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State of the GMI 1 Lerner Research Institute 2007 Operations Report Welcome State of the GMI.

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Presentation on theme: "State of the GMI 1 Lerner Research Institute 2007 Operations Report Welcome State of the GMI."— Presentation transcript:

1 State of the GMI 1 Lerner Research Institute 2007 Operations Report Welcome State of the GMI

2 LRI STAR Award Winners Peter Balint Petra Platzer There were 31 nominations submitted for Of the 10 winners chosen, GMI had 2 STARs – we’re very proud! This program recognizes individuals who have taken special initiative to help others and enrich the workplace

3 State of the GMI 3 GMI Employee of the Quarter Winners This award program offers an opportunity for GMI members to recognize peers for their accomplishments and contributions to GMI and being a pillar of Teamwork, Quality, Service or Innovation. Christina Rigelsky Christina Rigelsky 3 rd Quarter, 2008 Nichole Prescott Nichole Prescott 4 th Quarter, 2008 Todd Romigh Todd Romigh 1 st Quarter, 2009

4 State of the GMI 4 State of the GMI 4 State of the Cleveland Clinic Highlights

5 State of the GMI 5 State of Cleveland Clinic Quality: patient experience (ie. medical, physical & emotional) Status Research funding (including NIH) up 6% in 2008; publications up 5% Building of a new, national Reference Lab Center by 105 th St. Partnerships with: Google and Microsoft for home monitoring CVS’s “Minute Clinics” for increased patient volume Increased media coverage, brand awareness & non-Ohio presence (CC Abu Dhabi, Sheik Khalifa Medical Center, and Lou Ruvo Center for Brain Health) Status Increased accuracy in medical care (EMR) and pharmacy data entry (CPOE) Increased compliance and decreased delinquent medical records Improved patient access with new facilities Decreased complaints and increased patient satisfaction scores (above national average, but there is more work ahead) Innovation:

6 State of the GMI 6 Contributors to Premature Mortality Behavior Genetics Social Medical Access Environmental D.M. Cosgrove, MD, State of the Clinic, 2008 %

7 State of the GMI 7 State of Cleveland Clinic Status Strategic Council’s 4 main initiatives in 2009: 1. Patient Experience 2. Operational Excellence 3. Growth 4. Integration of the Health System Teamwork: Key areas: HR, IT, Wellness, Patient Experience, Quality & Safety Current strategic investments: 1. HR – employee engagement 2. IT – integration, upgrading, and streamlining multiple systems 3. Wellness – employee and patient benefits Improving communication and messaging to all employees

8 State of the GMI 8 State of Cleveland Clinic Status Reduction of overall wait time for outpatient appointments by 5 days (Same day Appt Initiative) Improved employee-focused benefits and wellness initiatives – Weight Watchers program (lost 75,000 pounds so far) – Smoking Cessation – Increased tuition reimbursement programs Nursing Magnet Status for main campus & Fairview 23andMe, a free service for physicians to participate in genomic screening Increased Environmental Stewardship, by recycling medical waste, exploring alternate energy sources and reducing energy consumption Service: patient and employee services given and received

9 State of the GMI 9 State of Cleveland Clinic Status CC is strong overall and Florida is turning a profit for the first time 90% of CC’s $5 billion revenue from patient revenue; patient portion is declining due to costs of expanding the facilities and payor mix change Guiding Principles for handling the current economic crisis: 1. Maintain Patient Care 2. Preserve Jobs 3. Maintain compensation 4. Invest in the Future Expense reduction actions taken thus far are working; Unlike other healthcare institutions, CC has not been forced to lay off any personnel For every $50,000 the Clinic can “save”, that translates to one job saved Finances:

10 State of the GMI 10 Initiatives overall are heading in the right direction We should not get too comfortable with our successes Take advantage of this opportunity and let it stimulate us to achieve our best Tom Brokaw: … “we cannot waste the opportunities that lie within this crisis; it isn’t what divides us that’s important; it’s what unites us – and we should continue to “Act as a Unit”….” State of Cleveland Clinic Key take-aways:

