Research MattersJune 27, 2019

WelcomeRob Herzog

VP Research Operations

WelcomeValerie McDevitt

Director of Research Services

Welcome Valerie McDevitt

DevotionSteven Smith, M.D.

Chief Scientific Officer

WholeMeUpdate

Steven Smith, M.D.Chief Scientific Officer

WholeMe Soft Launch

Collaborative Team• Cancer-Clinical Trials

• Cancer-NCI

• Cardiovascular

• Center for Collaborative Research

• Children’s

• IRB

• Neuroscience

• OSP

• ResIS

• TRI

• Whole-Person Research

• AIT Service Delivery

• IT Support

By the Numbers

• Ambassadors • 24 Research Staff

• 5 ResIS Support

• 90 participants enrolled • 65 pre-scheduled

• 25 walk-ins

• 7 Stations • 38 minutes = Average enrollment

• 20 minutes = Fastest enrollment

• 1 hour, 16 minutes = Slowest enrollment

Leadership Message

Kristin JimenezDuane Davis, M.D.

InstitutesDuane Davis, MD – CMO

Kristin Jimenez – COO

Agenda1. Defining Institutes

2. Market Dynamics

3. The Role of Research

What is an Institute?

Levels of Care Delivery

.

Service

A medical capability with a singular focus

Mammography

Program

Assembling a continuum of care to treat a

syndrome/disease built around certain

interdisciplinary services

Breast screening

Service line /

Center of

Excellence

Disease focused set of services required to

address health needs of patients with the

goal of achieving a multi-county audience

Comprehensive breast center

Cancer Institute

Institute

Fully developed comprehensive specialty focused network of care with a

regional or statewide audience with the following focus:

✓ Evidence-based practice

✓ Structured education (fellowships)

✓ Physician leadership

✓ Dedicated research governance

Less advanced / focused

More advanced / robust

• Regional or Statewide Presence• Formalized Governance Structure• Cross-Continuum• Multiple Sub-Specialties• Top Quartile Performance & Accreditations• Research & Education• Dedicated Teams and Facilities

Institute Criteria

Service ProgramService

Line/CoEInstitute

The SOAR ProcessS – Scientific

All research projects are reviewed by peer investigators and evaluated on clinical and scientific merit

Investigators present study at Research Review Forum

Project is open to discussion and questions

O – OperationalResearch Ops teams review all necessary aspects of the proposal to successfully execute the project

Particulars and yellow/red flags are discussed at RRF

A – AdministrativeResourcing, budget, and legal implications for the project are reviewed and discussed

R – ReviewScientific decisions are communicated through a letter to the Investigator

Project updates are provided at subsequent RRFs

The NSI RRF Process

Investigator reaches to

research unit leader with study

proposal

Physician Scientists evaluate the study (Scientific Impact

Score)

(Prior to RRF Meeting)

Investigator presents study at

RRF Meeting

Meetings occur bi-monthly

Research Team

Reviews project for operational feasibility

Physician Facilitator

communicates decisions and

recommendations for the project

Investigator works with Research Department to onboard and execute the

project

Market Dynamics

A National Trend

Summary of Trends

Demand for Lower Cost

Care

Diverse Competition

Demand for Excellence

Shifting Risk

• Shifting sites of care e.g. ASC• Remote Monitoring• Elimination of waste• Payor/Network Steerage for quality

and cost outcomes• Tech enabling shift in care sites

• Telemedicine• Minimally invasive

• Prevention and Wellness• Integrative Medicine• Episodic – Continuum Shifts• Distribution & Focus Factories

• Joint Ventures & Partnerships• Mega Groups, VC & Consolidations• Nimble micro-competitors• Clinically Integrated Networks &

ACOs

• Increased transparency: outcomes & cost

• Shift from practices to programs• Designations & Certifications• Training & Research• Breakthrough Innovations

MUST: Drive Quality & Grow Physician Leadership

MUST: Connect Care & Improve Network Integrity

MUST: Redistribute Services & Enable Capital Deployment

MUST: Accelerate Pace & Increase Access

Legislative Session 2019… What Happened?

Hospitals

• Deregulation of CON for general acute, rural, and long-term care.

• Hospitals will not be required to:

o Have an Emergency Department

o Accept Medicare or Medicaid

o Have a minimum # of beds

• Specialty hospitals remain prohibited for discharges that are 65% orthopedic, cardiac, cancer related or any combination.

ASCs

• Effective July 1, 2019

• Allows ASCs to keep patients overnight up to 24 hours.

• Authorizes the Agency to establish minimum standard for pediatric patients under the age of 18 years in an ASC.

Telehealth

• Defines telehealth and telehealth providers in Florida Statute.

• Outlines practice standards and reimbursement requirements for insurers and HMOs.

• Provides reimbursement options for out- of-state physician.

What’s Next?

• Quick Turnaround

• Committees Meet – September 2019

• First Day of Session - January 14

• On tap• 72-hour Recovery Care Centers• 48-hour ASC• Birthing Centers• Telehealth 2.0 • Property Tax / Community Benefit

A consumer-centric framework for

building Systems of Care around

specific conditions.

