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AI meets offers real-world benefits to healthcare

In contrast to the science fiction portrayal of evil computers plotting to overthrow humankind, artificial intelligence (AI) in fact seems poised to help improve human health in a multitude of ways, including flagging suspicious moles for dermatologist follow-up, monitoring blood volume in military field personnel and tracking flu outbreaks via Twitter.

The Colorado Clinical and Translational Science Institute (CCTSI) recently held the 7th annual CU-CSU Summit on the topic of “AI and Machine Learning in Biomedical Research”, with over 150 researchers, clinicians and student attendees from all three CU campuses and CSU.

Ronald Sokol, MD, CCTSI director, said, “The purpose of the CCTSI is to accelerate and catalyze translating discoveries into better patient care and population health by bringing together expertise from all our partners.” Rather than individual campuses operating in silos, the annual Summit brings together clinicians, basic and clinical researchers, post-doctoral fellows, mathematicians and others to highlight ongoing research excellence, establish collaborations and increase interconnectivity of the four campuses.

This year’s conference on AI hit capacity for registration, including attendance by more mathematicians and with more poster submissions than the preceding six events. “The topic of AI in research is everywhere. No one knows exactly what is going to happen,” Sokol said, referencing the many privacy and ethics concerns about AI use in research. “I’m here to learn too – I’m not sure I understand it all.”

Living up to the ‘hype’

Lawrence Hunter, director of the Computational Bioscience program at CU Anschutz, framed AI as having the potential to change the way people practice medicine. “There’s a lot of hype, so we need to be careful how we talk about it,” Hunter said.

What, specifically, is AI doing for biomedical research in Colorado? Michael Paul, PhD, assistant professor of Information Science from CU Boulder, uses social monitoring through sites like Twitter and Google to track and predict public health, including yearly flu rates and Zika virus outbreaks. The Centers for Disease Control (CDC) is typically considered the gold standard for public health information, but Paul points out that CDC data is always at least two weeks behind. In contrast, Google Trends provides a daily population snapshot: as a fictional example, ‘1 million people in Colorado searched for ‘flu symptoms on September 15, 2019’.

Steven Lakin of CSU
Steven Lakin, a CSU veterinary medicine student, displays his supercomputing research project at the CU-CSU Summit.

Social media sources like Twitter can be mined for tweets containing terms like ‘flu’ within a specific geographic area or demographic group of interest. Using Twitter, researchers can distinguish between “I have the flu” vs. “I hope I don’t get the flu”, whereas Google data cannot make this distinction.

Steve Moulton, MD, trauma surgeon, director of Trauma and Burn Services at Children’s Hospital Colorado and CU School of Medicine and co-founder of Flashback Technologies, Inc, used a machine learning system originally designed to help robots navigate unfamiliar terrain in outdoor, unstructured environments to create a new patented handheld medical device called the CipherOx, which was granted FDA clearance in 2018.

The CipherOx, developed in partnership with the Defense Advanced Research Projects Agency (DARPA) from the United States Department of Defense, monitors heart rate and oxygen saturation and estimates blood volume through a new AI-calculated number called the compensatory reserve index (CRI), which indicates how close a patient is to going into shock due to blood loss or dehydration. While designed to be used in military field operations, the CipherOx can also be used to monitor patients en route to the hospital and postpartum women. Of note, Moulton’s pilot studies were funded by the CCTSI.

AI basics

AI use in machine learning can be broken into three broad categories: supervised, unsupervised and reinforcement learning. In supervised learning, AI systems learn by being trained to make decisions. For example, in 2016 Google developed an AI-based tool to help ophthalmologists identify patients at risk for a diabetes complication known as diabetic retinopathy that can result in blindness. The Google algorithm learned from a set of images diagnosed by board-certified ophthalmologists and built a set of criteria for making yes vs. no decisions.

In unsupervised learning, AI relies on probabilities to evaluate complex datasets; predictive text on your cellphone is an example of this. In biomedical research, an example of unsupervised learning is using AI to analyze drug labels to find common safety concerns among drugs that treat similar conditions.

Finally, reinforcement learning, like Google’s AlphaZero, the world’s best machine chess player, allows AI to try a lot of options to maximize reward while minimizing a penalty. In reinforcement learning, an AI program can fully explore a hypothetical space without causing trouble. Reinforcement learning in biomedical research can be useful when AI is given a narrow range of choices, for example, predicting best patient response within a narrow range of possible drug doses.

Human mistakes vs. AI mistakes

According to Lawrence Hunter from CU Anschutz, a major problem with AI in healthcare is not proving how good AI is, but paying attention to where it fails. “With 92% correct AI, that gives us confidence that the system is accurate, but we have to be really careful about the other 8% because the kinds of errors AI makes are different (and can be more severe) than the kinds of errors humans make,” he said.

