September 15, 2003

Signature Programs Integral To
Health Center Progress, Board Told

The concept is sound, a plan exists, there's institutional commitment and buy-in, and considerable progress.

Yet there remain challenges, and a lot of work to be done.

That was the assessment of the Health Center's Signature Programs given by Kevin Kelly, the programs' director, to the Health Center's Board of Directors during an update at the board's quarterly meeting September 8.

Kelly spoke about a trio of clinical initiatives designed to build a stronger Health Center by closely linking areas of research excellence with clinical excellence. The initiatives are: the Center for Cardiology and Cardiovascular Biology; the UConn Comprehensive Cancer Center; and the Bone Biology and Musculoskeletal Institute.

In a wide-ranging report, Kelly informed the board of the progress that has been made: two programs now have leaders - Dr. Bruce Liang is director of the cardiology program, and Dr. Carolyn Runowicz will join the cancer program as director in October - and the musculoskeletal program is on the verge of moving from "vision to operational reality," he said, with groundbreaking for a new building planned for later this fall.

Procedurally, Kelly said, performance standards are being decided, public-private partnerships providing flexible and innovative financial arrangements are being established, and a culture change - the evolution of the departmental system - is continuing at the Health Center.

Despite the budget troubles of the late 1990s, said Dr. Peter J. Deckers, executive vice president for health affairs, "the past four years have been a season of light, not a season of darkness."

The financial difficulties "caused us to mature our research strategic plan," Deckers said, "and on the basis of that we went from $40 million dollars in extramural research funding to over $100 million in extramural research funding today.

"We've eliminated redundancy in the hospital, we've sharpened up our clinical strategic plan, and we took a hospital that was losing money to the point where at the end of this fiscal year, the hospital made well over $1 million, the faculty practice made money, and the entire Health Center made about a quarter of a million dollars on a $508 million budget," he said.

The Signature Programs have contributed to that turnaround because they have helped focus, consolidate, and conserve resources. By not trying to be all things to all people, Deckers said, the Health Center has been able to concentrate on the things it can do well.

Kelly said the Signature Programs seek to combine basic research with clinical medicine, bringing science from the laboratory to the bedside. For example, in the Bone Biology and Musculoskeletal Institute, basic science researchers, such as bone biologists, will work with bio-mechanical engineers, bio-materials specialists and experts, orthopedic physicians, and rheumatologists to provide a range of services to patients.

Musculoskeletal clinical services will be delivered in the new building, the Medical Arts Research Building. Included in the new structure will be an ambulatory surgery center created in partnership with a private health care management firm, Health Systems International Inc.

The board heard about an example of the benefits of the Signature Programs approach that occurred when a clinician and a researcher got together to work on colorectal cancer. Dr. Joel Levine is a professor of medicine and a gastroenterologist with a large practice. Daniel Rosenberg, an associate professor, is a molecular researcher working with precancerous colon lesions in mice. The two are now collaborating, using Rosenberg's research with Levine's patients at a genetic level to predict the risks of colon cancer.

"The day is gone where clinicians work in isolation and where scientists only work separately from clinical problems," said Levine.

The main challenge to the Signature Programs, Kelly told the board, is financial uncertainty, caused by vagaries in government and insurance reimbursement rates, as well as federal and state budgeting constraints.

After discussion, the board suggested a more in-depth examination of Health Center and Signature Program budget and finances, and creation of a long-term financial plan designed to guide institution and program finances in an era when government sources of revenue are likely to be limited.