December 3, 2012
Editor's Note: This story originally appeared in the December 2012 edition of ASU Magazine.
A decade ago, ASU President Michael M. Crow and Victor Trastek, then the CEO of Mayo Clinic in Arizona, were both new in town.They decided to meet. One day, they got together at a local deli for turkey sandwiches. On a napkin, they mapped out how their organizations might work together and how they could have the biggest impact.
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Ten years later, the collaboration mapped on the back of a napkin has grown far beyond the initial vision. ASU and the Mayo Clinic have created joint programs not only in health care, but just about anything that touches upon keeping people healthy: basic science, technology, business, law, even the arts and humanities. They have also collaborated extensively in the areas of research, policy and education. What these two leaders envisioned over lunch has become not simply a partnership, but a melding of cultures, and an intellectual cross-fertilization that is creating a whole new way of achieving good health.
Bound together by synergy and purpose
Within the next several years, Mayo Clinic is scheduled to open a branch of its medical school in Arizona, tying the institutions even more closely together as they initiate new activities designed to advance medical innovation. Ultimately, the university and the Mayo Clinic will be interlinked in a relationship that stands to effect the intellectual pursuits and personal health of nearly everyone at ASU.
“The two organizations are very complementary to each other,” says Keith D. Lindor, executive vice provost for Health Solutions and the dean of the College of Health Solutions. “ASU is a great university with a huge interest in health, but it doesn’t have an academic medical center associated with it, while Mayo is interested in innovation and improving care while lowering costs, but it’s tough to work through many of the key issues without the academic experts.”
Two accepted realities regarding health care are that rapid change is coming, and the stakes are huge. With a growing aging population, the United States must find new ways of improving health outcomes while lowering costs. Lindor points out that the country is already starting from behind in some ways.
“Our costs for health care are extraordinarily high, but we rank 49th in the world in terms of lifespan,” he says.
The ability to make a difference in that scenario is the major reason that Lindor came to ASU from the Mayo Clinic location in Rochester, Minn. “It was abundantly clear to me that the current healthcare system wasn’t working and that this was the chance to jump into the middle of things with the resources of a huge university that is committed to social embeddedness,” Lindor says.
Crow agreed the match between Mayo and ASU was a good one. “ASU is a comprehensive university designed to deliver an outstanding education capable of transforming society,” said Crow. “The chance to collaborate with a national, comprehensive clinical organization like the Mayo Clinic to produce more broadly educated physicians capable of delivering new, low-cost healthcare solutions is ideal.”
From the very beginning, the collaboration had obvious advantages, says Keith Stewart, a physician leader at the Mayo Clinic who also has an MBA and who is part of the team planning the future of the relationship.
“It’s a very synergistic relationship,” Stewart says. “The Mayo Clinic is among the best in the world in quality health care and bio-medical research, but we didn’t have access to academic programs in the natural sciences, humanities, law, business, engineering or computing to name just a few. On the flip side, ASU didn’t have access to a clinical partner with the depth and brand reputation of Mayo Clinic. There are not many places where ASU and the Mayo Clinic compete and many in which they can collaborate and partner.”
The ASU/Mayo partnership has a greater ability to navigate and shape these changes than other academic medical centers, in part because it is not an academic medical center, says Wyatt Decker, CEO of the Mayo Clinic in Arizona.
“One reason we work so well together is our shared sense of purpose,” he notes. “Mayo and ASU focus relentlessly on the needs of patients. It’sF this ability to focus on this main thing that makes this a super powerful collaboration.”
One of the first joint programs, created several years ago, was a natural pairing. ASU has long been home to a fine nursing school, the College of Nursing and Health Innovation, and the Mayo Clinic did not have an academic program for nursing education. As a result of the collaboration, ASU nursing students now have the chance to get coveted clinical learning placements at the Mayo Clinic, and Mayo has the first opportunity to hire the most talented nurses and take part in their education.
Although professional training is the headline activity at the college, the more significant part of the collaboration may be found in the second part of the college’s title: health innovation.
“ASU has a way to educate students that is very forward thinking, very pragmatic, very powerful and significant,” says Teri Pipe, dean for the College of Nursing and Health Innovation. “One of the things that our relationship with the Mayo Clinic gives us is a place for the clinical expression of academic and research initiatives at ASU.”
Better health outcomes by design
Some of those innovations involve professions one might not normally associate with health care. ASU has brought engineers, architects, designers and even artists to the Mayo Clinic to evaluate how the facilities and equipment – even the design of a room – can improve health.
Gerri Lamb, an associate professor at the College of Nursing and Health Innovation and the Herberger Institute for Design and the Arts, works with graduate students on projects linking healthcare and building design. “I’ve had the experience of being in a hospital room with architects and nurses, and all the architect has to say is ‘what do you like or not like about working in this room?’” Lamb says. “Within minutes, the nurses come up with 50 things that make working in the room better or worse. When healthcare professionals work with an architect or designer, they come up with solutions that help them become more effective and efficient.”
Designers also can improve health outcomes for patients, Lamb says. Things like where sinks are placed and what height they are set can make hand washing (and thus infection control) more likely. For patients, the way that waiting rooms look and are laid out can affect their expectations about getting well or their communication with staff. Small things like this affect health outcomes, something Lamb knows from academic studies, and also from personal experience.
“When one of my family members was treated at a cancer center, the waiting room had large glass windows that filled the room with light, which has a healing effect,” Lamb says. “On the other hand, the room was far away from where they were being treated, and the lack of contact with hospital staff was very isolating.
