Emory Woodruff Health Sciences Center
Update Events:
Sept. 28-Oct. 1: International AIDS Vaccine Conference


June 24, 2010
Table of Contents:
elderly_woman . timothy_williams_108 . . todd_sherer_108 . code_runner_108 . sarah_putney_108
Emory/DeKalb partner to protect abused seniors New Emory police presence at midtown Big-picture thinking from WLA Research sparks economic growth Code Runner: Residents design new app In brief

Electronic system eases COI disclosure and tracking
conflicteCOI, a new electronic system for identifying and tracking financial relationships that could present conflicts of interest, is now available for use by faculty throughout health sciences as well as other schools across the university. eCOI replaces the old annual COI disclosure paper form and makes life easier both for those disclosing information and for those reviewing it. It also provides better protection against potential conflicts than the old paper system.

  Brenda Seiton

eCOI covers three basic areas, according to Brenda Seiton, an assistant VP who oversees the COI office in Research Administration.

First, investigators use eCOI to report a financial relationship they may have that is related to a specific research project, as required by federal law. The investigator's research administrator then can track each form as it is completed and updated by the researcher during the course of the project.

"The system is easy and convenient and sends a confirmation when the investigator has completed the form," says research administrator Jason Patterson in nephrology. "It is definitely more credible and thorough than the old paper system. With eCOI, individual researchers use their Emory ID and password to log in and personally certify that they have read and understood what they are signing. With a paper form, it was easier for people to simply sign it without reading it."

  Helen Mayberg

For investigators, eCOI is more efficient "by orders of magnitude," says Helen Mayberg, professor of psychiatry, who is principal investigator on several NIH grants with many researchers and staff. "The problem with the old system was that the process was ambiguous for investigators. When you are online and work through the decision trees, the ambiguity gets worked out. You know what to do. It also helps us get COI reporting done faster so we can get to the main job we're here to do—the science."

A second application area for eCOI, says Seiton, is its use by faculty to request approval to conduct external activities, such as consulting for outside companies, law firms, and other organizations. The system routes the proposal to the department chair and dean’s office for approval. It also notifies the COI office when an issue arises from the proposed activity. In soon-to-be-released system updates, eCOI will notify Quality and Risk and Emory Healthcare's Compliance Office when the need arises. "We are continually adding revisions and tailoring functions to users' needs," says Seiton.

The third main application for eCOI is its use by the COI office, deans' offices, and EHC Compliance for what Seiton describes as an annual certification process. "We ask faculty to review their reported list of all external activities in this exercise, which gives us a snapshot of this information at a point in time once every year."

This annual process serves other purposes as well. It gives faculty the ability to delete activities that are no longer in effect and lets them see the status of financial relationships that have been reviewed by the COI office. It gives the schools a chance to review potential conflicts unrelated to research, such as receipt of royalties for textbooks used by students or the hiring of relatives on grant projects. Finally, the annual certification gives EHC's Compliance Office the opportunity to review any relationships that could be prohibited under patient "self-referral" laws, which regulate physician activities such as referral of patients for tests to an MRI practice or a clinical lab in which the doctor holds financial interest.

"eCOI helps us be proactive," says Anne Adams, Emory Healthcare's chief compliance officer. "We all worked together to develop it to make sure it covered all our needs."

Development of eCOI took place over a year, says Seiton. "We were having a hard time finding software that could do this, so we built it in-house through Marc Overcash's group in information technology. Now, other schools have been inquiring about the software’s capability and the process that we use."


Emory partners with DeKalb to protect abused seniors and disabled

Emory and DeKalb County formed a partnership in May to identify and protect abused elderly and/or disabled citizens within DeKalb. Those involved in creating a protection-pathway plan to address a growing need for protective services for this special-needs population included DeKalb County Solicitor-General Robert James, Wesley Woods Geriatric Hospital Chief of Medicine Thomas Price, Wesley Woods COO Al Blackwelder, and the VALARI (vulnerable adults living at risk invisibly) task force.

  Thomas Price

"This collaboration between Emory Healthcare and DeKalb County represents the first of its kind in the United States, a program where victims can find safe shelter from harm, receive state-of-the-art medical care for treatment of their injuries, and work toward regaining their independence with our help and the help of the VALARI team," says Price.

