committee chair for the society’s annual meeting. Before coming to Rochester in 2018, he served as division director of pediatric nephrology at the University of Iowa.
Compassion, Integrity Earn Denney-Koelsch National Palliative Care Award Award. The Cunniff-Dixon Foundation, which responds, striking a perfect balance between created and funds the awards, aims to enrich allowing her patients to reach the decision the relationships of doctors and patients who that is right for them but at the same time are near the end of life. gently guiding them to that decision when Denney-Koelsch, an assistant professor they are looking for help and support,” in URMC’s Division of Palliative Care, earned Korones says. “We are blessed to have one of three early-career awards. Colleagues Erin as a member of our pediatric and adult supporting her nomination praised her palliative care teams. Her personal integrity is knowledge, insightfulness, integrity, and unparalleled and an inspiration to us all. She sensitivity in the face of difficult, complex is so very richly deserving of this recognition, situations. and will parlay it into even better care of “It’s remarkable that Erin overflows with her patients.” such gifts and achievements so early in her Renowned palliative care expert career,” says Robert Horowitz (MD ’93, Timothy Quill (MD ’76, Res ’80, Flw ’81), Res ’98), chief of URMC’s Division of Palliative URMC professor of Medicine, Psychiatry, Care and the Georgia and Thomas Gosnell Medical Humanities and Nursing, praised Distinguished Professor in Palliative Care. Denney-Koelsch’s ability to understand that “She’s a great clinician, smart, gracious, illness impacts patients and families. “She compassionate, efficient and generous; is not afraid to address the most complex of an enthusiastic and creative teacher of clinical situations head on, and if she does trainees at all levels; and a remarkably not have clear answers herself, or if such When the anticipated joy of a baby’s arrival productive scholar with already a national, answers do not exist, she is willing to engage is devastated by potential loss, it takes a even international, reputation in perinatal herself and find others to help make the best special caregiver to provide meaningful, palliative care.” possible decisions in the midst of the most appropriate support. Recognizing this distinct URMC is the only organization represented daunting uncertainty,” Quill says. need, palliative care physician Erin Denneytwice in the history of the Cunniff-Dixon Denney-Koelsch is an Academic Palliative Koelsch (MD ’04, Res ’08, Flw ’10) formed an Physician Awards. David Korones, MD Medicine Council leader with the American interdisciplinary program to help expectant (Res ’91), professor of Pediatrics, Oncology Academy of Hospice and Palliative Medicine. parents of babies not likely to survive. and Neurology and chief of the Division of She is a Fellow of the American Academy of That insight and compassion are among Pediatric Palliative Care, won the 2015 Senior Hospice and Palliative Medicine, which the reasons she was one of five physicians Physician Award. is awarded for significant clinical, education in the country to be honored with a 2018 “As the end of life nears, patients and and scholarship contributions to field of Hastings Center Cunniff-Dixon Physician families look to us for guidance, and Erin Palliative Care. Thomas and Brenda Parkes, Linda (Parkes) and Joseph Clement, Walter and Barbara Parkes, Susan (Parkes) and Jon McNally 42
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Family’s Influence on Health a Hallmark of Campbell’s Tenure as Chair Following a behavioral and psychosocial medicine fellowship with pioneer George Engel, MD, and family therapy training in the Department of Psychiatry, Campbell rose quickly through the URMC ranks, becoming a full professor of both Family Medicine and Psychiatry in 1998. After serving a year as interim chair, in 2004 he was named the William Rocktaschel Professor and Chair of the Department of Family Medicine. “I appreciate Tom’s remarkable leadership
Thomas L. Campbell, MD, Professor and William Rocktaschel Chair in Family Medicine, hosted a 50th Anniversary Reunion of the Family Medicine Department in October 2018. Inviting an era of “new ideas, new energy, and new leadership,” Thomas L. Campbell, MD (Res ’82, Flw ’83, Flw ’87), has chosen to step down as chair of the URMC’s Department of Family Medicine in July 2019. Though he’ll end a chapter as the department’s leader for 15 years, the book on his contributions to the department’s progress will remain open. “It has been and continues to be an enormous honor and pleasure to serve as the chair of this department and to lead such a talented group of faculty,” Campbell says. “I am ready for a new phase in my professional and personal life. I plan to continue to develop and sustain innovative clinical, educational and research projects.” Renowned for his work on the influence of the family on health, Campbell was first attracted to Rochester’s biopsychosocial model as a resident nearly 40 years ago.
these past 15 years,” says Mark B. Taubman, MD, CEO of URMC and dean of the School of Medicine and Dentistry. “During his tenure as chair, Tom built one of the most highly regarded Family Medicine programs in the nation. The fact that more than 10 percent of this year’s Medical School graduates chose to pursue residencies in Family Medicine speaks to the positive experiences provided by Tom and his faculty. The Department’s research into issues such as health care disparities and mindfulness have been game-changing for the field.” In his early years at URMC, Campbell spearheaded the development of a psychosocial medicine curriculum for primary care, working with family psychologist Susan McDaniel, PhD. “Tom integrated mental health into the Family Medicine clinic in 1985, more than two decades before it was recognized as the gold standard of comprehensive care,” said McDaniel, vice chair of Family Medicine and the Laurie Sands Distinguished Professor of Families & Health in the Department of Psychiatry.
Campbell’s tenure as chair has been marked by significant growth of the department, which celebrated its 50th anniversary in 2018. He oversaw primary care practice transformation at Highland Family Medicine, training for team-based care for Family Medicine residents and other health professionals, and a research program that focuses on health disparities and physicianpatient communication, including a National Institutes of Health grant to assess the impact of a primary care-based, patient navigation program on cancer-related quality of care. “Tom Campbell has been a great leader and advocate for his faculty and the department’s clinical practice,” said Paul C. Levy, MD (Res ’86, Flw ’89), the Charles Ayrault Dewey Professor of Medicine and chair of the Department of Medicine. “I truly admire how he has led efforts to improve the care of some of our community’s most vulnerable patients and woven those efforts into his educational programs.” Recognized nationally for his vision and leadership, Campbell is a past president of the Association of Departments of Family Medicine and former chair of the Council of Academic Family Medicine, which represents the four academic family medicine organizations. He is currently on the Board of Family Medicine for America’s Health, formed by eight family medicine organizations to develop and implement a strategic plan for Family Medicine. He is the author of several influential, definitive reviews for the National Institute of Mental Health on the role of family in health and mental health care and has authored or coauthored more than 100 journal articles and book chapters. Campbell is planning an academic leave, after which he will return to continue patient care and teaching. Jeffrey M. Lyness (MD ’86), senior associate dean for Academic Affairs, is leading a national search for a successor.
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Ilan Goldenberg Returns to URMC as Director of Clinical Cardiovascular Research Ilan Goldenberg, MD, learned what it takes to run successful clinical trials from one of the best in the field. From 2004 to 2011, as a
faculty member in the Division of Cardiology at URMC, he worked closely with Arthur J. Moss, MD, who led the landmark Multicenter Automatic Defibrillator Implantation Trial (MADIT) and made some of the most significant discoveries in the prevention and treatment of sudden cardiac death. Moss passed away on February 14, 2018. Goldenberg intends to continue Moss’s research and plans to broaden the focus of the Heart Research Follow-up Program beyond sudden death, collaborating with investigators from the Aab Cardiovascular Research Institute (CVRI) and practicing physicians in the Division of Cardiology to create a multidisciplinary research team. Potential new areas of investigation include genetics, left ventricular assist device trials, and the use of new technologies to improve patient feedback and outcomes. In this newly created position, Goldenberg will consolidate all clinical cardiology research
into one team and expand the clinical studies conducted at the Medical Center. “Ilan has the vision and the imagination needed to grow our research enterprise and enhance Arthur’s legacy,” says Charles J. Lowenstein, MD, the Paul N. Yu Professor in Cardiology, chief of Cardiology and director of the Aab CVRI at URMC. “With his breadth of experience, proven administrative skills, and track record of expertly run trials, he is the ideal candidate to make the wonderful work we’re doing here even better, leading to new advances for heart patients in Rochester and around the world.” Before taking the role, Goldenberg served as professor and director of the Cardiology Division at Tel Aviv University in Israel, as well as director of the Department of Cardiology at Sheba Medical Center and of the Israeli Center for Cardiovascular Trials.
Joseph, Pioneer in Robotic Surgery, Tapped to Head Urology Department
Jean Joseph, MD, MBA, FACS (MD ’92, Res ’94, Res ’98), who was one of the first surgeons in the U.S. to perform a prostatectomy via robotic surgery, has been appointed Winfield W. Scott Professor and Chair of URMC Department of Urology. Prior to his appointment, Joseph served as professor of Urology and Oncology. He is the director of the Section of Urologic Laparoscopy and Robotic Surgery, and
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director of the URMC Center for Robotic Surgery and Innovation. “Jean is an innovator and international leader in robotic and minimally invasive surgery and improving outcomes of men treated surgically for prostate cancer,” says Mark Taubman, MD, CEO of URMC. “I am thankful that he has agreed to lead the Department of Urology during what will be a period of tremendous change as the demand and geographic reach of UR Medicine’s specialists and services continues to grow.” Joseph received his undergraduate degree in biology from Boston University and his medical degree and residency training at the University of Rochester Medical Center. In 2001, Joseph was among a handful of surgeons in the U.S. to first begin performing laparoscopic radical prostatectomy. Since then, he has performed nearly 5,000 robotic procedures and is frequently called upon train other physicians in robotic techniques and performs live surgical demonstrations at national and international symposiums. Joseph has served in a number of leadership positions in the Society of Urologic Robotic Surgery, the Endourological Society, and the American Urological Association.