11 State of the GMI 11 State of the Genomic Medicine Institute 2008 Annual Report Charis Eng, MD, Ph.D., FACP, Chair & Director June 22, 2009

12 State of the GMI 12 GMI Core Values To provide a work culture that enables us to bring genetics and genomics, through our research and clinics, into all subspecialties of the Cleveland Clinic’s healthcare system To promote scholarly activity (research), academic clinical practice and education To be the expert base for the principles and practice of genomic medicine To foster innovation ultimately directed at personalized genomic-based healthcare

13 State of the GMI 13 The Research Triad Research Labs “Cores” GMB IGAC Genomics CPGH GMI’s interdisciplinary design as a one-stop shop is aligned with the LRI’s Research Triad Mission and CC’s Tripartite academic mission

14 State of the GMI 14 New Personnel

15 State of the GMI 15 New Investigator Effie Sehayek, MD arrived June 2, 2008 Research Focus Genetics of sterol metabolism and atherosclerotic cardiovascular diseases Genetics of fat absorption from the intestine Academic Appointments Assistant Professor, Dept of Molecular Medicine, CCLCM Funding / Awards Scored in top 15 th percentile for recent R01 submission Effie Sehayek, MD Mike Greenberg postdoc Katie Lintner, Res Tech Laboratory Members:

16 State of the GMI 16 New Clinicians Holly Pederson, M.D. Primary Appointment: Center for Specialized Women’s Health Specialty: Breast Cancer CPGH role: Cancer Genetics Fellowship Marc Shapiro, M.D. Primary Appointment: Taussig Cancer Center Specialty: Lung, Breast, GI cancer CPGH role: Breast Cancer Clinical Geneticist

17 State of the GMI 17 Other Recruitment Highlights in 2008 Stephanie Fritz, Patient Service Representative Kristi Bennett, Eng lab postdoc Deborah Zygmunt, Aldred lab Sr Technician Jessi Mester, Genetic Counselor Tom Oravec, Labmatrix Data Entry Kathleen Babb, Research Admin Coordinator Jessi Kristi TomKathleen Deb Stephanie

18 State of the GMI 18 Other Recruitment Highlights in 2008 (cont’d) Gina Keeler, Clinical Manager Joshua Cowgill, Serre lab Technician Jim Hester, Serre lab Computing Jessi Moline, Genetic Counselor Michelle Maurer, Medical Secretary Shirley Tao, Zhang lab postdoc Michelle Gina Shirley Jim Jessi Josh

19 State of the GMI 19 Other Recruitment Highlights in 2008 (cont’d) Charissa Peterson, Eng lab Sr Technician Patty Arscott, Genetic Counselor Jason He, Eng lab postdoc Hui-Hui Liu, Zhang lab postdoc Shingo Ashida, Eng lab postdoc Toni Bartling, Ting lab postdoc CharissaPatty JasonHui-Hui ShingoToni

20 State of the GMI 20 Other Recruitment Highlights in 2009 (cont’d) Theresa Welgs, Genomics Core Junying Lei, Eng lab Sr Technician Min Zhu, Zhang lab postdoc Monika Hanus, GC Assistant Yiran Yang, Eng lab postdoc Meredith Holt, Project Manager TheresaJunying MinMonika Yi-RanMeredith

21 State of the GMI 21 Other Recruitment Highlights in 2009 (cont’d) Jeannie Choi, Ting lab Technician Hadley Miller, Serre lab Technician JeannieHadley Since 2007, we have had 31 people join GMI!

22 State of the GMI 22 Translational Disease-Oriented Research & Clinical Programs

23 State of the GMI 23 GMI’s Disease-Oriented Research Programs Disease Emphasis of GMI Laboratories  Cancer  Cardiovascular  Pulmonary  Neuro-Psych  Type 2 Diabetes

24 State of the GMI 24 Adjunct Staff: Complement GMI’s Research and Clinical Programs GenomicMedicine Cancer Heart, Vessels, Blood Lung Brain & Spine Opthamology Cell Biology Pediatrics, Obstetrics & Specialties Bioethics & Health Policy *Wilson Tang, M.D. *Elias Traboulsi, M.D. *Jonathan Smith, Ph.D. *Ruth Farrell, M.D. *Eric Kodish, M.D. *Richard Sharp, Ph.D. *Bruce Lamb, Ph.D. *Ruth Farrell, M.D. *Staff members with adjunct appointments in GMI.