Matt DeCamp, associate professor with the Center for Bioethics and Humanities from CU Anschutz, gave an example of this phenomenon: when AI was used to classify pictures, a picture of a dragonfly was alternatively identified as a skunk, sea lion, banana and mitten. “Some mistakes are easily detected (dragonfly doesn’t equal sea lion),” DeCamp said, “but other mistakes closer to the realm of reasonable may challenge how risks are evaluated by Institutional Review Boards (IRB),” the panels of scientists and clinicians responsible for evaluating patient risks in clinical trials.

THE AI LANDSCAPE

Matt DeCamp, associate professor with the Center for Bioethics and Humanities from CU Anschutz, framed the AI landscape:

  • Up to $6 billion anticipated for AI investment into biomedical research by 2021
  • At least 14 recent AI-related FDA approvals in past two years, mostly in imaging, ophthalmology and pathology
  • 55 active or pending clinical trials using the term “deep learning”
  • 141 startup biotech companies using AI
  • Insurance companies actively using AI to review records and optimize care for chronic conditions

In examples like Google’s system for helping ophthalmologists catch patients at risk of blindness, AI has been heralded as increasing patient access, particularly in rural areas and for patients with limited mobility, and decreasing costs for providers and hospitals. While potential for using AI to improve human health is high, DeCamp echoed Hunter’s comments and cautioned against automatic acceptance of AI superiority. “It’s possible that an AI system could be better on average, but remember that being better on average can obscure systematic biases for different subpopulations. And that is an issue of justice.”

Challenges and concerns

Some issues relative to AI use in biomedical research involve patient privacy. For example, a lawsuit made headlines this summer when a patient at the University of Chicago claimed that his privacy was violated in breach of contract and consumer protection law as a result of data sharing between the university and Google. Michael Paul from CU Boulder said that recent studies regarding use of recreational drug brings up obvious concerns about how to balance public health research with privacy, since Twitter exists in a public space.

Truly informed consent is also an ethical concern, given the ‘black box’ nature of AI algorithms. DeCamp from CU Anschutz clarified, “Black box, meaning that the algorithmic workings are not only unknown, but may be in principle unknowable.”

Just because we can, should we?

Matt DeCamp said that as an ethicist, AI raises big questions. “What is an appropriate use of AI in the first place? Just because we can, does that mean we should? For example, there’s interest in developing robot caregivers. Should we? Would computer-generated poetry be ‘real’ poetry?” Patients may fear further de-personalization of health care in a system that can already seem impersonal at times.

Long-lasting effects of AI are even more uncertain. Will AI change the way we think or act toward each other? DeCamp highlighted research from sociologist Sherry Turkle, PhD, from the Massachusetts Institute of Technology that validates this possibility. In summary of Turkle’s research, DeCamp said, “Computers don’t just change what we do, but also what we think.”

Guest contributor: Shawna Matthews, a CU Anschutz postdoc

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Study: Most Catholic hospitals don’t advertise religious restrictions

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In a survey of Catholic hospitals throughout the country, researchers at the University of Colorado Anschutz Medical Campus found many did not advertise their religious affiliation and the majority did not explain how that affiliation results in health care restrictions.

The research letter was published today in the Journal of the American Medical Association (JAMA).

Maryam Guiahi, MD, associate professor of Obstetrics and Gynecology at the University of Colorado School of Medicine, analyzed the websites of all hospitals listed in the Catholic Health Association of the United States’ Health Care Directory.

Study reveals 79 percent reported Catholic identity

Out of 646 hospitals examined, 507 or 79 percent reported their Catholic identity. The other 21 percent did not explicitly disclose it on their website. More concerning, only 28 percent specified how their religious affiliation might influence patient care.

Maryam Guiahi, MD, associate professor of Obstetrics and Gynecology at the University of Colorado School of Medicine
Maryam Guiahi, MD, associate professor of Obstetrics and Gynecology at the University of Colorado School of Medicine

“Patients need to know if they are going to a Catholic hospital and if that is going to affect the care they receive,” Guiahi said. “They may realize that a Catholic hospital might not provide abortions, but many do not realize that preventative services like contraceptives and tubal ligations are also restricted.”

The U.S. Conference of Catholic Bishops expects hospitals affiliated with the Catholic Church to abide by the Ethical and Religious Directives for Catholic Health Care Services. These directives interpret medical care based on the church’s moral teachings and limit aspects of reproductive and end-of-life-care.

One in five do not report their identity

“A basic cornerstone of medical ethics is to support patient autonomy,” said Guiahi. “One way to do this is to be transparent. It was surprising to find that one in five of these Catholic hospitals do not even report their identity and that the vast majority do not explain to patients what being Catholic means.”

Guiahi said hospitals may avoid transparency about restrictions to avoid losing patients.

“This means that many patients may waste their time at Catholic facilities when they encounter restrictions to common health services,” she said.

At the same time, some Catholic hospitals that openly cite the directives may actually provide restricted services using workarounds.

For example, rather than say they are giving a patient an intrauterine device for birth control, they might say it is being placed for heavy menstrual bleeding.

“There appears to be a lot of variability across Catholic sites in terms of what they provide and whether or not they use workarounds, which compounds health care consumer confusion,” explained Guiahi.  “Websites provide an opportunity to inform consumers about which services are provided and which ones are restricted and can thereby avoid conflicts in care.”

