1. Translational Research: Intersections of Stanford and the NIH
Importance of translational research
For Stanford
For the NIH
Strategic Planning
For Stanford: Translating Discoveries
For NIH: The NIH Roadmap
Opportunities for Intersection
11/22/201811/22/2018

2. Some Unique Attributes of Stanford
What is Unique About Stanford School of Medicine
Private University and Medical School permitting flexibility and strategic choices
Small in size but outstanding in quality of faculty and students
Contiguous location of the School of Medicine with Hospitals and University – a unique opportunity for innovation and translation
Outstanding portfolio of the School in research with a history of innovations and accomplishments in technology, science and medicine.
Ownership of Hospitals by University as a means of fostering a strategic alliance for translational medicine and innovative patient care
Location in Silicon Valley - connections to biotechnology
11/22/201811/22/2018

3. School of Medicine Mission Statement
To be a premier research-intensive medical school that improves health through leadership and collaborative discoveries and innovations in patient care, education and research.
11/22/201811/22/2018

4. Overarching Goals of the School of Medicine
Be a leader in the movement to reform and rejuvenate the educational and career development of physicians and biomedical innovators.
Transform the future of biomedical, translational, and clinical research and education by fostering novel collaborative alignments between basic and clinical scientists, clinicians, and educators throughout the University, as well as with public and private partners worldwide.
Earn the public’s trust and respect as a premier medical school through outstanding patient care and academic medicine
11/22/201811/22/2018

5. Strategic Planning Process
February
2002
Oct 2004
September January 2002
March On-Going
Strategic Planning Organization and Development Phase
Strategic Planning Implementation Phases
Strategic Planning Leadership Retreats
February
11/22/201811/22/2018

6. Important Relations in Integrated Strategic Planning
Medical Education
Finance/Administration
Graduate Education
Postgraduate Education/
Training
Communication
Research
Advocacy/Policy
Patient Care
Philanthropy
Professoriate
Information Resources & Technology
11/22/201811/22/2018

7. Major Issues Addressed at the 2002 - 2004 Leadership Retreats
Important School-Wide Issues and Questions
How can we best align our basic and clinical science faculty around common goals and shared objectives
What is the best way for Stanford to train future leaders in medicine and the biosciences?
What is the right size for the School of Medicine and how can we accomplish our missions within the billet caps of the University?
How can we best achieve our missions in interdisciplinary education and research and in translational medicine?
What are the best ways to align the School to its Hospitals?
Should the School have a single integrated campus or expand off-site?
Should the School and/or one or both Hospitals move to a new location?
11/22/201811/22/2018

8. So, what is the right size for the School of Medicine?
About or only slightly larger than present:
Full-time faculty is currently around 732
University cap for SoM faculty billets is 900
Need to develop and sustain excellence in science, education and clinical care
Evolution of the Clinician-Scholar/Investigator track - recent success in achieving Principal Investigator status
Development of Clinician-Educators - a work in progress
11/22/201811/22/2018

9. Uniqueness of Stanford
Excellence and the opportunities for interdisciplinary research and education is what makes Stanford unique - and what makes the whole greater than the sum of its parts!
Faculty-initiated interdisciplinary collaborations Interschool collaborations
Department of Bioengineering
University-wide Initiatives
BioX and the Clark Center
Environmental Sciences
International Affairs
School-wide Initiatives
Stanford Institutes of Medicine
Cancer/Stem Cell Biology
Cardiovascular
Neurosciences
Immunity,Transplantion, Infection
11/22/201811/22/2018

10. Scientific Themes of BioX- and Relation to the School of Medicine
Biocomputation
Image processing, bioinformatics, protein folding,
biomechanical simulation, remote teaching
Biodesign
Biorobotics, biosensors, surgical techniques,
medical devices, tissue repair, image guidance, therapeutic delivery systems
Imaging: molecules, cells, tissues, movement
Biophysics of single molecules
Chemical Biology
Genomics/proteomics
Systems neuroscience
Regenerative Medicine
11/22/201811/22/2018

11. The Clark Center
11/22/201811/22/2018

12. Departments (24) Applied Physics Biochemistry Bioengineering
Biological Sciences
Chemistry
Chemical Engineering
Civil & Environ. Engineering
Computer Sciences
Developmental Biology
Electrical Engineering
Genetics
Geological & Environ. Sci.
Health Research & Policy
Mechanical Engineering
Medicine
Molecular Pharmacology
Neurobiology
Pediatrics
Physics
Psychology
Radiology
Statistics
Structural Biology
Surgery
11/22/201811/22/2018