He has authored numerous journal articles on topics related to robotic and minimally invasive surgery. The URMC Department of Urology consists of 21 faculty providing the region’s most advanced urologic care for adult and pediatric patients and is active in several research areas including investigating new ways to diagnose and treat prostate, bladder, and kidney cancers, and developing advanced simulations to improve surgical outcomes and train surgeons. “The Department of Urology has a dynamic faculty with subspecialty interest spanning the entire field,” says Joseph. “Together we will build upon this strong foundation and make the department one of the nation’s leading centers for advanced, patient-centered urological care, scientific innovation, and a destination that attracts and trains the next generation of physicians and surgeons.” Joseph succeeds Edward Messing, MD, FACS, who has led the Urology Department since 1995. Messing is a renowned expert in the detection, prevention, and treatment of genitourinary cancers. Messing remains on the department’s faculty.
Libby to Focus on Enhancing Graduate Programs With a track record of growth as an innovative researcher and respected teacher and mentor, Richard T. (Rick) Libby, PhD, is positioned perfectly for his new role as senior associate dean for Graduate Education and Postdoctoral Affairs (GEPA) at the School of Medicine and Dentistry. Libby, a professor of Ophthalmology and of Biomedical Genetics, and a member of the University’s Center for Visual Science, will direct the PhD, postdoctoral and master’s degree programs. He succeeds Edith M. Lord, PhD, who served in the role for 10 years before shifting her focus to microbiology and immunology research. An innovative researcher in the neurobiology of glaucoma, Libby arrived in Rochester in 2006 after postdoctoral and fellowship experiences that enlightened him on the power of model genetics systems in the study of eye disease. Years spent training at the Medical Research Council’s Institute for Hearing Research in Nottingham, England, and the Jackson Laboratory in Bar Harbor, Maine, formed the foundation for his current laboratory, which is focused on understanding the cell signaling pathways that lead to vision loss in glaucoma. Libby is director of the Cell Biology of Disease Graduate Program, has served on numerous academic committees integral to research activities and graduate education, and is a respected mentor and teacher. He has published, as author or co-author, more than 60 peer-reviewed scientific articles and numerous reviews, book chapters, and commentaries, and has presented internationally on a range of topics in eye and vision research. “Rick understands that excellence in a research enterprise is essential to attracting the best and brightest talent and has articulated a vision for further improving the experience here, making it clear to the outside world that Rochester is the best place to learn and study,” says Mark Taubman, MD, CEO of the Medical Center and dean of the School of Medicine and Dentistry. “He is a passionate scientist whose experience in a clinical department will bring valuable insight
to graduate programs in basic and clinical research—a true asset to his role in helping prepare future generations of scientists.” “Complementing his expertise in leading graduate programs, and thorough understanding of their needs, Rick has developed a thoughtful approach to what it will take to continue moving them forward. It’s clear that he’s driven by a desire to develop our trainees and motivated to give them the best graduate/postdoctoral experience possible,” says Stephen Dewhurst, PhD, vice dean for Research at the School of Medicine and Dentistry and associate vice president for Health Sciences Research. “In addition, having developed his own career in a somewhat untraditional way, Rick brings an added dimension to understanding and supporting others who are exploring diverse career options.” Libby received a doctorate degree in biology from Boston College in the field of neurodevelopment. He was a postdoctoral fellow at the Medical Research Council’s Institute for Hearing Research and a postdoctoral fellow at the Jackson Laboratory. He joined the School of Medicine and Dentistry faculty as an assistant professor in 2006, was named associate professor in 2012, and professor in 2018.
“Rick is a great choice to succeed Edith Lord as the Senior Associate Dean for Graduate Education,” said Dirk Bohmann, PhD, Donald M. Foster, MD Professor in Biomedical Genetics and Senior Associate Dean for Basic Research, who led the search committee. “He realizes that research excellence and successful graduate and postdoctoral programs are mutually dependent. You cannot have one without the other. He will be a passionate advocate for the graduate students and postdocs.” “Under Dr. Lord’s leadership, GEPA has greatly enhanced the support and training of URMC’s graduate students and postdoctoral fellows,” Libby said. “In fact, GEPA has helped lead the nation in providing enhanced educational opportunities to ready trainees for the numerous careers available to the modern-day scientist. I am excited to be a part of this team. I look forward to further developing GEPA’s missions of providing world-class training for our graduate students and postdoctoral fellows, and to helping our trainees continue their important work focused on understanding human health and disease.” Lord’s four-decade career in Rochester is dotted with milestones and accomplishments. She joined the School of Medicine and Dentistry faculty as a senior instructor in 1976 and rose through the ranks to professor in 1994. In 10 years as senior associate dean, she worked to improve the experience of graduate students and postdocs in and outside the lab, adding Postdoctoral Affairs to the Office for Graduate Education’s name, standardizing salaries and benefits, and advocating on behalf of trainees. She spearheaded a revamping of the fundamental basic science courses, incorporating more workshops and active learning components and emphasizing team-based science. She also fostered professional development initiatives and guided efforts to support students’ health and wellbeing. Her return to the research lab will include focusing on an NIH grant to study the immune response in tumors.
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Zand Pegged to Lead Clinical Research Martin Zand, MD, PhD, has been named senior associate dean for Clinical Research at URMC. Zand, who co-directs URMC’s Clinical and Translational Science Institute and its new Center for Leading Innovation and Collaboration (CLIC), took up the new post on August 1, 2018. URMC is taking several steps to boost the number and quality of clinical trials conducted at the Medical Center. This includes developing a new office to speed start-up times for clinical trials and improve management and analysis of trial data. These efforts will help URMC answer clinical research questions faster and offer patients cutting-edge therapies and opportunities to participate in health research sooner. “Martin was a natural choice for this position,” says Mark B. Taubman, MD, dean of the University of Rochester School of Medicine and Dentistry and CEO of URMC.
Newly appointed senior associate dean for Clinical Research Martin Zand, MD, PhD, hopes to increase the number of high-impact clinical trials at the Medical Center, providing more opportunities for patients to participate in and benefit from research.
“He is perfectly positioned, through his intersecting clinical and scientific interests, to guide and support the University’s clinical research efforts.” Zand, a professor of nephrology and public health sciences at URMC, is a clinician, biomedical researcher, and data scientist. He is an internationally recognized expert in solid organ transplant immunobiology and his clinical practice focuses on holistic care of kidney transplant patients. As a data scientist, he aims to understand and improve influenza vaccination, population health and health care delivery. As senior associate dean for Clinical Research, Zand will focus on starting up the new Office of Clinical Research; creating a data ecosystem that integrates laboratory and clinical data; supporting clinical researchers by ensuring they have more time available to conduct research; and improving how we implement treatments and therapies.
McAnarney Named Distinguished University Professor Elizabeth R. “Lissa” McAnarney, MD (Flw ’70), professor and chair emerita of the Department of Pediatrics at the University of Rochester Medical Center, has been named a Distinguished University Professor, the highest title that the university bestows on its faculty. McAnarney, who served as pediatricianin-chief at UR Medicine’s Golisano Children’s Hospital from 1993 to 2006, is only the 13th recipient of the title in university’s history, and is the first woman to receive the honor. McAnarney earned her medical degree and an honorary degree, DSc, from SUNY Upstate Medical University, where she also completed her internship and residency. McAnarney is credited with the way that health care providers care for pregnant teens and their babies, working tirelessly to improve outcomes for these patients. The lead editor of the Textbook of Adolescent Medicine along with co-editor Richard E. Kreipe, MD, McAnarney’s advocacy efforts helped make adolescent medicine into a board-certified pediatric subspecialty.
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“I think that our Rochester community sees Lissa as one of the most influential leaders in our children’s hospital’s history, and, of course, that perception is entirely accurate,” says Mark Taubman, MD, CEO of URMC and dean of the School of Medicine and Dentistry. “But nationally, she is also among the most influential individuals in
adolescent medicine for the last 50 years. That field would not be what it is today without her influence and advocacy.” In 1993, McAnarney took on the dual role of pediatrician-in-chief of the children’s hospital, and chair of the Department of Pediatrics, making her the sixth chair in the department’s history and the first woman to serve in the role. During her 13-year tenure, full-time pediatric faculty doubled in size as did national and state grant support. “I am deeply grateful to have had such remarkable support over 50 years from the leadership of the University, the Medical Center, and the Department of Pediatrics to ‘dream dreams’ and to create ideas to improve the health of all children, particularly Rochester’s children,” says McAnarney. “Additionally, I am very grateful to our patients, their families and to our trainees, faculty, and staff for their contributions to our collective pursuit of optimal health for all children.”