25 State of the GMI 25 Outreach to other Research and Clinical Programs Multidisciplinary Programs Asthma and Pulmonary Hypertension (Erzurum) GMI: Michaela Aldred, Christina Rigelsky Barrett Esophagus/Esophageal Adenocarcinoma Consortium (Eng) GMI: Charis Eng, Brandie Leach Heritable Colorectal Cancer Multidisciplinary Research Group & High Risk Cancer (Church) GMI: Charis Eng, David Serre, Angela Ting, Brandie Leach Endocrine Neoplasia Genomics Research Group and Multidisciplinary Clinic (Eng) GMI: Charis Eng, Emily Edelman Head and Neck Neoplasia Genetics & Genomics Research Group & High Risk Clinic GMI: Michaela Aldred, Charis Eng, Emily Edelman Von Hippel-Lindau Disease Multidisciplinary (Virtual) Clinic (Eng) GMI: Charis Eng, Amy Shealy

26 State of the GMI 26 Outreach to other Research and Clinical Programs (cont’d) Gorlin Syndrome (Virtual) Clinic (Eng) GMI: Charis Eng, Amy Shealy Marfan Syndrome Multidisciplinary Clinic (Greenberg) GMI: Rocio Moran, Christina Rigelsky Tuberous Sclerosis Multidisciplinary Clinic (Gupta) GMI: Rocio Moran, Charis Eng, Amy Shealy Gene Dosage and Disease Susceptibility Research Group (Nadeau) GMI: David Serre, Angela Ting Diabetes Genomics Research Group (Serre) GMI: David Serre Neurofibromatosis Multidisciplinary Clinic (Rothner) GMI: Vickie Zurcher, Rebecca Mitchell, Allison Schreiber Hearing Management Clinic GMI: Rocio Moran, Allison Schreiber Vascular Anomalies Multidisciplinary Clinic GMI: Rocio Moran, Amy Shealy (new in 2008)

27 State of the GMI 27 Satellite Genetics Clinic Expansion CORS/DDI Colon CancerGC: Brandie Leach Hillcrest Prenatal/PreconceptionGC: Diane Clements Vascular Surgery ClinicGC: Christina Rigelsky, Patrica Arscott Vascular Medicine ClinicGC: Christina Rigelsky Fairview Moll Pavilion Breast CancerGC: Kate Lynch, Shanna Gustafson Beachwood CancerGC: Kate Lynch, Shanna Gustafson Prenatal/PreconceptionGC: Diane Clements Shaker Developmental & Behavior PediatricsAPN: Rebecca Mitchell (new in 2009)

28 State of the GMI 28 Publications & Education

29 State of the GMI 29 Publication Highlights Total Publications Articles (Impact Factor >10) 478 Books / Chapters122

30 State of the GMI 30 Teaching: Cleveland Clinic Lerner College of Medicine Primary Personnel Michaela Aldred, Ph.D. Charis Eng, M.D., Ph.D. Pieter Faber, Ph.D. Banu Gopalan, M.S. Shanna Gustafson, M.S. Rocio Moran, M.D. Mohammed Orloff, Ph.D. David Serre, Ph.D. Amy Shealy, M.S. Angela Ting, Ph.D. Secondary Personnel Marvin Natowicz, M.D., Ph.D. Ruth Farrell, M.D. Donna Hansel, Ph.D. Eric Kodish, M.D. Wilson Tang, M.D. Elias Traboulsi, M.D. Course Instructors

31 State of the GMI 31 Teaching: Molecular Medicine Ph.D. Program Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Inaugural Class Admissions Committee: GMI Representative: Michaela Aldred, Ph.D. Two of nine inaugural class students rotated in the Eng lab and one selected this lab for their thesis work. Ying Ni

32 State of the GMI 32 Funding

33 State of the GMI 33 LRI Research Funding $69 $68 $73 $76 $84 $90 $85 $91 $82 $101 $97 $ Federal Funding Trend Total Research Funding (Internal & External) $166 $202 $180 $223 $245 $258 Declines in NIH funding are being offset by gains in other federal non-NIH sources (i.e., DOD, NASA, DOE, etc.)

