Member Profile

University of Pittsburgh School of Medicine and the University of Pittsburgh Medical Center

Background

The goal of the University of Pittsburgh School of Medicine (UPSOM) is to educate physicians who are science-based, skilled, and compassionate clinicians prepared to meet the challenges of practicing medicine in the 21st century and to conduct cutting-edge biomedical research that is focused on improving the human condition and advancing the fundamental understanding of medical science.

The School of Medicine began as the Western Pennsylvania Medical College and graduated its first class of physicians in 1887. In the 1890s, the medical college became affiliated with the Western University of Pennsylvania, which originated as the Pittsburgh Academy in 1787, making it one of the nation's oldest academic institutions. Western University of Pennsylvania was renamed the University of Pittsburgh in 1908.

Today, UPSOM includes 29 departments, with 2,054 regular faculty members, plus 1,952 volunteer faculty. There are 577 M.D. students, plus 317 students enrolled in Ph.D. programs, 38 students in M.S. programs, and 25 students in certificate programs. Ninety-one students participate in the Medical Scientist Training Program. This program provides medical students who wish to pursue a career in biomedical research the opportunity to undertake doctoral work in basic science, engineering or public health at either the University of Pittsburgh or neighboring Carnegie Mellon University.

Through its close affiliation with the University of Pittsburgh Medical Center (UPMC), UPSOM offers students opportunities for clinical training, educational experiences, and research in virtually any medical specialty. Although they are legally separate and distinct entities, UPSOM and UPMC share a common commitment to excellence in education, research, and clinical care. As one of the nation's largest and most financially successful academic health care systems, UPMC encompasses more than 50,000 employees, 4,500 affiliated physicians, including 2,300 employed by the health system; and 20 tertiary care, specialty and community hospitals with more than 3,350 licensed beds serving 29 counties throughout western Pennsylvania. UPMC also includes specialized outpatient facilities, cancer centers, rehabilitation facilities, senior living facilities, imaging services, and doctors' offices in the sameregion. There are more than 1,350 medical residents and fellows in 143 training programs, and more than 1,000 nurses-in-training.

UPMC has received national recognition for its programs in the following specialties: ear, nose and throat; geriatrics; rheumatology; psychiatry; orthopedics; cancer; neurology and neurosurgery; gynecology; kidney disease; respiratory disorders; rehabilitation; urology; endocrinology; and digestive disorders. UPMC also has more clinical transplantation experience than any other center in the world, with more than 12,000 organ transplants in the past 20 years.

Hillman Cancer Center is the flagship facility in the UPMC Cancer Centers network of more than 40 clinical care facilities throughout the region and home of the University of Pittsburgh Cancer Institute, designated by the National Cancer Institute as a Comprehensive Cancer Center for cancer treatment, research, education and prevention.

UPMC's clinical programs have earned international recognition, drawing patients from around the world. In addition, the medical center is now transporting its expertise to other countries, including Italy (where it manages the Mediterranean Institute for Transplantation and Advanced Specialized Therapies in Palermo) as well as new ventures in Ireland and Qatar.

The Health Sciences Library System (HSLS) supports the educational, research, clinical, and service activities of the health sciences community of the University of Pittsburgh and UPMC through development and provision of innovative information resources and services.

Teamwork

A recent article in the journal Academic Medicine best describes the successful partnership between the University and UPMC:

In the synergistic evolution of their research, education, and clinical programs, [UPSOM] and UPMC have followed one core principle: What is good for one is good for both. The collaboration is underpinned by UPMC's commitment to its community mission, including support for the academic and research objectives of [UPSOM.]…Over time, UPMC acquired… hospitals through merger and negotiation, and, by 2008, had grown into a $7 billion global health enterprise. From the outset, the senior leaders of both UPMC and Pitt committed to collaborative decision making on all key issues. Under this coordinated decision-making model, UPMC oversees all clinical activity, including that from a consolidated physicians' practice plan. Pitt remains the guardian of all academic priorities, particularly faculty-based research. UPMC's steady financial success underpins the model. A series of interrelated agreements formally defines the relationship between Pitt and UPMC, including shared board seats and UPMC's committed ongoing financial support of [UPSOM]. In addition, the two institutions have jointly made research growth a priority. The payoff from this dynamic has been a steadily growing Pitt research portfolio, enhanced growth, visibility, and stature for UPMC, [UPSOM] and Pitt as a whole; and the sustained success of UPMC's clinical enterprise…

Levine AS et al. The relationship between the University of Pittsburgh School of Medicine and the University of Pittsburgh Medical Center—a profile in synergy. Academic Medicine 83(9):816-826, September 2008.

