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The Ohio State University Medical Center March 3, 2009 Ohio

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Title: The Ohio State University Medical Center March 3, 2009 Ohio


1
The Ohio State University Medical Center
  • March 3, 2009
  • Ohio School Employees Health Care Conference

2
Ohio School Board Requirements
  • Ohio school districts are required to provide
    access to providers that have demonstrated
    effectiveness based on objective measureable
    criteria in treating complex conditions such as
  • Transplant
  • Cancer
  • Heart Disease
  • High Risk Pregnancy
  • Morbid Obesity

3
Columbus Hospitals Outperformed Ohio and National
Average in 08
Source U.S. Department of Health and Human
Services on the Hospital Compare website
(www.hospitalcompare.hhs.gov). Using Medicare
quality indicators reported for participating
adult hospitals analysis compares the average
performance of OhioHealth, Mount Carmel, and OSU
Hospitals to the national average on each
indicator. The statistic reports on average how
much these local hospitals exceed the national
average on indicators within each category. 2008
Q2.
4
Employer Considerations
  • What employers look for -- quality, cost, access
  • Integrated health care system
  • Continuous improvement in delivery
  • Institutions delivering best practices
  • Physicians at forefront of clinical research
  • A multidisciplinary approach to disease
    prevention and disease management
  • Exclusive disease specific expertise

5
Alternative Measures
  • 16 consecutive years named one of America's Best
    Hospitals by US News World Report
  • 8 of 11 specialties currently ranked in central
    Ohio as Americas Best Hospitals, U.S. News
    World Report.
  • Cancer, ENT, Endocrinology, Gynecology, Kidney
    Disease, Orthopedics, Rehab, Respiratory Disease
  • 259 of 420 or 62 of central Ohio physicians
    listed in Americas Best Doctors.
  • 92 of physicians board-certified compared to
    85 nationally.

6
Centers of Excellence JCAHO
  • Designated a Center of Excellence in Bariatric
    Surgery by the American Society of Bariatric and
    Metabolic Surgery
  • Joint Commission disease specific certification
    for
  • Stroke Care
  • Lung Volume Reduction Surgery
  • Ventricular Assist Devices

7
Integration of Research and Clinical Practice
Clinical Question
Quality Assessment
Basic Bench Research
Clinical Protocol Standard of Care
Translational Application Development
Clinical Research Protocol
8
Importance of Research
  • OSUMC houses or co-manages more than 20 research
    centers and institutes and 25 core research
    laboratories, plus one affiliated research core
    lab
  • Ranked 21st by National Science Foundation in
    medical sciences for FY 2006, up from 25th in FY
    2005
  • More than 2,000 active clinical trials in
    virtually every medical specialty

9
Mortality Rates and UHC Comparisons
  • Risk adjusted mortality rates
  • Less than other academic medical centers
  • Only 1 US News World Report Honor Roll Hospital
    with a lower mortality index
  • Ranked 7th out of 100 Academic Medical Centers
  • Ranked in the top 25 in multiple disease groups
    compared to other academic medical centers
  • Includes Cardiology, General Medicine,
    Gastroenterology, Orthopedics, and General Surgery

10
Expected Mortality - FY 2008
Expected 1.00
11
Access to Unique Services
  • The regions leading comprehensive program, with
    a multidisciplinary team of ten board-certified
    high-risk prenatal MFM specialists more than any
    other regional health system.
  • OSUMC has the only dedicated Medical and Surgical
    Intensive Care units (MICU, SICU) in central
    Ohio, offering comprehensive services and
    specialties.
  • Ohio States MICU and SICU rank among the
    nations top performers, according to a UHC
    comparative study.
  • OSUMC has the only adult burn center in central
    Ohio, and is part of a Level 1 Trauma Center
  • Designated a Center of Excellence in 2006 by the
    American Society for Metabolic and Bariatric
    Surgery.

12
Access to Unique Services
  • Ohio States Stroke Center is the only center in
    Ohio to be Joint Commission certified as a
    Primary Stroke Center and CARF accredited as a
    Stroke Specialty program and Stroke Outpatient
    Rehabilitation program. The stroke team is
    on-site and available 24/7.
  • Dodd Hall Rehabilitation is consistently
    recognized as one of the top 10 inpatient
    rehabilitation programs in the country by
    U.S.News World Report.
  • Home to a new minimally invasive endovascular and
    vascular surgical suite, one of only a few of its
    kind in the world designed to treat a variety of
    brain and spinal cord injuries in the safest and
    most efficient environment. Patients are now in
    one room for imaging and the surgical
    intervention.
  • Leaders in the diagnosis and treatment of
    epilepsy offering the largest and most advanced
    Level 4 epilepsy monitoring unit staffed 24/7 and
    a range of epilepsy surgical interventions
    including use of deep-brain stimulation and awake
    craniotomy.

13
Comprehensive Transplant Program
  • Ohio States transplant center is central Ohios
    only adult transplant program providing patients
    kidney, liver, pancreas, heart and lung
    transplants.
  • Ohio State has performed more than 6,000
    transplants in the past 40 years and its
    kidney/pancreas program is one of the worlds
    busiest.
  • First auto-islet cell transplant performed in
    November 2008 to treat chronic pancreatitis and
    reduce the development of diabetes.
  • OSU Medical Center is one of a select group of
    medical centers in North America approved to
    process pancreatic islet cells for human
    transplant. Islet transplantation may cure type 1
    diabetes.

