Author Archives: roperhealth

Our Commitment to Excellence in Autism Research

As the Dean of the UNC School of Medicine (UNC SOM) and the CEO of UNC Health Care, I am surrounded by the best and brightest minds, all of whom work tirelessly to make our vision – to be the nation’s leading public academic health care system – a reality. One way we do that is through our unwavering commitment to research.

According to the CDC, 3.5 million Americans live with an autism spectrum disorder (ASD). In North Carolina alone, it is estimated that over 60,000 people live with ASD. As we celebrate Autism Awareness Month this April, I want to highlight the groundbreaking research the UNC SOM has conducted over the last year.

Last April, UNC SOM helped launch SPARK, the nation’s largest genetic research study for autism to better understand its causes and help usher in an era of personalized medicine and targeted treatment. This nationwide project, led locally by Joseph Piven, MD, and Gabriel Dichter, PhD, will collect information and DNA from 50,000 individuals with autism — along with their families — to better understand the genetics of this condition.

Since then, Piven, director of the Carolina Institute for Developmental Disabilities, and his team have unveiled numerous insights. In February, they published the results of a first-of-its-kind study that used MRIs to map the brains of infants. Using these MRI results, Piven and his team were able to correctly predict 80 percent of those infants who would later be diagnosed with autism at two years of age. Just last month, this team published yet another study which found that many toddlers diagnosed with autism at two years of age had a substantially greater amount of extra-axial cerebrospinal fluid (CSF) at both six months and one year – before diagnosis is possible – pointing to faulty CSF flow as one of the possible causes of autism.

Thanks to Dr. Piven, Dr. Dichter and several others, UNC SOM was awarded $223 million for autism-related research from 2006 to 2015. In the last ten years, 34 UNC departments have been awarded for their respective autism research. These investments make this research possible. Most importantly, it helps bring us closer to tackling some of our world’s most pressing health care challenges.

To learn more about the SPARK initiative, click here.

To learn more about the MRI autism study, click here.

To learn more about the CSF autism study, click here.

Revolutionizing Heart and Vascular Care

At UNC Health Care, we are always looking for new and innovative ways to serve our patients. One way we do that is through partnerships and collaboration. I am proud to say that, through our partnership with UNC REX Healthcare, we recently opened the doors of the new, state-of-the-art North Carolina Heart & Vascular Hospital on the Raleigh campus of UNC REX.

North Carolina has the 12th highest incidence of heart and vascular disease in the country. We lose about 18,000 people annually from heart disease. At the same time, the population continues to grow, increasing the demand for quality health care providers.

The 114-bed hospital is staffed by leading physicians in Wake County, and is now the hub for a premier heart and vascular program in the Southeast. Since we are an academic medical center, we also bring in medical students from the School of Medicine who are training in interventional cardiology and vascular surgery. This not only helps advance the teaching mission of the medical school, it also provides a closer connection to the research and advanced treatments provided by the Medical Center in Chapel Hill.

Since all of UNC REX’s heart and vascular services moved into this new facility, there are plans to improve and repurpose vacated space on its main campus to improve patient care. For example, part of this space will be converted into a behavioral health zone for patients being treated in the hospital’s emergency department – fulfilling a critical need in Wake County.

For more information on North Carolina Heart & Vascular, click here.

Improving Mental and Behavioral Health in Our State

UNC Health Care is committed to caring for all patients, including those with mental and behavioral health issues. As our population grows, the demand for beds and dedicated inpatient psychiatric care continues to rise.

In Wake County, more than 65,000 people suffer from a serious mental illness. Yet, from 2012 to 2015, we were one of just three states to decrease behavioral health spending each year. More than half of our counties are without a psychiatrist, and only 35 percent of our hospitals have a psychiatric unit.

Regular hospitals and health facilities often don’t have the time or resources necessary to help treat and provide services for those with mental health, behavioral and substance abuse problems.

At UNC Health Care, we are taking steps to address this growing need. At UNC REX, we have worked to improve our triage process in the emergency department to ensure that mental health patients get the care they need as quickly as possible. We also recently expanded UNC WakeBrook, a facility in Raleigh designed to care for those with mental health, behavioral and substance abuse problems.

At the federal level, we are pleased to see policymakers making mental and behavioral health a priority as well. Late last year, the 21st Century Cures Act was signed into law.

Among many other things, the Act strengthens laws mandating coverage parity for mental health care and provides funding to help increase the numbers of psychologists and psychiatrists.

The expansion of WakeBrook and the 21st Century Cures Act are steps in the right direction, but there are always opportunities to do more. We will continue working closely with public health officials and legislators to provide better care and better access to our state’s mental and behavioral health patients.


Today’s Research Is the Key to Tomorrow’s Treatments

At the UNC School of Medicine, our focus is on one thing: improving the health of patients across the state and the nation. We are nationally recognized for providing outstanding care and serving countless people across the state, day in and day out. We also earn national recognition for our research. In fact, this month alone, the National Institutes of Health (NIH) awarded researchers at UNC SOM three grants totaling more than $179 million. These investments in research are also investments in people, because they lead to better care for patients.