Innovation

Below are some of the many medical innovations developed at the University of Pittsburgh:

1950—Phillip S. Hench, MD, a 1920 graduate of UPSOM, and two other scientists win the Nobel Prize in Physiology or Medicine for discoveries relating to the hormones of the adrenal cortex.

1952—A killed-virus polio vaccine is developed by Jonas Salk, M.D., and a team of researchers, leading to a rapid and dramatic drop in the incidence of this previously unpreventable disease.

1958—Peter Safar, M.D., refines cardiopulmonary resuscitation (CPR) and extends it to cardio-pulmonary-cerebral resuscitation, which he assembled as a sequence of basic, advanced, and prolonged life support

1961—Klaus Hofmann, Ph.D., leads a team that develops a synthetic form of adrenocorticotropic hormone (ACTH) that performs all of the biological functions of the naturally occurring hormone.

1963—The Magovern-Cromie sutureless heart valve developed by George J. Magovern, M.D., and others enhances the speed and efficiency of heart valve replacement surgery and improves the survival rate of patients.

1984—Thomas E. Starzl, M.D., Ph.D., performs the world's first double transplant operation (simultaneous heart and liver) on a 6 ½-year-old girl.

1985—Bernard Fisher, M.D., and team are the first to recognize the systemic pattern of breast cancer development, leading to the conclusion that lumpectomy combined with radiation therapy is as effective as mastectomy in treating breast cancer. Fisher's group went on to show the effectiveness of chemotherapy and hormonal therapy (tamoxifen) in preventing recurrence.

1992—A team led by Geoffrey D. Block, M.D. produces the first sustained, proliferative growth of normal liver cells in the lab, laying the groundwork for development of artificial liver devices, possible treatments for acute liver failure, and gene therapy strategies.

1996—Investigators led by John W. Mellors, M.D., discover that plasma HIV load plays the critical role in determining the prognosis of AIDS patients.

1998—Studies led by Fisher demonstrate that the drug tamoxifen can substantially reduce the risk of breast cancer in high-risk women who have not yet developed the disease.

2004—In collaboration with colleagues in Sweden, researchers complete the first human study of a radioactive dye called Pittsburgh Compound B developed by William E. Klunk, M.D., Ph.D., and Chester A. Mathis, Ph.D., to detect, using PET scanning, the amyloid plaque deposits that are believed to signal Alzheimer's disease.

2005—Amin Kassam, M.D., Carl Snyderman, M.D., and Ricardo Carrau, M.D., pioneer endoscopic transnasal brain surgery, a revolutionary technique that uses the nose and nasal sinuses to gain access to hard-to-reach brain and spinal cord tumors previously considered to be inoperable.

Teaching

Highlights of the medical school curriculum include a focus on problem-based learning, evidence-based medicine, and extensive simulation training. The fourth-year Integrated Life Science (ILS) Program offers a choice of courses that revisit some aspect of basic science after students have had several years of clinical experience. All medical students engage in a scholarly project that is incorporated longitudinally throughout the curriculum. The intent of the scholarly project is to expose students to the mechanics of scientific investigation, encourage them to pursue research opportunities and help them understand the structure of thought underlying the practice of medicine.

UPSOM is expanding the use of Web-based applications of teaching materials. The curriculum Web site contains images, self-test questions, and other value-added course content. Syllabi, slides and lecture materials are posted on the Web site for all first- and second-year courses. "The Zone" is a one-stop, password-protected Web portal initiated by medical students and developed by them with administration's support as a convenient way to access e-mail, schedules, student affairs and financial aid information, commonly used applications, and other electronic materials. UPSOM's Laboratory for Education Technology serves as an incubator for new ideas and a means of fast-tracking the development of novel approaches to the use of technology applications in support of medical student learning.

