UCLA Health David Geffen School of Medicine SPRING 2014 CLOCKED UCLA researchers are redefining the science of concussion. SPRING 2014 VOLUME 34 NUMBER 2 LEADERSHIP A publication of UCLA Health and David Geffen School of Medicine at UCLA VICE CHANCELLOR, UCLA HEALTH SCIENCES DEAN, DAVID GEFFEN SCHOOL OF MEDICINE AT UCLA Inside This Issue GERALD S. LEVEY, MD, ENDOWED CHAIR A. Eugene Washington, MD, MSc PRESIDENT, UCLA HEALTH SYSTEM ASSOCIATE VICE CHANCELLOR, UCLA HEALTH SCIENCES David T. Feinberg, MD (RES ’92, FEL ’94), MBA CHIEF MARKETING OFFICER Meeting the Future Challenge Pattie Cuen Academic health centers must redefine Photo: Todd Cheney/UCLA Photography Photo: Ann Johannson Photo: Ann Johannson DIRECTOR, MARKETING COMMUNICATIONS Judi Goodfriend themselves if they are to survive in a changing Departments Features News + Notes EDITOR healthcare environment. David Greenwald 01 Leadership 16 Clocked 34 Faculty Photo: Stephanie Diani DESIGN DIRECTOR From the Dean: UCLA researchers are Notables, honors Meeting the future challenge. redefining the science of and achievements: Brad Donenfeld & Associates actual value of care provided for complex conditions. However, it BY DR. A. EUGENE WASHINGTON concussion. Up for a challenge. Why do academic health centers (AHCs) exist? This CONTRIBUTING WRITERS BY GREG CRITSER question is addressed in an article I wrote, along with David is also related to limited integration of care and unnecessary care. Greg Critser 02 In Box 36 Alumni 22 Geffen School of Medicine at UCLA and UCLA Health System What can AHCs do? We must adopt more of a patient Kim Kowsky A Family Affair What’s happening Readers respond. focus, developing approaches that follow the patient, deploying Karalee Miller Two UCLA medical from the MAA: colleagues, that appeared in the Journal of the American Medical Dr. Richard A. Rawson 04 The Cutting Edge researchers are engaged in East meets West. Association last November. We believe that these Institutions — multidisciplinary teams and integrated practice units across Shari Roan a very personal fight against departments. We must become more population-health centric, Kathy Svitil News and research: a lethal genetic illness that 38 Friends approximately 135 of them in the U.S. — exist to ensure Valerie Walker Breathing life into medical science. affects one in every 3,500 learning to care for the health of populations while using a Donor roundup: sustainable healthcare through their integrated missions of boys, including their son. The inaugural Luminary global budget to manage the health of a specific population. We EDITORIAL ADVISORY CO-CHAIRS 12 Conversation BY SHARI ROAN patient care, education and research. Yet, many of these centers Awards benefit UCLA’s John C. Mazziotta, MD (RES ’81, FEL ’83), PhD Dr. Patricia A. Ganz: Department of Head and operate in ways that threaten their viability. We state that AHCs must begin leveraging the vast reservoir of health-related big J. Thomas Rosenthal, MD Cancer care in crisis. 28 Zinging the Blues Neck Surgery. must reconfigure and transform rapidly if they are to survive. data to help create the most effective means of providing care. By using magnetic or EDITORIAL ADVISORY COMMITTEE We must shift to a value-conscious state of mind, eliminating electrical stimulation to 44 Why this concern? For too long, AHCs have existed as a Benjamin J. Ansell, MD ’92 (RES ’95) Epilogue alter neural activity in the Extending a hand in Iraq. cottage industry in a fragmented market, blind to the costs waste through the consistent use of evidence-based practices Sherin U. Devaskar, MD brain, neuromodulation Patrick T. Dowling, MD has opened a third front BY DR. RICHARD A. RAWSON of duplicative infrastructure and paid a premium for claims and by avoiding unnecessary tests. And AHCs must lead Steven M. Dubinett, MD for the treatment of difficult of quality, without the tools to measure or ensure it. As discovery in the prevention of disease and disability, recognizing Dieter R. Enzmann, MD psychiatric disorders. Judith C. Gasson, PhD BY KATHY SVITIL value-conscious purchasing forces AHCs to compete among that prevention is the ultimate value-added measure. Patricia A. Kapur, MD (FEL ’80) As profound change rapidly occurs in U.S. healthcare, the Shannon O’Kelley themselves and with other health organizations, many will face Bartly J. Mondino, MD critical threats. Centers that invested early in integrating care — fate of AHCs and our ultimate contribution will be determined Janet P. Pregler, MD by how we respond. Centers pursuing the disruptive Alan G. Robinson, MD primary care, information technology and analytics, as well Thomas B. Strouse, MD (RES ’91) as competing on value — are poised for continued growth. transformation we’ve outlined will not only survive but thrive. LuAnn A. Wilkerson, EdD But those that fail to respond effectively to the changing And these institutions will continue providing value to society, healthcare landscape may find their clinical revenues unable patients and communities. to support education and research and jeopardize their leadership in clinical