“Now, we’re starting to see more shared research and partnerships with industry,” says Andrew Vazzano, FAIA senior vice president at SmithGroup Inc.’s Chicago office. “Industry is now part of academic medical centers in terms of genomics research partnerships as genomics institutes, biotechnology, and biomedicine that are coming to the campus setting.”

Creating partnerships with companies is one way for health science centers to connect all aspects of the biomedical continuum, ranging from research and education to hospitals and industry. Such connections are vital to the effective integration of biomedical research, medical education, and patient care services.

Emerging linkages are also being forged in several capacities. For example, seeking global partners for research collaboration and data analysis; developing clinical outreach programs for teaching and conducting research at rural hospitals; using high-capacity computer networks to facilitate image transfer; and taking advantage of regional tissue banks for clinical research, especially at rural hospitals. These linkages are a vital part of the community by creating jobs and overall economic impact and growth, and are operating integrated facilities for research, teaching, and clinical trials.

“Every academic medical center is unique in terms of diversity and complexity. Therefore, there is no one model that will fit all organizations,” notes Vazzano. “However, we are seeing more and more medical centers creating linkages between research, teaching, the clinical setting, and industry partners.”

Complexity of Linkages

Connections between multiple entities can become complex since each constituency typically has its own priorities. However, they share a sense of community where all parties play a key role in accomplishing the prevailing vision of conducting more advanced research and providing enhanced education with the hope of ultimately providing better patient care.

The Phoenix Biomedical Campus, the University of Louisville Health Sciences Center, and the St. Jude Children’s Research Hospital are three institutions that demonstrate the benefits of effective linkages.

The first campus is a partnership between the City of Phoenix, the University of Arizona, Northern Arizona University, and Arizona State University. The 16-acre site is considered an integrated sub-campus that links research, health education, community redevelopment, and affiliated health care. The campus, which features the Genomics Institute and the Arizona Biomedical Research Collaborative, is expected to create 24,000 jobs and have an economic impact of more than $2 billion by 2025.

Collaboration is evident throughout the campus with the University of Arizona and Arizona State University co-existing in the same building and jointly funding the generic biosciences laboratories. St. Joseph’s Hospital relocated its clinical laboratories to the Genomics Institute in order to enhance synergy.

“The ability to link technologies and bring in different partners is part of the environment,” says Jens Mammen, a principal in SmithGroup’s Chicago office. “This is the latest technology in being able to deal with some of the trends.”

The University of Louisville Health Sciences Center in Kentucky is an integrated urban medical center campus, representing a partnership between the University’s Medical School, the University Hospital, the Jewish Hospital, and the Norton Hospital. Joint research collaboration and funding are occurring along with technology transfer among industry partners. The Center is facilitating innovation by working with the Louisville Medical Center Development Corp., the Life and Healthsciences Research Project, and the Cardio-Innovation Institute.

“The Cardio-Innovation Institute is the hybrid of having suites that investigate the bio-cardio device—rtificial heart—into techniques of surgical implantation,” says Mammen. “There are surgery rooms, laboratory suites, and the ability for industry partners to lease space at the University.”

St. Jude Children’s Research Hospital in Memphis, Tenn., is an integrated clinical research teaching facility with 77 patient beds, and a large outpatient component that drives a large housing need on campus. More than 2,000 clinicians and researchers currently work on the campus, but the number is expected to grow to 4,000. The master plan began with 16 acres, but the number has grown to 54. St. Jude’s collaborates with the University of Tennessee Medical School and the LeBonheur Children’s Hospital.

“What began as a very small children’s hospital and clinic is becoming quite a substantial international research institution,” says Vazzano. “There will be a total of 2.6 million sf of space needed to meet the program demand in 2030.”

The campus plan calls for pedestrian linkage to connect the biomedical research facilities to the patient care/translational sciences, which will link to outpatient and family housing.