34 State of the GMI 34 Research Funding Highlights New Grants in 2008 Charis Eng, M.D., Ph.D., NIH – PO1: “Genetic alterations that initiate follicular carcinogenesis” ($223 ADC, 5 yr) ; BCRF: “ Genes that affect mitochondrial function as novel mediators of beast cancer susceptibility ” ($129K ADC, 1yr); BCRF: “ Differential biallelic expression of PTEN in patients with heterozygous germline PTEN mutations as a novel mechanism of modulation of breast cancer risk ” ($79K ADC, 1yr); Hearst Foundation: “Inherited Breast Cancer Research Program ($150K ADC, 2 yr) Aldred, Michaela, Ph.D., AHA: “Progenitor Cells in Pulmonary Hypertension” ($70K ADC, 4yr) Zhang, Bin, Ph.D., NIH – March of Dimes: “ Receptor-mediated ER-to-Golgi transport of Coagulation factors V and VIII: Deficiencies in the early secretory pathway as pathogenic mechanisms of congenital disorders ” ($68K ADC, 2 yr); RO1: “ Receptor- mediated ER-to-Golgi transport of Coagulation factors V and VIII ” ($225K ADC, 5yr) New extramural funding in CY 2008 ~$1.1M ADC, or ~$5.9 million total funding

35 State of the GMI 35 Philanthropic Funding # of donations125 Amount (total)$100,000$8,000$410,000 Dr. Eng received first endowed chair in Cancer Genomics Research: $1.5 million endowed chair funded by Sondra and Stephen Hardis to further Cancer Genomics Research Arthur Blank Foundation William W. Baker Family Foundation Norma & Albert Geller Roger & Sharon Vail Ambrose Monell Foundation: ($100K ADC, 3yr) “Cancer Genomics Training Fellowship Program”

36 State of the GMI 36 Clinical Revenue New Genetic Counseling service reimbursement model implemented; utilizes first genetic counseling-specific billing code Decoupling Geneticist and Genetic Counselor billing schema has:  increased patient access  decreased patient appointment wait times  provided opportunities for satellite clinic service expansion Two recent Cleveland Clinic initiatives:  Same Day Appointments  Provider-based billing Net effect on clinical revenue is being analyzed GMI’s Center for Personalized Genetic Healthcare is a pioneer in transforming traditional clinical genetics services to a financially self-sustainable model with:  increased patient access  improved patient service

37 State of the GMI 37 Innovations & Commercialization 4 provisional patents filed  Charis Eng, M.D., Ph.D. (3)  Effie Sehayek, M.D. (1) “eGMI”  Patient-entered family history tool  Collection of personal and family medical history information  Creation of pedigree  Automated risk assessment  Utilizes MyConsult/eCC and Progeny

38 State of the GMI 38 Employee Engagement

39 State of the GMI 39 Gallup Employee Engagement Survey March, point scale: 1= Highly disagree  5= Highly Agree * 38 GMI employees GMI*LRICC Gallup 50 th % Gallup 75 th % Overall Engagement Overall Satisfaction GMI Commitment: “to make GMI the best workplace for GMIers” Committed to Quality Have Materials & Equip Know what’s Expected Mission/Purpose GMI Strengths GMI Opportunities

40 State of the GMI 40 Engagement Initiatives Job Expectation Clarification:  Review and redefining of all position’s key job responsibilities (KJR)  Creation of a Job Specification and Performance Roadmap (JSPR) Organizational Chart Refinement:  Defining subunit structures and mission statements Communication Improvement:  Increased forums (Town Hall, open staff meetings, Newsletter, etc) Employee Recognition:  GMI Employee of the Quarter award Socializing Opportunities:  Summer Picnic and Table 45 Happy Hour