Ultimately, she said, greater transparency about religious affiliation and care restrictions may allow patients to make informed choices.

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Ovia Health gives growing families support they need

From pregnancy to parenting, it is common that many soon-to-be and new parents and have many questions along the way.

To help answer these questions, the CU Health Plan is now offering Ovia Health to CU Health Plan members.

What is Ovia?

Ovia Health offers a suite of mobile applications to help families throughout each stage of family planning with education on fertility, pregnancy and parenting, as well as specific information about the maternity benefits available through the University of Colorado.

Distinct apps meet diverse needs

Ovia Fertility: Women can learn more about their health and fertility with cycle tracking, expert research and tips and instant data feedback. Use this app to predict periods and ovulation, track symptoms and mood and get pregnant faster.

Ovia Pregnancy: Get answers to pregnancy questions with articles, health and wellness tips. Use this app to track the growth of your baby, research effects of foods and medications, learn about your symptoms and have an overall healthier pregnancy.

Ovia Parenting: Ovia Parenting supports families with expert parenting articles, daily tips and guidance based on your child’s age and the ability to share updates with friends and family. Use this app to identify and understand developmental milestones, track progress and have an easier transition to life with a new family member.

Start using Ovia

To learn more about Ovia and sign up, visit the CU Health Plan online.

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Research initiative uses Big Data to improve patient care

Researchers at the University of Colorado College of Nursing are participating in an initiative to improve health care outcomes and efficiencies by using large clinical and administrative data in a pediatric acute care setting. The project was funded by a grant received from Data Science to Patient Value (D2V) from the CU School of Medicine.

D2V is a multidisciplinary research initiative that funds projects focusing on using technology and Big Data and their applications to health care through collaborations with multiple stakeholders, including providers, patients, health systems, payers and policy makers. Also playing key roles in the initiative are the CU College of Nursing and the Colorado School of Public Health (ColoradoSPH).

Using Big Data

The use of Big Data to improve health-care delivery is being studied by Principal Investigator John Welton, PhD, RN, FAAN, and Co-Investigators Marcelo Coca Perraillon, PhD, an assistant professor in the Department of Health, Systems, Management & Policy in the ColoradoSPH and Peggy Jenkins, PhD, RN, assistant professor in the College of Nursing. Their study focuses on developing a database warehouse called the Nursing Value Research Data Warehouse (NVRDW) that collects data for each nurse caring for each patient during hospitalization.

The PI for the study, Welton, states, “This is the largest database of its kind to date detailing the overall care delivered by individual nurses and provides exciting potential to better understand the factors leading to better hospital outcomes of care.”

‘This is the largest database of its kind to date detailing the overall care delivered by individual nurses.’ – John Welton, PhD, RN, FAAN

The NVRDW is a large “pool” of data collected from various sources within multiple organizations that can be used to improve patient outcomes or transform health-care systems and deliver quality care to patients. Additionally, it can be used by researchers as a resource to create innovative strategies that improve patient outcomes.

One of the products from the D2V study is the creation of a consortium of three schools of nursing including the University of Kansas and University of Minnesota to share expertise to collect Big Data across multiple institutions in the future and leverage the expertise developed from the D2V project to improve the quality of care and optimizing nursing care to lower health care costs.

“There is a distinct purpose for data stored in the warehouse, such as research or reporting to improve patient outcomes or transform health-care systems,” said Jenkins. “Because so much data are collected in health-care settings, it is important to resource teams working to standardize the data so it can be compared and used to inform innovation.”

Providing Quality Care

Playing a huge role in the future of health care, Big Data is becoming more important to measure the quality of care provided to patients. Jenkins believes that nurses are just one of many individual interprofessional providers of patient care who can help in improving the quality of health care.

Big Data’s impact on health care

With technology becoming more present in the delivery of health-care services, more data is being collected than ever before. From tracking vital signs to discover trends, charting patient care histories through electronic health records, or using multiple patients’ health histories to predict health conditions and create treatment plans, Big Data is being used to reduce costs, create innovative treatments and provide effective care in a timely manner.

“Interprofessional collaboration of data scientists, informaticians, nurse scientists, nurse leaders, academia, clinical practice sites, and industry is necessary to construct data warehouses,” she said.

Although not all hospitals and health-care settings have large database warehouses, the multidisciplinary work at the CU Anschutz Medical Campus is a step in the right direction. Problems such as incompatible data systems could make it hard to import data to use to improve quality of care. Patient confidentiality can also become an issue. With large amounts of data such as electronic health records being housed in one database, it can make patients’ information vulnerable to a security breech, so it is important to have clear protocols in place to make the data secure.

Additionally, Big Data can create higher-value care that is more efficient, effective, higher quality and more cost effective, which can improve the care patients receive from providers in all sectors of the health field. This is particularly essential to nursing care, Jenkins notes.

“Using new methods, nurses are viewed as unique providers of patient care, and the value of quality nursing care provided divided by costs can be measured,” she said. “There is much to be learned about nurse characteristics and processes contributing to quality patient outcomes.”