For instance, Baby Connectome Project (BCP) will help scientists to better understand what is needed to support brain development in the critical first years of life. This $4 million grant awarded to UNC SOM and the University of Minnesota will enable researchers to track the circuitries of the brain and its development from birth through childhood to uncover factors contributing to healthy brain development.

The UNC SOM was also included in a $157 million grant to launch Environmental influences on Child Health Outcomes (ECHO). This initiative aims to investigate how exposure to environmental factors in a child’s early development, from conception through early childhood, can influence later health outcomes. This means understanding how air pollution, stress and other factors can affect the biological process, with the goal of ensuring that every baby will have the opportunity to lead a healthy life.

Finally, the UNC/Emory Center for Innovative Technology, or iTech, will allow researchers to develop ways to address barriers to HIV care. The $18 million in funding will help researchers to target 15 to 24-year-olds at risk of or currently living with HIV through mobile apps that are intended to increase HIV testing. This means developing electronic health interventions for those who test positive for the virus, ultimately leading them to care and antiretroviral therapy.

These are all some of our most challenging health care issues. Thanks to the support from NIH, our researchers are making headway in finding the underlying causes – and potentially finding cures – for these challenges.

For more information about the Baby Connectome Project, click here.

For more information about ECHO, click here.

For more information about iTech, click here.

UNC Health Care Again Ranks Among Best Hospitals in the Nation

At UNC Health Care, our vision is clear: to be the nation’s leading public academic health care system. We are committed to providing North Carolinians with the highest level of care. We are continually looking for new and innovative ways to improve the quality of care that we provide for patients across our state. And we are clearly making progress. I am pleased to say that the recently released U.S. News & World Report 2016-2017 Best Hospitals rankings confirm our commitment to quality and excellence.

UNC Hospitals was nationally ranked or recognized as high performing in 10 clinical categories listed in the U.S. News & World Report 2016-2017 Best Hospitals rankings. Four of our specialties were ranked highest in the state.

Across the state, our system performed well. UNC Hospitals, UNC REX Hospital and UNC High Point Regional Hospital ranked No. 2, No. 10 and No. 16, respectively, in the Best Hospitals rankings for North Carolina.

UNC Hospitals ranked higher in eight clinical categories compared with the 2015-2016 rankings, including Urology, Cancer, Diabetes and Endocrinology, Nephrology, as well as Gastroenterology and GI Surgery.

I will elaborate on just how extraordinary this recognition is. U.S. News & World Report rankings are among the most prestigious of their kind. This year’s rankings began with a pool of 4,667 hospitals representing virtually all U.S. nonfederal community facilities. Only 153 hospitals in the United States, across all 16 specialty categories, performed well enough to be nationally ranked in one or more specialties. The scores are established on the basis of issues like severity-adjusted mortality and patient volume as well as on the hospital’s reputation among specialist physicians.

As UNC Health Care continues expanding across the state, we have remained steadfast in our core beliefs and values. This unwavering commitment to strive for excellence is what enables us to provide the best possible care for the people of North Carolina. And these scores are a clear indication that we are making tremendous progress on the goals we have set.

For a full list of U.S. News & World Report 2016-2016 Best Hospitals rankings and UNC Hospitals recognition, click here.

Commemorating Seven Decades of the Centers for Disease Control and Prevention

Last week, I had the privilege of providing remarks at the Centers for Disease Control and Prevention (CDC) Public Health Grand Rounds – Seven Decades of Firsts with Seven CDC Directors. The event marked the 70th anniversary of the CDC. It gave former directors, including myself, an opportunity to reflect on the CDC’s great work in the past, its relevance and continued importance today, and its need to maintain public health in the future.

As the director of the CDC from 1990 to 1993, I saw tremendous change in public health. The CDC began cultivating partnerships with academia, public health agencies and the private sector. At the same time, the CDC started to face more complex challenges. In addition to its focus on communicable diseases, the CDC embraced its role as the nation’s prevention agency, formally adding “and Prevention” to its name. As the CDC has continued to change to address changing needs in public health, I am happy to say that, in my opinion, the CDC name and mission are still as strong as ever.

The focus on prevention was reflected in many of our efforts during my time as CDC director. For instance, in the early ’90s, the CDC funded prevention programs aimed at tackling the expansion of HIV/AIDS. In 1991, the CDC identified a sharp increase in cases of tuberculosis that were related to HIV infection and AIDS; in that same year, the CDC reported that the number of reported AIDS cases in the United States had reached 200,000. Recognizing that prevention activities were needed at the community level, the CDC funded five HIV/AIDS demonstration projects that extended prevention efforts to community sites and elicited the help of community residents and peer groups to motivate behavior change.

The CDC played critical roles in the past, and it continues to be a vital force for global public health today. Outbreaks of viral diseases such as Ebola in 2015 and Zika this year remind us of the important role that the CDC plays with regard to education and protection.

The CDC drives policy and action nationally and around the globe, as well as right here in North Carolina. It is a vital resource as we work to ensure the best patient outcomes for people across our state, and I am confident that the CDC will continue to be a global leader in disease control, prevention and protection.

