1 00:00:05,480 --> 00:00:08,600 >> HELLO, EVERYBODY. 2 00:00:08,600 --> 00:00:11,560 IT'S GOOD TO SEE ALL OF YOU, WE 3 00:00:11,560 --> 00:00:13,880 ARE A MIX OF SOME LONG STANDING 4 00:00:13,880 --> 00:00:15,160 FOLKS HERE AND SOME NEW MEMBERS 5 00:00:15,160 --> 00:00:19,000 MORE ON THAT IN JUST A FEW 6 00:00:19,000 --> 00:00:20,800 MINUTES. 7 00:00:20,800 --> 00:00:22,240 I'M LAURA FORESE, I'M THE CHAIR 8 00:00:22,240 --> 00:00:24,920 OF THIS BOARD AND DELIGHTED TO 9 00:00:24,920 --> 00:00:26,200 SEE ALL OF YOU. 10 00:00:26,200 --> 00:00:28,800 WE ARE VERY EXCITED BY THE 11 00:00:28,800 --> 00:00:30,200 PROSPECT THAT OUR JULY MEETING 12 00:00:30,200 --> 00:00:33,400 WILL BE IN PERSON SO EVERYBODY 13 00:00:33,400 --> 00:00:34,880 KEEP YOUR FINGERS CROSSED ON 14 00:00:34,880 --> 00:00:35,400 THAT 1. 15 00:00:35,400 --> 00:00:41,840 WE'VE NOT BEEN ABLE TO GATHER AT 16 00:00:41,840 --> 00:00:43,360 THE CAMPUS LO THESE MANY 17 00:00:43,360 --> 00:00:44,920 MULTIPLE YEARS NOW SO IT WOULD 18 00:00:44,920 --> 00:00:47,680 BE TERRIFIC PARTICULARLY AS WE 19 00:00:47,680 --> 00:00:48,560 HAVE SOME NEW MEMBERS. 20 00:00:48,560 --> 00:00:50,160 I'M GOING TO TURN IT OVER TO 21 00:00:50,160 --> 00:00:52,240 LARRY IN HIS ROLL AS ACTING 22 00:00:52,240 --> 00:00:54,400 DIRECTOR IN DR. TAWAK IN JUST A 23 00:00:54,400 --> 00:00:54,600 MOMENT. 24 00:00:54,600 --> 00:01:03,360 I ALSO WANT TO WELCOME DR. TARA 25 00:01:03,360 --> 00:01:04,800 SCHWETZ, AS ACTING DEPUTY 26 00:01:04,800 --> 00:01:06,400 DIRECTOR, AND SHE WILL BE WITH 27 00:01:06,400 --> 00:01:15,600 US FOR PART OF THE MEETING AND 28 00:01:15,600 --> 00:01:18,200 THEN AS SHE--NEW ROLE SINCE 29 00:01:18,200 --> 00:01:20,600 WE'VE ALL BEEN TOGETHER LAST. 30 00:01:20,600 --> 00:01:22,200 THE ONLY BOARD MEMBER WHO 31 00:01:22,200 --> 00:01:24,080 COULDN'T MAKE IT TODAY WAS 32 00:01:24,080 --> 00:01:25,120 DR. JULIE [INDISCERNIBLE] SO WE 33 00:01:25,120 --> 00:01:26,440 HAVE A QUORUM AS I SAID AND 34 00:01:26,440 --> 00:01:30,400 WE'VE BEEN WORKING ON THE 35 00:01:30,400 --> 00:01:32,880 MEMBERSHIP OVER THE LAST COUPLE 36 00:01:32,880 --> 00:01:36,200 OF MONTHS, I WOULD SAY, JIM, 37 00:01:36,200 --> 00:01:37,280 TARA, LARRY AND MYSELF AND THE 38 00:01:37,280 --> 00:01:38,680 FIRST THING WE HAVE TO DO IS 39 00:01:38,680 --> 00:01:42,640 THAT WE'RE GOING TO SAY GOODBYE 40 00:01:42,640 --> 00:01:45,600 AFTER THIS MEETING TO OUR LONG 41 00:01:45,600 --> 00:01:46,600 STANDING MEMBER ELEN BERG WHO'S 42 00:01:46,600 --> 00:01:48,920 BEEN WITH US THE ENTIRE 6 YEARS, 43 00:01:48,920 --> 00:01:53,240 FOR ANYBODY WHO'S NEW TO ELEN 44 00:01:53,240 --> 00:01:55,560 YOU MUST NOW PICK UP THE MANTEL 45 00:01:55,560 --> 00:01:56,800 OF THIS FABULOUS COSTUMES AND 46 00:01:56,800 --> 00:01:58,040 ELEN DO YOU WANT TO UNMUTE AND 47 00:01:58,040 --> 00:01:59,960 SAY A FEW WORDS, WE ARE SURE 48 00:01:59,960 --> 00:02:01,600 GOING TO MISS YOU. 49 00:02:01,600 --> 00:02:03,680 YOU'VE BEEN A WONDERFUL BOARD 50 00:02:03,680 --> 00:02:03,920 MEMBER. 51 00:02:03,920 --> 00:02:05,120 >> S WHY, I WOULD LIKE TO SAY 52 00:02:05,120 --> 00:02:07,320 THAT I HAVE TRULY ENJOYED AND 53 00:02:07,320 --> 00:02:10,720 LEARNED SO MUCH FROM BEING A 54 00:02:10,720 --> 00:02:12,360 MEMBER OF GROUP AND I WANT TO 55 00:02:12,360 --> 00:02:15,360 SAY ON BEHALF OF PATIENTS 56 00:02:15,360 --> 00:02:16,680 EVERYWHERE IN THE WORLD, THANK 57 00:02:16,680 --> 00:02:21,680 YOU, EACH 1 OF YOU FOR ALL YOU 58 00:02:21,680 --> 00:02:21,840 DO. 59 00:02:21,840 --> 00:02:22,280 THANK YOU. 60 00:02:22,280 --> 00:02:23,360 >> THANK YOU SO MUCH. 61 00:02:23,360 --> 00:02:26,160 THANK YOU SO MUCH ELLEN, YOU 62 00:02:26,160 --> 00:02:36,800 HAVE 63 00:02:43,800 --> 00:02:45,080 BEEN A STALWART--RUTH 64 00:02:45,080 --> 00:02:46,200 BRINKLEY AND RICK AND I ARE ALSO 65 00:02:46,200 --> 00:02:48,440 GOING TO BE LEAVING THE BOARD 66 00:02:48,440 --> 00:02:52,360 THIS YEAR, ALSO MEMBERS FROM THE 67 00:02:52,360 --> 00:02:53,200 VERY BEGINNING. 68 00:02:53,200 --> 00:02:54,520 WE WILL STAGGER THAT A LITTLE 69 00:02:54,520 --> 00:02:56,840 BIT SO THAT WE WILL BE ABLE TO 70 00:02:56,840 --> 00:02:59,000 DO A SMOOTH TRANSITION AND IT 71 00:02:59,000 --> 00:03:01,760 LOOKS LIKE RICK AND I WILL BE 72 00:03:01,760 --> 00:03:06,000 HERE FOR THE JULY MEETING AGAIN, 73 00:03:06,000 --> 00:03:06,800 HOPEFULLY IN PERSON. 74 00:03:06,800 --> 00:03:11,280 ONE OTHER NOTE IN TERMS OF 75 00:03:11,280 --> 00:03:13,040 MEMBERSHIP, BILL HEIGHT LET US 76 00:03:13,040 --> 00:03:14,400 KNOW THAT UNFORTUNATELY HE WAS 77 00:03:14,400 --> 00:03:17,240 GOING TO NEED TO WITHDRAW DUE TO 78 00:03:17,240 --> 00:03:20,120 SOME OTHER COMMITMENTS SO WE 79 00:03:20,120 --> 00:03:20,440 THANK HIM. 80 00:03:20,440 --> 00:03:22,080 I GOT A CHANCE TO SPEAK TO HIM 81 00:03:22,080 --> 00:03:23,800 JUST A LITTLE WHILE AGO AND I 82 00:03:23,800 --> 00:03:29,000 KNOW HE ALSO APPRECIATED THE 83 00:03:29,000 --> 00:03:29,400 SERVICE. 84 00:03:29,400 --> 00:03:30,720 SO WITH THAT, AGAIN, I WANT TO 85 00:03:30,720 --> 00:03:32,160 WELCOME ALL OF OUR NEW MEMBERS 86 00:03:32,160 --> 00:03:36,720 AS WELL AS ALL OF OUR ONGOING 87 00:03:36,720 --> 00:03:36,960 MEMBERS. 88 00:03:36,960 --> 00:03:38,000 WE'RE EXCITED ABOUT EVERYTHING 89 00:03:38,000 --> 00:03:38,720 THAT'S TO COME. 90 00:03:38,720 --> 00:03:39,680 YOU'VE SEEN THE AGENDA. 