Welton adds, “We are at the start of our journey to better understand the inner workings of health care by examining the care of each provider. We know a lot about physician care, but we are just beginning to collect data at the individual nurse-patient unit of analysis.”

The foundational D2V project has started a national dialogue on how to use this work to collect increasingly larger datasets to complement the many efforts to improve future health-care systems.

Guest contributor: This story was written by freelance contributor Katherine Phillips

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CU Anschutz researchers discover an important breakthrough in pulmonary fibrosis

A team of investigators led by members of the University of Colorado School of Medicine faculty at CU Anschutz Medical Campus has identified a connection between mucus in the small airways and pulmonary fibrosis.

The findings are published in Nature Communications.

David Schwartz, MD
David Schwartz, MD, chair of the Department of Medicine at the CU School of Medicine

“The overproduction of a lung mucin (MUC5B) has consistently been shown to be the strongest risk for the development of idiopathic pulmonary fibrosis (IPF) and most recently rheumatoid arthritis-interstitial lung disease,” said senior and corresponding author David Schwartz, MD, chair of the Department of Medicine at the CU School of Medicine.

Schwartz adds, “The findings in this manuscript provide a critical breakthrough in understanding the cause and potentially the treatment of IPF by demonstrating that excess mucus in the small airways can cause lung fibrosis, in part, by impairing the mechanism of lung clearance. In aggregate, these discoveries have provided the means to identify an at-risk population, diagnose the disease prior to the development of irreversible scarring, focus on a unique therapeutic target (MUC5B) and a specific location in the lung (distal airway), and create a novel pathway for therapeutic intervention for a disease that is currently incurable.”

A critical need for early diagnosis

Idiopathic pulmonary fibrosis is the most common type of progressive lung fibrosis. Over time, the scarring gets worse and it becomes hard to take in a deep breath and the lungs cannot take in enough oxygen. The average length of survival of patients with IPF is three to five years, and a critical unmet need is to identify patients before the lung is scarred irreversibly.

image of lungsMucociliary dysfunction is an emerging paradigm in lung diseases. Previously considered a characteristic specific to obstructive diseases such as asthma and chronic obstructive pulmonary disease, and genetic diseases such as primary ciliary dyskinesia and cystic fibrosis, the importance of mucins, mucus, and mucociliary interactions has surfaced in diseases of the lung periphery, such as adenocarcinoma and IPF.

Genetic findings may prevent progression

The investigators on the current study in Nature Communications hypothesized that the potential role for mucociliary dysfunction as a driver of IPF pathology is supported by unique gene expression signatures in IPF. The investigators found that a specific genetic characteristic, known as the MUC5B promoter variant rs35705950, which results in a marked increase production of mucus in the lung is the strongest genetic risk factor for IPF. They also found this is the strongest risk factor for rheumatoid arthritis-interstitial lung disease.

The findings suggest that targeting MUC5B in the terminal airways of patients with preclinical stages of interstitial lung disease represents a strategy to prevent the progression of preclinical pulmonary fibrosis.

“This study shows how genetic findings in human diseases can generate new hypotheses, such as those related to impaired mucociliary clearance, that may lead to the discovery of novel molecular mechanisms and the development of early diagnostics and more accurate treatments for pulmonary fibrosis,” said James P. Kiley, PhD, Director of the Division of Lung Diseases at the National Heart, Lung, and Blood Institute.

The research in the study is supported by Jennifer Matsuda, PhD, at National Jewish Health for generating Muc5b transgenic mice, Melanie Sawyer at Parion Sciences for assistance with in vitro mucolytic testing, and Jake McDonald at Lovelace Respiratory Research Institute for support with aerosol delivery. This research was supported by the National Heart, Lung and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, Department of Defense, Cystic Fibrosis Foundation HILL16XXO and BOUCHER15RO, and Parion Sciences, Inc.

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CU Anschutz on forefront of reimagining health care

Amid spiraling costs, complexity and inefficiencies, the health care industry has reached an inflection point. It’s ripe for massive disruption.

Fortunately, the digital technology revolution is also on the rise, and it offers cutting-edge solutions to the problem. Digital health, remote monitoring systems and prescriptive analytics are just a few ways technology is intersecting with health care. Painting this picture were Richard Zane, MD, professor and chair of the Department of Emergency Medicine in the University of Colorado School of Medicine, and Kimberly Muller, managing director of CU Innovations. They presented the many ways the CU Anschutz Medical Campus is at the forefront of innovation and reimagined health care to about 50 members of the Metro Denver Executive Club at the Denver Country Club on Wednesday.

“What’s going to happen in the next two years, or 10 years, will fundamentally alter the way in which we deliver care, the way in which you get care, and the relationship of industry to health care,” Zane said.

Sobering statistics

After running through sobering statistics — health care costs the average American $10,000 per year (a total of $3.5 trillion), and medical error is the nation’s No. 3 cause of death — Zane showed the arc of technological advancement and noted that leading companies — Google and Amazon among them — are now putting health care in the crosshairs. By aggregating the barriers to care, wastefulness in the system and care outcomes, they are beginning to deliver solutions.