Phase One of the campus plan included the completion in November 2007 of a 325,000-sf  building, which was designed assuming that most patients would stay approximately 45 days. Patients and family members were surveyed to determine what amenities are important to them. Topping the list were safety; a stimulating, family-like environment; clarity of way finding; connection to staff/caregivers; and convenience, accessibility, and privacy, according to Mammen.

The $102-million Phase One building, which combines patient care and research in the same facility, includes a full cleanroom pharmacy and easy access for replacing large equipment. The building is versatile and flexible, enabling the patient floors and research floors to be interchangeable, if necessary. The floor-to-floor height is 20 feet with a fully walkable interstitial deck.

“Fundamentally, this is a new model of care and time will tell if we were right,” says Mammen.

Lab 2030—A Research Inquiry

SmithGroup conducted a survey, known as Lab 2030, to determine what leaders at universities throughout the country believe will be the primary drivers and the subsequent impact on their academic medical centers in the future. Questionnaires were completed by a variety of university personnel, ranging from principal investigators to department chairs and post-doctoral researchers.

The findings show expected changes in the traditional categories of bioscience. For example, advanced imaging technology will provide images at the atomic scale level; new technologies will be available for analysis of unique material properties; traditional boundaries will disappear with the integration of more discipline specialties; and research universities will be organized differently to respond to these changes. Michigan State University and Johns Hopkins University are already moving toward molecular teaching and whole-body systems investigation rather than traditional disciplines.

Technologies that will emerge in the next 20 to 30 years will feature proteomics advances to protein arrays and cell basis; electro-circular digoism to show shapes of proteins; pharmacogentics, which is the ability to understand an individual patient’s DNA and model the exact dosage for a particular treatment; nanotechnology advances in electromechanical, chemical, biological, and physical; the use of MRI and optical imaging for genetics research; virtual lab microscopy; vascular implantation; and crystallography for protein modeling.

“We’re going to see the interplay of all these technologies happen in an integrated way,” predicts Vazzano. “Having a much more integrated physical setting is going to be more imperative.”

The emerging scientific technology and categories, such as serology or the ability to get an unbiased accurate cell count, will change the composition and organization of research teams. The National Institutes of Health and the National Cancer Institute are shifting towards the interdisciplinary team that includes chemistry, animal models, and toxicology supporting the research team.

In the future, core research teams in medical research will feature the biologist who will collaborate with the chemist, mathematician, and information technology expert. Basic research teams will continue to focus on the principal investigator and eight staff members, although they will be more interdisciplinary. Teams will involve faculty, students, post-doctoral students, and technicians. As the research paradigms evolve, the primary activities of people in the laboratory will change with more work being done on computers and the environment being extremely collaborative.

The intra-disciplinary or intra-departmental teams will influence the design of the laboratories, prompting the creation of more thematic buildings focusing on a specific area of science. Lab assignments will be project-driven. Laboratories will be more connected with local communities in the future through powerful computer networks and being tied to industry to take advantage of using shared programs and advanced equipment.

Electronic communication will change the needs of laboratories, making it imperative to have the necessary infrastructure to support not only data, but also biomolecular imaging. The advanced communication technology will facilitate the global collaboration that is inherent in translational research.

The composition and organization of the research clinical teaching environment will also be different. The teaching will be driven by funding and technology. Research teams will be larger and will interact more with other universities and industries.

“The business of healthcare is becoming extremely competitive and complex,” notes Mammen. “It is really driving significantly towards a more holistic and wellness-based model. Over the past 30 years, we’ve changed from a sickness model to a transitional model in which hospitals have become clinical enterprises with integrated care. Translational sciences are creeping in and we’re seeing the adoption of e-linkages, whether it’s reading x-ray films off-hours in Australia or whether it’s an intensive care unit with a variety of different telemedicine technologies. As you get into new therapies and new types of technologies, the burden from a facilities perspective is on the academic medical center side.”

By Tracy Carbasho

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