The Ecosystem Approach

Staffing

Supportive

Care

Wellness &

Prevention

Research &

Training

Quality

Improvement

Screening &

Diagnosis

Facilities &

Technology

Treatment

Comprehensive

MSK Ecosystem

Addressing Gaps & The Role of Research

2019 Cancer Priorities

Staffing

Supportive

Care / End

of Life

Wellness &

Prevention

Research &

Training

Quality

Improvement

Screening &

Diagnosis

Facilities &

Technology

Treatment

FH Comprehensive

Cancer

EcosystemGENITOURINARY

(Prostate, Kidney, Bladder)_______________________________________________

BREAST_______________________________________________

Complete the Product

• Recruit GU Med Onc Leader

• Phase One Launch Moffitt

Single Standard of Care

• Multi-Disciplinary Clinic

• Alt, Orl, Cele

• Survivorship Clinic

Build Comprehensive Program

• Recruit Med Onc Leader

• Recruit Surg Onc Leader

• Phase One Launch Moffitt

Single Standard of Care

• Recruit for community

deficit in care:

• Med Onc- Alt, WP

• Surg Onc- Cele, Orl

• Multi-Disciplinary Clinic

Expansion

• Orl, Cele

• High Risk and Genetics

Program

• Survivorship Clinic

MELANOMA/SARCOMA_______________________________________________

Develop Program

• Joint Recruitment for Med

Onc & Surg Onc Leader

• Development of Key Program

Elements and Deployment

Plan

2019 Neuroscience Priorities

Staffing

Supportive

Care

Wellness &

Prevention

Research &

Training

Quality

Improvement

Screening &

Diagnosis

Facilities &

Technology

Treatment

FH Comprehensive

Neuroscience

Ecosystem

Spine

• One Model of Care

• Value Based Purchasing

• Population Health

Brain Health

• Recruitment of

subspecialists

underway

• Phase 1 location

opens April 2019

(Fairbanks)

Neuro Oncology

• MIBS Concierge

Sleep

• Ambulatory Pricing

2019 DH & Surgery Priorities

Staffing

Supportive

Care

Wellness &

Prevention

Research &

Training

Quality

Improvement

Screening &

Diagnosis

Facilities &

Technology

Treatment

Digestive Health

& Surgery

NUTRITION/METABOLISM_______________________________________________________

• Expand Bariatric Program at

Orlando

• New physician – Summer 2019

• Support Services

• MBSAQIP Accreditation

• System vision

• Alignment of AdventHealth

medical group bariatrics

programs

• Collaboration – Network of Care,

Research, Quality, Supply Chain

• Healthy Hospital Initiative

• Full Continuum of Care

IBD______________________________________________________

• Expansion of Dedicated IBD

program and clinic

• New physician – Fall 2019

• Develop team based

approach

• Expand comprehensive

support services

• Increase clinical trials

STOMACH & ESOPHAGEAL________________________________________________

Integrated Esophageal

Center (IEC)

• Increase access to

specialty physicians

• Motility evaluation of lung

transplant population

• Align Programs

• GI Coordinator - one stop

care

• Add satellite clinics to

improve access

• Future one-year motility

fellowship

• New technologies –

EndoFLIP

LAUNCH DHSI GOVERNANCE

COMMITTEE

2019 Cardiovascular Priorities

Staffing

Supportive

Care

Wellness

&

Prevention

Research &

Training

Quality

Improvement

Screening &

Diagnosis

Facilities &

Technolog

y

Treatment

FH Comprehensive

CVI Ecosystem

• Thoracic Surgery program

hybrid model with

Oncology

• Thoracic surgery program

design with surgical sites

at Altamonte, Celebration,

Winter Park and Apopka

/West Orange

• Aortic Surgery program

build a replacement for

Tom Martin and

sustainable destination

center

• ASC for appropriate site

of care for any thoracic

procedures

• Align or develop a high

quality pulmonary group

• ALD Leader for system

• Fully implement the ALD

Performa

• Expand Pulmonary Rehab

Pulmonary_______________________________________________

Thoracic and Aortic_______________________________________________

• ASC Strategy CV

• Fill all Cardiologist slots

• Programing for Health

Parks

• Partnerships to complete

our Gaps.

Ambulatory_______________________________________________

Institutes 2020 – “Must Dos”

Cardiovascular Neuroscience Orthopedics Cancer Digestive & Surgical

✓ Surgical Platform & Acquisition

✓ Grow Ambulatory Network: ASCs, VCC

✓ Grow Subspecialty: Thoracic, Aortic & ALD

✓ Stabilize IP Neurology & Grow OP Access

✓ Celebration Comprehensive Stroke

✓ Deploy Brain Health & Destination MIBS

✓ Sports Medicine

✓ Physician Alignment & Culture

✓ Deploy Hand to Shoulder Center

✓ Launch Moffitt & NCI

✓ Expand Medical Oncology

✓ Grow Subspecialty Expertise & MDCs

✓ Grow Obesity and Bariatric Network

✓ Launch IBD Strategy

✓ Recruits & Colocation Clinics

Q&AKristin Jimenez

Duane Davis, M.D.

Wrap-UpRob Herzog

VP Research Operations

AHRI Top Publications 2019

– Dr. Richard Pratley

– Dr. George Monir

– Drs. Bang, Arnoletti, Holt,Hasan, Naveneethan, Hawes,Varadarajulu, and Feranec

– Drs. Smith, Sparks, andParsons

– Dr. Richard Pratley

– Dr. Steven Smith

– Drs. Butt, Feranec,Sensakovic, Pepe,Siddiqui, Ward, and Burt

Thank you for attending!