Richard Zane, MD, speaks at country club
Richard Zane, MD, delivers a talk titled, “Can Innovation and the Digital Revolution Save Healthcare?” at the Denver Country Club.

Zane, who is also Chief Innovation Officer at UCHealth, noted that Google’s Verily has launched Project Baseline, which monitors everything about a person — respiration, heartbeat, reactions to environmental conditions, etc. Project Baseline collects so much data that it will create a new definition of a healthy human, he said.

But can the human brain interpret all of this data? “I don’t think so,” Zane said. “By 2025 knowledge is expected to double every 12 to 14 hours. The only way we’re going to deal with this is by partnering with machines. We have to figure that out: How we use data science, and how we can allow electronic medical records to help us.”

Information at fingertips

For example, technology offers promising solutions to the prescription-drug conundrum. Currently, a couple variables mainly factor into the drug a physician prescribes a patient, Zane said. They are: was this medicine effective in another patient I treated with a similar condition, and can I properly spell the drug’s name? Imagine, he said, if doctors instead could use a tool that easily culls prescriptive analytics from a patient’s electronic medical record. It would scour each person’s medical record, learn everything about the patient and match a drug to the diagnosis. “With the click of a button, we know the medicine that I just prescribed is not only the right one, but your insurance will cover it and the pharmacy has it,” he said.

As another example, he noted that UCHealth has implemented successful remote care through technology. Using video uplink, sub-specialists based on the CU Anschutz Medical Campus deliver care to patients with tertiary illness in UCHealth’s Longs Peak Hospital in Longmont. “But what’s to prevent Amazon from having all the sub-specialists, or Google or anyone?” he said.

And what about soon-to-come 5G digital connectivity, which will further revolutionize the many wearable biometric-monitoring devices on the market? “It’s a game-changer,” Zane said. “Maybe we can develop a patch that costs $30 to make and lasts for three months. You put it on, collect all your biometric data. Then all of the sudden, like air traffic control, doctors will be able to see all their patients and figure out who does and doesn’t need care.”

Turning game-changers into reality

Muller said the goal of CU Innovations is to take these game-changing visions and turn them into reality. She noted that venture capital is growing exponentially in health care, but a problem remains: Many of the advancements are occurring in silos, separate from the point of care within health systems.

Kimberly Muller, CU Innovations
Kimberly Muller, managing director of CU Innovations, explained the importance of technology companies and clinicians working side by side, as they do at the CU Anschutz Medical Campus, to forge innovations.

Some research shows that as many as 95 percent of new health care technologies are never adopted in a clinical setting, she said. That’s where CU Innovations and the CU Anschutz Medical Campus comes in.

“We have the entire continuum — pediatrics all the way to geriatrics — and that broad system represents every setting in health care. We have an academic medical center, community hospitals, urgent care, clinics and at-home settings,” Muller said. “Imagine if we use this large system as a Clinical Validation Laboratory to test all of the technologies that Dr. Zane talked about. In fact, that’s what we’ve been building.”

The Clinical Validation Lab has received interest from hundreds of companies and is regarded as a national model for accelerating the transfer of world-class research and ideas to the marketplace.

Side-by-side collaboration

“Now you truly have the convergence of technology companies coming together, working side by side with clinicians, to figure out how we get those adoptions (by physicians and patients) and turn that technology failure rate on its head,” Muller said.

She added that by studying every major vertical within health care — payers, device manufacturers, pharmaceuticals, etc. — CU Innovations has a holistic vision of the industry and understands how technologies can be best advanced.

“We continue to form partnerships with health systems around the country, so we can take the work happening here and scale it quickly, instead of the 20-year cycle that we’ve traditionally seen in health care,” Muller said.

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Conference tackles challenging ethical dilemmas in health care

Health care professionals face ethical dilemmas every day. They don’t have the luxury to treat ethics and gray areas of morality as intellectual parlay, because these challenging situations arise with regularity.

Matthew Wynia
Matthew Wynia, director of the Center for Bioethics and Humanities, leads a session at the recent Aspen Ethical Leadership Program.

While medical ethics courses are part of academic programs, it’s rare to practice moving beyond the hypothetical and into the realm of reality. How should health care professionals act ethically?

This question and others were discussed at the third annual Aspen Ethical Leadership Program (AELP), held recently in downtown Aspen. The inclusive and forward-thinking program on ethical leadership is geared toward people across the health care spectrum — physicians, students, administrators, lawyers, insurance providers and other leaders. The program is led by founders Matthew Wynia, MD, MPH, director of the Center for Bioethics and Humanities at the CU Anschutz Medical Campus, and Ira Bedzow, director of the Biomedical Ethics and Humanities Program at New York Medical College.

Attendees participated in plenary sessions, panels and case studies, all in a highly engaged setting due to the intimate size of the three-day conference. Bringing together professionals from across the spectrum of health care to train in identification and generation of solutions to the ethical dilemmas of our modern age demonstrates the immense power of inter-professional collaboration.