The Peter M. Winter Institute for Simulation Education and Research (WISER) is the world's largest health care simulation center affiliated with an academic medical center. WISER's mission is to conduct research and training programs utilizing simulation-based education to provide a safe environment for patients at UPMC and its affiliates. At WISER, health care students and professionals at all levels can perform complex and critical procedures on sophisticated simulators that bleed, breathe, cough and cry. Their skin can be cut by scalpels and their veins injected with medications. Simulator models include adults, children and a pregnant female and her fetus. Task trainers representing particular anatomical systems or parts help participants learn specific procedures, such as the placement of ventilator tubes and intravenous lines. Patient care scenarios can be suddenly altered by simulating an unexpected complication. Data from the simulation sessions can provide feedback to participants or can be used for research and the development of new education programs and improved patient safety. Last year, WISER helped nearly 2,500 health care professionals gain new skills and created approximately 10,000 simulated health care encounters.

Discovery

The University of Pittsburgh, led by the School of Medicine, currently ranks sixth among educational institutions and affiliates in funding from the National Institutes of Health (NIH). In fiscal year 2008, the University spent approximately $516 million for research in the health sciences, an increase of approximately 3.8 percent from the previous year. Areas of research emphasis include:

• Translational science
• Drug discovery and design
• Organ transplantation/immunology
• Stem cell therapy, tissue engineering and regenerative medicine
• Artificial organ and medical device development
• Cancer diagnostics and therapy
• Cardiology
• Gene therapy
• Bioinformatics and computational biology
• Psychiatry, neuroscience and neurological surgery
• Vaccine development
• Hemostasis and vascular biology
• Structural biology
• Developmental biology
• Clinical trials management

From 1999 through 2007, 56 companies were formed that were dependent upon the licensing of technology developed at the University of Pittsburgh; a majority of these were in the life sciences.

Current Projects: Technological Innovations

eRecord

UPMC is focused on using advanced information technology both to assure quality and safety in patient care and to streamline its business practices. Innovations such as eRecord, UPMC's electronic health record system, reduce errors and costs by enabling clinicians to access important patient information without the need to page through paper records. Additional computerized systems track and dispense medications, transmit diagnostic images, and give people with diabetes and other chronic conditions an online portal for communicating with their doctors and accessing disease management tools.

UPMC's Interoperability Project is an information technology initiative designed to make it easier and faster for care providers to access a patient's complete electronic medical record in one place. UPMC is partnering with the software company, dbMotion, to develop a tool to access and integrate patient information from the full range of UPMC eRecord systems, databases, and file formats. The goal is to enable providers to instantly view a unified patient record that presents everything on file about their patient, instead of checking a half-dozen different applications to get what they need.

The service-oriented software architecture of dbMotion's application enables it, with UPMC, to provide caregivers secure access to an integrated patient record composed from the patient's medical data maintained at facilities that are otherwise unconnected or have no common technology through which to share data, without replacing existing information systems. A key goal of the project is to achieve "semantic interoperability"—the actual transfer of meaning—among the varied clinical systems to seamlessly share patient information and allow physicians and other clinicians, no matter where they practice in the network, to have full access to all the information they need to make decisions at the moment they need it.

UPMC's interoperability program went "live" on February 15, 2008. Initial users have been able to view and act on information about clinical problems, allergies, medications, and laboratory results that their usual electronic systems would not have provided as quickly and conveniently.

Pilot Project: "Smart" Patient Rooms

In late 2007, UPMC introduced six "smart" patient rooms that recognize doctors and nurses as they enter, and shows them relevant patient information on a bedside monitor, including the latest clinical updates, and other pertinent data. Patients can view a second monitor to learn the identify and role of each caregiver who enters the room, and other information, such as prompts to ask for help in getting out of bed if they are at risk for falls. A spotlight focuses on the hand sanitizer dispenser when people enter or leave, reminding them to wash their hands.

The system uses ultrasound tracking devices to identify the numerous caregivers whom a patient might encounter on any given day, and is customized based on a health professional's need for the data. For example, a phlebotomist coming to draw blood would view only current lab orders and allergy information.

This technology is designed to enhance patient safety, allow clinicians to spend more time at the bedside and simplify the jobs of health care workers. After testing and evaluation, UPMC plans to expand this concept to additional rooms and facilities, and to add other features, including reminders to patients of when their next pain medication is due, or to health care workers about patients who need to be turned because they are at risk for bedsores.

Other initiatives in UPMC's commitment to information technology include the development and system-wide deployment of systems to improve patient safety; access to care, such as appointment scheduling, registration for clinical services, and insurance eligibility management; business practices, including billing, claims, and contract management; and resource planning, such as purchasing, materials management, and payroll systems.