91 00:03:39,680 --> 00:03:41,200 WE WILL HEAR ABOUT A NUMBER OF 92 00:03:41,200 --> 00:03:43,000 EXCITING THINGS, SOME OF WHICH 93 00:03:43,000 --> 00:03:45,000 IS NEW AND SOME OF WHICH IS A 94 00:03:45,000 --> 00:03:47,400 CONTINUATION OF WHAT WE'VE BEEN 95 00:03:47,400 --> 00:03:48,840 DOING AND WITH THAT, LARRY, I 96 00:03:48,840 --> 00:03:50,880 WILL TURN IT OVER TO YOU. 97 00:03:50,880 --> 00:03:51,640 THANK YOU. 98 00:03:51,640 --> 00:03:52,120 >> GREAT. 99 00:03:52,120 --> 00:03:53,600 THANK YOU SO MUCH LAURA AND GOOD 100 00:03:53,600 --> 00:03:57,200 MORNING TO ALL OF YOU. 101 00:03:57,200 --> 00:03:58,600 SO AS LAURA MENTIONED, THE LAST 102 00:03:58,600 --> 00:04:01,600 TIME I SPOKE TO YOU BACK IN JULY 103 00:04:01,600 --> 00:04:04,440 OF 21, I WAS SERVING AS THE 104 00:04:04,440 --> 00:04:05,640 PRINCIPAL DEPUTY DIRECTOR OF NIH 105 00:04:05,640 --> 00:04:08,280 AND I WAS FILLING IN FOR FRANCIS 106 00:04:08,280 --> 00:04:09,880 WHO WAS UNABLE TO ATTEND. 107 00:04:09,880 --> 00:04:12,560 SO NOW AS YOU'VE HEARD, FAST 108 00:04:12,560 --> 00:04:13,840 FORWARD, TODAY I'M HERE IN THIS 109 00:04:13,840 --> 00:04:17,000 NEW ROLE AS ACTING DIRECTOR OF 110 00:04:17,000 --> 00:04:19,280 NIH BUT MY ROLE WILL BE PRETTY 111 00:04:19,280 --> 00:04:19,680 MUCH THE SAME. 112 00:04:19,680 --> 00:04:21,960 I'M JUST GOING TO GIVE YOU A 113 00:04:21,960 --> 00:04:26,320 QUICK UPDATE ON NIH AND A FEW OF 114 00:04:26,320 --> 00:04:27,000 ITS ACTIVITIES. 115 00:04:27,000 --> 00:04:31,680 BUT FIRST, I ALSO WANT TO THANK 116 00:04:31,680 --> 00:04:32,440 ELLEN. 117 00:04:32,440 --> 00:04:33,800 YOU KNOW, AS I FOUNDING MEMBER 118 00:04:33,800 --> 00:04:37,920 AND AS A FORMER NIH RESEARCH 119 00:04:37,920 --> 00:04:39,880 PARTICIPANT, REALLY, YOU HAVE 120 00:04:39,880 --> 00:04:42,040 PROVIDED US WITH SUCH IMPORTANT 121 00:04:42,040 --> 00:04:46,600 INSIGHT OVER THESE YEARS AND I 122 00:04:46,600 --> 00:04:48,120 JUST--WE REALLY OWE YOU A DEBT 123 00:04:48,120 --> 00:04:49,880 OF GRATITUDE SO PERSONALLY I 124 00:04:49,880 --> 00:04:51,280 WANT TO EXTEND MY THANKS AND I 125 00:04:51,280 --> 00:04:53,560 KNOW THAT FRANCIS WOULD ALSO 126 00:04:53,560 --> 00:04:55,360 LIKE TO SEND THOSE THANKS TO YOU 127 00:04:55,360 --> 00:04:57,480 AS WELL. 128 00:04:57,480 --> 00:04:59,600 SO ELLEXER EN, THANK YOU SO VERY 129 00:04:59,600 --> 00:05:00,240 MUCH. 130 00:05:00,240 --> 00:05:02,840 >> YOU'RE VERY WELCOME. 131 00:05:02,840 --> 00:05:05,280 >> WE DO HAVE AS LAURA 132 00:05:05,280 --> 00:05:05,920 MENTIONED, NEW MEMBERS OF THE 133 00:05:05,920 --> 00:05:10,560 BOARD AND I'M GOING TO INTRODUCE 134 00:05:10,560 --> 00:05:12,600 THEM AND I BELIEVE 3 OF THE 4 135 00:05:12,600 --> 00:05:16,760 HAVE BEEN ABLE TO JOIN US. 136 00:05:16,760 --> 00:05:19,200 THE FIRST DR. CRAIG SAMUT, 137 00:05:19,200 --> 00:05:20,880 MANAGING DIRECTOR OF ITO 138 00:05:20,880 --> 00:05:23,640 ADVISORS WHICH IS A HEALTHCARE 139 00:05:23,640 --> 00:05:24,520 ADVISORY AND INVESTMENT FIRM. 140 00:05:24,520 --> 00:05:26,840 CRAIG IS A NATIONALLY RECOGNIZED 141 00:05:26,840 --> 00:05:28,600 THOUGHT LEADER ON INDUSTRY 142 00:05:28,600 --> 00:05:30,320 TRANSFORMATION, CARE DELIVERY 143 00:05:30,320 --> 00:05:32,320 AND HEALTHCARE POLICY, SO CRAIG, 144 00:05:32,320 --> 00:05:35,920 WELCOME, THANK YOU SO MUCH FOR 145 00:05:35,920 --> 00:05:39,440 BEING WITH US. 146 00:05:39,440 --> 00:05:40,760 DR. DAVID CHIN, DIRECTOR OF 147 00:05:40,760 --> 00:05:42,600 EXECUTIVE EDUCATION AND 148 00:05:42,600 --> 00:05:44,680 CO-DIRECTOR OF THE MPH MBA 149 00:05:44,680 --> 00:05:47,440 PROGRAM AT THE HOPKINS BLOOMBERG 150 00:05:47,440 --> 00:05:50,400 SCHOOL OF PUBLIC HEALTH. 151 00:05:50,400 --> 00:05:52,160 DAVID IS ALSO CHAIRS THE BOARD 152 00:05:52,160 --> 00:05:53,760 OF THE NATIONAL COMMITTEE FOR 153 00:05:53,760 --> 00:05:56,640 QUALITY ASSURANCE. 154 00:05:56,640 --> 00:05:57,400 SO DAVID, WELCOME. 155 00:05:57,400 --> 00:05:59,000 THANK YOU SO MUCH FOR DOING 156 00:05:59,000 --> 00:06:06,520 THIS, WE HAVE 2 PATIENT 157 00:06:06,520 --> 00:06:07,600 REPRESENTATIVES. 158 00:06:07,600 --> 00:06:08,880 ANTWON ETICS ROYSTER IS WITH US 159 00:06:08,880 --> 00:06:11,800 TODAY, SHE'S A CIVIC MINDED 160 00:06:11,800 --> 00:06:12,960 ACTIVIST BORN AND RAISED IN 161 00:06:12,960 --> 00:06:19,560 WASHINGTON D. C. AND LIVES IN 162 00:06:19,560 --> 00:06:21,040 ALLEGEHENY COUNT 163 00:06:21,040 --> 00:06:26,320 NEUROECTODERMAL, MARYLAND. 164 00:06:26,320 --> 00:06:27,320 ANTOINETTE IS--WELCOME AND THANK 165 00:06:27,320 --> 00:06:31,320 YOU SO MUCH FOR BEING WILLING TO 166 00:06:31,320 --> 00:06:33,400 DO THIS. 167 00:06:33,400 --> 00:06:39,360 OUR FINAL MEMBER, ALSO A PATIENT 168 00:06:39,360 --> 00:06:40,040 REPRESENTATIVE IS DAVID 169 00:06:40,040 --> 00:06:41,120 [INDISCERNIBLE] ON WHO 170 00:06:41,120 --> 00:06:43,000 UNFORTUNATELY IS NOT ABLE TO BE 171 00:06:43,000 --> 00:06:44,440 WITH US, I WAS TOLD EMPLOY SO AT 172 00:06:44,440 --> 00:06:46,040 THE NEXT MEETING WE WILL GIVE 173 00:06:46,040 --> 00:06:47,560 HIM A PROPER INTRODUCTION BUT 174 00:06:47,560 --> 00:06:49,800 JUST FOR ALL OF YOUR AWARENESS, 175 00:06:49,800 --> 00:06:52,120 HE IS MANAGING DIRECTOR OF THE 176 00:06:52,120 --> 00:06:53,720 QX GROUP, HE HAS EXTENSIVE 177 00:06:53,720 --> 00:06:56,000 PUBLIC AND PRIVATE SECTOR 178 00:06:56,000 --> 00:06:57,800 EXPERIENCE WITH INNOVATIST 179 00:06:57,800 --> 00:06:59,080 TECHNOLOGY AND CROSS FUNCTIONAL 180 00:06:59,080 --> 00:07:00,720 TEAMS TO ACHIEVE MISSION 181 00:07:00,720 --> 00:07:01,040 REQUIREMENTS. 