Department of Medicine Faculty Meeting Announcements - September 2016

Faculty meeting announcements for the Department of Medicine include updates on section chief searches, upcoming events like Evans Days, grand rounds speakers, faculty distribution by rank, and more. The meeting covers a range of topics such as academic reviews, faculty programs, and appointments within the department.

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1. Department of Medicine Faculty Meeting Monday, September 12, 2016 Announcements AY 2016 Annual Review 1

2. Announcements Section Chief Searches-Update Hematology Oncology Infectious Disease Clinical Faculty Compensation Committee being formed Evans Junior Faculty Merit Award RFA soon DOM Website being redesigned Ceremony to award Seldin Professorship- Darrell Kotton, October 31- details to follow 2

3. Evans Days October 13 and 14 Poster Session Thurs, Oct 13, 9-12 noon Gala Awards Dinner October 13, 2016 Speakers: Wilkins Visiting Professor: Glenn Dranoff, M.D., Ph.D., Global Head Exploratory Immuno-Oncology Novartis Ingelfinger Visiting Professor: John Carrethers, M.D., John G. Searle Professor and Chair, Department of Medicine, University of Michigan 3

4. Grand Rounds Speakers Topic Date Speaker September 16th ROBERT M. LEVIN LECTURE Iodine and the Thyroid 1960- 2016 Lewis Braverman, MD September 23rd SUE KIM HANSON LECTURE RIPK1 in Cell Death and Inflammation Manolis Pasparakis, Ph.D. October 7th "When Quality Improvement is Neither Quality Nor Improvement (and what to do about it)" Michael D. Howell, MD, MPH October 14th INGELFINGER VISITING PROFESSOR ~ EVANS DAYS Tentative presentation title: "Modulation of Colorectal Cancer by Inflammation John M. Carethers, M.D. (SPEAKER WILL ALSO DO MORNING REPORT) November 11th Cardiology Grand Rounds Dr. Ashvin Pande November 18th CLINICAL / RESEARCH Topic: TBD Dr. Hollis Day and Dr. Lindsay Farrer 4

5. Annual Review 2016 Academic Year DOM Faculty Clinical Programs Research Programs Education Programs Faculty Development and Diversity Programs Finance and Research Administration Summary Appendix 5

6. Faculty Distribution by Rank Rank Total Women (%) URM s (%) Professor 72 16 (22) 2 (2) Associate Professor 84 31 (36) 3 (3) Assistant Professor 166 92 (55) 12 (7) Instructor 99 71 (71) 11 (11) 421 425 211 (50) 203 (47) 29 (6.8) 27 (6.3) Total AY16 Total AY 15 6

7. Distribution of Faculty Effort (FTE) 7

8. Appointments and Promotions New Hires - 44 Promotions - 14 - 6 Assistant Professors - 1 Clinical Assistant Professor - 4 Associate Professors - 3 Professors 8

9. Promotions Section Faculty Member Rank (anticipated) Professor Professor Professor Associate Professor Research Associate Professor Assistant Professor Assistant Professor Associate Professor Cardiology Cardiology Computational Biomedicine Computational Biomedicine Endocrinology Endocrinology Endocrinology Noyan Gokce, MD Flora Sam, MD Marc Lenburg, PhD William Evan Johnson, PhD Lucia Plant, PhD Julia Xu, PhD Devin Steenkamp, MC Gustavo Mostoslavsky, MD, PhD Sarah Kimball, MD Sarah Bagley, MD Nicolette Oleng, MD Laurence Beck, MD Sandeep Ghai, MD Rivka Ayalon, MD Gastroenterology General Internal Medicine General Internal Medicine General Internal Medicine Nephrology Nephrology Nephrology Assistant Professor Assistant Professor Clinical Assistant Professor Associate Professor Assistant Professor Assistant Professor 9

10. Annual Review 2016 Academic Year DOM Faculty Clinical Programs Research Programs Education Programs Faculty Development and Diversity Programs Finance and Research Administration Summary Appendix 10

11. Clinical Programs 11

12. Clinical Highlights DOM Subspecialty Referral Compendium moved into the distribution and implementation phase within NHCs and GIM->housed on BMC Intranet and resource section of Epic Physician Satisfaction/Advocacy Advisory Group established with plans to garner input from faculty and craft practical and innovative solutions to improve clinician satisfaction All sections on target to meet Meaningful Use First DOM Clinical Innovations Award established Epic Optimization Continued to provide significant input to Epic optimization 2015 upgrade with improvements to chart review, health maintenance, in-basket organization accomplished early today 12

