emoryhealthcare.org One Year Later: Lessons Learned from Ebola in the U.S. and Academic Medicine’s Role in Preparing for the Next Threat Bryce Gartland, MD, FHM CEO, Emory University Hospital Bruce Ribner, MD, M.P.H. Director, Emory SCDU 1

emoryhealthcare.org DEFINING ACADEMIC MEDICINE Clinical Care EducationResearch 2

emoryhealthcare.org DEFINING ACADEMIC MEDICINE Clinical Care EducationResearch 3 U.S. Story of Ebola

emoryhealthcare.org WOODRUFF HEALTH SCIENCE CENTER Clinical Care Emory University Hospital 733 bed quaternary care facility ~ 30,000 admissions per year High acuity with Case Mix Index of 2.3 ~ 15% of patients arrive via acute-to-acute transfer Transplant, Neurosciences, Cardiovascular, Oncology, Complex Surgical Care, Critical Care Location of Serious Communicable Disease Unit (SCDU) 4

emoryhealthcare.org WOODRUFF HEALTH SCIENCE CENTER Research $572 million funding Highlights: – Ebola/Vaccine – CDC/ASPR – Lasker Award (DeLong) – TAVR 5

emoryhealthcare.org WOODRUFF HEALTH SCIENCE CENTER Education School of Medicine – 560 medical students – > 1,200 residents/fellows – 98 accredited programs School of Nursing – 525 RN students Rollins School of Public Health – > 1,100 masters degree students 6

Course of the Current Ebola Outbreak December 2013: 2 year-old boy in Meliandou, Guinea, developed an illness characterized by fever, black stools, and vomiting- he died two days later August 2014: first two American healthcare workers admitted to the Emory Serious Communicable Diseases Unit (established 2001) Ultimately 11 patients with Ebola virus disease would be cared for in U.S. facilities, and several more would be managed for high risk exposures Current outbreak totals: 28,421 infected 11,297 fatalities

What Have We Learned Clinical observations made in academic medical centers patients with serious communicable diseases can safely be cared for in U.S. facilities back bone of care for EVD is aggressive resuscitation patients can survive even after multiorgan failure Therapeutics insufficient data to reach any conclusions Vaccines some promising vaccines but may not be sufficient data

Preparedness is Critical There will be another infectious diseases outbreak SARS, avian influenza, MERS, Ebola By failing to prepare, you are preparing to fail ― Benjamin Franklin

What Do We Need Going Forward Need a continued robust infrastructure to allay anxiety and deliver effective patient care -National Ebola Training and Education Center -Hospital Preparedness Program Need to be able to react quickly to evaluate new therapeutics and vaccines

emoryhealthcare.org LESSONS LEARNED 1.Health system preparedness is not a one time event – it requires ongoing investment. 2.Academic Medical Centers are uniquely capable and competent to successfully meet the demands for responses to Ebola and similar situations. 3.Must foster and, where feasible, structure improved collaboration between health systems and governmental agencies. 11

emoryhealthcare.org LESSONS LEARNED Health system preparedness is not a one time event – it requires ongoing investment. Must maintain federal funding Clinical Research Education “Preparedness” is not enough, more is required to be successful 12

emoryhealthcare.org LESSONS LEARNED Academic Medical Centers are uniquely capable and competent to successfully meet the demands for responses to Ebola and similar situations. 13 Clinical Team Success = Necessary Resources Research/ Education Culture

emoryhealthcare.org LESSONS LEARNED Must foster and, where feasible, structure improved collaboration between health systems and governmental agencies. Use Ebola as a learning opportunity Remove barriers to inter-system/inter-agency collaboration and decision making Expedite system responsiveness 14

emoryhealthcare.org SUCCESS IN PARTNERSHIP 15

emoryhealthcare.org 16 Questions?