182 00:07:01,040 --> 00:07:03,800 AND SO, I'M SURE YOU WILL ALL 183 00:07:03,800 --> 00:07:05,840 AGREE JUST BY LISTENING TO THESE 184 00:07:05,840 --> 00:07:08,400 VERY, VERY BRIEF BIOS OF THESE 185 00:07:08,400 --> 00:07:09,680 VERY ACCOMPLISHED PEOPLE THAT WE 186 00:07:09,680 --> 00:07:12,840 ARE VERY FORTUNATE TO HAVE ALL 187 00:07:12,840 --> 00:07:14,600 OF THEM COME TO SERVE ON THE 188 00:07:14,600 --> 00:07:16,800 BOARD AND TO PROVIDE US WITH 189 00:07:16,800 --> 00:07:19,120 THEIR UNIQUE INSIGHTS. 190 00:07:19,120 --> 00:07:21,040 YES, ELLEN,. 191 00:07:21,040 --> 00:07:22,120 >> ANTOINETTE, I WOULD LIKE TO 192 00:07:22,120 --> 00:07:25,480 SAY, I WILL BE WILLING TO LOAN 193 00:07:25,480 --> 00:07:27,800 YOU ANY COSTUME ACCESSORYS YOU 194 00:07:27,800 --> 00:07:32,000 MIGHT BE NEEDING. 195 00:07:32,000 --> 00:07:32,360 >> [LAUGHTER] 196 00:07:32,360 --> 00:07:33,400 >> THANKS, ELLEN. 197 00:07:33,400 --> 00:07:33,640 >> OKAY. 198 00:07:33,640 --> 00:07:35,600 WELL, WE LOOK FORWARD TO THAT 199 00:07:35,600 --> 00:07:39,280 JULY MEETING NOW, ANTOINETTE, WE 200 00:07:39,280 --> 00:07:39,920 CAN'T WAIT. 201 00:07:39,920 --> 00:07:40,400 [LAUGHTER] 202 00:07:40,400 --> 00:07:45,240 SO LET ME JUST COVER A FEW 203 00:07:45,240 --> 00:07:45,480 THINGS. 204 00:07:45,480 --> 00:07:49,160 SO WE ARE NOW IN A TRANSITION 205 00:07:49,160 --> 00:07:52,600 PERIOD IN TERMS OF LEADERSHIP AT 206 00:07:52,600 --> 00:07:54,160 NIH AND OF COURSE FOR MANY OF 207 00:07:54,160 --> 00:07:59,120 YOU, YOU HAVE NEVER EXPERIENCED 208 00:07:59,120 --> 00:08:00,800 THIS BEFORE BECAUSE FRANCIS' 209 00:08:00,800 --> 00:08:03,160 TENURE AS NIH DIRECTOR SPANNED 210 00:08:03,160 --> 00:08:08,400 12 YEARS WHICH WAS 211 00:08:08,400 --> 00:08:08,720 UNPRECEDENTED. 212 00:08:08,720 --> 00:08:11,080 MULTIPLE ADMINISTRATIONS AND SO, 213 00:08:11,080 --> 00:08:12,560 YOU WOKE UP EVERY DAY KNOWING 214 00:08:12,560 --> 00:08:17,040 THAT FRANCIS WAS THE NIH LEADER 215 00:08:17,040 --> 00:08:21,400 AND THEN THIS DECISION OF HIS TO 216 00:08:21,400 --> 00:08:24,000 STEP BACK SEEMINGLY ONLY FOR A 217 00:08:24,000 --> 00:08:26,000 FEW WEEKS TO HIS LABORATORY 218 00:08:26,000 --> 00:08:29,720 BECAUSE HE IS NOW THE ACTING 219 00:08:29,720 --> 00:08:33,680 SCIENCE ADVISOR TO THE 220 00:08:33,680 --> 00:08:34,160 PRESIDENT. 221 00:08:34,160 --> 00:08:37,360 IT IS ALSO UNIQUE IN THAT WE ARE 222 00:08:37,360 --> 00:08:40,200 COMING UP TOWARDS MIDTERM 223 00:08:40,200 --> 00:08:43,600 ELECTIONS AND THAT ALWAYS ADDS A 224 00:08:43,600 --> 00:08:47,760 LITTLE INTRIGUE AND FRANKLY SOME 225 00:08:47,760 --> 00:08:49,760 UNCERTAINTY, PARTICULARLY VIS A 226 00:08:49,760 --> 00:08:54,360 VIS THE BUDGETARY PROCESS, AND I 227 00:08:54,360 --> 00:08:56,440 THINK THAT, YOU KNOW THOSE OF US 228 00:08:56,440 --> 00:08:59,120 WHO HAVE BEEN HERE LONGER THAN 229 00:08:59,120 --> 00:09:03,360 THE 12 YEARS OF FRANCIS' TENURE, 230 00:09:03,360 --> 00:09:07,680 KNOW THAT EVERYTHING WILL BE 231 00:09:07,680 --> 00:09:09,280 FINE. 232 00:09:09,280 --> 00:09:11,920 WE WILL ORDERLY, SEE THE 233 00:09:11,920 --> 00:09:14,200 APPOINTMENT OF A NEW PERMANENT 234 00:09:14,200 --> 00:09:22,720 NIH DIRECTOR IN DUE COURSE AND 235 00:09:22,720 --> 00:09:26,600 HE OR SHE WILL INHERIT A 236 00:09:26,600 --> 00:09:27,760 SPECTACULAR LEADERSHIP TERM WHO 237 00:09:27,760 --> 00:09:29,280 WILL WORK VERY CLOSELY WITH THEM 238 00:09:29,280 --> 00:09:31,600 AS THEY BEGIN TO THINK THROUGH 239 00:09:31,600 --> 00:09:35,240 THEIR OWN NEW PERSPECTIVE, NEW 240 00:09:35,240 --> 00:09:38,360 AGENDA AND OBVIOUSLY, WE AT NIH 241 00:09:38,360 --> 00:09:39,600 LOOK FORWARD TO THAT, FOR THE 242 00:09:39,600 --> 00:09:41,280 NEW MEMBERS OF THE BOARD WHO MAY 243 00:09:41,280 --> 00:09:44,880 NOT BE AS FAMILIAR WITH THIS AS 244 00:09:44,880 --> 00:09:48,520 OTHERS, WHAT THIS ENTAILS IS A 245 00:09:48,520 --> 00:09:50,200 NOMINATION BY THE PRESIDENT TO 246 00:09:50,200 --> 00:09:53,360 THE SENATE AND THEN THE SENATE 247 00:09:53,360 --> 00:09:55,160 NEEDS TO HAVE A CONFIRMATION 248 00:09:55,160 --> 00:09:58,440 PROCESS FOR THE NIH DIRECTOR 249 00:09:58,440 --> 00:09:58,720 POSITION. 250 00:09:58,720 --> 00:10:01,400 SO IT IS A PRESIDENTIAL 251 00:10:01,400 --> 00:10:04,600 APPOINTEE WITH SENATE 252 00:10:04,600 --> 00:10:08,000 CONFIRMATION. 253 00:10:08,000 --> 00:10:11,000 THE TIMING TONY FAUCI SAID TO 254 00:10:11,000 --> 00:10:13,440 ME, ANYONE WHO TELLS YOU THEY 255 00:10:13,440 --> 00:10:13,800 KNOW, DOESN'T. 256 00:10:13,800 --> 00:10:14,840 IT'S THE SORT OF THING THAT YOU 257 00:10:14,840 --> 00:10:19,120 JUST HAVE TO LET THE PROCESS 258 00:10:19,120 --> 00:10:23,280 WORK ITSELF THROUGH AND YOU KNOW 259 00:10:23,280 --> 00:10:24,960 I AM VERY CONFIDENT THAT THE 260 00:10:24,960 --> 00:10:26,600 PRESIDENT WILL NOMINATE A 261 00:10:26,600 --> 00:10:28,160 SPECTACULAR CANDIDATE AND 262 00:10:28,160 --> 00:10:29,640 HOPEFULLY THE SENATE WILL IN 263 00:10:29,640 --> 00:10:37,840 VERY DUE COURSE CONFIRM HIS 264 00:10:37,840 --> 00:10:39,200 NOMINEE. 265 00:10:39,200 --> 00:10:42,000 AGAIN AS LAURA ALLUDED TO DURING 266 00:10:42,000 --> 00:10:43,720 THIS INTERIM PERIOD, I AM 267 00:10:43,720 --> 00:10:47,840 REALLY, REALLY FORTUNATE TO HAVE 268 00:10:47,840 --> 00:10:51,200 3 SPECTACULAR LEADERS WHO HAVE 269 00:10:51,200 --> 00:10:55,040 STEPPED INTO ACTING ROLES, 270 00:10:55,040 --> 00:10:56,000 DR. TARA SCHWETZ, WHO IS WITH US 271 00:10:56,000 --> 00:10:59,680 ON THE CALL NOW, TARA WAS ON 272 00:10:59,680 --> 00:11:02,800 DETAIL TO ASTP WHERE SHE WAS 273 00:11:02,800 --> 00:11:05,320 ARCHITECTING WHAT HAS BECOME 274 00:11:05,320 --> 00:11:05,560 ARPA-H. 275 00:11:05,560 --> 00:11:08,760 AND I WAS VERY FORTUNATE TO HAVE 276 00:11:08,760 --> 00:11:09,320 HER COME BACK. 277 00:11:09,320 --> 00:11:10,760 I'M NOT SURE HOW SHE FEELS ABOUT 278 00:11:10,760 --> 00:11:15,560 IT BUT THIS IS REALLY BEEN AN 279 00:11:15,560 --> 00:11:17,120 ENORMOUS HELP TO ME BEING ABLE 280 00:11:17,120 --> 00:11:20,040 TO COUNT ON TARA FOR ALL MATTER 281 00:11:20,040 --> 00:11:21,480 OF THINGS. 