Messing Honored for Advancing Urological Care
Edward Messing, MD, FACS, has been recognized by the American Urological Association (AUA) for 35 years of accomplishments in improving care for individuals with bladder, kidney, prostate,
and testicular cancer. Messing received the Ramon Guiteras Award at the AUA’s annual meeting in May 2018 in San Francisco. The award is presented annually to an individual deemed to have made outstanding contributions to the art and science of urology. Founded in 1902, AUA is the leading national and international educational, scientific, and clinical organization for the specialty of urology with more than 20,000 members worldwide. Messing, a professor in the Department of Urology and the Wilmot Cancer Institute, is a renowned expert in the diagnosis and treatment of genitourinary cancers. His research contributions have ranged from enhancing our knowledge of the basic molecular and genetic components that contribute to the development and progression of cancers of the bladder, prostate, and kidney, and translating this
research into new ways to detect, prevent, and treat these diseases. He has also designed and conducted landmark phase III clinical trials for each of these cancers, led a bladder cancer study that resulted in a simple in-office urine test to screen for the disease, and has helped shape the national recommendations for the screening of prostate cancer and the use of radiation to treat forms of the disease. Messing received his medical degree from New York University in 1972 and conducted his training at NYU, Stanford University, and the University of California, Los Angeles. He served on the faculty at the University of Wisconsin for 13 years before arriving at URMC in 1995 to become chair of the Department of Urology, a position he held until stepping down on January 1, 2018.
Vertino Named Inaugural Wilmot Distinguished Professor, Associate Director of Translational Research
Paula M. Vertino, PhD, recently joined URMC as a professor of Biomedical Genetics and as the associate director of translational research at Wilmot Cancer Institute. She says URMC and Wilmot come with incredible potential. “I see a lot of great opportunities in Rochester to interact with faculty doing foundational research, to bring it from
concept to application for new treatments or diagnostic advances,” says Vertino. “It’s a very collaborative environment, all on one campus, and a really great base to build from.” An expert in epigenetics and how aberrant gene expression leads to cancer, Vertino will also serve as the Wilmot Distinguished Professor, an endowed position funded by the family of James P. Wilmot, the cancer institute’s namesake. Over her career, Vertino has had more than 70 peer-reviewed scientific publications and more than 20 years of continuous, overlapping cancer-relevant funding. Vertino’s lab is located at the Wilmot Cancer Center, which was designed to encourage collaboration between scientists and clinicians. As director of Translational Research, Vertino will be responsible for facilitating interaction among scientists and clinicians with the goal of accelerating the development
of laboratory discoveries into technologies or treatments for use with patients. Originally from the Buffalo area, Vertino pursued graduate work at Roswell Park Comprehensive Cancer Center and received her doctorate from the State University of New York at Buffalo. She completed her postdoctoral training in cancer genetics at Johns Hopkins Oncology Center. In 1996, Vertino joined the faculty at Emory University, where she served as a professor in Radiation Oncology and led the Cancer Genetics and Epigenetics Program at Winship Cancer Institute. She also has served as a regular member on the Cancer Etiology study section at the National Institutes of Health, and she is currently a member of the NCI-A parent committee that oversees the review of National Cancer Institute designated cancer centers nationwide.
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Cardiac Surgeons Lead Nation with New Approach for Heart Pump Implantation URMC cardiac surgeons recently introduced a minimally invasive approach to implanting the newest heart pump available for people with congestive heart failure. The implant technique is believed to be the first in the nation, and potentially a game-changer for patients. The HeartMate 3™ LVAD is the nextgeneration left ventricular assist device for advanced congestive heart failure. The device supplements the pumping action of a weakened heart. It is approved for use as a bridge-to-transplant. URMC is Upstate New York’s only center approved to use LVADs, because of the strength of its comprehensive heart failure and transplantation program. “This is a significant advance for patients who can receive this life-saving device without weeks or months of recovery,” says heart transplant surgeon Igor Gosev, MD. He worked closely with cardiac surgeon Peter Knight, MD (Flw ’87), and anesthesiologist Laurent Glance, MD, to carefully place the one-pound device near the base of the heart of a Southern Tier man.
Knight, who is the Marjorie B. Morris Endowed Professor in Cardiac Surgery, says the minimally invasive approach with the LVAD has been the goal because the new device is smaller and the placement on the heart is optimal. Knight leads the Minimally Invasive Cardiac Surgery Program, has advanced techniques over the last two decades, and is nationally recognized for his innovation and leadership in the field. “This is a great example of teamwork and dedication to providing the best care for our patients,” says Cardiac Surgery Chief Sunil Prasad, MD, the Dr. Jude S. Sauer Family Distinguished Professor in Cardiac Surgery. “In this procedure, Dr. Knight, who has performed hundreds of minimally invasive heart surgeries, and Dr. Gosev, who has implanted hundreds of LVADs, came together to use this minimally invasive approach and our patients have done extremely well.” According to Prasad, the collaborative nature of the Heart and Vascular program led to this advance, which is being studied by peers at
other academic medical centers. The Heart and Vascular team has been implanting LVADs for nearly 20 years, having participated in early clinical studies that led to their standard use for heart failure. To date, the team has provided LVADs to more than 500 people, some of whom have traveled from northern New York, Albany, Buffalo and the Southern Tier and Pennsylvania for care. Using this approach, patients often experience less pain and blood loss, lower risk of complications, shorter hospital stays, and improved quality of life and heart function.
Quill Recognized with Lifetime Achievement Award More than 20 years ago, Timothy E. Quill (MD ’76, Res ’80, Flw ’81) gained notoriety as the lead physician plaintiff in a case that went to the U.S. Supreme Court, challenging the New York State law prohibiting physicianassisted death. Now, the internationally recognized pioneer in palliative care and end-of-life decision making is the recipient of the American Academy of Hospital and Palliative Medicine’s (AAHPM) highest honor—a Lifetime Achievement Award. Quill is a professor of Medicine, Psychiatry, Medical Humanities, and Nursing, acting director of the URMC Paul M. Schyve Center for Bioethics, and founding director of the URMC’s Palliative Care Program. He is a renowned patient advocate and sought-after speaker on various aspects of the doctorpatient relationship, with special focus on end-of-life decision-making. “I am honored to receive this award because it reflects the outstanding collective clinical, educational and research efforts of our URMC Interprofessional Palliative Care Team,” Quill says. “Together we are actualizing the promise of Rochester’s 48
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biopsychosocial model, and applying it to the care our most seriously ill patients and their families.” AAHPM cited Quill’s contributions to the national organization, including serving as its president in 2012, and as lead author and editor for its Primer of Palliative Care.
In 2013, he was designated as an AAHPM Visionary and awarded its Palliative Medicine Community Award for advancing the field of palliative care through distinctive mentorship and leadership and serving as a role model for others engaged in improving the care of the dying. In Rochester, Quill has influenced the growth of palliative care community-wide. Under his leadership, URMC’s Palliative Care Program grew into a full-service program encompassing teaching, research, outpatient and in-home consultations, and inpatient care. Under his direction, in 2009 Strong Memorial Hospital opened the region’s first hospitalbased palliative care unit. Quill is a regular, invited contributor to respected national journals and has written several books on end-of-life issues, including Physician-Assisted Dying: The Case for Palliative Care and Patient Choice, and Caring for Patients at the End of Life: Facing an Uncertain Future Together.
Baciewicz Honored as National Leader in Combating Opioid Addiction The American Association for the Treatment of Opioid Dependence (AATOD) presented URMC professor of Clinical Psychiatry and Strong Recovery medical director Gloria J. Baciewicz (MD ’74, Res ’82), with the Nyswander/Dole “Marie” Award at the AATOD international conference in New York City. The award is one of the nation’s top honors in the prevention and treatment of opioid addiction, and it recognizes Baciewicz for her 25 years as a star-clinician, leader, and innovator in the field. Board-certified in psychiatry, addiction psychiatry and addiction medicine, Baciewicz has been a dedicated champion, educator, and supporter of medication-assisted treatment for nearly three decades. Some of her accomplishments include expanding the capacity of Strong Recovery’s outpatient opioid treatment program in 2016 (from 650 to nearly 1,000 slots), providing outreach and consultation to residential treatment agencies
and the Rochester Drug Treatment Court, incorporating medication-assisted treatments into the traditional “drug-free” outpatient
clinics, the development of an Addiction Medicine Fellowship at URMC, and providing free Narcan kit distribution and education across the Rochester area. A fellow of the American Psychiatric Association and the American Society of Addiction Medicine, Baciewicz has chaired the Addiction Medicine Committee of the Monroe County Medical Society since 1998. “Gloria has been the dedicated addictiontreatment champion in our area for many years and has repeatedly broken ground in her field,” said H. Benjamin (Ben) Lee, MD, the John Romano Professor and Chair of Psychiatry at URMC. “Many Upstate New York localities and politicians were steadfastly opposed to the use of methadone to treat addiction 25 years ago, and she regularly encountered much of the same resistance that Drs. Nyswander and Dole experienced in New York City during the late 1960s, when they first put forth their findings.”