13. The BioX Program Biology, Medicine, Engineering, Chemistry,
Physics, and
Computer Science
11/22/201811/22/2018

14. The Stanford Institutes of Medicine
CSCI
CVI
ITII
NIS
Center for Genetics/Genomics
Center for Imaging
Center for Informatics/Bioinformatics
11/22/201811/22/2018

15. Developing Aligned Partnerships
Stanford University School of Medicine
Stanford Hospital & Clinics
Lucile Packard Children’s Hospital
Cancer/Stem Cell Biology and Medicine Institute
Clinical Cancer Center
Cancer Center
Neurosciences Institute
Center for Neurosciences
Center for Brain and Behavior
Cardiovascular Medicine Institute
Cardiac Center
Heart Center
Institute for Immunity, Transplantation, Infection
Transplant Center
11/22/201811/22/2018

16. Supporting Translational Research
Enhancing the infrastructure to support clinical investigation
Biostatistics
Study design and data management
Financial management
Technology Transfer
Project Assistance (Chris Webb)
Creating a Center for Translational Research
Supporting the GCRC
Glaser Pediatric Research Network
Stimulating translational research
BioX Awards
Beckman/Medicine Translational Investigation Awards
Dean’s Office Awards for Translational Research
11/22/201811/22/2018

17. Educating Future Leaders
The New Stanford Curriculum
Reduce the amount of time in structured classes to permit time for research and scholarly development
Better balance the curriculum by including both clinical and basic science experiences throughout medical school training
Develop required majors (“scholarly concentrations”) for all students to enhance independent research capabilities
11/22/201811/22/2018

18. New Stanford Curriculum
Residency and Fellowship
Undergraduate
Clinical
Scholarly track
Basic science
Clinical research
Molecular medicine
Community Medicine
Bioengineering
Health economics
Year
11/22/201811/22/2018

19. Scholarly Concentrations
Tracks
Scholars track
Original research track
Current and some upcoming Scholarly Concentrations
Bioethics and the Humanities
Biocomputation
Bioengineering
Clinical Research
Community Health and Public Service(MPH with Berkeley)
Health Care Policy and Research
Immunology
Neuroscience (under development)
Molecular Basis of Medicine
Women’s Health
Independent Study
Joint Degree Programs
11/22/201811/22/2018

20. Educating Future Leaders
Graduate Students
Continue to foster knowledge and skills in basic science
Foster knowledge in clinical and translational medicine
Masters in Clinical Science
Provide opportunities for joint degrees (e.g., business, law, engineering)
Role of the New Commission on Graduate Education
Residents and Postdoctoral Scholars
Promote opportunities for Scholarly Concentration
Consider development of a PhD program for Residents/Fellows
11/22/201811/22/2018

21. Learning and Knowledge Center
BioX
Stanford Hospitals
Stanford Institutes of Medicine
Embedded Learning
Enriched Content
Integrated Services
Clinic Sites
Personal Consultant
Learning Commons Immersive Learning
VA Hospital
Education
Research
Clinical Care
Self-directed, interactive learning, medical scholars
Translational medicine, genomics, computational biology
Clinical decisions, innovative diagnosis and treatment
11/22/201811/22/2018

22. The NIH Perspective Acute to chronic diseases Aging Population
Health Disparities
Emerging Diseases
Biodefense
11/22/201811/22/2018

23. NIH Perspective Science Driven Opportunities Human Genome Project
Functional Genomics
Proteomics
Integrative biology of disease
Revolutionary Research Methodologies
Information Sciences
11/22/201811/22/2018

24. NEED TO TRANSFORM MEDICAL RESEARCH IN THE 21st CENTURY
20th Century
Treat disease when symptoms appear and normal function has been lost
WHY: we did not understand the molecular and cellular events leading to disease
Expensive in financial and disability costs
21st Century
Intervene before symptoms appear and preserve normal function for as long as possible
WHY: Understanding of preclinical molecular events and Ability to detect patients at risk.
Orders of magnitude more effective
11/22/201811/22/2018

25. NIH Roadmap Goal
Accelerate basic research discoveries and speed translation of those discoveries into clinical practice
Explicitly address roadblocks that slow the pace of medical research in improving the health of the American people
11/22/201811/22/2018