13. Clinical Highlights With BMC strategy team, led several Inpatient Initiatives on patient flow, discharge time, multidisciplinary rounds, Call Center follow-up appointments at discharge and ED sign-out processes In collaboration with CT Surgery, established an interdisciplinary transcatheter aortic valve program; to date, 18 percutaneous aortic valve replacements have been performed successfully without complication Memory Disorders Clinic established in Geriatrics for English and Spanish-speaking patients Care-Givers Stress Reduction Program establishedin Geriatrics 13

14. Clinical Highlights Expansion of Tobacco Cessation Program to inpatient setting Ongoing growth of Lung cancer screening/nodule program ICU Alcohol Withdrawal Protocol established and implemented Continued growth of multidisciplinary Sarcoidosis Program Transgender Medicine and Surgery Center established (first in New England) in addition to transgender medicine elective and transgender medicine curriculum with the medical school Multidisciplinary Thyroid Center established Addiction Medicine Inpatient Consult Service established 14

15. Ambulatory Measures 15

16. DOM Ambulatory FY16 Performance For the period ending May 31st, 2016 Month to date FY16 YTD YTD Budget / Goal Variance YTD % YTD Status Ambulatory volume 20,888 164,590 159,853 3.0% 1 Patient experience 2 89.2% 89.7% 90.9% -1.2% Primary care access 3 78% 81% 80% 1.0% Specialty access 49% 49% 56% -7.0% 4 16

17. Visit Volume (period ending August 31,2016) 2016 YTD Budget 18,867 7,061 11,234 99,478 4,530 13,642 35,291 21,711 25,973 12,490 250,277 691,509 2016 YTD Variance 12.3% 5.5% 4.8% 3.0% 1.4% 0.5% -1.1% -1.4% -4.0% -9.0% 1.4% -1.8% 2015 Actual 2015 Variance 2016 YTD 23,125 7,705 11,873 105,992 4,731 13,834 37,758 23,184 26,911 11,697 266,810 4.7% -2.8% -16.5% -0.4% -6.8% 2.4% -10.3% -6.6% -2.4% 3.3% -3.0% 21,190 7,449 11,776 102,437 4,595 13,709 34,916 21,407 24,930 11,360 253,769 679,155 ID Renal Rheumatology GIM Geriatrics GI Endocrine Cardiology Hem/Onc Pulmonary Total BMC 17 Source: BMC Dashboard/SDK

18. Ambulatory New Pt. Access (14 d) (period ending July 31, 2016) 2013 75% 63% 79% 56% 63% 65% 69% 41% 63% 73% 15% 2014 91% 67% 80% 70% 67% 49% 77% 34% 51% 73% 25% 2015 91% 79% 72% 65% 67% 67% 21% 35% 21% 46% 39% 2016 YTD 86% 79% 79% 66% 65% 63% 45% 34% 33% 25% 22% GIM Oncology Geriatrics Renal Hematology ID Rheumatology Endocrine GI Cardiology Pulmonary 18

19. Patient Experience (likelihood to recommend) (period ending June 30, 2016) 2013 75% 77% 85% 81% 85% 78% 70% 75% 68% 69% 67% 72% 2014 78% 83% 84% 81% 84% 77% 78% 84% 67% 74% 68% 80% 2015 78% 76% 75% 82% 80% 80% 73% 76% 74% 71% 67% 68% 2016 YTD 90.9% 94.7% 94.3% 93.7% 93.2% 91.6% 90.9% 90.5% 89.0% 88.4% 86.6% 86.0% Goal Pulmonary Oncology Cardiology Hematology Renal Geriatrics Rheumatology ID Endocrine GIM GI 30 19

20. Inpatient Measures 20

21. DOM inpatient clinical operations FY16 performance Last three months FY16 YTD Goal1 YTD Status 0.891 (Apr - Jun) 0.899 (Oct - Jun) 0.903 1 LOS O/E 3:01 PM (May - Jul) 2:59 PM (Oct - Jul) Avg. discharge time 2:37 PM 2 36 hours (Oct - Jun) 35 hours (May - Jul) OBS LOS (hours) 35 hours 3 18.84% (Apr Jun) 18.58% (Oct Jul Readmission rate 17.49% 4 1 To calculate department level goals, individual patients given department level goal and then calculated an average across the relevant patients. Note will change slightly every month given distribution of patients and last month of readmissions data is provided from an internal predictive model developed by the Data Analytics & Reporting team Source: SDK, Data Analytics & Reporting team 21

22. DOM Inpatient Discharges Department of Medicine Inpatient Discharges by Academic Year 1200 1000 800 AY2016 N=9467 600 AY2015 N=9297 AY2014 N=9681 AY2013 N=9728 400 N=10571 AY2012 200 0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 22