Horowitz Chosen to Lead Division of Palliative Care
After a mid-career move from emergency medicine to palliative care, Robert K. Horowitz (MD ’93, Res ’98), now leads an interdisciplinary team focused on helping patients and their family members achieve the best possible quality of life in the face of serious illness. Recently named chief of the Division of Palliative Care and the Georgia and Thomas Gosnell Distinguished Professor in Palliative Care at URMC, Horowitz was drawn to the
field after years of work in human services, emergency medicine, and with cystic fibrosis patients. He joined the Palliative Care Program in 2010, where he previously served as its clinical director, acting chief, and interim chief. Horowitz says working in palliative care often requires a very personal approach. “I discovered that my deepest strengths and satisfactions reside in tending to patients with serious and progressive illness, in which the best care involves not just technical excellence, but also being a listening and compassionate presence,” he notes. “I think this is the essence of the Palliative Care specialty.” A Rochester native, Horowitz helped establish the Medical Center’s Adult Cystic Fibrosis Program and served as its medical director for 16 years. Timothy Quill (MD ’76, Res ’80, Flw’81), former division chief and a renowned palliative care expert says, “I am extremely excited that Rob has been chosen to lead the Palliative Care Program through its next phase of growth and development. His wide-ranging experience in medicine, pediatrics, and
medical education, as well as his role leading the Adult Cystic Fibrosis Program make him uniquely qualified to take on this role.” In addition to clinical and administrative responsibilities, Horowitz maintains an active teaching schedule and speaks both locally and nationally to professionals, health care trainees, and community groups about a variety of subjects, including how to have difficult conversations, ways of better understanding pain and symptom management, planning for advance care, and self-care for clinicians. He is a valued educator and respected mentor, and he directs the medical school’s comprehensive assessments of communication skills, medical knowledge and professionalism. Horowitz also facilitates several support and reflection groups for clinicians, staff, and trainees. Board-certified in Hospice and Palliative Medicine, Internal Medicine and Pediatrics, Horowitz has earned the 2016 Leonard Tow Humanism in Medicine Award, and numerous honors for teaching.
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FACULTY NEWS
Meeting the Needs of Older Cancer Patients
Many cancer patients in the U.S. are older than 65, have an elderly spouse as their chief care-giver, limits on their functional ability, a restricted budget, and perhaps other health issues or risks of illnesses such as heart disease and diabetes. And yet they are an understudied group. Many oncologists are not properly trained in how to assess these disabilities or the realworld experiences of their older patients, despite a great need for this type of care. Wilmot Cancer Institute geriatric oncologist Supriya G. Mohile, MD, MS, has been a trailblazer in the growing field of geriatric oncology and a champion for closing the gap in knowledge about how to safely and effectively treat older adults with cancer. She was named the 2018 winner of the B.J.
Kennedy Award by the American Society of Clinical Oncology (ASCO) and delivered the Kennedy Lecture at ASCO’s annual meeting in Chicago. The award stemmed in part from a decade-long effort by Mohile and others to encourage the use of geriatric assessment tools to inform treatment decisions and improve communication between physicians and elderly patients. She was selected for the ASCO award from among the 40,000 members of the professional society, and recognized for outstanding contributions to research, diagnosis, and treatment of cancer in the elderly. “Cancer is a disease of aging and Americans are living longer,” Mohile says. “I’m proud of the progress we’ve made in our research, and grateful for the opportunity to seek practical interventions to improve the quality of life of older adults. I’m also honored to be part of a team of national experts that is so committed to this issue. We will continue to educate thought-leaders in oncology about the need for more tools for treating older patients.” Mohile was also the first author for a new set of evidence-based geriatric oncology guidelines for oncologists, published by the Journal of Clinical Oncology in May 2018. The guidelines make recommendations on how to manage the unique vulnerabilities of patients 65 years and older. And in September 2018, ASCO also
highlighted Mohile’s latest work its Quality Care Symposium—a study focusing on financial toxicity among older patients. It showed that nearly one in five cancer patients between the ages of 70 and 96 face serious financial hardship. Despite this fact, cost issues were only discussed about half the time by oncologists during office visits. Mohile and her team developed an easy screening tool, based on the current literature that asks questions about whether a patient has sufficient income for food, housing, medications, and other basic needs. A professor of Medicine and Surgery at URMC, Mohile was recently named to the Philip and Marilyn Wehrheim Professorship at Wilmot, an endowed chair established to support translational research. She founded a geriatric oncology clinic a Wilmot—one of only few such programs in the U.S.—that has grown to include four physicians dually certified in geriatrics and oncology. “Supriya is an outstanding member of our Wilmot faculty, and is now appropriately recognized by ASCO as an international leader in the field of geriatric oncology,” says Jonathan Friedberg, MD, MMSc, director of the Wilmot Cancer Institute and the Samuel E. Durand Chair in Medicine. “In addition to her research accomplishments, she leads one of the largest geriatric oncology clinical programs in the country, right here in Rochester.”
Zent Named Leukemia Research Editor-in-Chief Clive S. Zent, MD, professor of Medicine, Hematology/Oncology, has been named editor-in-chief of Leukemia Research, an international journal focused on basic and applied clinical research in hematologic malignancies. Established in 1977, Leukemia Research includes studies on cellular and molecular biology, genetics, immunology, epidemiology, clinical evaluation, and therapy of hematologic malignancies. Zent succeeds Eric J. Feldman, MD, formerly of Weill-Cornell Medicine, as the journal’s editor, and he is the second faculty member from URMC to hold this post.
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John M. Bennett, MD, professor emeritus of Medicine, Pathology and Laboratory Medicine, also served as editor for the journal. At Wilmot, Zent leads the lymphoma program, and his clinical expertise is in chronic lymphocytic leukemia (CLL) and related lymphoid malignancies. His research focuses on the therapeutic monoclonal antibodies used to treat CLL, as well as the use of molecular prognostic markers in the management and diagnosis of CLL and related diseases, and evaluation and management of autoimmune cytopenias and second malignancies complicating CLL.
URMC Leaders Influence Academic Medicine Nationally A group of URMC leaders are helping to shape academic medicine through their roles with the Association of American Medical Colleges (AAMC). Jeffrey Lyness (MD ’86), senior associate dean of Academic Affairs, chairs AAMC’s Group on Faculty Affairs, which supports faculty and provides resources to help deans and administrators implement policies and activities to advance their organization’s missions. Janine Shapiro, MD (Res ’85), associate dean for Faculty Development, chair-elect of AAMC’s Northeast Group on Educational Affairs since May 2017, becomes chair in April 2019. Shapiro is also the regional director for AAMC’s Leadership Education and Development Program and she serves on the AAMC Council for Faculty and Academic Societies as the elected representative for the Society for Academic Continuing Medical Education. Linda H. Chaudron (MD ’92), associate vice president and senior associate dean for Inclusion and Culture Development, in November 2018 advanced from chair-elect to chair of the Group on Women in Medicine and Science (GWIMS) steering committee, which promotes the full participation of women within academic medicine and assesses gender equity, recruitment and retention, awards and recognition, and career advancement.
John Cullen, PhD (Flw ’02), director of Diversity and Inclusion for the Clinical & Translational Science Institute and assistant director of the UR’s Susan B. Anthony Center, was selected to serve as the issuebased representative for the GWIMS steering committee with a focus on male allyship and the need to support women in academic biomedical research. Katy Stevenson, MPP, program administrator for Strategy, Planning and Development, in April 2019 advances from chair-elect to chair of AAMC’s Group for Institutional Planning, which works to advance the discipline of planning in academic medicine by enhancing the skills and knowledge of professional planners, promoting the value of planning and connecting people, resources, and ideas. David Bernstein (MBA ‘16), SMD class of 2019, concluded his term as chair of the AAMC’s Organization of Student Representatives, which tackles some of the most significant concerns of medical students across the country.
David R. Lambert, MD, senior associate dean for Medical Student Education, shown taking a selfie with medical students, is chair-elect of the Liaison Committee on Medical Education (LCME). When he takes office in June, Lambert will be the first School of Medicine and Dentistry faculty member to chair LCME, a U.S. Department of Education-recognized accrediting body jointly sponsored by AAMC and the American Medical Association.
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IN MEMORIAM IN MEMORIAM
For the children with autism spectrum disorder and their families, early and accurate detection is key to improving quality of life. University of Rochester neuroscience researchers work tirelessly to better understand the complexities of ASD in the quest to expand and improve interventions and therapies. This relentless Rochester optimism drove the breakthrough discovery of using auditory stimulus to detect signs of ASD in kids as young as age two. And the earlier the detection, the earlier the treatments, the greater the outcomes —for generations to come.
The Rochester Effect.
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For treatment ever better. EverBetter.Rochester.edu
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PHILANTHROPY Kera, Cindy, and Jim Panzetta in the Panzetta Family Imaging & Procedural Care Unit in Golisano Children’s Hospital.
Panzetta Gift Creates Two Endowed Funds Jim and Cindy Panzetta are leaving a legacy of helping children and their families in the Rochester community. Longtime supporters of Golisano Children’s Hospital, the Panzettas have made a large bequest gift to support pediatric fellowships and music therapy. The Panzetta Family Endowed Fund for Education and Training will help train the next generation of pediatric specialists. Golisano Children’s Hospital currently has 18 different pediatric fellowship programs, and approximately 45 percent of fellows
are eventually hired as full-time faculty members. Additionally, their gift will create the Panzetta Family Music Therapy Endowed Fund to enhance the Children’s Hospital program to integrate music therapists into children’s treatment plans, and help teach things like breathing techniques and muscle relaxation. Music therapists also provide a welcome distraction for inpatients. The Panzetta’s generous philanthropy includes the Panzetta Family Imaging and Procedural Care Unit—named in honor of their daughter, Kera—comprised of a procedure room, several pre- and postprocedure patient bays, a waiting room, a prominent nurse station, and the pediatric MRI room. In addition to their bequest, the Panzettas have established a generous University-managed charitable remainder unitrust which pays an income for life. As the University endowment grows, so does their income. They are members of the University’s Wilson Society, which recognizes individuals who are making a lasting impact with a planned gift.