282 00:11:21,480 --> 00:11:24,600 IN TURN, DR. COURTNEY ACKLAND 283 00:11:24,600 --> 00:11:40,160 WHO WILL BE JOINING YOU LATER IN 284 00:11:40,160 --> 00:11:41,320 THE DAY--CARRY WOLLENETZ, WHO IS 285 00:11:41,320 --> 00:11:43,600 THE HEAD OF SCIENCE POLICY IS ON 286 00:11:43,600 --> 00:11:48,120 DETAIL TO OSTP AND SO DR. LYRIC 287 00:11:48,120 --> 00:11:49,600 JOGGERRENSON IS ACTING DIRECTOR 288 00:11:49,600 --> 00:11:51,280 OF THE OFFICE OF SCIENCE POLICY, 289 00:11:51,280 --> 00:11:54,800 SO AGAIN, I AM VERY GRATEFUL TO 290 00:11:54,800 --> 00:11:58,080 THESE 3 LEADERS AND THEY ARE 291 00:11:58,080 --> 00:12:00,000 MAKING MY LIFE A WHOLE LOT 292 00:12:00,000 --> 00:12:01,000 EASIER. 293 00:12:01,000 --> 00:12:04,360 ONE MORE APPOINTMENT TO NOTE AND 294 00:12:04,360 --> 00:12:10,280 THAT IS ON MARCH 1st, THE 295 00:12:10,280 --> 00:12:12,960 FOUNDATION FOR NIH, THE FNIH 296 00:12:12,960 --> 00:12:14,600 ANNOUNCED THE APPOINTMENT OF 297 00:12:14,600 --> 00:12:18,000 FORMER CDC DIRECTOR AND MERK 298 00:12:18,000 --> 00:12:20,400 EXECUTIVE DR. JULIE 299 00:12:20,400 --> 00:12:22,720 [INDISCERNIBLE] AS ITS NEXT 300 00:12:22,720 --> 00:12:24,600 CHIEF EXECUTIVE OFFICER. 301 00:12:24,600 --> 00:12:27,360 JULIE HAS ALREADY ASSUMED A 302 00:12:27,360 --> 00:12:29,280 BOARD ROLE WITH THE FOUNDATION 303 00:12:29,280 --> 00:12:31,920 BUT SHE WILL NOT BECOME THE CEO 304 00:12:31,920 --> 00:12:34,000 OFFICIALLY OF THE FOUNDATION 305 00:12:34,000 --> 00:12:36,560 UNTIL MAY 16th AS SHE FINISHES 306 00:12:36,560 --> 00:12:39,000 UP SOME OBLIGATIONS IN HER 307 00:12:39,000 --> 00:12:39,560 CURRENT ROLE. 308 00:12:39,560 --> 00:12:40,600 SO WE'RE LOOKING FORWARD TO 309 00:12:40,600 --> 00:12:44,400 BEING ABLE TO WORK WITH THE 310 00:12:44,400 --> 00:12:44,640 DOCTOR. 311 00:12:44,640 --> 00:12:46,000 A NUMBER OF US HAVE WORKED WITH 312 00:12:46,000 --> 00:12:48,640 HER IN THE PAST AND HER PREVIOUS 313 00:12:48,640 --> 00:12:51,240 GOVERNMENTAL SERVICE ROLES AND 314 00:12:51,240 --> 00:12:55,440 SO, OBVIOUSLY WE ARE CERTAINLY 315 00:12:55,440 --> 00:13:01,200 LOOKING FORWARD TO THAT. 316 00:13:01,200 --> 00:13:09,080 FUNDING, LOTS GOING ON, WE HAD 317 00:13:09,080 --> 00:13:10,480 THIS FASCINATING NEXUS OF BEING 318 00:13:10,480 --> 00:13:13,400 FORTUNATE TO GET THE FY22 BUDGET 319 00:13:13,400 --> 00:13:17,600 IN THE FORM OF AN OMNIBUS OF NOT 320 00:13:17,600 --> 00:13:19,680 TOO LONG AGO AND THEN VERY 321 00:13:19,680 --> 00:13:21,880 SHORTLY THEREAFTER, THE RELEASE 322 00:13:21,880 --> 00:13:26,400 OF THE PRESIDENT'S PROPOSED FY23 323 00:13:26,400 --> 00:13:26,640 BUDGET. 324 00:13:26,640 --> 00:13:29,720 AND WHEN THESE THINGS COME CLOSE 325 00:13:29,720 --> 00:13:34,240 TO 1 ANOTHER, IT CAN LEAD TO A 326 00:13:34,240 --> 00:13:36,680 LITTLE CONFUSION, BUT WE ARE 327 00:13:36,680 --> 00:13:38,880 FIRST, IN TERMS OF THE FY22 328 00:13:38,880 --> 00:13:41,600 BUDGET WHICH WE NOW HAVE, AS IT 329 00:13:41,600 --> 00:13:44,160 HAS PASSED TO CONGRESS, WE ARE 330 00:13:44,160 --> 00:13:45,400 EXTREMELY GRATEFUL TO THE 331 00:13:45,400 --> 00:13:49,400 CONGRESS FOR THEIR SUPPORT. 332 00:13:49,400 --> 00:13:53,520 THE TOTAL BUDGET FOR FY22 IS 333 00:13:53,520 --> 00:13:54,680 45.18 BILLION DOLLARS. 334 00:13:54,680 --> 00:14:00,840 THAT'S AN INCREASE OF 2.24 335 00:14:00,840 --> 00:14:03,120 BILLION OVER FISCAL YEAR 21 AND 336 00:14:03,120 --> 00:14:04,720 THAT'S A 5.2% INKRES. 337 00:14:04,720 --> 00:14:09,000 SO THAT'S RATHER SPECTACULAR IN 338 00:14:09,000 --> 00:14:11,080 MY OPINION GIVEN THE STATE OF 339 00:14:11,080 --> 00:14:14,160 THE WORLD AFFAIRS AND SO FORTH. 340 00:14:14,160 --> 00:14:16,840 THE GENERAL INCREASE TO 341 00:14:16,840 --> 00:14:20,160 INSTITUTES AND CENTERS WAS 3.4%. 342 00:14:20,160 --> 00:14:24,840 A NUMBER OF SPECIFIC INCREASES 343 00:14:24,840 --> 00:14:28,200 WERE INCLUDED, ALZHEIMER'S 344 00:14:28,200 --> 00:14:29,400 DISEASE, AN ADDITIONAL 345 00:14:29,400 --> 00:14:29,760 $289 MILLION. 346 00:14:29,760 --> 00:14:32,320 CANCER RESEARCH AN ADDITIONAL 347 00:14:32,320 --> 00:14:32,800 150 MILLION. 348 00:14:32,800 --> 00:14:37,600 RESEARCH FOR OPIOID USE 349 00:14:37,600 --> 00:14:38,520 DISORDER, AN ADDITIONAL 350 00:14:38,520 --> 00:14:41,560 75 MILLION, THE BRAIN 351 00:14:41,560 --> 00:14:42,080 INITIATIVE, AN ADDITIONAL 352 00:14:42,080 --> 00:14:44,200 60 MILLION AND THEN FINALLY AN 353 00:14:44,200 --> 00:14:46,040 ADDITIONAL $50 MILLION TO 354 00:14:46,040 --> 00:14:49,400 SUPPORT HEALTH DISPARITIES 355 00:14:49,400 --> 00:14:49,680 RESEARCH. 356 00:14:49,680 --> 00:14:52,840 AND SO THAT IS MUCH APPRECIATED. 357 00:14:52,840 --> 00:14:56,760 IN ADDITION WITHIN THIS BUDGET, 358 00:14:56,760 --> 00:14:59,120 CONGRESS APPROPRIATED 1 BILLION 359 00:14:59,120 --> 00:15:01,640 DOLLARS TO ESTABLISH THE 360 00:15:01,640 --> 00:15:03,880 ADVANCED RESEARCH PROJECTS 361 00:15:03,880 --> 00:15:07,440 AGENCY FOR HEALTH OR ARPA-H 362 00:15:07,440 --> 00:15:12,000 WITHIN THE DEPARTMENT OF HEALTH 363 00:15:12,000 --> 00:15:13,400 AND HUMAN SERVICES JUST A COUPLE 364 00:15:13,400 --> 00:15:17,040 DAYS AGO, THE SECRETARY 365 00:15:17,040 --> 00:15:19,640 ANNOUNCED THAT HE IS USING HIS 366 00:15:19,640 --> 00:15:20,920 AUTHORITY TO TRANSFER ARPA-H 367 00:15:20,920 --> 00:15:25,800 AUTHORITIES AND FUNDS TO THE 368 00:15:25,800 --> 00:15:26,200 NIH. 369 00:15:26,200 --> 00:15:31,960 THE ARPA-H DIRECTOR WILL BE A 370 00:15:31,960 --> 00:15:34,360 PRESIDENTIAL APPOINTEE NOT 371 00:15:34,360 --> 00:15:34,960 REQUIRING SENATE CONFIRMATION 372 00:15:34,960 --> 00:15:36,880 BUT WILL BE A PRESIDENTIAL 373 00:15:36,880 --> 00:15:37,280 APPOINTEE. 