23. DOM Average Length of Stay Department of Medicine Average Length of Stay by Academic Year 8 7 6 5 4 N=5.5 N=5.72 N=5.16 AY2016 3 AY2015 AY2014 2 N=4.83 AY2013 N=4.72 AY2012 1 0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 23

24. Clinical Financial Performance 24

25. Clinical Volume (# wRVUs) 740,000 730,000 720,000 710,000 700,000 690,000 680,000 2011 2012 2013 2014 2015 2016 25

26. Reimbursement $ per wRVU 51.50 51.00 50.50 50.00 49.50 49.00 48.50 48.00 47.50 47.00 2011 2012 2013 2014 2015 2016 26

27. Clinical Collections $M 37.5 37 36.5 36 35.5 35 34.5 34 33.5 33 2011 2012 2013 2014 2015 2016 27

28. Clinical Metrics - The Positives Ambulatory visit volume up 1.4% (above budget) Primary care access for new patients remains high Patient experience (likelihood to recommend) above goal in most sections LOS shorter than goal in Geriatrics, Heme-Onc, Gen Med teams, MP Hospitalists Readmission rate lower than goal for Gen Med, Heart Failure and Geriatrics wRVUs increased slightly Receipt lag decreased by 2.1 days Days in Accounts Receivable decreased (>90 days 13.9%) 28

29. Clinical Metrics - The Negatives Progress in improving access uneven across the department and access still too low in several sections Average discharge time remains later than goal Readmission rate above goal in Cardiology, Heme-Onc, ID, Hospitalists and Renal services Payment per wRVU decreased and clinical collections decreased First time denials increased 3.4% 29

30. Quality Performance 30

31. Quality Highlights BMC Preventable Harms Index (PHI) O/E 0.959 BMC patient experience above QUEST goal, UHC 45th percentile 70% (YTD 72.9%) Early Warning System implemented QI/PS trainee pathway growing in popularity PGY2 QI curriculum - increasingly meaningful projects IPASS handoff bundle implemented successfully DOM residents attended and presented QI projects at national IHI conference 31

32. Mortality O/E Trend (April 2014-June 2016) Medical Patients BMC Patients 32

33. Clinical and Quality Goals for AY17 Improve physician and staff satisfaction in the Ambulatory setting Work with eMERGE team on improving efficiency and effectiveness of EMR Fully implement Evidence-based /Consensus Criteria for Referral to Specialty Clinics to integrate primary and subspecialty care; integration within Epic Increase outpatient visit volume and improve new patient access Implement physician component of patient experience initiatives Continue to develop initiatives to improve discharge time and patient flow 33

34. Clinical and Quality Goals for AY17, con t Continue IPASS implementation Work with BMC to meet the publically reported preventable harm index goal (with specific work in CAUTI, CLABSI, C diff, and DVT prophylaxis) Evaluate whether unintended disparities (or just differences) exist in our ambulatory and inpatient goals and metrics 34

35. Annual Review 2016 Academic Year DOM Faculty Clinical Programs Research Programs Education Programs Faculty Development and Diversity Programs Finance and Research Administration Summary Appendix 35

36. New Research Awards ($m) (excludes VA, NEIDL, and RWMC) 110 100 90 80 70 60 BUSM 50 40 BMC 30 TOTAL 20 10 2013 2014 2015 2016 36

37. ECIBR Overview ? Over 224 Faculty Members, and over 133 core participants since 2009 55 from Department of Medicine 26 from basic science departments 12 from dental school, 8 from School of Public Health and 27 from Charles River Campus of BU 13 collaborators from outside BU 148 funded grants (out of 272 applications) 459 co-PI interdisciplinary publications since 2009 37

38. ? Ongoing Affinity Research Collaboratives HOST-PATHOGEN INTERACTION: THE CASE OF PNEUMONIA (PneumoniARC) Dr. Jay Mizgerd THROMBOSIS TO HEMOSTASIS IN HEALTH AND DISEASE (Drs. Vipul Chitalia, Jean Francis, Mark Sloan and Katya Ravid) ETIOLOGY AND PATHOGENESIS OF ORAL CANCER (EPOC) Drs. Maria Kukuruzinsa, Avrum Spira and Maria Trojanowska 38