Heard of ‘Hard Call’?

Check out this podcast that explores tough ethical decisions in health care.

An interesting component of this year’s program was that many cases fell into the black-and-white category, rather than morally ambiguous areas. Yet, even in situations where consensus regarding solutions was easily obtained, participants quickly learned that the development of policies to carry out those decisions was still quite difficult when confronted with the reality of their implementation.

Finances, a wide variety of stakeholders, conflicting values of autonomy and utilitarianism, and legal obligations — an array of factors must be considered and provide challenges to taking ethical action. The interactive programming of AELP could be likened to a mental gym where ethical muscles are built and strengthened.

Next year’s program will take place from Sept. 9–11.

Guest contributor: Taylor Soderborg, an MD/PhD candidate in the Integrative Physiology Program at the CU School of Medicine.

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Chancellor Don Elliman honored with American Cancer Society Champion of Hope Award

“I love my job. I get to go to work every day surrounded by people who are trying to make the world a better place: to give people life, to give people hope.”

With those words, CU Anschutz Medical Campus Chancellor Don Elliman accepted the American Cancer Society’s Champions of Hope Award on Saturday night, Nov. 10. Elliman was chosen for his distinguished service and leadership, and honored with this TRIBUTE VIDEO.

Dr. Schulick with Chancellor Elliman
Chancellor Elliman is congratulated by Richard Schulick, MD, director of the CU Cancer Center, at the ASC Champion of Hope gala.

The Champions of Hope Award recognizes outstanding partners of the American Cancer Society – of which CU Anschutz certainly is one. Since 1955, the Society has funded nearly 200 cancer-related research grants at CU, $31 million worth. Currently, it’s funding 17 multi-year research grants totaling $8.8 million in Colorado, many of which are at CU Anschutz. Elliman thanked the Society for its ongoing support of cancer research.

Speaking of his “belief that we will see more advances in health care in the coming decade than we’ve seen in the last 50 years, maybe longer,” Elliman noted that many of these breakthroughs are likely to be in the area of cancer care and cure. Citing immunology and immunotherapy efforts underway at CU Anschutz, he said “with CAR-T cell and other novel therapeutics, people who have failed all standard therapies and are out of options, have hope, and a good chance to cure. And that’s just one example.”

More than 300 people attended the Champion of Hope gala, held at the EXDO Event Center in Denver’s RiNo Art District. The event highlighted the Society’s accomplishments of the past 100 years as the largest nonprofit funder of cancer research in the United States, and raised more than $209,000 for cancer research in Colorado.

Elliman was quick to note that as much as he appreciated the honor, it was not his alone. CU Anschutz collaborates with cancer organizations, health care facilities, nonprofit organizations, government institutions and corporate sponsors to help achieve the common goal of eliminating cancer.

“I get the plaque,” he said, “but you are the real champions of hope.”

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State of the Campus: ‘Unmatched trajectory’

With a nod to the visionaries who came before him, those who dreamed of what the former Fitzsimons Army medical site could become, University of Colorado Anschutz Chancellor Don Elliman said in his State of the Campus address that the campus is on a grand journey, one closer to its beginning than its end.

State of the Campus Elliman
Chancellor Elliman said in his address: “The task now is to imagine the course for the next 20 years.”

And the key is imagination.

In an address that honored the past, noted recent accomplishments and mostly invoked the future — “imagine” was a central theme — the chancellor asked the full auditorium to pause, take stock and do a bit of daydreaming.

“The task now is to imagine the course for the next 20 years,” he said. About 250 faculty, staff and students listened to Elliman’s address Tuesday in the Hensel Phelps West Auditorium.

Through data, visual graphics and a description of our mission, the chancellor explained the qualities that distinguish the CU Anschutz Medical Campus from other academic medical centers, most notably in how the campus has become a major health care destination as well as an economic engine for Colorado and the entire Rocky Mountain region.

He said the campus’s trifold mission remains steadfast: “To provide the finest medical care in the world, to push the science behind that care to new horizons, to train those who will deliver that care in the future.”

Stellar numbers

The keys to reaching these goals, he said, are to work even harder at attracting and retaining the best talent and to continue driving innovation.

State of the Campus audience
Audience members listen attentively to the State of the Campus address in Hensel Phelps West Auditorium.

Elliman said the campus’s greatest strength is intellectual entrepreneurship; our nimbleness, dedication and innovation has pushed the institution to world-class status. He cited rising figures in various performance areas over the past five years:

  • university revenues climbed 67 percent (an average of 11 percent a year);
  • clinical revenues, which account for half of the university revenues, have grown even faster;
  • outpatient visits are now over 2 million a year (up 76 percent from 2013);
  • enrollment of underrepresented minority students has grown by 44 percent;
  • total research awards crested over $500 million this year for the first time (up 32 percent from 2013); and
  • unprecedented gains in philanthropy (up 93 percent from 2013).

“Taken all together the picture is a trajectory that is probably unmatched by any other academic medical campus in North America,” he said. “As I said, it’s only the beginning.”