374 00:15:37,280 --> 00:15:40,480 SO THIS IS EQUIV LEAPT TO THE 375 00:15:40,480 --> 00:15:41,400 CANCER CENTER DISTRICTOR. 376 00:15:41,400 --> 00:15:43,720 SO SOME OF YOU KNOW AT NIH WE 377 00:15:43,720 --> 00:15:45,640 ONLY HAVE 2 POLITICAL 378 00:15:45,640 --> 00:15:47,600 APPOINTEES, THE NIH DIRECTOR 379 00:15:47,600 --> 00:15:51,160 WHICH IS A POLITICAL APPOINTEE 380 00:15:51,160 --> 00:15:52,000 REQUIRING SENATE CONFIRMATION 381 00:15:52,000 --> 00:15:56,560 AND THE NCI DIRECTOR WHO IS A 382 00:15:56,560 --> 00:15:57,400 POLITICAL APPOINTEE, THERE WILL 383 00:15:57,400 --> 00:16:00,520 NOW BE A THIRD AND THAT WILL BE 384 00:16:00,520 --> 00:16:01,600 THE ARPA-H DIRECTOR. 385 00:16:01,600 --> 00:16:06,400 HOWEVER WHAT IS UNIQUE ABOUT 386 00:16:06,400 --> 00:16:08,920 THIS POSITION IS IT THAT THE 387 00:16:08,920 --> 00:16:12,360 ARPA-H DIRECTOR WILL REPORT TO 388 00:16:12,360 --> 00:16:13,760 THE HHS SECRETARY. 389 00:16:13,760 --> 00:16:16,600 HE OR SHE WILL HAVE A DIRECT 390 00:16:16,600 --> 00:16:18,640 REPORT TO THE SECRETARY AND WILL 391 00:16:18,640 --> 00:16:21,040 HAVE AUTHORITY FOR 392 00:16:21,040 --> 00:16:24,960 ADMINISTRATION AND OPERATIONS OF 393 00:16:24,960 --> 00:16:25,280 ARPA-H. 394 00:16:25,280 --> 00:16:29,400 NIH IS POISED TO HELP PROVIDE 395 00:16:29,400 --> 00:16:31,360 ADMINISTRATIVE AND OPERATIONAL 396 00:16:31,360 --> 00:16:33,280 SUPPORT FOR THIS NEW ENTITY. 397 00:16:33,280 --> 00:16:40,120 TO GET IT UP AND RUNNING, AS RAN 398 00:16:40,120 --> 00:16:51,320 EDUCATIONALLY AND EFFICIENTLY AS 399 00:16:51,320 --> 00:16:51,600 POSSIBLE. 400 00:16:51,600 --> 00:16:53,600 AND AGAIN WE LOOK FORWARD TO 401 00:16:53,600 --> 00:16:56,160 WORKING WITH THAT INDIVIDUAL TO 402 00:16:56,160 --> 00:16:59,600 FACILITATE THE STAND UP OF THIS 403 00:16:59,600 --> 00:17:00,160 NEW ORGANIZATION. 404 00:17:00,160 --> 00:17:02,360 AS I MENTIONED THE PRESIDENT'S 405 00:17:02,360 --> 00:17:06,640 FY23 BUDGET PLAN WAS RELEASED ON 406 00:17:06,640 --> 00:17:06,880 MONDAY. 407 00:17:06,880 --> 00:17:11,400 WE NOW HAVE APPROPRIATIONS 408 00:17:11,400 --> 00:17:12,680 HEARINGS SET. 409 00:17:12,680 --> 00:17:13,600 THE HOUSE APPROPRIATIONS HEARING 410 00:17:13,600 --> 00:17:16,320 WILL BE ON MAY 11th, THE 411 00:17:16,320 --> 00:17:21,480 SENATE HEARING WILL BE ON MAY 412 00:17:21,480 --> 00:17:24,480 18th GIVEN THE TIMING FOR THE 413 00:17:24,480 --> 00:17:27,000 APPOINTMENT OF THE NEW PERMANENT 414 00:17:27,000 --> 00:17:29,680 DIRECTOR, I'M IT AND SO IT WILL 415 00:17:29,680 --> 00:17:33,680 BE MY PRIVILEGE TO REPRESENT NIH 416 00:17:33,680 --> 00:17:36,520 IN THIS MANNER TOGETHER WITH A 417 00:17:36,520 --> 00:17:38,400 NUMBER OF INSTITUTE AND CENTER 418 00:17:38,400 --> 00:17:43,000 DIRECTORS WHO ARE SELECTED BY 419 00:17:43,000 --> 00:17:48,480 THE RESPECTIVE BODIES OF 420 00:17:48,480 --> 00:17:48,760 CONGRESS. 421 00:17:48,760 --> 00:17:50,040 SO I JUST WOULD LIKE TO CLOSE 422 00:17:50,040 --> 00:17:51,800 WITH A PIECE OF GREAT NEWS FOR 423 00:17:51,800 --> 00:17:54,600 THE FUTURE OF NIH RESEARCH. 424 00:17:54,600 --> 00:17:57,840 I WANT TO CONGRATULATE THE 425 00:17:57,840 --> 00:17:59,680 CLINICAL CENTER ON THE RECENT 426 00:17:59,680 --> 00:18:02,800 AWARD OF A CONTRACT FOR THE NEW 427 00:18:02,800 --> 00:18:07,200 SURGERY RADIOLOGY AND LABORATORY 428 00:18:07,200 --> 00:18:07,520 MEDICINE WING. 429 00:18:07,520 --> 00:18:10,760 NOW FOR THOSE OF YOU ON THE 430 00:18:10,760 --> 00:18:13,040 BOARD YOU KNOW THIS IS A BIG 431 00:18:13,040 --> 00:18:13,240 DEAL. 432 00:18:13,240 --> 00:18:15,600 OF COURSE, THE BOARD IS ONLY 6 433 00:18:15,600 --> 00:18:16,400 YEARS OLD. 434 00:18:16,400 --> 00:18:18,040 THIS HAS GONE WAY BEFORE THAT IN 435 00:18:18,040 --> 00:18:20,480 TERMS OF PLANNING AND ASPIRATION 436 00:18:20,480 --> 00:18:24,600 AND SO FORTH AND SO WE'RE REALLY 437 00:18:24,600 --> 00:18:29,520 VERY, VERY EXCITED TO SEE THIS 438 00:18:29,520 --> 00:18:30,000 FRUITION OF THIS. 439 00:18:30,000 --> 00:18:37,080 I GUESS AT THE PRESENT TIME THE 440 00:18:37,080 --> 00:18:39,800 BUILD OUT DATE IS 2028. 441 00:18:39,800 --> 00:18:41,800 SO MOST OF YOU WILL BE ABLE TO 442 00:18:41,800 --> 00:18:44,880 SEE THIS AND BENEFIT FROM IT BUT 443 00:18:44,880 --> 00:18:47,360 REALLY LOOKING FORWARD TO THIS 444 00:18:47,360 --> 00:18:47,760 FOR SURE. 445 00:18:47,760 --> 00:18:49,400 AND SO WITH THAT, I AM VERY 446 00:18:49,400 --> 00:18:52,240 PLEASED TO TURN THINGS OVER TO 447 00:18:52,240 --> 00:18:54,480 JIM AND WISH YOU ALL THE BEST 448 00:18:54,480 --> 00:18:58,720 FOR TODAY'S DISCUSSIONS AND 449 00:18:58,720 --> 00:18:59,040 DELIBERATIONS. 450 00:18:59,040 --> 00:19:03,800 >> HEY, LARRY JUMP BACK IN, THAT 451 00:19:03,800 --> 00:19:04,880 IS FABULOUS NEWS. 452 00:19:04,880 --> 00:19:06,160 YES, WE'VE BEEN TALKING ABOUT 453 00:19:06,160 --> 00:19:07,800 THAT FOR AT LEAST 6 YEARS AS YOU 454 00:19:07,800 --> 00:19:09,240 SAID AND MANY PEOPLE FOR PLANE 455 00:19:09,240 --> 00:19:12,200 YEARS BEFORE THAT, IT'S 456 00:19:12,200 --> 00:19:12,640 FANTASTIC. 457 00:19:12,640 --> 00:19:13,840 BEFORE WE LET YOU GO, I JUST 458 00:19:13,840 --> 00:19:16,840 WANT TO SEE IF THERE ARE ANY 459 00:19:16,840 --> 00:19:17,680 QUESTIONS FOR YOU. 460 00:19:17,680 --> 00:19:20,760 ANYTHING ANYBODY WANTS TO RAISE? 