"While my team at Wesley Woods works to restore the victim's mental and physical well-being, our colleagues at VALARI will work to restore their social and financial status. In the past, these souls often had no choice but to return to the abusive environment. Now they will have a fair chance at health, happiness, and a life without fear."

The protection pathway begins at the victim's residence, where the alleged victim will be assessed by DeKalb police. If the person is determined to meet VALARI criteria, a VALARI representative will be notified and begin victim advocacy. If determined to need urgent medical attention, the person will be sent to Emory University Hospital's ER and then admitted if appropriate. If hospitalization is unnecessary, a temporary living environment will need to be obtained.

The VALARI volunteer will coordinate with a representative of the Wesley Woods campus to determine the most appropriate of three potential temporary housing options based on the following criteria:

Level 1: Person can function independently and is not acutely ill. There is need only for emergency housing and meals. In this case, s/he will be housed in an available efficiency apartment at Wesley Woods Towers.

Level 2: Person is not acutely ill and cannot live independently. If s/he meets criteria for respite care under Medicaid, the person will be housed in an appropriate room at Budd Terrace nursing home.

Level 3: Person has developed evidence of acute illness or active disease since prior assessment. The person will be admitted for 24-hour observation to Wesley Woods Hospital, and a geriatric assessment will be conducted by a physician within 24 hours. Read more.


Emory police now on site at midtown campus

  Tim Williams
  Craig Watson

The Emory University Police Department recently joined the ranks of Emory Healthcare Public Safety and the Atlanta Police Department (APD) to patrol the campus at Emory University Hospital Midtown (EUHM). "In the few months that the Emory police have been here, their presence has been tremendous," says Timothy Williams, EUHM public safety director.

Emory Healthcare public safety officers have been stationed at EUHM since the early 1970s, with their numbers having grown substantially since that time. However, the boundary of their jurisdiction—only to the sidewalk of the hospital’s property and no further—is more limited than that of the Emory police.

Because it is a campus law enforcement division, Emory police can patrol 500 yards outside of the nearest building on its property. This allows officers to patrol past the hospital grounds and into the neighborhood, making the added police presence a benefit for the surrounding community.

"The additional visibility and presence provided by Emory police officers enhances both the reality and the perception of safety in the community," says Craig Watson, Emory's chief of police. Emory now has 10 officers patrolling EUHM’s campus, with four more to be added.

A May 23rd robbery and shooting near EUHM demonstrated the value of increased police presence, says Williams. "While the victim survived and the assailants were quickly captured, extra officers helped ensure the safety of patients, patients' families, employees, and physicians."

In April 2009, Emory partnered with the APD to open a mini Atlanta police precinct at EUHM. Located in the Orr Building on Peachtree Street, the Zone 5 mini-precinct houses 30 sworn police employees, including lieutenants, sergeants, and officers, with responsibility for patrolling midtown and downtown Atlanta.

"Since APD and Emory police moved onto our property, crimes such as trespassing and auto break-ins have decreased by more than 20%," says Williams.

Williams adds that his own public safety officers at EUHM work to keep the campus and surrounding area not only safe but also clean. Along with other employees at EUHM, the public safety officers have partnered with some local improvement groups to clean up nearby streets, parks, and neighborhoods. "It’s an important part of being good neighbors."


Big-picture thinking from WLA

WLA class of 2010

Each year, fellows in the Woodruff Leadership Academy (WLA) divide into four multidisciplinary teams to tackle projects strategic to the WHSC's future. Following are summaries of project findings that the class of 2010 presented to WHSC leadership and board members at their graduation in May.

Patient- and family-centered care (PFCC) at Emory
The team found that achieving a culture of PFCC would require bridging different perceptions of PFCC by patients and families, physicians, and nurses.