Louis A. Goldstein Distinguished Professorship in Spinal Surgery
Richard Goldstein (MD ’70) has made a bequest gift to generously endow the Louis A. Goldstein Distinguished Professorship in Spinal Surgery in honor of his father, Louis A. Goldstein (MD ’32, Res ’37). Goldstein is a prominent internist from Boston. Beloved in the Boston area, he began his career in 1976 working at Massachusetts
Dr. Richard I. Burton and Margaret L. Burton Hand Endowment Richard I. Burton, MD (Res ’64) and his wife, Margaret, have made a significant commitment through their estate plans to establish the Dr. Richard I. Burton and Margaret L. Burton Hand Endowment. In the future, if the fund reaches $1.5 million, the Burtons prefer that the fund become a professorship in their names. Burton and his 50-plus years of service to URMC and the Department of Orthopaedics & Rehabilitation have been a catalyst for the transformation of musculoskeletal care in the region. The Burton Endowment will support the work of a fellow in hand surgery and cover costs such as research and biomechanic and lab supplies. Burton established the Hand Fellowship program at URMC in July 1976. “Dick and Peggy’s tremendous vision and generosity ensures that our graduates in orthopaedic and hand surgery are second 54
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to none in their preparation to treat those individuals in the next generation with injuries and disorders of the hand,” says Paul T. Rubery, MD, Marjorie Strong Wehle Professor in Orthopaedics and chair of the Department of Orthopaedics and Rehabilitation. “The Department is extraordinarily grateful to Dick and Peggy for this fantastic legacy.” “Changes in medicine and escalating costs create challenges to remain competitive and continue to attract recruits from throughout the country,” says Warren Hammert, MD, division chief, Hand and Wrist. “The generous support of Dr. and Mrs. Burton to establish a hand endowment will help support research and educational initiatives that are essential to our mission.” During Burton’s 12-year tenure as chair of the Department of Orthopaedics and Rehabilitation, he developed the vision for a
multidisciplinary research center focusing on orthopaedic conditions. He is credited with building the department into one of the country’s top five orthopaedic research programs in National Institutes of Health
General Hospital and Spaulding Rehabilitation Hospital. In 1981, Goldstein began a 15-year tenure at New England Deaconess Hospital serving as an associate in medicine, a physician, and as medical director. In 1996, he accepted the medical director position in the Transitional Care Unit at Beth Israel Deaconess Hospital. As a medical consultant for the German consulate in Boston, Goldstein worked with Nazi concentration camp survivors to document their symptoms of post-traumatic stress syndrome so they could receive additional medical support and restitution. He has been a member of several organizations including the American Economic Association, the American Society of Internal Medicine, and the American Federation for Clinical Research. Goldstein also funded the Mildred Messinger Goldstein Fund, in honor of his mother, to provide support to the Eastman Community Music School. Louis Goldstein led the Division of Orthopaedic Surgery from 1969 to 1974 and became professor emeritus of Orthopaedic Surgery in 1986. He was a pioneer in the understanding of spinal deformities and orthopaedic surgery.
funding. His breakthrough surgery for a common type of arthritis of the thumb, known internationally as the “Burton procedure,” is recognized as the gold standard therapy for this condition and is taught to orthopaedic surgeons throughout the world. As a result of his expertise, some of Burton’s patients have included prominent national leaders. He is currently the special advisor to the senior associate dean for academic affairs for the School of Medicine and Dentistry. Margaret Burton has been a true partner every step of the way. She is scientist in her own right, working as a research chemist at Polaroid and then for two years at the University of Rochester. If you would like to make a gift or learn more, please visit uofr.us/burton or contact Dianne Moll at 585-273-5506 or dianne.moll@ rochester.edu.
Sands Family, Constellation Brands Provide $4 Million Lead Gift for ICU at F.F. Thompson
The new Constellation-Sands Intensive Care Unit at F.F. Thompson Hospital will be completed in 2020.
The Sands family and Constellation Brands are pledging a generous lead gift of $4 million to build a new $11 million Intensive Care Unit (ICU) at F.F. Thompson Hospital in Canandaigua, N.Y. In recognition of this commitment, the new unit will be named the Constellation-Sands Intensive Care Unit. F.F. Thompson Hospital is part of UR Medicine Thompson Health. The 8,600-square-foot ICU will increase the number of beds to 12 and will be staffed by full-time intensivists—physicians who are specially trained in the care and management of critical care patients. When completed in 2020, Thompson Hospital will be able to care for an estimated 250 to 330 additional patients per year in its new ICU, which will significantly reduce the need to transfer patients to Rochester due to limited capacity. Patient rooms will have ample space for advanced monitoring equipment and bedside visits from loved ones. “Our ability to care for more ICU patients locally will ease the tremendous burden placed on families, while at the same time decrease the overall cost of care regionally,” says Michael F. Stapleton, Jr., Thompson Health president and CEO. “We are delighted to be able to contribute to Thompson’s future growth while helping to fund a crucial regional medical resource,” says Rob Sands, CEO of Constellation Brands. “Our Constellation employees and the Sands family recognize that a healthy community is the foundation for success.” For more information or to make a gift, contact the F.F. Thompson Foundation at foundation@thompsonhealth.org or 585-396-6155.
Thompson Hospital will be able to care for an estimated 250 to 330 additional patients per year in its new ICU.
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IN MEMORIAM IN MEMORIAM
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Tristram Smith, PhD
Robert G. Newman (’62 MD)
Tristram Smith, PhD, whose research on behavioral interventions changed the landscape of care for children with autism spectrum disorders (ASD), died after suffering a heart attack on August 6, 2018. He was 57. At the time of his death, Smith was serving as the Haggerty-Friedman Professor in Developmental/Behavioral Pediatric Research at URMC, where he had worked since joining faculty in 2000. His research in the late 1980s and early 1990s, conducted alongside the late O. Ivar Lovaas, PhD, showed that many children with ASD could be successfully treated with behavior-based interventions, which allowed some to catch up to their peers in school. The work helped move treatment of children with ASD away from psychotherapy—which had been used with nominal effectiveness for decades—and toward applied-behavior based models. The sea change in treatment paved the way for ASD screenings in schools and pediatricians’ offices and led to numerous additional studies on behavior-based interventions. In the wake of the deluge of clinical studies that followed his early work, Smith examined the comparative effectiveness of the various emerging treatments. A prolific researcher, he published hundreds of papers on ASD, and spent his spare time pushing for policy changes that would allow effective treatments to become available to more patients. More recently, Smith demonstrated that clinical training programs for parents and caregivers could translate to tremendous behavior gains for the child, which spawned another wave of research, along with national and international efforts to implement clinical programs. Colleagues remembered him as a gentle, compassionate man who shied away from the spotlight, always preferring to showcase his partners and collaborators. “Perhaps it is a bit old-fashioned to say, but he was the epitome of a dying breed—a true gentleman,” says John Foxe, PhD, chair of the Department of Neuroscience at URMC. “Working shoulderto-shoulder with him to build the University of Rochester’s clinical research program in autism and other intellectual and developmental disabilities was one of the great honors of my career.” “He could say in 30 words what would take the rest of us a lifetime,” says Susan Hyman, MD, chief of the Division of Developmental and Behavioral Pediatrics at URMC. “He may have been unassuming, but when he spoke, everyone would listen. I can’t begin to tell you what a loss this is for all of us.” Smith earned his doctorate in clinical psychology at the University of California, Los Angeles (UCLA). He worked at Washington State University, Drake University, and UCLA prior to his time in Rochester. He is survived by his wife, Jennifer Katz; children, Jonah Smith and Madeleine Katz; sisters, Lisa Smith Trollbäck and Rebecca Smith Waddell; nieces and nephews.
Robert G. Newman (’62 MD), best known for championing methadone as a safe treatment for opioid use disorder and his work to define addiction as a chronic medical condition, died on Aug. 1, 2018 in Manhattan. He was 80. Newman’s commitment to treating addiction and advocating for public health were cornerstones of his career. He served as president of the Beth Israel Medical Center and as an assistant health commissioner for New York City. Newman is also credited with opening an AIDS outpatient clinic and was an early proponent of needle exchanges for injecting drug users to help stem the tide of new HIV infections. In addition to the AIDS clinic, Newman set up a clinic for gay women and another that offered care to Japanese patients. Newman was a dedicated ambassador for the University of Rochester. In 1994, he joined Rochester’s Board of Trustees and served on the academic affairs, health affairs, and financial planning committees. Recognized around the world as a leader in addiction treatment, in 2012, Newman was awarded the EUROPAD Chimera Award by the European Opiate Addiction Treatment Association, which recognizes those most committed to “realizing their dream of helping drug addicts.” At the time, he was only the second non-European to be a recipient. During his time as an assistant health commissioner, Newman was particularly focused on the growing opioid addiction epidemic and destigmatizing those who fell victim to it. He predicted that the widespread abuse of opioids would have two lasting effects: patients suffering from chronic pain would find it difficult to receive optimal treatment, and that people who do not fit the typical mold of a drug-abuser would be recognized as patients who need help. Early in his career, Newman’s efforts to promote methadone for addiction treatment were controversial. At the time it was illegal in many New York jurisdictions to prescribe methadone as treatment. However, his methods were eventually supported and he was tapped by Mayor John Lindsay to expand New York City’s addiction treatment program. Born on Oct. 26, 1937, in the Netherlands, Newman fled Europe in 1939 with his parents Rudolph Newman and Eva Feilchenfeld Newman. He was raised in the New York metropolitan area, where he spent much of his life. Newman also lived for a while in Frankfurt, Germany. Newman attended New York University, where he earned a bachelor’s degree in 1958. In 1962 he received his medical degree from the URSMD, followed by a master’s in public health from the University of California, Berkeley. Newman was a professor of epidemiology and population health, and of psychiatry and behavioral sciences at the Albert Einstein College of Medicine in the Bronx, where he taught from 1994 to 2012. Newman is survived by his wife, Seiko Kusuba Newman, whom he met while serving in Japan as an Air Force surgeon; their daughter, Hana Newman; three grandchildren; his son, Seiji, and his brothers, Thomas and Steven.