41 Key: Admin Support Staff Management Team Executive Team Dr Eng Chair Business Advisory Board Research Admin Coordinator Babb Computing Balint Director, Transl Devel Rerko THE GENOMIC MEDICINE INSTITUTE Admin Asst Wilcox Manager, Integ Devel Platzer Admin Asst Blount Center for Personalized Genetic Healthcare Dir: Eng PSRs, GC Assts, Med Sec MDs Cancer Genetics / General Genetics Clinic Med Dir: Eng / Moran Clinical Mgr: Keeler ANP Genetic Counselors Reimbursement Specialist GMI Enterprise Rerko Project Mgr Holt Genetics Educ Cdtr X IT Architect X eGMI Platzer Database Proj Mgr GC Biorepository Mgr: X Clinical Research Program Mgr: X Research Study/Prog Coordinators Int Genomics & Analysis Mgr: Gopalan Bioinformatics/ Biostatistics Labmatrix Eng Lab Aldred Lab Zhang Lab Ting Lab Serre Lab Research Sehayek Lab PI Admin Assts Blount/Wilcox Res Admin Cdtr Babb Genomics Core P Faber

42 State of the GMI 42 Engagement: Next Steps Completion of all employee JSPRs Continued implementation of constructive and regular performance feedback Continued focus on improving communications Continued supervisor/manager training to be “engaging managers” Next round of subgroup meetings to identify next action item plans 2009 Gallup survey: June 24 - July 17  LRI goal: improve scores by 5%

43 State of the GMI 43 Community Benefit & Wellness

44 State of the GMI 44 Institute Diversity Program GMI Members on Diversity Council 2008:Banu Gopalan, Coordinator Kylie Drake Institute Wellness Program Conversational English Program (CEP) - Todd Romigh (coach) - Several GMI participants GMI TRIes Triathlon Club (runners, bikers, swimmers) Nichole Prescott Commit10 Challenge Program Rebecca Mitchell

45 State of the GMI 45 Community Benefit United Way campaign – Last year, CC raised $1.8 million for local community resource centers – In 2008, GMI had 45.2% participation – 2009 campaign about to begin; GMI team captain is ? – 2 GMI folks participated in “United Way Day of Caring” LRI’s Harvest for Hunger- generated 215 pounds of food, $2,400 in donations Bolton School Supplies- generated ~$16,000 of supplies GMI Feature in Cleveland Clinic-Community Breakfast & the Community Service Booklet Rebecca Mitchell, M.S.N, C.N.S., camp nurse at Knox County 4-H Camp resulted in Caitlin Pugh Scholarship Fund donations.

46 State of the GMI 46 Cold Spring Harbor Laboratory Invited Lecturer: David Serre, Ph.D Educational & Outreach Highlights 8 th Intl Anticancer Research Conference Invited Lecturer: Angela Ting, Ph.D. 6 th Intl Conference on the Biology of Childhood Renal Cancers Invited Lecturer: Michaela Aldred, Ph.D. 27 th Annual Meeting of National Society of Genetic Counselors Session Co-chair: Emily Edelman, M.S., CGC Educational Breakout Session: Amy Shealy, M.S., CGC Genetics Education Campaign Kickoff Dr. Eng, Dr. Traboulsi, Dr. Moran, Cheryl Scacheri and Champions “Genetics in Health and Disease” symposium

47 State of the GMI 47 Educational Highlights (Continued) Neurofibromatosis: A 21 st Century Perspective Invited Participants: Vickie Zurcher, M.D., Rebecca Mitchell, MSN, C.N.S., Allison Schreiber, M.S., CGC Aspiring Physicians & Research Scientists Conference Invited Panelist: Mohammed Orloff, Ph.D. The CPGH Genetic Counseling Internship program trained 2 GC students American Society of Human Genetics Invited Science Session: “Organismal and Cellular Phenotypes of Breast Cancer Susceptibility Genes” Chair: Charis Eng, M.D., Ph.D. 18 th Annual Symposium of Society of Black Academic Surgeons Invited Lecture: Charis Eng, M.D., Ph.D. 6 th Annual Pediatric Neurology Update Seminar Invited Presenter: Rocio Moran, M.D.