461 00:19:20,760 --> 00:19:22,200 YOU CAN JUST UNMUTE YOURSELF IF 462 00:19:22,200 --> 00:19:23,840 YOU WANT TO ASK LARRY A 463 00:19:23,840 --> 00:19:24,120 QUESTION. 464 00:19:24,120 --> 00:19:27,120 >> SO LARRY, THIS IS STEPHANIE, 465 00:19:27,120 --> 00:19:28,800 JUST ACTUALLY MORE OF A 466 00:19:28,800 --> 00:19:30,480 CURIOSITY AND IF TIME DOES NOT 467 00:19:30,480 --> 00:19:34,080 PERMIT, CAN TAKE IT OFFLINE BUT 468 00:19:34,080 --> 00:19:35,560 CURIOUS ABOUT ARPA-H AND THE 469 00:19:35,560 --> 00:19:37,760 DECISION TO HAVE IT HOUSED SORT 470 00:19:37,760 --> 00:19:40,400 OF IN 2 DIFFERENT PLACES AND 471 00:19:40,400 --> 00:19:42,600 JUST WONDERING IF YOU HAVE A 472 00:19:42,600 --> 00:19:47,480 PERSPECTIVE AS TO WHAT THAT WILL 473 00:19:47,480 --> 00:19:48,440 MEAN, WHAT ARPA-H WILL 474 00:19:48,440 --> 00:19:49,760 ULTIMATELY BE ABLE TO ACCOMPLISH 475 00:19:49,760 --> 00:19:51,760 THAT IT WILL BE HOUSE INDEED 2 476 00:19:51,760 --> 00:19:52,600 DIFFERENT PLACES? 477 00:19:52,600 --> 00:19:54,440 >> WELL, I WILL ASK TARA TO 478 00:19:54,440 --> 00:19:58,600 RESPOND AS WELL, BUT FROM MY 479 00:19:58,600 --> 00:19:59,400 PERSPECTIVE, I THINK WE HAVE, 480 00:19:59,400 --> 00:20:04,280 YOU KNOW THE BEST OF THE BOTH 481 00:20:04,280 --> 00:20:05,200 WORLDS. 482 00:20:05,200 --> 00:20:07,080 EVERYBODY IN CONTEMPLATING THIS 483 00:20:07,080 --> 00:20:09,560 NEW ORGANIZATION, INDICATE THAD 484 00:20:09,560 --> 00:20:15,600 IT NEEDED TO BE UNENCUMBERED AND 485 00:20:15,600 --> 00:20:18,520 INDEPENDENT BUT WE HAVE CERTAIN 486 00:20:18,520 --> 00:20:20,960 EQUITIES HERE AT NIH THAT I 487 00:20:20,960 --> 00:20:22,600 THINK WILL INSURE A VERY RAPID 488 00:20:22,600 --> 00:20:24,000 AND ROBUST START FOR THE 489 00:20:24,000 --> 00:20:24,320 ORGANIZATION. 490 00:20:24,320 --> 00:20:26,360 SO I THINK WE HAVE THE BEST OF 491 00:20:26,360 --> 00:20:28,560 BOTH WORLDS BUT TARA WHO 492 00:20:28,560 --> 00:20:30,080 ARCHITECTED THIS WHILE AT OSTP 493 00:20:30,080 --> 00:20:32,920 AND HAS CONTINUED TO WORK VERY 494 00:20:32,920 --> 00:20:35,960 HARD ON THESE ISSUES HAS JOINED 495 00:20:35,960 --> 00:20:37,560 US, TARA WHAT ARE ARE YOUR 496 00:20:37,560 --> 00:20:39,600 THOUGHTS ON THIS, PLEASE? 497 00:20:39,600 --> 00:20:39,880 >> YES. 498 00:20:39,880 --> 00:20:40,360 THANKS. 499 00:20:40,360 --> 00:20:41,480 I THINK YOU'RE RIGHT. 500 00:20:41,480 --> 00:20:43,800 YOU HIT THE NAILOT HEAD THERE. 501 00:20:43,800 --> 00:20:49,520 I MEAN, THERE ARE LOTS OF VERY 502 00:20:49,520 --> 00:20:50,360 OPERATIONAL AND STRUCTURAL 503 00:20:50,360 --> 00:20:51,400 FUNCTIONALITIES THAT HAVE TO BE 504 00:20:51,400 --> 00:20:54,800 BUILT WHEN YOU'RE BUILDING UP A 505 00:20:54,800 --> 00:20:56,120 BRAND NEW ORGANIZATION AND WE 506 00:20:56,120 --> 00:20:57,880 GET THE BENEFIT OF BEING ABLE TO 507 00:20:57,880 --> 00:21:00,600 LEVERAGE THOSE AT NIH AS WELL AS 508 00:21:00,600 --> 00:21:03,240 YOU KNOW HAVING A CLOSE 509 00:21:03,240 --> 00:21:04,400 CONNECTION TO MANY OF THE 510 00:21:04,400 --> 00:21:07,520 SCIENTISTS HERE AT NIH AND TO 511 00:21:07,520 --> 00:21:08,800 BENEFIT FROM SOME OF THEIR 512 00:21:08,800 --> 00:21:11,280 SCIENTIFIC KNOWLEDGE AND 513 00:21:11,280 --> 00:21:13,120 EXPERTISE, WHILE ALSO 514 00:21:13,120 --> 00:21:13,600 MAINTAINING AN ESSENTIAL 515 00:21:13,600 --> 00:21:16,240 ELMETROPOLITAN OF WHAT THEY CALL 516 00:21:16,240 --> 00:21:18,360 THIS ARPA-H MODEL WHICH, YOU 517 00:21:18,360 --> 00:21:21,000 KNOW KIND OF 1 OF THE 518 00:21:21,000 --> 00:21:22,160 FUNDAMENTAL TENANTS IS AUTONOMY. 519 00:21:22,160 --> 00:21:24,400 SO HAVING THAT DIRECT CONNECTION 520 00:21:24,400 --> 00:21:28,000 TO THE SECRETARY WILL SORT OF 521 00:21:28,000 --> 00:21:29,560 CHECK THAT BOX. 522 00:21:29,560 --> 00:21:31,920 IT'S ALSO SIMILAR TO HOW IN THE 523 00:21:31,920 --> 00:21:35,720 ENERGY SECTOR THERE'S AN ARP A-E 524 00:21:35,720 --> 00:21:37,560 AND SIMILAR TO HOW THEY ARE 525 00:21:37,560 --> 00:21:40,520 STRUCTURED WITHIN THE DEPARTMENT 526 00:21:40,520 --> 00:21:41,160 OF ENERGY. 527 00:21:41,160 --> 00:21:43,600 >> THANK YOU, TARA, I WILL ADMIT 528 00:21:43,600 --> 00:21:45,160 MY IGNORANCE, I DIDN'T KNOW 529 00:21:45,160 --> 00:21:48,520 THERE WAS AN ARP A-E. 530 00:21:48,520 --> 00:21:49,200 OKAY, THANK YOU. 531 00:21:49,200 --> 00:21:59,120 >> YEAH, THERE'S BEEN A 532 00:21:59,120 --> 00:22:01,480 PROLIFERATION--TO SHARE THIS 533 00:22:01,480 --> 00:22:01,800 INFORMATION. 534 00:22:01,800 --> 00:22:03,760 >> LEARNING EXPERIENCE FOR ME. 535 00:22:03,760 --> 00:22:05,280 >> THANK YOU. 536 00:22:05,280 --> 00:22:05,600 >> GREAT. 537 00:22:05,600 --> 00:22:15,200 ANYONE ELSE, QUESTION FOR LARRY? 538 00:22:15,200 --> 00:22:15,400 HAD. 539 00:22:15,400 --> 00:22:16,200 >> KD--SALLY HA. 540 00:22:16,200 --> 00:22:18,160 >> CAN YOU REPEAT THAT PLEASE? 541 00:22:18,160 --> 00:22:21,040 >> WHAT ARE THE ACRONYMS OR HOW 542 00:22:21,040 --> 00:22:24,800 DO YOU SPELL THE ARPA-H. 543 00:22:24,800 --> 00:22:25,200 >> IT'S-- 544 00:22:25,200 --> 00:22:26,080 >> GO AHEAD TARA. 545 00:22:26,080 --> 00:22:27,600 >> IT'S THE ADVANCED RESEARCH 546 00:22:27,600 --> 00:22:35,280 PROJECTED PS AGENCY FOR HEALTH. 547 00:22:35,280 --> 00:22:37,680 A-R-P A- H. 548 00:22:37,680 --> 00:22:41,800 >> ONE MORE TIME? 549 00:22:41,800 --> 00:22:42,280 >> A-R-P-A-H. 550 00:22:42,280 --> 00:22:46,040 >> OKAY, THANK YOU. 551 00:22:46,040 --> 00:22:47,560 ADVANCED RESEARCH PROJECT AGENCY 552 00:22:47,560 --> 00:22:48,800 FOR HEALTH. 