Research Matters - AdventHealth Research Institute...cardiac, cancer related or any combination....
Transcript of Research Matters - AdventHealth Research Institute...cardiac, cancer related or any combination....
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Research MattersJune 27, 2019
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WelcomeRob Herzog
VP Research Operations
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WelcomeValerie McDevitt
Director of Research Services
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Welcome Valerie McDevitt
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DevotionSteven Smith, M.D.
Chief Scientific Officer
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WholeMeUpdate
Steven Smith, M.D.Chief Scientific Officer
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WholeMe Soft Launch
Collaborative Team• Cancer-Clinical Trials
• Cancer-NCI
• Cardiovascular
• Center for Collaborative Research
• Children’s
• IRB
• Neuroscience
• OSP
• ResIS
• TRI
• Whole-Person Research
• AIT Service Delivery
• IT Support
By the Numbers
• Ambassadors • 24 Research Staff
• 5 ResIS Support
• 90 participants enrolled • 65 pre-scheduled
• 25 walk-ins
• 7 Stations • 38 minutes = Average enrollment
• 20 minutes = Fastest enrollment
• 1 hour, 16 minutes = Slowest enrollment
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Leadership Message
Kristin JimenezDuane Davis, M.D.
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InstitutesDuane Davis, MD – CMO
Kristin Jimenez – COO
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Agenda1. Defining Institutes
2. Market Dynamics
3. The Role of Research
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What is an Institute?
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Levels of Care Delivery
.
Service
A medical capability with a singular focus
Mammography
Program
Assembling a continuum of care to treat a
syndrome/disease built around certain
interdisciplinary services
Breast screening
Service line /
Center of
Excellence
Disease focused set of services required to
address health needs of patients with the
goal of achieving a multi-county audience
Comprehensive breast center
Cancer Institute
Institute
Fully developed comprehensive specialty focused network of care with a
regional or statewide audience with the following focus:
✓ Evidence-based practice
✓ Structured education (fellowships)
✓ Physician leadership
✓ Dedicated research governance
Less advanced / focused
More advanced / robust
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• Regional or Statewide Presence• Formalized Governance Structure• Cross-Continuum• Multiple Sub-Specialties• Top Quartile Performance & Accreditations• Research & Education• Dedicated Teams and Facilities
Institute Criteria
Service ProgramService
Line/CoEInstitute
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The SOAR ProcessS – Scientific
All research projects are reviewed by peer investigators and evaluated on clinical and scientific merit
Investigators present study at Research Review Forum
Project is open to discussion and questions
O – OperationalResearch Ops teams review all necessary aspects of the proposal to successfully execute the project
Particulars and yellow/red flags are discussed at RRF
A – AdministrativeResourcing, budget, and legal implications for the project are reviewed and discussed
R – ReviewScientific decisions are communicated through a letter to the Investigator
Project updates are provided at subsequent RRFs
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The NSI RRF Process
Investigator reaches to
research unit leader with study
proposal
Physician Scientists evaluate the study (Scientific Impact
Score)
(Prior to RRF Meeting)
Investigator presents study at
RRF Meeting
Meetings occur bi-monthly
Research Team
Reviews project for operational feasibility
Physician Facilitator
communicates decisions and
recommendations for the project
Investigator works with Research Department to onboard and execute the
project
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Market Dynamics
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A National Trend
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Summary of Trends
Demand for Lower Cost
Care
Diverse Competition
Demand for Excellence
Shifting Risk
• Shifting sites of care e.g. ASC• Remote Monitoring• Elimination of waste• Payor/Network Steerage for quality
and cost outcomes• Tech enabling shift in care sites
• Telemedicine• Minimally invasive
• Prevention and Wellness• Integrative Medicine• Episodic – Continuum Shifts• Distribution & Focus Factories
• Joint Ventures & Partnerships• Mega Groups, VC & Consolidations• Nimble micro-competitors• Clinically Integrated Networks &
ACOs
• Increased transparency: outcomes & cost
• Shift from practices to programs• Designations & Certifications• Training & Research• Breakthrough Innovations
MUST: Drive Quality & Grow Physician Leadership
MUST: Connect Care & Improve Network Integrity
MUST: Redistribute Services & Enable Capital Deployment
MUST: Accelerate Pace & Increase Access
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Legislative Session 2019… What Happened?
Hospitals
• Deregulation of CON for general acute, rural, and long-term care.
• Hospitals will not be required to:
o Have an Emergency Department
o Accept Medicare or Medicaid
o Have a minimum # of beds
• Specialty hospitals remain prohibited for discharges that are 65% orthopedic, cardiac, cancer related or any combination.
ASCs
• Effective July 1, 2019
• Allows ASCs to keep patients overnight up to 24 hours.
• Authorizes the Agency to establish minimum standard for pediatric patients under the age of 18 years in an ASC.
Telehealth
• Defines telehealth and telehealth providers in Florida Statute.
• Outlines practice standards and reimbursement requirements for insurers and HMOs.
• Provides reimbursement options for out- of-state physician.
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What’s Next?
• Quick Turnaround
• Committees Meet – September 2019
• First Day of Session - January 14
• On tap• 72-hour Recovery Care Centers• 48-hour ASC• Birthing Centers• Telehealth 2.0 • Property Tax / Community Benefit
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A consumer-centric framework for
building Systems of Care around
specific conditions.