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Harold L. Brodell (’54 MD) Harold L. Brodell (’54 MD) passed away on May 22, 2018. Brodell was in private practice for 30 years and served as the president of the medical staff at Trumbull Memorial Hospital in Warren, Ohio from 1978 to 1980. Standing at seven members, the Brodell family is among the longest legacy families at the University of Rochester School of Medicine and Dentistry.
In Memoriam Word has reached us of the passing of the following alumni and friends. The School of Medicine and Dentistry expresses its sympathy to their loved ones. (From February 28, 2018 to August 16, 2018)
Ferdinand A. Bonan (Res ’53) Harold Louis Brodell (MD ’54) Donald Leroy Brown (Res ’60) Harold L. Bushey (MD ’54) John W. Colgan (MD ’46) Margaret (Thomson) Colgan (MD ’53) William Connick (Flw ’98) Robert C. Dale (Flw ’78) Edwin Ned Freeman (Res ’60) Charles Morton Gluck (Res ’64) Ivan Merle Grotenhuis (MS ’59) Madeline Goldstein Haft (BA ’50, MS ’57) Larry Wayne Hill (MS ’56) Eleanor Nicholson Humphrey (BA ’37, MD ’41) Stephen Joshua Kunitz (MD ’64) Bernard Levinson (MD ’52) Sinclair Ross Mackay (Res ’62) Richard V. McCloskey (MS ’60, MD ’60 ) George J. Meyer (MD ’52) Alvin N. Morris (MD ’47) Robert G. Newman (MD ’62) John A. O’Sullivan (Res ’73) Daniel Starr Pettee (Res ’63) Nicolas C. Russo (Res ’72) Leslie G. Taylor (MD ’59) Marenes R. Tripp (MS ’56) Theodore F. Vanzandt (BS ’46, MD ’49) Gary W. Wahl (Res ’82, Flw ’85)
The Brodell family has one of the longest legacies at the University of Rochester School of Medicine and Dentistry.
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Rochester guests attended the Nobel festivities at Strickland’s invitation. From left, Scott Carney, director of the Institute of Optics; University President Richard Feldman; Strickland; and Michael Campbell, director of the Laboratory for Laser Energetics.
Rochester Represents at Nobel Prize Ceremony by Lindsey Valich
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Photo: University of Waterloo
The groundbreaking work of three scholars with ties to the University of Rochester took center stage when pioneering laser scientist Donna Strickland ’89 (PhD) and her Rochester advisor Gerard Mourou formally received the Nobel Prize in Physics, and Paul Romer, whose early career tenure-track appointment was in Rochester’s Department of Economics, received the Nobel Prize in Economic Sciences. Strickland, who is now an associate professor of physics and astronomy at the University of Waterloo in Ontario, Canada, and Mourou, now a professor at the École Polytechnique in France, are being recognized for their Rochester work to develop “chirped-pulse amplification,” a technology that harnesses the power of lasers as precision tools and helped pave the way for laser-eye surgery, the machining of key parts for cell phones and other devices, tools for cancer treatment, and other clinical and commercial applications. The technology was the basis for Strickland’s 1988 doctoral dissertation at Rochester, where she was a graduate student working with Morou at the University’s Laboratory for Laser Energetics. They both receive a share of the Nobel Prize in Physics. Romer, who was an assistant professor in the Department of Economics from 1982 to 1988 shortly after receiving his PhD from the University of Chicago, will be awarded the Nobel Prize for his work to assess the interaction of technology, productivity, and economic growth. He shares the prize with economist William Nordhaus of Yale University.
A message from our Alumni Council President Greetings, Alumni! On behalf of the University of Rochester School of Medicine and Dentistry Alumni Council, I am thrilled to have this opportunity to connect with you through Rochester Medicine. The Council has continued to evolve under phenomenal leadership, and it is our intention to leverage the accomplishments of years past, while driving the Council forward in new and exciting directions. In this forum, we look forward to bringing you valuable content and stimulating robust discussion within our alumni community. What should you expect from the Council in the coming year? We have developed a new strategic plan, built on the pillars of growth, engagement, and communication. The SMD Alumni Council is committed to serving the alumni community, supporting Alumni Relations and Advancement, and inspiring the current student population. In order to achieve the lofty goals we’ve set for the coming years, we are relying on our alumni base to get involved! We welcome your input on programming ideas, and encourage you to engage with current students as mentors and networking resources. We also hope to provide the support you seek, as alumni, to foster your own personal and professional development. In coordination with the University-wide Project 10,000, we will work to Go, Give, Help, and Connect in an effort to strengthen and grow our alumni community. Starting with the revamp of our strategic plan above to a refresh to our Council committees, the team has a number of new programs set to roll out in the coming year. From this new “President’s Page” here in Rochester Medicine, to development of a new Council newsletter that will target current students and new alumni, to a partnership with the Meliora Collective to help onboard alumni into the University’s innovative webportal, the Communication Committee, chaired by Jill Weimer ’97, ’05M (PhD) has a lot of exciting new programs in the
works. The Bridge Committee, spearheaded by Michael Schneider ’73, ’77M (MD), has set priorities this year to enhance the Student Ambassador Program as well as the HOST Program, which is focused on connecting alumni with students during job search the interview process. Moreover, the committee will be working closely with admissions in our proposed Always Connected Program, with a goal of leveraging our alumni’s unique perspectives and experiences to help recruit the best candidates. Lastly, the Awards Committee, chaired by James Brodell ’83M (Res) will continue to spearhead the recognition of our esteemed alumni, and work with the communications team to prepare alumni spotlights for the soon to be launched alumni newsletter. Moving forward, our plan is to use this forum to discuss matters that are important to you from the perspective of the Alumni Council. In the coming issues, key areas that we plan to focus on include; highlighting innovation and discovery from our alums, ways that the university and council are working to promote diversity and communication, how alumni can help advocate for investments and resources, and how you can help support education and networking efforts within your region. If you are interested in contributing to the mission of the Alumni Council, want to become involved with our efforts, or have ideas of items you would like to see us address, we encourage you to reach out! All the best,
Jennifer L. Stripay ’14M (MS), ’16M (PhD )
President, UR SMD Alumni Council
Additional Information:
https://www.urmc.rochester.edu/smd/alumni/alumni-council.aspx https://thecollective.rochester.edu
Contact Information:
Dr. Jennifer L. Stripay: jennifer.stripay@gmail.com Jolie Spiers: jolie.spiers@rochester.edu
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CLASS NOTES If you see any alumni whom you would like to contact, use the Online Directory at www.alumniconnections.com/URMC to find address information. Submit class notes to your class agent or to RochesterMedicineMagazine@ urmc.rochester.edu. Note: MD alumni are listed alphabetically by class. Resident and fellow alumni follow in alphabetical order, and graduate alumni are listed separately in alphabetical order.
MD Alumni 1962
1976
1982
1979
Robert A. Wood was named 201819 president of the American Academy of Allergy, Asthma & Immunology (AAAI) on March 5, 2018. Wood is a professor of Pediatrics at the Johns Hopkins School of Medicine and professor of International Health at the Johns Hopkins Bloomberg School of Public Health. Established in 1943, AAAI has nearly 7,000 members and represents allergists, asthma specialists, clinical immunologists and others with a special interest in the research and treatment of allergic and immunologic diseases.
Timothy E. Quill (Res ’79) was honored with a Lifetime Achievement Award from the Academy of Hospice and Palliative Medicine at its annual assembly in March 2018. Quill was founding director of URMC’s Palliative Care Program. A professor of Medicine, Psychiatry, Medical Humanities and Nursing, he currently serves as acting director of URMC’s Paul M. Schyve, MD Center for Bioethics. See full story on page 48.
James D. Potter retired from his career in family medicine and substance abuse treatment in Peterborough, N.H. Potter started his own practice there in 1982, often being on call around-the-clock, and picking up shifts in Monadnock Community Hospital’s ED and ICU. Potter became medical director at Beech Hill Hospital, a substance-abuse treatment center in Dublin, N.H., in 1986, where he served for 10 years before returning to primary care at Jaffrey Family Medicine.
1980
G. Allen Power, Jr. (’76) (Res ’83) was featured in a Forbes article, “Protecting People with Dementia from Harm,” the fourth in a series examining improving the quality of life for those living with dementia. Power is a clinical associate professor of Medicine at URMSD and an international educator on transformational models of care for older adults, especially those with changing cognitive abilities. Ernest A. Bates was appointed to the board of directors of Apollo Medical Holdings, Inc. Board certified in neurosurgery, Bates founded American Shared Hospital Services, a publically traded health care company that leases state-of-the-art medical equipment to hospitals across the U.S. and abroad. Apollo is a leading physician-centric integrated population health management company, which provides coordinated, outcomesbased high-quality medical care for patients, particularly senior patients and patients with multiple chronic conditions, in a cost-effective manner.