14
National Cancer Institutes
  • The James is one of only 10 other freestanding
    cancer hospitals recognized by the federal
    government to be PPS Exempt.
  • One of only two NCI-designated comprehensive
    cancer centers in Ohio and the only one in
    central and southeast Ohio.
  • Total active clinical trials (diagnostic,
    treatment and prevention) number 231of which 65
    are investigator-initiated..45 Phase I trials.

15
Performance Measurement
  • The James measures performance in a variety of
    areas, working collaboratively with its peer
    group
  • Memorial Sloan-Kettering Cancer Center
  • M.D. Anderson Cancer Center
  • City of Hope National Medical Center
  • Dana-Farber Cancer Institute
  • Fox Chase Cancer Center
  • H. Lee Moffitt Cancer Center Research Institute
  • Roswell Park Cancer Institute
  • Sylvester Cancer Center
  • Seattle Cancer Care Alliance

16
Cancer Care Integration by Specialty
17
Patient StoryCarl Stewart
18
Cardiovascular Medicine Surgery
  • Only free-standing academic heart hospital /
    cardiopulmonary research institute combination in
    the U.S.
  • Davis Heart Lung Research Institute contains
    100,000 square feet of research space with gt 50
    funded investigators
  • Ross Heart Hospital represents one-stop shop for
    all cardiovascular services

19
Cardiovascular Medicine Surgery
  • Sub-specialized approach to care
  • Integrated multidisciplinary programs, e.g.
  • Heart Failure (CV Medicine Cardiac Surgery)
  • Vascular Disease (CV Medicine Vascular Surgery)
  • Sleep Apnea and CVD (CV Medicine Pulmonary)
  • Congenital Heart Disease (OSUMC Childrens)
  • Arrhythmia Mgmt. (CV Medicine Cardiac Surgery)
  • Metabolic Syndrome (CV Medicine, Endocrinology,
    Family Medicine, Pharmacy
  • Emphasis on evidence-based practice
  • Focus on quality and outcomes

20
Cardiovascular Medicine Surgery
Vascular Medicine and Interventions
Genetics in Cardiovascular Disease
Cardiovascular Imaging
Advanced Therapies for Heart Failure
CV Disease Database Development
Cardiovascular Disease in Women
Stem Cell Therapies for CV Disease
Invasive Electrophysiology
21
Cardiovascular Medicine Surgery
  • In 1999, OSUMC became the first site in the
    United States to perform a robotic heart
    procedure using the Da Vinci Surgical System.
    Today, surgeons perform endoscopic coronary
    artery bypass procedures and the worlds first
    robotic, beating heart MAZE procedure, a
    procedure used to treat atrial fibrillation.
  • Ohio State offers one of the nations largest
    ventricular assist device programs, enrolling
    more patients in the Thoratec HeartMate II trial
    than any other site, and one of a handful of
    programs in the United States to offer the total
    artificial heart implant.
  • Vascular surgeons have seen a 50 percent growth
    in endovascular treatment of infrarenal and
    thoracic aortic aneurysms as well as endovascular
    approaches to treatment of lower extremity
    arterial disease.

22
Regional STEMI Program
23
Heart Failure Program
  • Most rapidly growing form of heart disease
  • Prevalence of gt5 million Americans
  • 500,000 new patients diagnosed each year
  • Most common DRG for those gt65 years
  • Treatment options
  • Medical therapy
  • 20-30 2 year survival (NYHA class IV)
  • Device therapy
  • Transplantation
  • Approaching 70 5 year survival

24
Advanced Therapy for Heart Failure
William Abraham, MD Philip Binkley, MD, MPH
Juan Crestanello, MD David Feldman, MD, PhD
Veronica Franco, MD, MPH Garrie Haas, MD Ayesha
Hasan, MD Carl Leier, MD Sai Sudhakar, MD,
Benjamin Sun, MD
Industry Sponsored Trials
NIH/NHLBI Sponsored Trials
HeartNet PEERLESS HF
HeartPOD HOMEOSTASIS II
CardioMEMs sensor CHAMPION
Orqis MOMENTUM
Chronicle ICD REDUCEhf
25
New Approach to Managing Heart Failure
26
Why Mechanical Support?
  • gt 5,000 patients listed for cardiac
    transplantation in the United States
  • 20-30 per year die waiting
  • lt 3,500 cardiac transplants performed per year
    worldwide
  • Unchanged since 1989
  • Mechanical support can provide viable options as
    alternatives to transplantation

ISHLT database
27
VAD Procedures per Year
28
STS Observed/Expected Mortality Ratios
  • In 2008, the Mortality rate for Coronary Bypass
    Surgery at OSUMC was 73 better than our expected
    rate
  • Rates for Bypass, Valve, or Bypass Valve Combo
    Surgery was 41 better than expected

Source Society of Thoracic Surgery
29
Normal Outcome for Heart Catheterizations
Rate of Normal Cardiac Catheterizations
30
The Ohio State University Medical Center
  • March 3, 2009
  • Ohio School Employees Health Care Conference
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