The Ecosystem Approach
Staffing
Supportive
Care
Wellness &
Prevention
Research &
Training
Quality
Improvement
Screening &
Diagnosis
Facilities &
Technology
Treatment
Comprehensive
MSK Ecosystem
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Addressing Gaps & The Role of Research
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2019 Cancer Priorities
Staffing
Supportive
Care / End
of Life
Wellness &
Prevention
Research &
Training
Quality
Improvement
Screening &
Diagnosis
Facilities &
Technology
Treatment
FH Comprehensive
Cancer
EcosystemGENITOURINARY
(Prostate, Kidney, Bladder)_______________________________________________
BREAST_______________________________________________
Complete the Product
• Recruit GU Med Onc Leader
• Phase One Launch Moffitt
Single Standard of Care
• Multi-Disciplinary Clinic
• Alt, Orl, Cele
• Survivorship Clinic
Build Comprehensive Program
• Recruit Med Onc Leader
• Recruit Surg Onc Leader
• Phase One Launch Moffitt
Single Standard of Care
• Recruit for community
deficit in care:
• Med Onc- Alt, WP
• Surg Onc- Cele, Orl
• Multi-Disciplinary Clinic
Expansion
• Orl, Cele
• High Risk and Genetics
Program
• Survivorship Clinic
MELANOMA/SARCOMA_______________________________________________
Develop Program
• Joint Recruitment for Med
Onc & Surg Onc Leader
• Development of Key Program
Elements and Deployment
Plan
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2019 Neuroscience Priorities
Staffing
Supportive
Care
Wellness &
Prevention
Research &
Training
Quality
Improvement
Screening &
Diagnosis
Facilities &
Technology
Treatment
FH Comprehensive
Neuroscience
Ecosystem
Spine
• One Model of Care
• Value Based Purchasing
• Population Health
Brain Health
• Recruitment of
subspecialists
underway
• Phase 1 location
opens April 2019
(Fairbanks)
Neuro Oncology
• MIBS Concierge
Sleep
• Ambulatory Pricing
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2019 DH & Surgery Priorities
Staffing
Supportive
Care
Wellness &
Prevention
Research &
Training
Quality
Improvement
Screening &
Diagnosis
Facilities &
Technology
Treatment
Digestive Health
& Surgery
NUTRITION/METABOLISM_______________________________________________________
• Expand Bariatric Program at
Orlando
• New physician – Summer 2019
• Support Services
• MBSAQIP Accreditation
• System vision
• Alignment of AdventHealth
medical group bariatrics
programs
• Collaboration – Network of Care,
Research, Quality, Supply Chain
• Healthy Hospital Initiative
• Full Continuum of Care
IBD______________________________________________________
• Expansion of Dedicated IBD
program and clinic
• New physician – Fall 2019
• Develop team based
approach
• Expand comprehensive
support services
• Increase clinical trials
STOMACH & ESOPHAGEAL________________________________________________
Integrated Esophageal
Center (IEC)
• Increase access to
specialty physicians
• Motility evaluation of lung
transplant population
• Align Programs
• GI Coordinator - one stop
care
• Add satellite clinics to
improve access
• Future one-year motility
fellowship
• New technologies –
EndoFLIP
LAUNCH DHSI GOVERNANCE
COMMITTEE
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2019 Cardiovascular Priorities
Staffing
Supportive
Care
Wellness
&
Prevention
Research &
Training
Quality
Improvement
Screening &
Diagnosis
Facilities &
Technolog
y
Treatment
FH Comprehensive
CVI Ecosystem
• Thoracic Surgery program
hybrid model with
Oncology
• Thoracic surgery program
design with surgical sites
at Altamonte, Celebration,
Winter Park and Apopka
/West Orange
• Aortic Surgery program
build a replacement for
Tom Martin and
sustainable destination
center
• ASC for appropriate site
of care for any thoracic
procedures
• Align or develop a high
quality pulmonary group
• ALD Leader for system
• Fully implement the ALD
Performa
• Expand Pulmonary Rehab
Pulmonary_______________________________________________
Thoracic and Aortic_______________________________________________
• ASC Strategy CV
• Fill all Cardiologist slots
• Programing for Health
Parks
• Partnerships to complete
our Gaps.
Ambulatory_______________________________________________
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Institutes 2020 – “Must Dos”
Cardiovascular Neuroscience Orthopedics Cancer Digestive & Surgical
✓ Surgical Platform & Acquisition
✓ Grow Ambulatory Network: ASCs, VCC
✓ Grow Subspecialty: Thoracic, Aortic & ALD
✓ Stabilize IP Neurology & Grow OP Access
✓ Celebration Comprehensive Stroke
✓ Deploy Brain Health & Destination MIBS
✓ Sports Medicine
✓ Physician Alignment & Culture
✓ Deploy Hand to Shoulder Center
✓ Launch Moffitt & NCI
✓ Expand Medical Oncology
✓ Grow Subspecialty Expertise & MDCs
✓ Grow Obesity and Bariatric Network
✓ Launch IBD Strategy
✓ Recruits & Colocation Clinics
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Q&AKristin Jimenez
Duane Davis, M.D.
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Wrap-UpRob Herzog
VP Research Operations
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AHRI Top Publications 2019
– Dr. Richard Pratley
– Dr. George Monir
– Drs. Bang, Arnoletti, Holt,Hasan, Naveneethan, Hawes,Varadarajulu, and Feranec
– Drs. Smith, Sparks, andParsons
– Dr. Richard Pratley
– Dr. Steven Smith
– Drs. Butt, Feranec,Sensakovic, Pepe,Siddiqui, Ward, and Burt
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Thank you for attending!