“I look at ‘how does the system really work for patients and their families?’ Especially the very vulnerable,” Lamb continues. “What I look at is how do we make all the parts of a system work for people, so they get care they need?”
A radical inclusiveness
The involvement of designers and architects in health care is only one small example of a radical inclusiveness that Mayo Clinic and ASU are pioneering in all aspects of health care. On one level, that means creating joint degree programs that cover all the many kinds of expertise needed to carry out a health enterprise. The Mayo Clinic and ASU now collaborate on five master’s degree programs: law, biomedical informatics, biomedical engineering, mass communication and business administration.
When the first class of medical students graduates from the Arizona branch of the Mayo Medical School, they will also earn a new degree jointly designed by Mayo and ASU – a Master of Science in Health Care Delivery. The courses for the degree program will bring together students and professionals in medicine, pharmacy, nursing, social work, administration and business, and educate them together in all aspects of healthcare delivery, says Lamb, who was part of the group designing the curriculum for the program.
“Right now, we continue to educate students in professional silos and then expect them to come together and communicate and collaborate well,” Lamb says. “We need to educate students so that they have experience working together and are prepared to be effective team members. Effective team performance is essential for providing high quality and cost effective care,” she says.
Collaborations beyond health
On another level, the radical inclusiveness of the ASU/Mayo collaboration means bringing together experts whose areas of expertise include mathematics, economics, physics and even astronomy. “In a broad sense, it’s very powerful when you can bring experts in different disciplines together to intersect around an important issue,” Decker asserts.
The fertile coming together of great minds around health care reminds Decker of another time, described in a book called “The Medici Effect,” which describes the period during the Renaissance when the Medici family flourished in what is now northern Italy because it became a patron of influential scientists, mathematicians, writers and artists of the era.
“We are getting our own Renaissance as a result of the collaboration with ASU, or our own burst of innovation,” he says.
One of those with a front row seat to these bursts of innovation is Gianrico Farrugia, director of the Mayo Center for Individualized Medicine. One of the problems that occupies Farrugia’s mind is how to make genomics useful to medical providers and patients. Ultimately, knowing a patient’s genetic profile can offer valuable information about their risks for certain disease and about what medications and treatments might work best.
“We each have 3 billion base pairs of information, so in order to make this information relevant to patients it is essential to use bioinformatics,” Farrugia says. “ASU has a very strong bioinformatics program, which is very useful to us, and the Mayo Clinic has the patients ASU needs in order to provide the testing ground for new ideas.”
Farrugia notes that a parallel situation exists for ASU’s extensive research efforts in biomarkers – biological signs indicating a certain disease state – which will need a clinical collaborator with a large patient population to bring the promising science to fruition.
Farrugia also points out that ideas for medical innovation can go both ways, and that ASU and Mayo are co-investing in funding the best ideas from both institutions. “We ask for people’s best ideas, ideas that are high risk – so they may not get funding from traditional sources – but also high reward if they succeed,” Farrugia says.
Others also are noticing the vast potential benefits of the ASU/Mayo collaboration and are bringing funds to the table. This year, the Virginia G. Piper Charitable Trust has established a $10-million strategic investment fund at ASU to enable the university to improve all aspects of healthcare delivery. The trust will provide $2 million per year for five years to provide seed funding for innovation in nine areas, such as bioinformatics, the Arizona Obesity Initiative, nutrition and health promotion, biological and systems engineering, and others.
“Every investment we make in ASU has had exceptional impact and we have no doubt that this one will as well,” says Judy Jolley Mohraz, president and CEO of the Virginia G. Piper Charitable Trust. “ASU is a young institution with amazing growth and an incredible story to tell. The work that they are doing is tremendously important for our community, for health delivery and for the generation of knowledge.”
One of the side benefits of the strong effort at healthcare innovation in the Valley may be improved economic health. One of the markers of a developing nation coming of age is the ability to have a car industry, because making cars requires expertise in a wide range of disciplines – metalwork, glass, electronics, precision engineering, modern supply and inventory, and so on. Keith Lindor observes that modern healthcare research requires similarly broad expertise in disciplines, each of which spawns new industry and employments.
The city of Phoenix, ASU and Mayo Clinic will plan jointly for the Arizona Biomedical Corridor in northeast Phoenix, which will accommodate biotechnology companies and related research, clinical and academic uses, and support commercial development.
Distributing health in the future
The greatest trend in health care, according to Lindor, and the area in which ASU and Mayo Clinic can excel, is actually a movement away from the traditional concept of healthcare itself. “Delivery models will be much different (in the future), with much more reliance on people with a nursing background, a behavioral change background, an education background, and not on physicians doing all those things,” Lindor says. “We will move toward a distributed model.”
And the focus of this distributed system will shift the emphasis from health care – taking care of people when they are sick, toward health – keeping people from getting sick in the first place.
“Just one example of this is that ASU has a program to help teachers be health ambassadors, imparting good nutrition and health habits in grade school, because many of us think that good health habits start early, ” Lindor says.
The only constant in the future of health improvement is change, Lindor says. “We envision what the future might look like and teach people to thrive in that future, but we also give them the flexibility to adapt to changes in that model.”
Those involved in creating that future find the process thrilling. Pipe speaks for many when she says, “I get so excited about it, I can hardly stand it.”
Written by Christopher Vaughan, a freelance science writer based in Menlo Park, Calif.