2019 HIGHLIGHTS CHAIR’S MESSAGE . 2 FACULTY AFFAIRS . 6 VETERANS AFFAIRS . 8 BASIC & TRANSLATIONAL RESEARCH PROGRAMS . .10 CLINICAL & HEALTH SERVICES RESEARCH PROGRAMS . .12 ADMINISTRATIVE PROGRAMS . 14. UNDERGRADUATE MEDICAL EDUCATION . .16 GRADUATE MEDICAL EDUCATION . .18 QUALITY & INNOVATION AND EXTERNAL RELATIONS . 20. DIVERSITY, EQUITY & WELL-BEING . .25 AWARDS . 27. PROFESSORSHIPS . .28 HONORING OUR PAST . .34 CREATING A LEGACY . 48. FUELING INNOVATION . .64 DEVELOPING BETTER TREATMENTS & CURES . 84. ADVANCING CLINICAL CARE . 98. CHAIR’S MESSAGE CHAIR’S REPORT John Carethers, MD | Chair of Internal Medicine During 2019, the Department of Internal Medicine turned 171 years old, and the University of Michigan Hospital, where our faculty work, turned 150 years old. Throughout this history, our faculty and staff have done many wonderful things for our patients, our department, our institution and our state and country. We continued to be recognized and honored for our excellence in many ways during the past year. Now we are focused on using these strengths to step up like never before as we face the many unknowns of health care in the coming year. THE ROOTS OF OUR SUCCESS NATIONAL HONORS I selected this year’s annual report theme, “The U.S. News & World Report Roots of Our Success — Philanthropy’s Role in 2019–2020 Rankings Advancing Our Mission,” because I wanted to highlight the many stories made possible by our Hospital No . 11 (Honor Roll) donors . Philanthropy allows our department to Specialty Areas go above and beyond in all areas . It emboldens Pulmonary No . 10 risk in research, allowing us to find better cures Endocrinology No . 11 and treatments . It allows us to innovate medical Rheumatology No . 12 education for future generations . It inspires us Cardiology & Heart Surgery No . 13 to push the limits of understanding of the best Geriatrics No . 15 ways to care for patients and to bring those ideas Gastroenterology & GI Surgery No . 20 to life in the clinic . I hold the John G . Searle Nephrology No . 32 Professorship in Internal Medicine — the very Diabetes & Cancer No . 34 first professorship developed for our department in 1968 . When I took on the role of chair in 2009, Medical Education there were 28 professorships . Now just 10 years The U-M Medical School was ranked No . later, we have more than 100! The tremendous 6 for training primary care physicians and impact of this growth of support is reflected for internal medicine . It is No . 16 nationally throughout the pages of this report . among research medical schools . 2 2019 INTERNAL MEDICINE ANNUAL REPORT CHAIR’S MESSAGE HOSPITAL ADMISSIONS NEW ROLES Scott Flanders, MD, was named 16,840 3,912 16,794 9,388 16,730 9,811 16,919 9,644 16,929 8,873 Michigan Medicine’s chief clinical Internal medicine faculty are strategic officer for the University providing valuable leadership of Michigan Health System . 2014-15 2015-16 2016-17 2017-18 2018-19 through our department, Michigan Total 20,752 Total 26,182 Total 26,541 Total 26,563 Total 25,802 Medicine and the university . Bethany Moore, PhD, became n Discharges n Observation Cases the acting department chair for Leslie Aldrich, MD; David the Department of Microbiology & OUTPATIENT OFFICE VISITS Smith, MD and Vallerie Immunology at U-M . McLaughlin, MD, became associate chief clinical officers in our new U-M Medical Group 2019 PATIENT CARE ambulatory care structure . Our volume of off-site primary and specialty care and on-site 135,111 150,202 111,369 16,572 145,387 164,796 120,087 19,268 151,414 167,921 118,879 19,214 163,071 171,597 135,432 18,888 168,919 174,695 153,939 17,711 Eve Kerr, MD, MPH was named specialty care continued to the inaugural vice chair for equity, increase during 2019 . This is inclusion and well-being for the 2014-15 2015-16 2016-17 2017-18 2018-19 primarily due to the great success Total 413,254 Total 449,538 Total 457,428 Total 488,988 Total 515,264 Department of Internal Medicine, of our many new outpatient along with Assistant Vice Chairs n Off-Site Primary Care n On-Site Specialty Care n Off-Site Specialty Care n On-Site Primary Care facilities in Ann Arbor, Brighton, Sarah Gualano, MD, and Livonia and Northville helping GROSS PROFESSIONAL CHARGES (in thousands) Michael Lukela, MD (page 25) . us meet the growing demand Timothy Laing, MD, previously for patient care in southeast our vice chair for clinical Michigan . operations, transitioned to director 137,030 57,329 45,809 146,705 59,678 52,576 143,812 74,007 55,202 166,311 62,967 57,850 175,580 67,468 60,470 of billing and compliance . He will be working with our new Clinical Experience & Quality Team that began in early 2020 (page 22) . 