26. What is the NIH Roadmap?
A framework of priorities the NIH as a whole must address in order to optimize its entire research portfolio.
A set of initiatives that are central to extending the quality of healthy life for people in this country and around the world.
A vision for a more efficient and productive system of biomedical and behavioral research.
11/22/201811/22/2018

27. Roadblocks NIH Perspective Bench Bedside Public System Broken
11/22/201811/22/2018

28. NIH Roadmap for Medical Research
11/22/201811/22/2018

29. NIH Perspective New Pathways to Discovery
Molecular Libraries and Imaging Probes
Building Blocks, Biological Pathways and Networks
Structural Biology
Bioinformatics and Computational Biology
Nanomedicine
11/22/201811/22/2018

30. NIH Perspective Research Teams of the Future
Explore new organizational models for scientific teams
Multi-disciplinary and Inter-disciplinary
Larger, coordinated, resource-sharing
Preserve the investigator(s)-initiated strategy
11/22/201811/22/2018

31. 11/22/201811/22/2018

32. NIH Perspective Clinical Research is the Key to Translating Knowledge
11/22/201811/22/2018

33. Then: Now: NIH Perspective Translational Research: Haphazard Evolution
Cottage industry and select centers
Now:
Complex requirements: regulation, technology, speed, efficiency
Greater links to basic science
11/22/201811/22/2018

34. Research Teams of the Future
NIH Perspective
Research Teams of the Future
Interdisciplinary
Research Teams;
Pioneer Award
Public-Private
Partnerships
Bench
Bedside
Public
Building Blocks and Pathways
Molecular Libraries
Bioinformatics and
Computational
Biology
Structural Biology
Nanomedicine
11/22/201811/22/2018

35. NIH Perspective Re-engineering the Clinical Research Enterprise
Developing new partnerships of research
Patient communities
Community-based health care providers
Academic researchers
Lower barriers to innovation
Building better integrated clinical research networks
Academic centers linked to community-based physicians
11/22/201811/22/2018

36. Potential Outcomes of Molecular Libraries & Imaging Probes Activities
NIH Perspective
Potential Outcomes of Molecular Libraries & Imaging Probes Activities
Development of research tools (molecular probes and novel assays) to facilitate studies of biology and pathophysiology
Advances in biological research leading to the identification and validation of novel biological targets for therapeutics development
Discovery of biological markers to monitor disease progression and to predict treatment response
11/22/201811/22/2018

37. National Centers for Biomedical Computing
NIH Perspective
National Centers for Biomedical Computing
Partnerships of:
Computer scientists
Biomedical computational scientists
Experimental and clinical biomedical and behavioral researchers
Focused on software rather than hardware
Each National Center to have Driving Biological Projects
Programs in preparation for partnerships between individual investigators and National Centers
Stanford was just named one of four National Centers
11/22/201811/22/2018

38. Nanomedicine Roadmap Initiative
NIH Perspective
Nanomedicine Roadmap Initiative
Nanomedicine describes the interface of biology and nanotechnology to understand and treat disease.
Nanomedicine is a departure from the majority of nanotechnology research in that it integrates biomolecular processes toward developing therapies.
Will need to develop new tools and a nanomedicine lexicon for shared use by engineers and biologists.
Next Steps: Concept Development Awards in ’04; solicitation for Nanomedicine Development Centers in ‘05
11/22/201811/22/2018

39. Research Teams of the Future
NIH Perspective
Research Teams of the Future
Interdisciplinary
Research Teams;
Pioneer Award
Public-Private
Partnerships
Bench
Bedside
Public
Building Blocks and Pathways
Molecular Libraries
Bioinformatics and
Computational
Biology
Structural Biology
Nanomedicine
11/22/201811/22/2018

40. Research Teams of the Future
NIH Perspective
Research Teams of the Future
Initiatives within this theme provides mechanisms for interdisciplinary research, high-risk strategies and public-private partnerships.
Including:
Encouraging Multi- and Interdisciplinary teams
Supporting larger, coordinated, resource sharing teams
Preserving investigator-initiated strategy
Promoting investigators to take creative, unexplored avenues of research
11/22/201811/22/2018