Presented by
• Kimberly Arriola
• Amy Chen
• Brett Coryell
• Philip Shayne
• Andrea Woods

The team surveyed these three groups, asking them to rank the importance of specific PFCC areas and Emory's performance in those areas. The 127 patients/families and the 987 providers who responded (mostly nurses, despite multiple efforts to reach physicians) differed somewhat in perceived importance of PFCC. Patients/families more often viewed family members as an integral part of the patient/family/provider relationship than did providers. They also viewed Emory's delivery of PFCC more favorably than did providers for all indicators except for awareness of a written policy on medical error disclosure (both groups agreed Emory could do better in actual practice of disclosure).

This survey suggests that current efforts to train, disseminate information to, and engage providers in PFCC delivery may be insufficient. Read more.

Retaining and developing the most talented trainees
Retention of truly elite WHSC graduates—especially MD/PhD trainees and PhD and advanced practice nurses—could be improved and brought more in line with that at top benchmark institutions. The "rising stars" interviewed by group members reported making decisions about whether to stay at Emory or seek greener fields based on quality of training, opportunities for collaboration, and prospects for mentorship more often than on financial and material considerations.

Presented by
• Daniel Brat
• Elizabeth Buffalo
• Pamela Hoppie
• Maeve Howett
• Jim McKay
• Jason Stein

To increase retention and productivity of these brightest and best, the team proposes a Woodruff Mentored Scholars Program (WMSP), in which faculty from medicine, nursing, public health, and Yerkes would identify high-potential trainees, exemplary staff, and junior faculty early in their careers and provide them research mentors and protected research time. After one year, WMSP scholars would apply for a mentored award. Ideally, they would earn appointments in one or more departments and schools, thus increasing collaborative research. Read more.

Allied health professions at Emory
Current Emory programs to prepare allied health professionals, some of them ranked among the best nationally, are distributed across various medical school departments and Emory Healthcare with little coordination or interaction. Some may not be "right-sized." Most have little or no grant funding and therefore operate primarily on tuition revenues. And less than 10% of graduates of all Emory allied health programs (with the exception of Radiologic Technology) stay to work in Emory Healthcare.

Presented by
• Judy Belt
• Lisa Bernstein
• Stacy Higgins
• Alex Isakov
• Ted Johnson
• Brooke Moore

As roles of and demands for allied health professionals increase, Emory has a significant opportunity to leverage existing resources and opportunities for collaboration. The team recommends immediate establishment of an Office of Health Professions to coordinate existing allied health programs and identify new ones. The team believes that potential additional allied health areas best aligned with Emory initiatives and priorities include occupational therapy, dietetics/nutrition, speech therapy, and health information management. The team also recommends development of an Emory School of Allied Health Professionals once a critical mass of programs is in place. Read more.

Expanding the role of non-physician providers in chronic care
This team proposes expansion of clinical roles for physician assistants, nurse practitioners, and other non-physician providers working in integrated health care teams (IHTs) within Emory Healthcare. This team approach is often used in primary care. The team's proposal focuses on specialized chronic care, similar to that already in place in various areas throughout Emory Healthcare, for example

Presented by
• Viola Vaccarino
• Francois Villinger
• Diane Woods
• Robin Rutherford
• Amy Langston

- Emory's breast cancer team, where a nurse navigator coordinates activities from the time of initial referral,
- the bone marrow transplant team, where mid-level providers provide much routine post-transplant care and nurses are the contact for problems, and
- the heart failure team, where specialized nurses provide intensive post-discharge care.

Specific recommendations include evaluating these and other Emory models, approaching health care insurers regarding a patient/condition-based fee structure (as opposed to fee for service), and establishing pilot projects and monitoring them with established metrics such as outcomes, readmission, and ER visits.

The team expects IHTs to improve quality of patient care, access to the health care team, and patient, caregiver, and staff satisfaction. Read more.


Research sparks economic growth

A new report released last month from the Science Coalition demonstrates the link between federally funded basic research and economic growth and highlights four Emory start-up companies among its 100 "success stories."

  Todd Sherer directs tech transfer at Emory.

