Feb. 6, 2012 | Feb. 6, 2011 | Efforts to expand student enrollment, improve patient care and extend research positions the University of Arkansas for Medical Sciences (UAMS) for the future regardless of the challenges, said Chancellor Dan Rahn, M.D.

In his annual State of the University report Feb. 3, the chancellor celebrated a year of accomplishments while detailing the challenges posed by rising unreimbursed care and other changes in health care. Developing an institutional strategy for the possibilities of genomic medicine (personalized care); improvements in care and efficiency afforded through the concept of patient- and family-centered care; and leadership in academic programs that address health care workforce needs are among the strategies for addressing those challenges, he said.

“If we stay focused on our value to society, we will advance our mission and we will lead toward better health, better health care and lower costs in the future,” Rahn said. “The financial challenges are not going to go away, but everybody in health care has that.

“These are achievable goals, but there’s a long distance between how the system functions now and where we want it to be.”

Unreimbursed care is rising at a time when the economy has put pressure on revenue. A survey done by the Council of Teaching Hospitals for calendar year 2010 found that UAMS ranked fourth highest for unreimbursed care among 95 similar academic medical centers.

Regardless of the outcome of federal health care reform, there will be increased demand for care. The health care system continues to be ill suited to deliver uniform, efficient high-quality care across time and different sites of care, Rahn said.

The chancellor reviewed the year of achievements across the UAMS academic, patient care and research missions. A focus on health and improving health in Arkansas unifies all of the work of the state’s only academic health center, he said.

UAMS is expanding educational and clinical reach through distance education and communications technology. A high-speed data network was bolstered and will be expanded by the $102 million grant awarded to UAMS in 2010.

Through this initiative, fiber-optic cable and teleconferencing equipment will ultimately link the state’s four-year colleges and universities, community colleges, hospitals and clinics to enable online education, distance health and decentralized research. The UAMS Center for Distance Health is overseeing successful and growing programs like ANGELS, which helps high-risk pregnant women and their newborns get medical care and Arkansas SAVES, which makes lifesaving stroke treatment available 24 hours a day throughout the state.

Academically, UAMS is seeing record enrollment and record graduation rates. From 2007 to 2011, applications were up 7.9 percent, enrollment was up almost 10 percent to 2,819 students and graduation rates were up 28.3 percent from 707 to 907.

“The fact that graduation is increasing at a greater rate than enrollment reflects better retention to graduation,” he said.

There are now 107 students on the regional UAMS Northwest campus in Fayetteville, enrolled in Medicine, Pharmacy, Nursing and programs of the College of Health Related Professions.

New programs and academic areas of emphasis include:

• Planned development of a physician assistant program, doctorate of nursing practice and degrees in regulatory science
• Programs developed in translational research (regulatory science), pharmaceutical sciences and research (bioengineering, bioinformatics, nanomedicine).
• Preparing students for system reform with emphasis on inter-professional education, team care, engaged/service learning and translational research

In research, UAMS continues to rank in the top 20 percent among all U.S. colleges and universities nationally in research funding from the federal government. Rahn noted the research figure was in spite of flat to nearly flat budgets for research for most funding agencies, especially the National institutes of Health. Research grants year to date for Fiscal Year 2012 total just more than $78 million and are running ahead of last year, he said.

Research investments are paying off. The Winthrop P. Rockefeller Cancer Institute is preparing to open two new research floors, to include personalized medicine – where medical treatment can be more targeted to an individual patient based on their genetic makeup.

“Genomic sciences underlie all of medicine which, by definition, encompasses all programs and colleges at UAMS,” Rahn said. “Eventually, genomic or personalized medicine will influence or permeate all that we do.”

The chancellor noted that many individual researchers are working in genetics, genomic, epigenetic and proteomic fields at UAMS. The challenge is how to enable the creativity of the research already underway while providing coordinated institutional support. Then, he said, the connection must be made between research advances, clinical care and education to advance patient care now and in the future.

UAMS established its seventh institute in 2011, the Translational Research Institute with a focus on quickly turning new research discoveries into new or improved medical treatments.

Other research points of interest included:
• The internationally known multiple myeloma program in the Myeloma Institute for Research and Therapy marked treatment of its 10,000th patient in 2011 while continuing to advance personalized medicine through clinical trials with treatment determined by the genetic profile of each patient’s myeloma.
• The Cancer Institute hopes to achieve cancer center designation from the National Cancer Institute – long a goal of the institute – within three to five years.
• Behavioral health accomplishments at the Psychiatric Research Institute include establishment of the Women’s Mental Health Center and the continued development of the brain imaging research center using functional MRI to see the brain at work under various conditions.

Development of an institution wide clinical data warehouse, which went online in fall 2011, contains clinical information on more than 675,000 patients as a resource for research. The project will boost research. The project will boost research and support efforts to develop more personalized medicine. The next step with this will be a tissue repository.

The data warehouse also offers a resource for an increased focus on personalized medicine.

Clinical care at UAMS was highlighted in 2011 by a “nearly flawless” survey conducted by the Joint Commission organization that oversees hospital accreditation. The surveyors who came to UAMS were extremely impressed and they left using phrases like “model hospital” and “best survey.” Survey results this outstanding are almost unheard of, Rahn said.

UAMS was named the best hospital in the Central Arkansas area by U.S. News & World Report. Also, 38 UAMS faculty physicians are among the 48 Arkansas physicians named as “Top Doctors in the U.S.,” a list published by Castle Connelly Medical and U.S. News.

In January UAMS opened a new off-campus location on Financial Center Parkway in west Little Rock that includes internal medicine and obstetrics and gynecology clinics as well as a sleep medicine lab.

Development and implementation of concepts for patient- and family-centered care (PFCC) – standards of patient care that will help UAMS improve the health of patients has started, Rahn said. From a focus on team care to electronic medical records to patient education efforts, the goal is to improve care for patients from clinic to hospital to the transition to care outside the hospital.

Other clinical programs accomplishments and areas of emphasis going forward include:
• Creation of the SmartCare program in January that promoted use of UAMS clinical programs by UAMS employees
• Continued development of the patient-centered medical home concept to improve efficiency and quality of care for patients
• A new clinical information system