MedServe: An Investment in our State

Investment in medical education is invaluable to the future of our state. That is why at the UNC School of Medicine, we work day in and day out to attract the best and brightest minds who will go on to provide top-quality care to patients across our state.

Recently, two medical and business school students from UNC-Chapel Hill and Duke launched MedServe, a first-of-its-kind program that pairs 13 outstanding recent college graduates with primary care clinics in rural or underserved communities across North Carolina for two years of immersive service. Fellows kicked off their summers with a week of training at the UNC School of Medicine, where they gained practical skills and knowledge to help in their clinical roles.

Many people don’t realize it, but the UNC School of Medicine serves North Carolinians in all 100 counties of the state, reaching rural and underserved populations. However, this task is becoming more challenging as our population continues to grow. We are now the nation’s ninth most populous state, and we’re adding about 100,000 new residents each year. By 2030, that’s like adding another third of our current population.

MedServe is helping address this challenge. It’s increasing awareness for the importance of primary care, providing care to communities that need it most and providing vital experiences to future physicians. This is the kind of innovative and collaborative approach that will bring real improvements throughout our state.

At UNC, we constantly strive to provide empathetic, expert care to all North Carolinians. This is what we call complete care. I am thrilled that MedServe is taking part in our ambitious, yet necessary, mission.

To learn more about MedServe, click here.


Serving Patients Across North Carolina

In recent years, it has become harder for independent community hospitals to thrive on their own. This transition has resulted in significant and rapid growth for UNC Health Care.

A number of independent hospitals have asked us to assist them. Most recently, they have requested we manage their hospitals while they remain separate legal entities.

We have two criteria for deciding the communities in which we will partner:

  1. We only go where we are invited; and
  2. Any involvement we might have must be at least “budget neutral” for us.

At UNC Health Care, we are committed to serving patients across North Carolina. We recently forged new relationships with Wayne Memorial Hospital and Lenoir Memorial Hospital, which means our organization now includes 10 hospitals and hospital systems across the state. We are truly serving patients across North Carolina. This is right on target with our mission as the state’s health care system: to improve the health of all North Carolinians, regardless of their ability to pay.

While this growth makes good business sense and ties directly to our mission, to some, it may seem like a lot of growth in a short amount of time. However, I strongly believe that our expansion is good for our patients. When hospitals across the state ask us to partner with them, and the partnership can be accomplished in a way that is mutually beneficial, we will be there to help serve patients in the communities where they live.

I am extremely proud that we have had the opportunity to provide even more North Carolinians with the highest level of empathetic and expert care. And we will continue to do so, as long as it continues to benefit the people of our state.

Research Leads to Better Patient Outcomes

As dean of the UNC School of Medicine and CEO of UNC Health Care, I have the fortune of working alongside some of the best and brightest minds in health care. Through research, innovation and advanced health care delivery, they are responsible for tackling some of our most pressing health care challenges.

For instance, for the first time, a global research effort led by John Buse, MD, PhD, professor of medicine at the UNC School of Medicine and director of the UNC Diabetes Center, determined that a new Type 2 diabetes therapy proves better than traditional insulin injections.

The drug IDegLira proved to be more effective than basal insulin glargine injections at reducing the average amount of blood sugar over the course of several months. The new therapy was also associated with weight loss and a substantially lower rate of hypoglycemia – i.e., low blood sugar – compared with more commonly used injections, a major development in the treatment of Type 2 diabetes.

Another area where our researchers are making breakthroughs is in autism and neurodegenerative diseases.  Dr. Mark Zylka, PhD, associate professor of cell biology and physiology at UNC, led a team of researchers who published a study on the role that a new class of fungicides could play in autism and neurodegenerative disease. Along with his team, Dr. Zylka found a class of commonly used fungicides that produce gene expression changes similar to those in people with autism and neurodegenerative conditions, including Alzheimer’s disease and Huntington’s disease. The study, published in Nature Communications, describes a new way to home in on chemicals that have the potential to affect brain functions.

This is the kind of research that makes UNC one of the leading academic medical centers in the nation. More importantly, research drives better care and leads to more effective treatments.

For more information on the diabetes study, click here.

For more information on the fungicide study, click here.

Using Technology to Research and More Effectively Treat Postpartum Depression

At UNC, we are always looking for new and innovative ways of delivering better, more complete care. Recently, researchers from the UNC School of Medicine launched a free iPhone app to engage women in a genetics research study about postpartum depression (PPD) and most importantly, to understand the causes and find more effective treatments.

The ResearchKit app, called PPD ACT, surveys women to identify those who have had symptoms of PPD. The app also invites certain women based on survey responses to provide DNA samples so that researchers can study the genes of those impacted by PPD.

Samantha Meltzer-Brody, MD, MPH, director of the Perinatal Psychiatry Program at the UNC Center for Women’s Mood Disorders, and Patrick Sullivan, MD, director of the UNC Center for Psychiatric Genomics, led efforts to design the study and develop the app.

This is the kind of innovative, meaningful work that makes UNC a leader in medicine and enables us to continue best serving our growing patient population.

To download the app, click here.

To learn more about the study, click here.