39. BU IBRO Boston University Interdisciplinary Biomedical Research Office Evans Center for Interdisciplinary Biomedical Research at BU School of Medicinex New Pre-ARCs 2016 Precision Medicine and Neurodegenerative Disease Drs. Rhoda Au, Neil Kowall and Lindsay Farrer) Mobile Health and Informatics (Drs. Belinda Borrelli, Lisa Quintiliani and Julie Keysor) Systems Biology Approaches to Microbiome Research (Drs. Daniel Segr and Evan Johnson) Metabolic Clinical Research Collaborative (Drs. Jude Deeney, Markus Bachschmid and Barbara Corkey) Pre-ARC in Discussion: Mechanics & Biology of Brain Trauma (Bubbles and the Brain) (Drs. Jacy Bird, Alice White, Ann McKee and Lee Goldstein) 39

40. BU IBRO and ECIBR Goals AY 17 Promote Innovative Team Science, Collaborative funding and Metrics at University level within the CTSI and BU Interdisciplinary Biomedical Research Office (BU IBRO) Develop Team Science Focused on Cancer Research in collaboration between IBRO and the Cancer Center (plans in discussions with Dr. Spira) Newly-developed cross-campus thematic seminars and workshops Cross-campus yearly Research Retreat in planning stages for early 2017 Developing with the Boston Museum of Science the Creation of a Yearly BU IBRO Lectureship of Relevance to Current Topics of Interest and Open to the Public Educational Goals: New IBRO-Post Doc Office Program of Interdisciplinary Research at Post Doc level; continue to develop the MS program 40

41. Research Activities, AY16 Number of faculty using the Cores was 124 Sig Grant Awarded to Core Temperature-controlled metabolic measurement system for mice. Increased non-academic off campus Core users to eight companies. Funding Awards: Bridge 2 Pilot 11 K Supplement 6 >95% grant support 21 Training Grant Supplemental 15 41 New DOM Brochure

42. Research Activities, AY16 Implemented a new Center for Translational Epidemiology and Comparative Effectiveness Research Implemented a new Center for Implementation and Improvement Science Clinical/Basic Grand Rounds Implemented Completed consolidation of Core Management under Thomas Balon First Research Faculty Incentive Plan 42

43. Research Goals, AY17 Continue support for Researchers through the First Step Program: evaluation of application Specific Aims page Develop approaches to the current funding environment through the Clinical/Basic/Population Research Collaborations Work with BU and BMC to facilitate investments in research programs Submit additional SIG grant applications to support Cores Develop improved metrics for Cores and Programs43

44. Annual Review 2016 Academic Year DOM Faculty Clinical Programs Research Programs Education Programs Faculty Development and Diversity Programs Finance and Research Administration Summary Appendix 44

45. Residency Program Education Activities, AY16 Excellent Match, filling all 4 tracks and recruiting 7 under-represented minorities Intraining Exam Results for three PGY classes ranged from 67th to 81st percentile Asher Tulsky appointed Director of Resident Development Developed coaching program and success team (faculty trained in resident remediation) Jenny Siegel appointed Associate Program Director Sheilah Bernard now Assistant Program Director with roles in remediation, recruitment, and teaching 45

46. In-Training Examination Results (AY 2008-2015) 100 90 87 82 81 80 79 80 76 73 73 69 70 67 65 64 62 62 61 61 60 58 Percentile Rank 60 50 50 42 40 35 30 20 10 0 2008 2009 2010 2011 Academic Year 2012 2013 2014 2015 PGY1 PGY2 PGY3 46

47. BU Applicant History Year Total # of BU Applicants 2012 2013 2014 2015 2016 # Matched Notes 61 65 71 61 67 3 6 11 8 17 3 Categorical; 4 Categorical; 1 Primary Care; 1 Prelim 8 Categorical; 1 Primary Care; 2 Prelim 6 Categorical; 1 Primary Care; 1 Preventive Med 10 Categorical; 1 Primary Care; 6 Prelim BU Applicant History 80 70 60 50 40 30 20 10 0 2012 2013 2014 2015 2016 47 Total # BU Applicants # Matched

48. Residency Program Education Goals, AY17 Successfully implement resident coaching program Facilitate better resident participation in scholarly activities with use of recently created faculty research database Improve the quality of academic half day conferences to address educational gaps as identified by topics covered, ACGME survey feedback, and IM-ITE scores Disseminate program s educational innovations Continue to increase diversity of trainees 48

49. Student Education AY 16 Evals from Office of Med Educ at BUSM for 2016 95% of students rate the quality of the Medicine 1 Clerkship educational experience as good or excellent > 95% agree or strongly agree that residents and faculty were professional role models 82% agree or strongly agree that mid-clerkship feedback was useful Students seek more observation of clinical skills 49

50. Student Education AY 16 From AAMC Graduate Questionnaire (GQ): Slippage in Med I evaluation over past few years and below national median for: - Quality of educational experiences - Effectiveness of teaching provided by residents and faculty 50

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