48 State of the GMI 48 Cleveland Museum of Natural History Exhibit: “RACE: Are we so different?” Dawn Caraballo Genomics Town Hall Dawn Caraballo, Drs. Moran and Serre, Cheryl Scacheri Special Events & Community Outreach Minority Men’s Health Fair Dawn Caraballo School, Library and Support Group talks in 2008 Over a dozen educational talks given by various GMI personnel in 2008 WKYC: Family Health History Day Dr. Eng, Shanna Gustafson PBS: “In the Family” documentary Cheryl Scacheri (message board)

49 State of the GMI 49 Awards & Honors GMI was honored as the featured member of the month (August) by the Personalized Medicine Coalition Charis Eng, MD, PhD, Chair GMI, named Chair of the Clinical Science Committee of the Personalized Medicine Coalition. Charis Eng, MD, PhD was elected to the Best Doctors in America database for her work in Clinical Cancer Genetics and Cancer Genomic Medicine. Charis Eng, MD, PhD was a Visiting Professor in the Human Manpower Development Planning Programme of Singapore’s National Cancer Center Charis Eng, MD, PhD was awarded the LRI Excellence Award for Outstanding Science and Marvin Natowicz, MD, PhD was awarded the LRI Excellence Award for Outstanding Educator Kristi Benett, PhD and Ying Ni, MS were both awarded entry into the AAAS/Excellence in Science Program award for

50 State of the GMI 50 Awards & Honors Stacy Williams and Crystal Sterling were awarded the McNair Undergraduate Summer Research Scholarship for Minority Students Excelling in the Sciences CONGRATULATIONS Shireen Ganapathi was awarded the American Cancer Society Joseph F. Silber Undergraduate Research Fellowship Guillaume Assie, MD, PhD was named a Finalist for the Cotterman Award for Best Trainee-First Authored Paper published in Am J Hum Genet Rebecca Mitchell, RN and Patricia Pritchard were awarded LRI Star Awards in 2008

51 State of the GMI Brief Updates Angela Ting, Ph.D. received a Wilson Foundation grant ($91K ADC, 2yr) Bin Zhang, Ph.D., received an R01 summer student supplement ($8.5K) Brandie Leach, MS, CGC and group received a National Society of Genetic Counselor SIG grant ($2K) Published our first GMI Newsletter, “Translations” Met with CC Employee Health Plan to develop a model for appropriate genetic testing recommendations and reimbursement schemas Providing education to CC surrounding direct-to-consumer genomics companies and their utility Highlighted by the Advisory Board Company in their Genomic Centers of the Future Presentation

52 State of the GMI 52 GMI Goals & Challenges

53 State of the GMI 53 State of the GMI 53 Short-term Goals for 2009 Meet budgetary expectations Increase clinical revenue and satellite services Increase GMI grant funding by >20% Implement Cancer module of eGMI prototype in GMI and Taussig Cancer Center Improve employee engagement by at least 5% Improve developmental opportunities for Assistant Staff and employees Recruit key personnel in Clinical Research Study and Genetics Education Programs Increase quantity and quality of publications Obtain next generation high-throughput sequencer

54 State of the GMI 54 Continuing Objectives Reduce GMI’s dependency on CC operating revenue across all units by 2011 Further increase depth and breadth of research programs Continue to re-examine clinical genetics and genetic counseling process to standardize and implement the best models Develop and implement relevant eGMI modules to integrate genetic screening processes into CC patient care Continue outreach and education efforts for understanding and utilizing genetics and genomics processes in patient care Further train next generation of biomedical researchers in CCLCM and Molecular Medicine programs Increase endowment funding and philanthropic support

55 State of the GMI 55 Challenges ahead Stagnant NIH budget Small annual allocation of capital funding for research from CC Growing Federal regulations lead to compliance concerns Lack of unassigned laboratory, office and clinic space Integration of genomic medicine into CC processes and medical specialties Scarcity of qualified clinical geneticists or genomic medicine physicians Legislative reform for Genetic Medicine

56 State of the GMI 56 Thank you all for your hard work and a productive year! GMI Goals & Successes: QualityServiceInnovationTeamwork We are on the right trend and together as a unit, we will accomplish our mission.

57 State of the GMI 57 Questions? Now for a visual highlight of 2008 from Peter ….


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