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Capitol Hill Briefing Focuses on Lessons Learned from Ebola Response

Capitol Hill Briefing
October 13, 2015

The need for preparedness and collaboration to respond to future outbreaks of communicable diseases was the focus of an October 13 Capitol Hill briefing titled "One Year Later: Lessons Learned from Ebola in the U.S. and Academic Medicine's Role in Preparing for the Next Threat."  The briefing was hosted by the Association of American Medical Colleges (AAMC) and the Congressional Academic Medicine Caucus.

Panel participants included Bryce Gartland, MD, FHM, chief executive officer of Emory University Hospital; Bruce Ribner, MD, MPH, medical director, Infectious Disease Unit at Emory University Hospital, Serious Communicable Disease Unit; and James Le Duc, PhD, director of the Galveston National Laboratory at The University of Texas Medical Branch; and was moderated by Atul Grover MD, PhD, chief public policy officer at the AAMC. The presenters focused on the role of academic medicine in the response to last year’s Ebola virus outbreak and what could be done to prepare for the next occurrence of a highly communicable disease.

Dr. Grover provided an overview of the role academic medicine plays in health care, with a focus on the research and patient care AAMC-member institutions provided in response to the Ebola outbreak and their unique qualifications to deal with the next threat.

“Investments in academic medical centers are critical to strengthening the nation’s preparedness for both known and emerging threats,” Dr. Grover said, noting AAMC’s efforts to coordinate between federal officials and member medical schools and teaching hospitals as the national response unfolded, including a strong partnership with the Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR). A total of 50 of the 55 Centers for Disease Control (CDC)-designated Ebola treatment centers are AAMC-member teaching hospitals, and 8 of the 9 Department of Health and Human Services (HHS)-designated Regional Ebola Treatment Centers are major teaching hospitals.

Dr. Grover also discussed how the research, education, and patient care infrastructure of academic medical centers (AMCs), including Emory and University of Nebraska Medical Center (UNMC), was key to putting a response like the one to Ebola into action. “It not something you can do overnight,” he said. He described the role that Medicare Indirect Medical Education (IME) payments play in partially offsetting expenses associated with the specialized services and more complex patients treated almost exclusively at teaching hospitals.

Dr. Gartland and Dr. Ribner combined their presentations, providing a summary of Emory University Hospital’s response, including being one of the first hospitals along with UNMC to treat patients diagnosed elsewhere and treating the first patients diagnosed in the U.S., from two perspectives—the clinical and the administrative. Both discussed the importance of sustained preparation and funding to ensure preparedness for future crises.

Dr. Ribner noted that the ability to provide care for patients in 2014 began in 2001 with a partnership between Emory and the CDC that led to the establishment of the specialized isolation unit used to treat Ebola patients, but funding cuts had occurred in the interim.

“By the time we received that call in 2014, our budget had been cut to one-third of what it was in 2001,” Dr. Ribner said, adding that we must “preserve and maintain a robust infrastructure to manage the next outbreak.”

Dr. Gartland discussed how the culture of academic medical centers (AMCs) and their threefold mission—to provide high-level clinical care, train the next generation of doctors, and conduct valuable groundbreaking medical research—along with the availability of the necessary resources at them, made AMCs uniquely capable and competent to successfully meet demands for responses to Ebola or similar situations.

“The ability to mobilize a vaccine and get it out into the environment was the success of the tripartite mission of academic medicine,” Dr. Gartland said. “We must foster improved collaboration between health systems and government agencies” in order to respond to the next outbreak.

Dr. Le Duc concluded the presentations by explaining the role of research in the response to Ebola and future outbreaks. He discussed the various vaccines and tests that had been developed, noting the long-term federal investment—including support through the National Institutes of Health (NIH) and other government agencies—that led to them.

“The problem is sustainability. There must be a constant pipeline in order to create akin vaccines and assays for other communicable diseases, and to deal with future outbreaks,” Dr. Le Duc said. “The federal sector and academic community are intimately linked, especially for conditions that are low incidence, high impact."

The speakers expressed gratitude for emergency supplemental funding provided to address Ebola expenses, though Dr. Grover noted that to date HHS has released only about one third of the $576 million in funding designated to ASPR for Ebola treatment centers. He described how their costs have already exceeded the modest amount of funding made available to them, and indicated AAMC would be working with HHS and OMB to ensure the remainder of the funds are expended as intended.

Dr. Grover also described the importance of continued funding to hospitals through ASPR for the Hospital Preparedness Program (HPP), another program whose funding has diminished over time.

Tannaz Rasouli
Sr. Director, Public Policy & Strategic Outreach
Telephone: 202-828-0525

Susan Beach
Senior Director, Strategic Communications
Telephone: 202-828-0983

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