training. One of the factors contributing to the precarious state of many AHCs is siloed clinical care that has diminished © Copyright 2014 by The Regents of the accessibility and coordination of care for patients and allowed A. Eugene Washington, MD, MSc University of California. Permission to reprint may be granted by contacting the editor, unnecessary duplication of services and comparatively poorer Vice Chancellor, UCLA Health Sciences To read U Magazine U Magazine, 10920 Wilshire Blvd., Suite 1850, outcomes. Pricing that is higher than comparable services Dean, David Geffen School of Medicine at UCLA Los Angeles, CA 90024. online, go to: E-mail: [email protected] magazine.uclahealth.org elsewhere is another problem. To some degree this reflects the Gerald S. Levey, MD, Endowed Chair Printed on recycled paper. Cover Illustration: Wade Harris U MAGAZINE 1 LEADERSHIP Meeting the Future Challenge Academic health centers must redefine themselves if they are to survive in a changing healthcare environment. Photo: Stephanie Diani Why do academic health centers (AHCs) exist? This actual value of care provided for complex conditions. However, it question is addressed in an article I wrote, along with David is also related to limited integration of care and unnecessary care. Geffen School of Medicine at UCLA and UCLA Health System What can AHCs do? We must adopt more of a patient colleagues, that appeared in the Journal of the American Medical focus, developing approaches that follow the patient, deploying Association last November. We believe that these Institutions — multidisciplinary teams and integrated practice units across approximately 135 of them in the U.S. — exist to ensure departments. We must become more population-health centric, sustainable healthcare through their integrated missions of learning to care for the health of populations while using a patient care, education and research. Yet, many of these centers global budget to manage the health of a specific population. We operate in ways that threaten their viability. We state that AHCs must begin leveraging the vast reservoir of health-related big must reconfigure and transform rapidly if they are to survive. data to help create the most effective means of providing care. Why this concern? For too long, AHCs have existed as a We must shift to a value-conscious state of mind, eliminating cottage industry in a fragmented market, blind to the costs waste through the consistent use of evidence-based practices of duplicative infrastructure and paid a premium for claims and by avoiding unnecessary tests. And AHCs must lead of quality, without the tools to measure or ensure it. As discovery in the prevention of disease and disability, recognizing value-conscious purchasing forces AHCs to compete among that prevention is the ultimate value-added measure. themselves and with other health organizations, many will face As profound change rapidly occurs in U.S. healthcare, the critical threats. Centers that invested early in integrating care — fate of AHCs and our ultimate contribution will be determined primary care, information technology and analytics, as well by how we respond. Centers pursuing the disruptive as competing on value — are poised for continued growth. transformation we’ve outlined will not only survive but thrive. But those that fail to respond effectively to the changing And these institutions will continue providing value to society, healthcare landscape may find their clinical revenues unable patients and communities. to support education and research and jeopardize their leadership in clinical training. One of the factors contributing to the precarious state of many AHCs is siloed clinical care that has diminished accessibility and coordination of care for patients and allowed A. Eugene Washington, MD, MSc unnecessary duplication of services and comparatively poorer Vice Chancellor, UCLA Health Sciences outcomes. Pricing that is higher than comparable services Dean, David Geffen School of Medicine at UCLA elsewhere is another problem. To some degree this reflects the Gerald S. Levey, MD, Endowed Chair U Magazine 1 IN BOX letters to the editor FOR THOSE WHO GIVE ALL, UCLA Health and should not be allowed in a rational society, UCLA Health David Geffen School of Medicine I was sitting at the David Geffen School of Medicine I enjoyed Shari WINTER 2014 FALL 2013 kitchen table eating but then again, America has never embraced Roan’s article, a bowl of soup. As rational thought. A good start for those wishing “Joint Liability” WE GIVE WHATEVER IS NEEDED we had just stopped to escape ignorance would be Blind Faith: (Fall 2013, page UCLA is deeply committed to working with our military partners to heal the body, mind and spirit of our print edition of The Unholy Alliance of Religion and Medicine, 24), on the issues A PROMISE by Richard P. Sloan. America’s wounded warriors. The new Ronald A. Katz Center for Collaborative Military Medicine at UCLA FULFILLED the San Francisco surrounding A revolutionary technology opens doors to the brave new world of Chronicle and personalized medicine.