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1981
David B. Nash was elected to the board of directors at ANI Pharmaceuticals, Inc. Nash is founding dean of the Jefferson College of Population Health at Thomas Jefferson University in Philadelphia, Pa. He serves on the boards of Humana, Inc., and InfoMC. Nationally recognized for his work in outcomes management, medical staff development, and quality-ofcare improvement, Nash also has a BA in economics from Vassar College and an MBA in health administration from the Wharton School at the University of Pennsylvania.
Kathy Chrismer (Res ’84) joined Reliant Medical Group’s Department of Pediatrics in Worcester, Mass. Certified by the American Board of Pediatrics, Chrismer sees patients at a new Reliant office in Holden, Mass.
1983
Jeff Harp (Res ’86) appeared on Rochester’s CBS affiliate WROC-TV’s News 8 at Sunrise to discuss relief options for people who suffer from acute lower back pain. In addition to his role as residency director at Highland Family Medicine, Harp holds parttime professorships in the departments of Family Medicine and Psychiatry at URSMD.
1987
Jeffrey J. Bazarian (Res ’90, MPH ’02) was lead author on a study that led to creation of the Banyan Brain Trauma Indicator ®, the first U.S. blood test that helps determine if people who have suffered a blow to the head could have a traumatic brain injury, such as brain bleeding or bruising. The study, published in The Lancet Neurology, included close to 2,000 individuals presenting with a head injury at 22 emergency departments in the U.S. and Europe. Bazarian is a professor of Emergency Medicine at URMC and has researched concussions and traumatic brain injuries for more than 20 years. See full story on page 10.
1990
Robert C. Babkowski (’86) (Res ’95) was named to iSpecimen’s Advisory Board, counseling the company quarterly in its mission of supplying biomedical researchers with the specimens they need. Babkowski is chair of Pathology at Stamford Hospital in Stamford, Conn., and founded the Stamford Pathology Group PC. Headquartered in Lexington, Mass., iSpecimen is a privately held company that connects health care organizations that have access to patients and specimens with the scientists who need them.
1991
Michael Vilardo was named chief of ophthalmology services at the Veterans Affairs Medical Center of Western New York. He served as an assistant professor at URMC since 1998.
1993
Meeru Sathi-Welsch (’89) was named a 2018 Top Doctor in East Patchogue, N.Y, an award that honors health care practitioners who have demonstrated clinical excellence while delivering the highest standards of patient care. Sathi-Welsch is certified by the American Board of Anesthesiology in both Anesthesiology and Pain Medicine, and also serves as a clinical assistant professor at New York’s Weill-Cornell Medical College.
1996
John Markman was elected to the Board of Directors for the American Pain Society. A professor of neurosurgery and neurology at
URSMD, he directs the Neuromedicine Pain Management Center and the Translational Pain Management Program. Based in Chicago, the American Pain Society is a multidisciplinary community that brings together a diverse group of scientists, clinicians and other professionals to increase the knowledge of pain and transform public policy and clinical practice to reduce painrelated suffering.
2003
Jeff Clark was named chief licensing officer for Enzychem Lifesciences Corp. Founded in 1999, Enzychem is a global new drug development biopharmaceutical company headquartered in Seoul, South Korea. Also a patent attorney, Clark previously worked at the global law firm DLA Piper LLP, where he counseled life science and biotech companies in all aspects of patent law. He was a clinical fellow in the Cardiovascular Research Center and Department of Cardiology at Massachusetts General Hospital, as well as in the Molecular and Vascular Medicine, Renal Unit, at Beth Israel Deaconess Medical Center in Boston.
2013
Eric Hansen (’08) was recently named assistant professor in the Department of Medicine at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences. A palliative care physician at Roswell Park Comprehensive Cancer Center, he did his residency training in internal medicine at McGaw Medical Center of Northwestern University, and completed his fellowship training in palliative care at Johns Hopkins Hospital.
Resident & Fellow Alumni
2004
Erin Denney-Koelsch (Res ’08, Flw ’10) received the 2018 Hastings Center CunniffDixon Physician Award, a national award for physicians who care for people at the end of life. She is an assistant professor of medicine in the Division of Palliative Care at URMC, which has the distinction of being the only organization represented twice in the history of the Cunniff-Dixon Physician Award. (David Korones, Flw ’91, won in 2015.) See full story on page 42.
2011
Amy Potter appeared on Rochester’s CBS affiliate WROC-TV in May 2018 to discuss summer skin safety tips. Potter currently works at Highland Family Medicine and is a senior instructor in the Department of Family Medicine at the University of Rochester School of Medicine and Dentistry.
Seymour I. Schwartz (Res ’57) received the Eastman Medal at the University of Rochester 2018 commencement ceremonies in May. The medal recognizes outstanding achievement and dedicated service in honor of the University’s great benefactor and founder of Eastman Kodak Company, George Eastman. Schwartz is the Distinguished Alumni Professor of Surgery at URSMD. His career spans seven decades, including serving as chair of the Department of Surgery and surgeon-in-chief of Strong Memorial Hospital from 1987 to 1998. His Principles of Surgery, in its 10th edition, is one of the main textbooks for medical students and junior surgical residents.
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CLASS NOTES Cynthia Angel (Res ’85) was honored by Highland Hospital as its Physician of the Year. She is a gynecologic oncologist at the hospital and professor of Obstetrics and Gynecology at URSMD. She was nominated for the award by hospital administrators, colleagues and co-workers for her excellence in health care over her close to 30-year career.
Elizabeth R. McAnarney (Res ’70) is the first woman to receive the honor of Distinguished University Professor from the University of Rochester, the school’s highest faculty honor. McAnarney is a professor and chair emerita of the Department of Pediatrics at URMC, and served as pediatrician-in-chief at Golisano Children’s Hospital from 1993 to 2006. She has worked tirelessly to improve patient outcomes and change doctors’ approach to the care of pregnant teens and their babies. See full story on page 46. Gloria J. Baciewicz (’74) (Res ’82), New York state’s only nominee, was presented with the Nyswander/Dole “Marie” Award by the American Association for the Treatment of Opioid Dependence, the preeminent recognition in the field of opioid treatment. Baciewicz serves as a professor of Clinical Psychiatry at URMC and medical director at Strong Recovery. She is board certified in psychiatry, addiction psychiatry and addiction medicine, and has worked in the field of opioid treatment for nearly 30 years. See full story on page 49.
Jeff Harp (MD ’83, Res ’86) See MD Class of 1983 Lisa Beck (Res ’87) received the Achievement Award in Autoimmune and Inflammatory Skin Disorders from the American Skin Association at the Society for Investigative Dermatology annual meeting in May 2018. Beck holds a Dean’s Professorship in the Department of Dermatology at URSMD. Her current research includes an NIH-funded study to determine why certain patients are susceptible to the herpes simplex and staphylococcus aureus viruses. Beck has 20 years of experience studying and treating atopic dermatitis and eczema. Ronald Epstein (Res ’87) was featured in an ABC News article examining whether or not individuals who see the same doctor over time live longer lives. The review, a collaboration between the U.K. University of Exeter Medical School and St. Leonard’s Practice in Exeter, analyzed 22 smaller studies from nine different countries. It found that about 81 percent of the studies reviewed showed a statistically significant reduction in mortality associated with people who saw the same doctor over a long period of time. Epstein is a professor of Family Medicine, Psychiatry, Oncology and Medicine at URSMD.
G. Allen Power, Jr. (MD ’80, Res ’83) See MD Class of 1980
Jeffrey J. Bazarian (MD ’87, Res ’90, MPH ’02) See MD Class of 1987
Kathy Chrismer (MD ‘82, Res ‘84) See MD Class of 1982
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Betty Rabinowitz (Res ’90, Flw ’92) assumed the role of chief medical officer at NextGen Healthcare, bringing her extensive clinical background and expertise in population health to the company’s leadership team. Rabinowitz was a founder and former CEO of EagleDream Health, the cloud-based analytics and population health management solution now known as NextGen Population Health. The platform drives insights across clinical, financial and administrative data to optimize ambulatory practice performance. Rabinowitz previously served as professor of Clinical Medicine and medical director of URMC’s Center for Primary Care. Robert C. Babkowski (MD ’90, Res ’95) See MD Class of 1990 Mark Fox (Res ’01, MPH ’05), was appointed deputy health officer for the St. Joseph County Health Department in South Bend, Ind. The newly created leadership position supports the department’s plan for targeting the area’s problem with lead-poisoned children. According to the release of state data in 2016, neighborhoods on South Bend’s northwest side had some of the highest rates of lead-poisoned children in the state. Fox also sits on the county’s Board of Health and is director and associate dean of the Indiana University School of Medicine’s South Bend campus. Ngoc Thai (Res ’02) was named chair of the Department of Surgery for Allegheny Health Network (AHN), overseeing surgical services provided by AHN’s eight hospitals and 22 outpatient centers across western Pennsylvania. He also serves as the director of the Center for Abdominal Transplantation at Allegheny General Hospital. Thai is certified by the American Board of Surgery and is a member of the American Society of Transplant Surgeons, the Center for Organ Recovery & Education, and the Transplant Recipient International Organization.