41. NIH Director’s Pioneer Award
NIH Perspective
NIH Director’s Pioneer Award
New program to support individuals with untested, potentially groundbreaking ideas!
Encourages innovation, risk-taking
Totally new application and peer review process
Expected to be highly competitive
Expanded eligibility – (not only traditional biomedical investigators)
Provides $500,000/year for 5 years
One of our new Bioengineering faculty recruits, Dr. Steve Quake, was just named a recipient.
Moving from Research Training, the NIH Roadmap initiatives also include a major award to recognize and celebrate, publicly, those researchers who explore ideas that were considered risky.
The NIH Director’s Pioneer Award will provide funds for five years to allow these investigators to develop and test far-ranging ideas that relate to the NIH mission. The Pioneer award will not replace ongoing research projects or simply expand the funding of persons already supported.
Note that not only traditional biomedical investigators are eligible for this award; there does need to be evidence of interest in exploring topics of biomedical relevance.
The nomination process allows for self-nomination, and the criteria for eligibility and details of the selection process are detailed on the NIH Roadmap website.
11/22/201811/22/2018

42. Re-engineering Clinical Research
NIH Perspective
Re-engineering Clinical Research
Interdisciplinary
Research
Pioneer Award
Public-Private Partnerships
Bench
Bedside
Public
Building Blocks and Pathways
Molecular Libraries
Bioinformatics and
Computational
Biology
Structural Biology
Nanomedicine
Integrated Research Networks
Clinical Research Informatics
National Clinical Research Associates
Clinical outcomes
Clinical Research Policy
Training
Translational
Research
Initiatives
11/22/201811/22/2018

43. NIH Perspective Integration of Clinical Research Networks
Create inter-operable ‘Network of Networks’
National Electronic Clinical Trials/Research Network (NECTAR initiative)
Common data standards, informatics
Software application tools for protocol preparation, IRB management, adverse event reports
Use existing networks to rapidly address questions beyond their traditional scope
11/22/201811/22/2018

44. Engaging the public in clinical research is a priority.
NIH Perspective
Engaging the public in clinical research is a priority.
It is not an option.
11/22/201811/22/2018

45. NIH Perspective Clinical trial participation very low
<5% of Americans enroll in cancer trials
Small proportion of physicians enroll patients in more than three-quarters of all trials
Need for diversity
The only way we can move forward with getting the best care to our patients is by finding out what works.
The cancer community has forged the way in endorsing the value of clinical trials for culling the most effective treatments for various types of malignancy.
Hodgkin’s lymphoma and many childhood cancers are curable because of clinical research. We need to expand these successes to all areas of disease treatment and prevention.
We need to do a better job of displacing the image of the “guinea pig” and introducing the notion that patients are an active participant in their health care. They deserve access to the newest discoveries.
This requires a partnership with patients and community-based physician networks.
11/22/201811/22/2018

46. “How does the NIH Roadmap benefit research funded by NIH ICs?”
NIH Perspective
“How does the NIH Roadmap benefit research funded by NIH ICs?”
Speeding removal of major and fundamental roadblocks common to all diseases
Institutes working together to solve issues
This is a common trans-NIH pool of transforming investments open to all disease areas for competition
11/22/201811/22/2018

47. NIH Perspective
The NIH Roadmap pools resources for specific enabling investments that individual Institutes could not undertake:
Expanding molecular probe libraries publicly available to researchers
Increasing the number of publicly available molecular probes
Improving the implementation of breakthrough research trials through the creation of interdisciplinary research teams
Supporting high-risk pioneering research
11/22/201811/22/2018

48. NIH Perspective
The Roadmap will address core problems to accelerate research
Complexity of molecular interactions that lead to disease
More rapid development of promising breakthroughs
Supporting translational research
Exploring integration and interoperability of clinical research networks
Addressing clinical research policy analysis and coordination
Creating “communities of research” by involving community-based practitioners
11/22/201811/22/2018

49. Roadmap Funding (dollars in millions)
FY04
FY05
FY06
FY07
FY08
FY09
Total
Pathways to
Discovery 65
137
169
182
209
188
948
Research
Teams 27 39 44 92 96 93
390
Clinical 38 61
120
174
214
227
833
130
237
332
448
520
507
2,172
Directors Fund ??
Total NIH in Same
Period is > $220 Billions
Roadmap initiative is about .9% of NIH budget
Totals on table may not add due to rounding
11/22/201811/22/2018

50. Stanford and the NIH
There are important areas of alignment between Stanford’s Strategic Plan “Translating Discoveries” and the NIH Roadmap
There are opportunities to participate in new program areas emanating from the NIH Roadmap and to build on strategic goals of Stanford.
There is the need to balance the important investments in basic research (which has been the soul of Stanford) against the more applied research portfolio emerging from the Roadmap.
We must help create and develop the future - at Stanford and with the NIH.
11/22/201811/22/2018