Emory start-ups highlighted in the report include

• GeoVax, Inc., Smyrna, Ga. Vaccines for diseases caused by HIV and other infectious agents

• Pharmasset, Inc., Princeton, NJ. Drugs to treat viral infections

• Syntermed, Inc., Atlanta. Diagnostic medical imaging software

• Triangle Pharmaceuticals (acquired by Gilead Sciences, Foster City, Calif.). Drugs to treat life-threatening diseases, including HIV/AIDS, in areas of unmet medical need

The Emory-related companies are highlighted along with superstars Google, Genentech, Cisco Systems, and iRobot. Read more. Read a June 7 op-ed by President Wagner on this topic in Atlanta Business Chronicle.


Residents create app to run/organize medical codes

_ code_runner_245

Two Emory residents, Christopher Holland (neurosurgery) and George Leach (emergency medicine) have developed an iPhone mobile app that leads users through a typical high-stress emergency situation, allowing them to run medical codes by showing current advanced cardiac life support (ACLS) algorithms in a simple format. Code Runner presents ACLS algorithms in real time while recording each defibrillation, medication administered, and cardiac rhythm change during a cardiac arrest.


  _   From the Executive VP

Fred Sanfilippo, MD, PhD  

Centers make impressive strides

Faculty and staff across the Woodruff Health Sciences Center understand the many merits of multidisciplinary centers, which reflect our major goals of providing new models and excellence and our major strategies of alignment, leverage, and synergy, especially across academic and clinical missions. Our Emory Transplant Center and Winship Cancer Institute are great examples of well-established WHSC centers, and we're now seeing terrific headway by each of our newer centers as well.

The Emory Center for Critical Care (ECCC), led by Dr. Tim Buchman, is the first of its kind in the nation. Its mission is to train the next generation of physicians, surgeons, and scientists. The ECCC will house Emory's advanced training programs in critical care anesthesiology, surgical critical care, and pulmonary/medical critical care. An NIH-funded Pulmonary Medicine Postdoctoral Training Program emphasizes basic and translational clinical research, and plans are being developed to sponsor critical care training for hospitalists, emergency physicians, and neurologists.

The Emory Center for Health in Aging, under the leadership of Dr. Ted Johnson, has submitted three center grants totaling $13 million to federal and foundation funders to try to gain resources to support staffing, infrastructure, and program development and has expanded research and outreach program opportunities and capabilities. The center's goal is to eliminate by 2020 the need for long-term nursing home admission as a routine destination for older adults as they age in Georgia.

The Center for Comprehensive Informatics, led by Dr. Joel Saltz, is working to engage researchers, align programs, teach students, and connect information systems to optimize health care quality. To date, the center has recruited six faculty members and, working closely with partner Georgia Tech, has submitted 26 collaborative proposals totaling $77 million.

The Emory Palliative Care Center, led by Dr. Tammie Quest, seeks to improve quality of life and wellness by addressing the physical, psychological, ethical, spiritual, and social needs of patients with serious, life-threatening, or progressive chronic illnesses and to provide support to their families and caregivers. The focus in the center's first 90 days has been on environmental assessment; helping stakeholders understand the center's vision, mission, and goals; and identifying areas for collaboration and focus. A team of external reviewers recently assessed the center and gave an outstanding exit interview with high praise both for the program's potential and for its leadership in Dr. Quest.

The Emory Heart and Vascular Center is committed to providing patient- and family-centered cardiovascular health care with quality and value in an environment that promotes innovative research and aims to conquer and prevent cardiovascular disease while inspiring and training future leaders in cardiovascular care. The center has been restructured, and recruitment for a new director is in its final stages, with three leading candidates conducting presentations to physician-faculty and research-scientists regarding their current clinical and research concentrations.

These and other Emory centers are using a comprehensive, collaborative framework to make impressive strides toward our vision of transforming health and healing. And, as always, it's the people involved who are the key to their success.

Please share your thoughts and feedback at evphafeedback@emory.edu.

In brief

NIH praises Emory IRB

Sarah Putney directs Emory's IRB  

The Emory Institutional Review Board has received special recognition from the National Institute of Allergy and Infectious Diseases for its work in support of Emory's H1N1 emergency response and research.

As one of eight national Vaccine and Treatment Evaluation Units sponsored by the NIH, Emory was part of last summer’s critical national review of H1N1 vaccines through clinical trials. The Emory IRB was able to review vaccine protocols rapidly and thoroughly, and the Emory Vaccine Center began enrolling adults, children, and asthma patients in August in clinical trials of H1N1 vaccines. The trials evaluated vaccine safety and immunogenicity in five age groups, in addition to determining how best to give the H1N1 vaccine in combination with the seasonal flu vaccine.