He outlined a number of the priorities for the future:

  1. Invest in clinical excellence.

Elliman said CU Anschutz greatly benefits from having highly ranked pediatric and adult hospitals right on campus — an asset that needs to be leveraged. After listing the many accolades received by both University of Colorado Hospital and Children’s Hospital Colorado, the chancellor said, “There is no magic here. The story is people. Recruiting and retaining the best of the best is the game we are in, and our success will define our future.”

State of the Campus Ted Harms
The audience gives Ted Harms, executive director of The Anschutz Foundation, a round of applause after Chancellor Elliman recognizes the foundation’s recent $120 million gift to the CU Anschutz Medical Campus.

He noted that the talent-recruitment effort received two major boosts this year: The $47 million in program support from UCHealth to the Cancer Center with Rich Schulick, MD, as its new director, matched by a similar investment from the School of Medicine; and The Anschutz Foundation gift.

The latter was a $120 million gift, the largest in campus history and in cash terms the largest in the history of all of CU; 60 percent of the gift will go to talent recruitment. The audience gave Ted Harms, executive director of the foundation, strong applause.

  1. Increase and diversify research funding.

CU Anschutz’s research enterprise, one that is redefining the future of health care, sets the campus apart from our regional health care competitors, Elliman said. Congress is poised to increase National Institutes of Health (NIH) funding by about $2 billion next year — the NIH supplies about 42 percent of our total research funding — and the campus continues to diversify its research portfolio from other sources.

‘The story is people. Recruiting and retaining the best of the best is the game we are in, and our success will define our future.’ — Chancellor Don Elliman

A focal point is the Colorado Center for Personalized Medicine, which is gaining major traction in integrating bio specimens with data from electronic health records and other sources to power bioinformatics for research and precisely tailored treatment.

Also, CU Anschutz is making strides in streamlining its processes to support research grants.

  1. Invest in innovation.

With the arrival of CU Innovations in 2015, “we’ve totally re-engineered the innovation development process, created real clinical validation programs with both UCHealth and Colorado Children’s Hospital, and built new corporate partnerships with the likes of Eli Lilly and GSK, and others,” he said. “Over 200 companies visited us in the last year alone, and what we’ve built has become a true national model. And it’s just beginning.”

State of the Campus Elliman
Chancellor Elliman visits with attendees before his State of the Campus address.

Internal invention disclosures have increased over the past three years, from 70 per year to more than 200 annually.

  1. Significantly escalate our work in mental health and wellness.

The National Mental Health Innovation Center continues to employ new ideas and methods, including virtual reality, to break barriers in mental health care. The center complements the expanded work of the Helen and Arthur E. Depression Center; the Marcus Institute for Brain Health; and the Steven A. Cohen Military Family Clinic.

While progress has been made on campus in support of mental wellness, more than doubling our investment in student services, the support of all campus constituencies — students, faculty and staff — needs to be increased. Elliman noted these efforts will be boosted by The Anschutz Foundation gift.

  1. Increase regional and national marketing efforts.

The chancellor reported steps have been taken to establish a communications and marketing team that is focused on elevating the CU Anschutz profile regionally and nationwide. The team will oversee the rollout of our brand identity, a newly redesigned CU Anschutz website, and more robust content sharing across campus platforms and channels.

State of the Campus 2018

Watch and read the complete address here.

Further boosting the branding and identity of CU Anschutz will be the long-awaited shift to a domain name of “cuanschutz.edu” early next year. “It’s time — past time — we start telling the world about the specialists of this institution,” he said.

The year ahead

The year ahead teems with possibilities and breakthroughs, Elliman said, highlighted by our research enterprise further gaining momentum via:

  • immunotherapy advances that will see us start to deliver clinical trials in more than minimally manipulated cells to patients in our partner hospitals;
  • the Gates Biomanufacturing Facility’s ability to handle the development of these cells — a major competitive advantage;
  • a retooling of the Office of Research to lead in connecting researchers with complementary interests and promoting more collaboration; and
  • the continued development of a comprehensive plan to define our position and role in addressing the mental health crisis in our region and our nation.

He highlighted accomplishments and innovations occurring within each of our schools and colleges; said a world-class-asset is in the makings with the continued expansion of our bioengineering program; underscored the record-breaking work of the Advancement team, including its role in supporting the much-needed Anschutz Health Sciences building (groundbreaking in January); and said two new commercialization reserves will be coming out of CU Innovations — one supporting early stage, proof-of-concept development and the other investing in commercial IP.

Challenges on the horizon

Bumpy roads ahead in the health care marketplace are presaged by a triumvirate of “possibles”:

  • the possible reduction of reimbursements at the federal level;
  • the possible reductions in population coverage; and
  • depending on who our next governor is, the possible overhaul of Colorado’s health system.

“Any of these changes would have huge impacts on us and our affiliates,” Elliman said. “The one thing we do know is that the cost of health care cannot continue to rise; it’s not fiscally sustainable. We have to be partners in finding ways to reduce the cost of care. We ignore that at our peril.”