553 00:22:48,800 --> 00:22:49,120 >> THANKS. 554 00:22:49,120 --> 00:22:51,880 >> IT'S A RIFF OFF OF DARPA, 555 00:22:51,880 --> 00:22:54,880 WHICH IS THE PROTOTYPICAL MODEL 556 00:22:54,880 --> 00:22:58,280 BUT THERE'S ALSO--NOW I'M OUT OF 557 00:22:58,280 --> 00:23:02,800 MY ELEMENT, ARP A E, ARPI,. 558 00:23:02,800 --> 00:23:07,720 >> ARPI IS ALSO THERE'S HS ARPA. 559 00:23:07,720 --> 00:23:19,400 THERE'S A LITTLE GROUP OF THEM, 560 00:23:19,400 --> 00:23:21,720 BUT DARPA IS THE DEFENSE VERSION 561 00:23:21,720 --> 00:23:22,800 BEEN AROUND SINCE THE 60S AND 562 00:23:22,800 --> 00:23:24,760 HAD A ROLE IN CREATING A BUNCH 563 00:23:24,760 --> 00:23:27,040 OF THINGS WE APPRECIATE TODAY 564 00:23:27,040 --> 00:23:28,880 INCLUDING INTERNET AND 565 00:23:28,880 --> 00:23:30,000 SELF-DRIVING CARS AND GPS. 566 00:23:30,000 --> 00:23:32,280 >> WE ARE NOT GOING TO HAVE A 567 00:23:32,280 --> 00:23:35,280 QUIZ AT THE END OF ALL OF THESE, 568 00:23:35,280 --> 00:23:41,960 BUT WE WILL HAVE THOSE IN THE 569 00:23:41,960 --> 00:23:42,200 MINUTES. 570 00:23:42,200 --> 00:23:44,320 SO WE CAN KEEP TRACK OF THEM. 571 00:23:44,320 --> 00:23:45,760 OKAY, NOT SEEING ANYONE ELSE 572 00:23:45,760 --> 00:23:47,200 JUMP IN, LARRY, THANKS SO MUCH 573 00:23:47,200 --> 00:23:48,680 FOR BEING HERE TODAY AND THANKS 574 00:23:48,680 --> 00:23:50,560 FOR EVERYTHING YOU'RE DOING AND 575 00:23:50,560 --> 00:23:52,040 YOU'RE RIGHT, YOU'RE ABLY 576 00:23:52,040 --> 00:23:55,520 ASSISTED BY A GREAT TEAM. 577 00:23:55,520 --> 00:23:55,800 >> INDEED. 578 00:23:55,800 --> 00:23:56,120 THANK YOU. 579 00:23:56,120 --> 00:23:57,560 >> AND WITH THAT, JIM, WE WILL 580 00:23:57,560 --> 00:24:00,600 HEAD OVER TO YOU FOR THE CEO 581 00:24:00,600 --> 00:24:00,800 REPORT. 582 00:24:00,800 --> 00:24:02,400 >> BEFORE YOU PUT UP THE SLIDES, 583 00:24:02,400 --> 00:24:05,000 TAKE THE SLIDES DOWN FOR JUST A 584 00:24:05,000 --> 00:24:06,560 MINUTE, WITH SO MANY NEW 585 00:24:06,560 --> 00:24:12,200 MEMBERS, I WANT TO INTRODUCE THE 586 00:24:12,200 --> 00:24:13,280 FOLKS HERE FROM THE CLINICAL 587 00:24:13,280 --> 00:24:15,200 CENTER WHRO SOME OF YOU MAY OR 588 00:24:15,200 --> 00:24:16,200 MAY NOT KNOW. 589 00:24:16,200 --> 00:24:17,880 FIRST OF ALL, FROM HERE IN THE 590 00:24:17,880 --> 00:24:19,600 CLINICAL CENTER, BUT SOMEBODY 591 00:24:19,600 --> 00:24:21,640 WHO'S A REGULAR AT THESE 592 00:24:21,640 --> 00:24:24,400 MEETINGS, HAS BEEN THROUGHOUT IS 593 00:24:24,400 --> 00:24:26,800 DR. MICHAEL GOTTESBE MAN, AND 594 00:24:26,800 --> 00:24:27,800 DR. GOTTESMAN IS THE DEPUTY 595 00:24:27,800 --> 00:24:33,200 DIRECTOR OF THE NIH FOR 596 00:24:33,200 --> 00:24:34,720 INTRAMURAL RESEARCH AND THE 597 00:24:34,720 --> 00:24:36,680 CLINICAL CENTER SITS SQUARELY IN 598 00:24:36,680 --> 00:24:41,800 THE MIDDLE OF THE INTRAMURAL 599 00:24:41,800 --> 00:24:42,200 RESEARCH PROGRAM. 600 00:24:42,200 --> 00:24:45,280 THE SECOND PERSON I WANT TO 601 00:24:45,280 --> 00:24:47,600 INTRODUCE IS COLLEEN HADIGAN, 602 00:24:47,600 --> 00:24:49,120 COLLEEN IS THE CHIEF MEDICAL 603 00:24:49,120 --> 00:24:52,720 OFFICER OF THE CLINICAL MEDICAL 604 00:24:52,720 --> 00:24:55,120 CENTER IF YOU REMEMBER BACK AT 605 00:24:55,120 --> 00:24:57,480 OUR OCTOBER MEETING, COLLEEN 606 00:24:57,480 --> 00:24:58,120 SIGNED THE AGREEMENT ACCEPTING 607 00:24:58,120 --> 00:25:00,520 THE POSITION IN THE OCTOBER 608 00:25:00,520 --> 00:25:04,760 MEETING WHICH WAS QUITE 609 00:25:04,760 --> 00:25:09,000 EVENTFUL. 610 00:25:09,000 --> 00:25:10,160 PIAS, [INDISCERNIBLE] IS THE 611 00:25:10,160 --> 00:25:12,360 CHIEF OPERATING OFFICER OF THE 612 00:25:12,360 --> 00:25:14,720 CLINICAL CENTER OF NIH, PIAS HAS 613 00:25:14,720 --> 00:25:16,200 BEEN HERE A BIT MORE THAN A YEAR 614 00:25:16,200 --> 00:25:20,600 OR LESS THAN I HAVE BEEN AND 615 00:25:20,600 --> 00:25:22,920 BARBARA JORDAN IS THE ACTING 616 00:25:22,920 --> 00:25:24,000 CHIEF NURSING OFFICER OR THE 617 00:25:24,000 --> 00:25:25,600 CLINICAL CENTER AND YOU WILL SEE 618 00:25:25,600 --> 00:25:30,720 THAT WE'RE IN THE PROCESS OF THE 619 00:25:30,720 --> 00:25:32,520 NATIONAL RECRUITING EFFORT TO 620 00:25:32,520 --> 00:25:38,400 FIND THE NEXT CNO FOR THE 621 00:25:38,400 --> 00:25:39,600 CLINICAL CENTER THERE ARE 3 622 00:25:39,600 --> 00:25:40,560 PEOPLE ON THAT YOU WILL HEAR 623 00:25:40,560 --> 00:25:43,080 FROM A BIT, AND I WON'T 624 00:25:43,080 --> 00:25:45,360 INTRODUCE THEM, THAT'S DAVID 625 00:25:45,360 --> 00:25:48,200 LANG, CHEF OF THE PATIENT SAFETY 626 00:25:48,200 --> 00:25:50,360 AND CLINICAL QUALITY, AND 627 00:25:50,360 --> 00:25:51,800 MARILYN FARINRE, WHO IS THE 628 00:25:51,800 --> 00:25:53,880 CHIEF OF PHARMACY OPERATIONS WHO 629 00:25:53,880 --> 00:25:55,320 YOU WILL HEAR ABOUT IN A LITTLE 630 00:25:55,320 --> 00:25:57,840 BIT AND LAST BUT NOT LEAST, I 631 00:25:57,840 --> 00:26:02,520 WANT TO ACKNOWLEDGE THE EFFORTS 632 00:26:02,520 --> 00:26:05,040 OF NATASHA POINTER AND PAT 633 00:26:05,040 --> 00:26:07,760 PURRINGER, THERE ARE A LOT OF 634 00:26:07,760 --> 00:26:08,640 HOUSEKEEPING ISSUES TRANSFERRED 635 00:26:08,640 --> 00:26:11,800 FROM SORT OF THE NIH CENTRAL TO 636 00:26:11,800 --> 00:26:14,600 THE CLINICAL CENTER AND PAT AND 637 00:26:14,600 --> 00:26:17,720 NATASHA HAVE BEEN IN 638 00:26:17,720 --> 00:26:19,040 COMMUNICATION WITH ALL OF YOU, I 639 00:26:19,040 --> 00:26:19,240 THINK. 