A certificate of recognition to the Emory IRB reads: "Your dedication, perseverance, and commitment to excellence were essential for carrying out the rapid response to the H1N1 pandemic. Your efforts have advanced knowledge and improved health worldwide."

Cooper to receive Koch Award


Emory immunologist Max Cooper will receive the 2010 Robert Koch Award in November at the Berlin Brandenburg Academy of Sciences. Cooper, a Georgia Research Alliance Eminent Scholar,
is recognized for his fundamental contributions to immunology, especially understanding of functions of different populations of lymphocytes. Read more.

Winship awards seed grants

Suresh Ramalingam is investigating breath analysis for early detection of lung cancer.

The first research seed grants made possible by a $4.7 million gift to Winship Cancer Institute last fall were awarded recently to five cancer researchers: Daqing Wu (urology), Xingming Deng (rad onc), Brian Polack (pathology), Suresh Ramalingam (hem-onc), and Carla Berg (public health). The gift—from James Kennedy, CEO of Cox Enterprises, and his wife, Sarah—also supports faculty recruitment and mentoring, clinical trials, and Winship's survivorship program. Read more.

Anderson is CFO of Emory's hospitals


Greg Anderson,Emory Hospitals' new CFO, came to Emory this past January from St. Francis Hospital and Health Centers in Indianapolis, where he served as regional VP of finance. He has more than 13 years of experience in health care financial management and operations. He succeeded Mark Aycock as CFO for Emory University Hospital, Emory University Hospital Midtown, and Wesley Woods Center and reports to Jimmy Hatcher, CFO of Emory Healthcare.

Hoover heads finance and admin in nursing school


Rob Hoover has been named associate dean of finance and administration in the nursing school after having served in this role in an interim capacity. Hoover joined the school in 2004 as director of admission and student services. Read more.

No more five-digit dialing between Grady and Emory

As of June 4, five-digit dialing between Emory and Grady was discontinued to allow numbers in each institution's dial range to expand to accommodate growth. From Emory, callers dialing in the 5-xxxx range receive a recorded announcement instructing them to dial 9 plus the full 10-digit number. Those who need to know how to dial an Emory-charged long distance number from Grady should call 404-727-4320 for instructions.

Additional honors/appointments

Susan Grant (chief nursing officer for Emory Healthcare), Mary Gullatte (assoc. chief nursing officer, EUH Midtown), and Lynn Sibley (assoc. professor in nursing) will be inducted as fellows in the American Academy of Nursing in November.

MIchael M.E. Johns, Emory chancellor and former EVPHA, received an honorary degree from Johns Hopkins, where he is former dean of medicine and VP of the university.


Congratulations to the 95-plus Emory doctors featured as Top Doctors in this month's issue of Atlanta Magazine. Read more. Congrats also to Emory physicians honored in Atlanta Business Chronicle's annual health care heroes competition: Sheryl Gabram-Mendola (winner in community outreach) and Tanveer Rab and Sandra Amaral (both finalists in the physician category).

In case you missed it

Read the guest column by Donna Hyland (president and CEO of Children's Healthcare of Atlanta) in Emory Health magazine about how Emory and Children's are leveraging resources on behalf of Georgia's children.

In memory

mary_woody_245Mary Woody, former director of nursing at Emory University Hospital and former interim dean in the nursing school, died April 28 at 84. She was professor emerita. Read more.

Upcoming events

Eric Hunter  

Sept. 28-Oct. 1: AIDS Vaccine 2010, Omni Hotel. The Emory Center for AIDS Research is local host for this 10th annual conference, which is expected to attract more than 1,000 researchers, clinicians, and community advocates from around the world. Eric Hunter, Emory CFAR co-director and Georgia Research Alliance (GRA) Eminent Scholar, is chair of the conference, and co-chairs are Jim Curran, Carlos del Rio, and Harriet Robinson. The GRA also is a partner. Early registration deadline is July 16. More information.