Matthew Osborne (Res ’07) was named medical director of the Emergency Department at UR Medicine Thompson Hospital in Canandaigua, N.Y. Osborne served as an attending physician in the department since 2009 and was a flight surgeon and lieutenant commander in the U.S. Navy. He received his MD from Georgetown University before completing a three-year Emergency Medicine residency at UR Medicine’s Strong Memorial Hospital. Erin Denney-Koelsch (MD ’04, Res ’08, Flw ’10) See MD Class of 2004 Eugene Palchik (Res ’08) joined St. Joseph’s Health in Syracuse, N.Y. as a vascular surgeon. He previously held a similar position with Vascular & Endovascular Associates of New Jersey. Palchik holds registered physician in vascular interpretation (RPVI) certification from the Alliance for Physician Certification and Advancement. Fahad Saeed (Flw ’16) was lead author on a URMC study that found that men with advanced cancer are 30 percent less likely than women to consider palliative care. Researchers believe the findings reflect social norms about gender roles with men often seeing themselves as the family protector, and in their desire to be cast as a “fighter” may view palliative care as giving up. Saeed is a palliative care specialist and assistant professor of Medicine and Public Health Sciences at URMC. The study was published in the Journal of Pain and Symptom Management.
PhD Alumni Paul Coleman (PhD ’53) was appointed to Neurotype, Inc.’s Scientific Advisory Board. Coleman is an associate at the University of Arizona McKnight Brain Institute and a research professor at Arizona State University’s Biodesign Institute. He was named professor emeritus in Psychology at URMC in 2007. He also served as editorin-chief and is currently editor emeritus for the Journal of Neurobiology and Aging. Michael Zuscik (MS ’89, PhD ’93) was featured in a Forbes article examining how some bacteria living in the intestines might be responsible for causing arthritis in obese persons. Along with University of Rochester research partners, Robert Mooney, PhD, and Steen Gill, PhD, Zuscik found that, not only did the fat diet make the mice obese and diabetic, there were also changes in their gut microbiomes that correlated with signs of gross systemic inflammation, specifically in their knees, where the researchers triggered osteoarthritis by a meniscal tear that is known to cause osteoarthritis. Zuscik also discussed the research on CBC Radio. See full story on page 12.
Jennifer Mathews (MS ’05, PhD ’07) was named associate dean for the Albany College of Pharmacy and Health Sciences Vermont Campus. Opened in 2009, the campus remains the only Doctor of Pharmacy program in Vermont. Mathews previously served as an associate dean at Stony Brook University School of Pharmacy and Pharmaceutical Sciences, and associate professor in the Department of Pharmaceutical Sciences in the Wegmans School of Pharmacy at St. John Fisher College in Rochester. Anita Peoples (MS ’08, PhD ’12, MPH ’16) received the Pain and Symptom Management Special Merit Award from the National Comprehensive Cancer Network, authoring the highest ranked abstract in pain management research, “Effect of pretreatment sleep disturbance on radiation therapy-induced pain in 676 women with breast cancer (Abstract 10100).” She is a research assistant professor in the Department of Surgery at URMC.
Graduate Aumni
Jeffrey J. Bazarian (MD ’87, Res ’90, MPH ’02) See MD Class of 1987 Mark Fox, MD (Res ’01, MPH ’05) See Resident & Fellow Alumni Anita Peoples (MS ’08, PhD ’12, MPH ’16) See PhD Alumni
1ST IN WNY
UR MEDICINE UNVEILED UPSTATE NEW YORK’S FIRST MOBILE STROKE UNIT, A HIGH-TECH ‘EMERGENCY ROOM ON WHEELS’ THAT IS DESIGNED TO PROVIDE LIFE-SAVING CARE TO STROKE VICTIMS.
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Cover Story: Keep Moving: UR Orthopaedics & Rehabilitation continued from page 25 The orthopaedics campus will build on that success, and in the tradition of the department’s commitment to “Meliora,” it will set aggressive goals for the facility. “As we envision a new campus, we are building not just more space, but a place that fully integrates clinical teams, researchers, educators, residents, and fellows in one setting to foster greater collaboration that will yield advances in clinical quality, scientific exploration, and physician training,” Rubery says.
A Look Ahead The new campus will mean more clinical space to address the projected increases in patient volumes. An Orthopaedic enterprise that grew from four clinic rooms in Strong Memorial Hospital in 1974 to 133 today will need still more space to cover current and future patient demands. While Orthopaedics will continue to have outpatient sites throughout the Rochester region, the campus will centralize core services in one site. As Rubery explains, Phase I is projected to be complete in three years and will include 350,000 square feet of new space, primarily dedicated to clinical modules for outpatient care, Orthopaedic urgent care, and ambulatory surgery. The site will also house the Center for Human Athleticism and Musculoskeletal Performance and Prevention (CHAMPP), with facilities and equipment for video-enabled motion capture/
analysis, a cardiovascular lab, an aquatic center, and classrooms focused on wellness and performance training. CHAMPP will be headquarters for UR Fitness Science, a strategic approach to helping large populations of patients reverse the negative trends of obesity, inactivity, and preventable injury. Led by Sports Medicine Division Chief Mike Maloney, MD, CHAMPP will be a multidisciplinary center for proactive health care—combining Sports Medicine clinical teams, athletic performance training, physical therapy and rehabilitation, nutrition, and behavioral health. Phase II will expand the new site to accommodate innovative clinical, research, and education programs, which will add another 250,000 square feet over the next 10 years. This phase of the build will add space for residency and staff training, including an auditorium, an education center, a skills lab, and a mechanical testing space. CMSR will retain its lab space at the Medical Center but will have additional space at the campus for clinical trials, bone density testing, and motion analysis. Phase II also will include administrative space for physician offices, as well as accommodations for residents and fellows, billing, schedulers, and conference space. Plans are subject to approval by the Board of Trustees in early 2019. Taubman says the campus will be a place where researchers, clinical care teams, and patients can share a productive setting to accelerate
the department’s work on developing new approaches to care and new cures. “As we invest in new facilities, we are building spaces that promote multidisciplinary, multi-departmental collaboration between clinical staff, researchers, learners, administrative and IT staff, and patients themselves,” Taubman notes. “With this new project, we envision a facility that provides patients battling mobility problems with convenient access to all of the services and technologies they may require throughout their care. And while CMSR will retain its facilities in the Medical Center, the new facility will integrate research activity on-site with clinical care delivery.” As it looks forward to the next steps in its growth and evolution, the Department of Orthopaedics carries on a tradition of innovation. And it understands its role in answering some of the most pressing health problems our nation faces. “Some of the most groundbreaking treatments for Orthopaedic conditions that physicians around the world use today got their start here,” Rubery says. “As we move forward, we’ll be guided by the principles of biopsychosocial medicine that imbues our thinking at URMC. And today’s innovators, like the pioneers that came before them, will redefine what orthopaedics means to an individual’s well-being, and what our specialty can contribute to the nation’s health care delivery.”
Demand for UR Medicine
350,000
Orthopaedics services continues to rise
300,000
dramatically, driving 250,000
the need for expanded UR Medicine Orthopaedics Projected Visits
200,000
outpatient clinic, and rehabilitation space to
150,000 13 14 15 16 17 18 19 20 21 22 FISCAL YEAR
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operating room,
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meet expected needs.
A Gift of Gratitude The School of Medicine and Dentistry’s Toxicology program was in its infancy in the 1960s when Drs. Judith and James MacGregor ’71M (PhD) met as graduate students. It has now earned an international reputation as a center of excellence for the education of those who ensure the safety of drugs and chemicals. “We feel like part of the family that helped develop our field, and are indebted to the University for our full and wonderful careers,” they said. When planning their estate, the MacGregors expressed their gratitude to Rochester by funding a flip charitable remainder unitrust using a secondary property. They enjoyed an income tax deduction, paid no capital gains tax on the property sale, and receive five percent variable income for life as managed in the University’s long-term investment pool. The MacGregors established the Toxicology Student Professional Development Fund that provides annual support for conferences, retreats, and other learning experiences for students. Their planned gift will endow this fund and ensure that support will continue in perpetuity. “This gift was a way to ensure that future students have the same opportunities we did,” said James and Judith, who are Founding Members of the Wilson Society and contributing members of the George Eastman Circle.
I m ag I n e yo u r l e g ac y. P l a n to d ay to m a k e I t h a P P e n .
To learn more about charitable remainder trusts and other planned giving methods, contact the Office of Trusts, Estates & Gift Planning (800) 635-4672 • (585) 275-8894 giftplanning@rochester.edu • www.rochester.giftplans.org
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University of Rochester School of Medicine and Dentistry 601 Elmwood Avenue, Box 643 Rochester, NY 14642
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SAVE THE DATE
WHIPPLE SOCIETY 48th ANNUAL GEORGE H.
DINNER AND AWARDS PRESENTATION
The George Hoyt Whipple Society recognizes donors who support the School of Medicine and Dentistry with an annual gift of $1,500 or more. Gifts to the School of Medicine and Dentistry ensure young physicians and scientists receive an education that enables them to deliver Medicine of the Highest Order. The University of Rochester School of Medicine is deeply grateful for the leadership demonstrated by all of its donors for their generosity and dedication to educating future medical professionals in the Rochester tradition. Whipple Society members are honored at an annual dinner during Meliora Weekend. This year’s dinner will be held on Thursday, October 3, 2019.
UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY Thursday, October 3, 2019 Monroe Golf Club
For more information on joining the Whipple Society, contact the School of Medicine and Dentistry Office of Alumni Relations and Advancement at 1-800-333-4428 or alumni@admin.rochester.edu
