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BUILDING THE RESEARCH ENTERPRISE

BUILDING THE RESEARCH ENTERPRISE. John R. Feussner, MD, MPH Medical University of South Carolina. CHALLENGES FOR RESEARCH THINK CHANGE BE DYNAMIC. Expand spectrum of research Embrace patient-centered research Invest in a diversified research workforce

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BUILDING THE RESEARCH ENTERPRISE

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  1. BUILDING THE RESEARCH ENTERPRISE John R. Feussner, MD, MPH Medical University of South Carolina

  2. CHALLENGES FOR RESEARCHTHINK CHANGE BE DYNAMIC • Expand spectrum of research • Embrace patient-centered research • Invest in a diversified research workforce • Foster interdisciplinary research teams • Protect productive research time

  3. CHALLENGES FOR RESEARCHTHINK CHANGE BE DYNAMIC • Save endangered clinical investigators • Recruit and train new investigators • Implement systems thinking, doing • Apply research discoveries

  4. WHERE TO START, NOW? • Vision or strategic goals • College, Department • Tactics and resources • Who, what, how, when? • Define base state • How much can you afford?

  5. WHAT IS CLINCIAL RESEARCH • Epidemiology • Clinical—patient focused as in clinical trials • Public Health—population focused • Health Services Research • Systems focused—patient, provider, delivery system • Patient safety • Quality Improvement • Not research but uses similar methods • Health Policy Research • Econometric modeling—Cost minimization, CEA, CBA

  6. WHAT IS CLINICAL RESEARCH “Research is clinical when the smallest unit of investigation is an intact human being”

  7. WHERE TO START

  8. CHALLENGES FOR RESEARCHTHINK CHANGE BE DYNAMIC • Value clinical research • Embrace patient-centered research • Invest in faculty expertise • Physician investigators—department/division • PhD expertise—Biostats, Epi Methods • Formal clinical research training • Infrastructure—Grants management, IRB • Protect productive research time

  9. STRATEGIC GOAL Increase Research Funding

  10. KEY DELIVERABLES • Recruit & retain productive researchers • Train research-oriented clinicians • MSCR opportunities • Increase RCDA’s • Focus on junior faculty development • Create template for K awards

  11. MILESTONES/METRICS • Overall level of research funding • Department/division based performance • Investigator initiated, industry participation • Research faculty recruitment & retention • Participation in clinical research training • Number of career development awards

  12. TACTICS AND RESOURCES • Identify Department/College assets • Promote areas of strength • Targets of improvement • Facilitate collaboration (college wide) • Organizational expertise—CTSA, CRO, CTU • Faculty expertise, e.g., biostats, epi methods • Research infrastructure • statistical computing/data management • Research regulatory and management

  13. TACTICS AND RESOURCES • Faculty • Mentors • Individual/team • Trainees/faculty • Skilled Phd faculty • Clinical research training • Career development • Training grants • Individual RCDA’s

  14. TACTICS AND RESOURCES • Targeted recruiting • Small wins—Trials, RCDA’s • Big wins—Centers • NIH funded CTSA as asset • VA wild card—asset or not??

  15. VA RESEARCH AS ASSET? • Research resources • Biomedical • Health services and epidemiology • Clinical trials network (large scale) • RCD opportunities (100% VA salary) • Stable infrastructure • Electronic medical record • National health care network

  16. FUNDING FOR MEDICAL RESEARCH • NIH Budget $29.5 Billion • NSF Budget $ 6.4 Billion • VA Research Budget $ .9 Billion

  17. FUNDING FOR MEDICAL RESEARCH • NCI (FY 2008) $4.8 B • NIAID $4.6 B • NHLBI $2.9 B • NIDDK $1.6 B • NINDS $1.5 B • NIMH $1.4 B • NICHD $1.3 B • NIA $1.0 B • NIDA $1.0 B • DVA $0.9 B

  18. TACTICS AND RESOURCES • Allocation methods for scare resources • Strategic goals • Productivity driven • Business model facilitates decision making • No exceptions—see the financials • Under-estimate available (external) assets • Over-estimate time to acquire new resources/assets

  19. DEFINE THE BASE STATE • Successful departments • Successful faculty • Funding metrics/productivity • All money facilitates success

  20. July 2009 FACULTY GROWTH 253 235 231 199 187 *expected

  21. CLINICAL RESEARCH FACULTY SALARY

  22. Research RESEARCH AWARDS Overall, a 43.3% increase in Research Award $’s over FY08 A 30% increase in Federal and 58% increase in Corporate Awards

  23. BARRIERS TO SUCCESS • Unengaged department/division leadership • Faculty below critical mass • Faculty expertise • Finances--dollars to recruit/build • Infrastructure • Organization, facilities, equipment • Information technology and data systems • Administration and regulatory • Research culture • Flat federal/private research funding

  24. FUTURE PLANNING When Alice met the Cheshire cat, she asked, “would you please tell me which way I ought to go from here?” Said the cat, “That depends on where you want to get to.” Charles Lutwidge Dodgson Alice’s Adventures in Wonderland

  25. “Each success only buys an admission ticket to a more difficult problem.” Henry A. Kissinger

  26. THE RED QUEENEFFECT . . . “well in our country”, said Alice, still panting a little, “you’d generally get to somewhere else—if you ran very fast for a very long time as we’ve been doing.” “A slow sort of country”, said the Queen. “Now here, you see, it takes all the running you can do, to keep in the same place. If you want to get to somewhere else you must run at least twice as fast as that!” Louis Carroll Through the Looking Glass

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