2014-15 2015-16 2016-17 2017-18 2018-19 Total 240,168 Total 258,959 Total 273,021 Total 287,128 Total 303,518 n Outpatient Specialty n Inpatient Specialty n General Medicine Inpatient + Outpatient 2019 INTERNAL MEDICINE ANNUAL REPORT 2019 INTERNAL MEDICINE ANNUAL REPORT 3 CHAIR’S MESSAGE A NEW HOSPITAL neurosciences and cardiovascular Michigan Medicine focuses its or our department . On the next services . Each of the 264 rooms resources on meeting the needs page, we’ve added a brief In late October 2019, Michigan in the hospital will be private of the COVID-19 crisis . overview of the current Medicine broke ground on a new and will be capable of being COVID-19 response at 12-story adult inpatient hospital . converted to intensive care . STEPPING UP Michigan Medicine . The facility is needed to increase The 690,000-gross-square-foot patient access while also As we go to print with our hospital will allow more patients providing state-of-the-art care to report this year, our world has to access Michigan Medicine’s patients, with an emphasis on just been hit with a global high level of care . Currently, clinical pandemic . This is a time unlike hospital facilities often operate at anything any of us has seen more than 90 percent capacity . before . Every day I am humbled This project was slated by the incredible heart, courage, to be completed in determination and hope our 2024 but has faculty, staff, residents and been put on students are bringing to the temporary frontlines . Many of the same hold as people you see featured in this report are now taking every bit of their talent, energy, compassion and innovation and applying that to this unknown, new world . We are determined to help more patients survive and thrive, to protect frontline workers and to find new solutions to treating and preventing COVID-19 . I have never been prouder of our work 4 2019 INTERNAL MEDICINE ANNUAL REPORT CHAIR’S MESSAGE COVID-19 RESPONSE The state of Michigan capabilities are available within its doors to non-Veteran (i .e ., producing and distributing hand providers to HCQ vs . placebo By analyzing the registry data, confirmed its first two the university’s hospitals . All “humanitarian” or “civilian”) sanitizer to the local homeless to identify whether HCQ can participants of the MI-COVID19 COVID-19 cases on March staff caring for these patients are admissions on April 5, 2020 . To population . reduce infections in health care initiative aim to identify factors 10, 2020 . In the three prepared, trained and have the date, VAAAHS has cared for more providers at high risk and reduce associated with higher levels weeks that followed, the right supplies . civilians during the COVID crisis OUTPATIENT CARE the overall severity of COVID-19 . of critical COVID-19 illness number of cases in the than any VA in the country outside and worse outcomes; identify Division of Hospital Medicine To help our patients receive state soared to more than of New York City . Many internal IMPROVING COVID-19 CARE patient characteristics and Chief Vineet Chopra, MD, MSc, appropriate care with minimal 10,000, making it one of the medicine faculty have been part treatment regimens associated led the creation of the all-COVID risk of spreading disease in their Michigan Medicine has also nation’s hot spots . Michigan of this effort including Sanjay with improved outcomes; unit, with a team of hospitalists, communities wherever possible, teamed up with 25 other Michigan Medicine has been getting Saint, MD, MPH, the chief of and understand long-term nurse practitioners, physician we are providing enhanced hospitals and Blue Cross Blue many direct and transferred medicine at VAAAHS . complications for hospitalized assistants, nurses, respiratory access to outpatient care Shield of Michigan to collect COVID-19 patients since mid- patients . therapists and other staff during the COVID-19 pandemic, comprehensive clinical data on March . MEDICAL SCHOOL volunteers . including a COVID-19 hotline, COVID-19 patients to be included On March 17, the U-M Medical curbside screening and enhanced in an extensive registry that will REGIONAL INFECTIOUS By the end of March, they had School suspended student clinical access to virtual care (e-visits or provide insight into best practices CONTAINMENT UNIT handed over the reins to a team rotations and moved all classes video visits) . in treating patients with the virus . of experienced intensive care Part of Michigan Medicine’s online, in accordance with professionals, so the unit could Titled MI-COVID19, the comprehensive COVID-19 guidance from the Association PROTECTING PROVIDERS focus on the sickest patients . comprehensive, multisite registry planning and response program of American Medical Colleges . The RICU team moved on to A study led by internal medicine will likely be one of the largest included opening an isolation unit Faculty members continued to transforming other areas of the faculty Marisa Miceli, MD, collections of COVID-19 patient called the Regional Infectious mentor students beyond the hospital, and training their staff, in and Peter Higgins, MD, data in the country .