State of the Campus chatting
After his address, Chancellor Elliman chats with Richard Schulick, MD, director of the CU Cancer Center, left, and Gerald Dodd, MD, professor of radiology.

On the flip side, he said, while our counterparts are dealing with stagnation, CU Anschutz faces enviable problems from growth, especially in terms of parking and infrastructure.

Other key challenges include retaining top talent and maintaining support levels required to fuel innovation. In all of these areas, The Anschutz Foundation gift will be a major asset.

Huge momentum

“In short, we have built huge momentum, and we have many unique strengths,” Elliman said. “The most important of these is the fact that we have, on one unified campus, six wonderful schools and colleges and two highly ranked hospitals.”

How to best leverage all of these assets brought the chancellor back to the start of his address — imagination, and the fact that all the work done at CU Anschutz comes down to people.

It is people, he said, who will scan the horizon for fresh ways to imagine the future, even if it is something currently beyond the confines of our current imagination.

He closed the address by showing a stirring video that tells the story of the exemplary care provided to a cancer patient — essentially why we do what we do. “These are the stories we’re going to be sharing to promote the great work of the people in this room and on this campus,” Elliman said. “Your stories. And we can’t wait to tell them.”

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Students map career paths at Pre-Health Day

While their college careers are just beginning, freshmen twins Christina and Danielle Gonzalez, aspiring to be an oncologist and orthopedic surgeon, respectively, can foresee a day when they possibly operate a clinic together. The journey is certain to present some challenges, but the name will be easy — Gonzalez & Gonzalez.

Students at Pre-Health Day
From left, Danielle Gonzalez, Aden Martinez and Christina Gonzalez — all pre-med undergraduates at Colorado State University-Pueblo — are impressed by the breadth of academic programs available at CU Anschutz.

To get started on this road, the sisters took advantage of the fourth annual CU Pre-Health Day at the University of Colorado Anschutz Medical Campus. The event drew more than 350 undergraduate and high school students who spent a recent Saturday at CU Anschutz learning about health care professions.

Attractive campus

The Gonzalezes were joined by fellow Colorado State University-Pueblo classmate Aden Martinez. Martinez, who said it’s never too soon to consider career options. “We like to get exposed to health careers early while we can and maybe in later years come back and learn more about what the campus here has to offer,” said Martinez, who is eyeing the chiropractic field. The trio started the day attending a session about preparing for the Medical College Admission Test (MCAT).

“I wasn’t really sure what to expect of Colorado,” said Danielle Gonzalez, who grew up in Florida. “I expected this to be a smaller campus, but it’s actually very big and it looks very professional. It looks like everybody here knows exactly what they want to do.”

Pre-Health Day showcased nine professional and translational research fields — dental medicine, public health, biomedical research, nursing, pharmacy, physician assistant, anesthesiologist assistant, physical therapy and medicine — and educated students about the admission and application process, how to prepare for entrance exams and exposed them to current students and alumni who had made the transition to health care careers.

Valuable advice

“It’s days like this where students can actually speak with representatives on campus and get some one-on-one face time,” said Justin Rowe, senior recruiting specialist in the Skaggs School of Pharmacy and Pharmaceutical Sciences. Web sites are great for providing information, he said, but “it’s events like this where you can ask questions and get information directly from experts who are qualified to give you valuable advice.”

Tyler Carpenter at CU Anschutz
Tyler Carpenter, a freshman at Falcon High School near Colorado Springs, joined the hundreds of high school students from across Colorado at Pre-Health Day.

The groups split between sessions in the Education 2 Building (undergraduates) and Education 1 (high school students). Tyler Carpenter, a freshman at Falcon High School near Colorado Springs, traveled to Aurora with his family. “I want to explore all the health stuff,” said Carpenter, who is especially interested in forensic pathology.

Carl Johnson, director of student engagement at CU Anschutz, said the aspiring health students heard not only practical advice from current CU Anschutz students and alums, but also inspiring messages about bettering society as a whole. He said representatives from all seven CU Anschutz schools and colleges — School of Dental Medicine, Graduate School, School of Medicine, College of Nursing, Skaggs School of Pharmacy and Pharmaceutical Sciences and the Colorado School of Public Health — took turns describing their disciplines to a room full of hundreds of students.

Sense of camaraderie

“It was amazing how that sense of camaraderie came through about the importance of the health sciences field in general, and how they’re all looking at ways to give back,” Johnson said. “That’s what this event is about — just to celebrate and honor what CU Anschutz is. Here, it’s not just about one particular school or college, but how all the disciplines interact and how significantly they impact health care — hospitals, clinics and rural medicine — in Colorado and around the world.”

This global message of the importance of health care resonated with the student participants, including the Gonzalezes from Pueblo. Both sisters were impressed by CU Anschutz and the quality of its many educational, clinical and research offerings. “It’s definitely something I’m going to look into,” Danielle said. Christina added, “I’m definitely planning on applying here.”

Editor’s note: The video was produced by Stephanie Carlson, content producer, Marketing & Communications, Skaggs School of Pharmacy and Pharmaceutical Sciences.

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