640 00:26:19,240 --> 00:26:23,240 I THINK YOU ALL HAVE THEIR 641 00:26:23,240 --> 00:26:25,320 E-MAIL ADDRESSES AND THEY HAVE 642 00:26:25,320 --> 00:26:27,760 BEEN VERY DILIGENT IN TRYING TO 643 00:26:27,760 --> 00:26:29,160 MAKE SURE THIS FIRST EPISODE OF 644 00:26:29,160 --> 00:26:30,040 THE CLINICAL CENTER RESEARCH 645 00:26:30,040 --> 00:26:32,520 HOSPITAL BOARD FOR WHICH THEY 646 00:26:32,520 --> 00:26:34,800 HAVE A GREAT DEAL OF 647 00:26:34,800 --> 00:26:35,880 RESPONSIBILITY HAS BEEN PULLED 648 00:26:35,880 --> 00:26:37,760 TOGETHER PRETTY WELL AND SO I 649 00:26:37,760 --> 00:26:39,800 WANT TO ACKNOWLEDGE THEM. 650 00:26:39,800 --> 00:26:47,840 AND NOW, I THINK WE CAN GO TO 651 00:26:47,840 --> 00:26:48,400 THE SLIDES. 652 00:26:48,400 --> 00:26:54,480 GO AHEAD AND GO TO THE NEXT 653 00:26:54,480 --> 00:26:54,720 SLIDE. 654 00:26:54,720 --> 00:27:09,040 SO AGAIN, WELCOME TO ALL THE NEW 655 00:27:09,040 --> 00:27:09,400 MEMBERS. 656 00:27:09,400 --> 00:27:10,800 >> BOARD BUT ALSO CONNECTED ME 657 00:27:10,800 --> 00:27:15,200 WITH OTHER PEOPLE INCLUDING 658 00:27:15,200 --> 00:27:18,080 DR. SA MITT, WHO ALSO AGREED TO 659 00:27:18,080 --> 00:27:20,240 BE A MEMBER OF THIS BOARD. 660 00:27:20,240 --> 00:27:25,680 WE GOT A REGRET YESTERDAY FROM 661 00:27:25,680 --> 00:27:27,400 DAVID BAUM, I'M VERY SORRY HE 662 00:27:27,400 --> 00:27:29,800 CAN'T BE HERE TODAY BUT DAVID 663 00:27:29,800 --> 00:27:32,920 WILL BE A REGULAR PARTICIPANT 664 00:27:32,920 --> 00:27:41,360 AND WE'RE VERY HAPPY TO HAVE 665 00:27:41,360 --> 00:27:42,080 ANTOINETTE, ROYSTER, THOSE WHO 666 00:27:42,080 --> 00:27:44,240 HAVE BEEN ON THE CLINICAL CENTER 667 00:27:44,240 --> 00:27:49,200 RESEARCH BOARD FOR A WHILE WILL 668 00:27:49,200 --> 00:27:50,320 REMEMBER ANTOINETTE AND THEY 669 00:27:50,320 --> 00:27:51,800 CAME FROM THE SAME RESEARCH 670 00:27:51,800 --> 00:27:56,640 POPULATION OR PATIENT POPULATION 671 00:27:56,640 --> 00:27:58,400 AND IT WAS VERY INTERESTING BUT 672 00:27:58,400 --> 00:28:03,800 JUST ABOUT THE TIME WE CELTED ON 673 00:28:03,800 --> 00:28:07,160 ASKING ANTOINETTE TO JOIN US, 674 00:28:07,160 --> 00:28:09,920 SHE WAS RECEIVING REQUESTS FROM 675 00:28:09,920 --> 00:28:12,080 BEEs FAMILY AND WONDERING WHAT 676 00:28:12,080 --> 00:28:16,240 WOULD HAPPEN WITH BEE'S SPOT, 677 00:28:16,240 --> 00:28:20,360 NOW ELLEN IS LEAVING THE CCRHB 678 00:28:20,360 --> 00:28:21,560 BUT SHE'S NOT LEVELS INCREASING 679 00:28:21,560 --> 00:28:23,440 THE PATIENT CENTER OR THE 680 00:28:23,440 --> 00:28:24,000 PATIENT ADVISORY GROUP. 681 00:28:24,000 --> 00:28:25,560 SO ELEN WE HAVE A MEETING COMING 682 00:28:25,560 --> 00:28:27,200 UP IN A COUPLE WEEKS, I EXPECT 683 00:28:27,200 --> 00:28:30,080 TO SEE YOU THERE AND AND I CAN'T 684 00:28:30,080 --> 00:28:31,000 WAIT TO SEE LAWN MOWER YOU'RE 685 00:28:31,000 --> 00:28:35,400 GOING TO WEAR FOR US ON THAT 686 00:28:35,400 --> 00:28:35,640 DAY. 687 00:28:35,640 --> 00:28:36,840 BUT ELLEN IS 1 OF THOSE SPECIAL 688 00:28:36,840 --> 00:28:38,480 PEOPLE WHO MAKE ITS MORE FUN TO 689 00:28:38,480 --> 00:28:40,800 GET UP AND COME TO THE MEETING 690 00:28:40,800 --> 00:28:43,560 AND THAT AND EVERY GROUP THAT'S 691 00:28:43,560 --> 00:28:44,560 INVOLVED IN SERIOUS BUSINESS 692 00:28:44,560 --> 00:28:48,880 NEEDS AT LEAST 1 PERSON WHO WILL 693 00:28:48,880 --> 00:28:51,920 DO THAT FOR THE GROUP AND 694 00:28:51,920 --> 00:28:54,360 ELLENOIR HAS BEEN THAT PERSON AT 695 00:28:54,360 --> 00:28:57,240 THE SAME TIME PROVIDING PROFOUND 696 00:28:57,240 --> 00:28:58,320 PATIENT INSIGHTS AND ASKING 697 00:28:58,320 --> 00:29:03,880 QUESTIONS THAT WERE IMPORTANT. 698 00:29:03,880 --> 00:29:04,840 NEXT SLIDE. 699 00:29:04,840 --> 00:29:06,800 SO WE USUALLY BEGIN THESE BY 700 00:29:06,800 --> 00:29:07,520 ACKNOWLEDGING THE CONTRIBUTION 701 00:29:07,520 --> 00:29:11,480 OF THE CLINICAL CENTER STAFF AND 702 00:29:11,480 --> 00:29:14,160 THIS ITERATION, WE WANT TO 703 00:29:14,160 --> 00:29:16,440 INDICATE HOW PROUD WE ARE OF OUR 704 00:29:16,440 --> 00:29:19,080 2 BOARD MEMBERS LISTED IN THE 705 00:29:19,080 --> 00:29:21,840 2022 CLASS OF TOP WOMEN LEADERS 706 00:29:21,840 --> 00:29:24,760 IN HEALTHCARE AND THAT'S OUR 707 00:29:24,760 --> 00:29:30,200 CHAIR DR. FORESE AND ALSO RUTH 708 00:29:30,200 --> 00:29:30,600 WILLIAMS-BRINKLEY. 709 00:29:30,600 --> 00:29:32,840 1 OTHER NOTE ABOUT RUTH IS 710 00:29:32,840 --> 00:29:34,000 RIEWGHTD WILL BE LEAVING THE 711 00:29:34,000 --> 00:29:36,000 BOARD AS LAURA WILL BE LEAVES 712 00:29:36,000 --> 00:29:38,200 OVER THE COURSE OF THE NEXT FEW 713 00:29:38,200 --> 00:29:38,440 MONTHS. 714 00:29:38,440 --> 00:29:40,960 RUTH IS 1 OF THE HEALTHCARE EXEC 715 00:29:40,960 --> 00:29:42,600 TIEVERS WHO BROUGHT A NURSING 716 00:29:42,600 --> 00:29:43,800 BACKGROUND TO THE CLINICAL 717 00:29:43,800 --> 00:29:46,360 CENTER RESEARCH HOSPITAL BOARD, 718 00:29:46,360 --> 00:29:49,360 THE OTHER WAS JANET ERICSON, AND 719 00:29:49,360 --> 00:29:51,520 NOW WITH RUTH LEAVING WITH THAT 720 00:29:51,520 --> 00:29:55,720 LEFT A VOID IN THE--WITH 721 00:29:55,720 --> 00:29:58,880 SOMEBODY WHO COULD BRING THE 722 00:29:58,880 --> 00:30:01,080 VOICE OF THE NURSE TO THE 723 00:30:01,080 --> 00:30:05,400 CLINICAL CENTER RESEARCH 724 00:30:05,400 --> 00:30:06,600 HOSPITAL BOARD AND THAT AND IT'S 725 00:30:06,600 --> 00:30:07,640 A LITTLE EARLY BUT I WOULD SAY 726 00:30:07,640 --> 00:30:11,360 THAT I HAD A VERY GOOD--I HAD A 727 00:30:11,360 --> 00:30:12,920 VERY GOOD CONVERSATION YESTERDAY 728 00:30:12,920 --> 00:30:15,160 WITH A NURSE EXECUTIVE, NOT A 729 00:30:15,160 --> 00:30:17,520 NURSE EXECUTIVE BUT A CEO OF A 730 00:30:17,520 --> 00:30:21,280 HOSPITAL THAT YOU WOULD ALL 731 00:30:21,280 --> 00:30:22,440 RECOGNIZE AND VERY EXCITED ABOUT 732 00:30:22,440 --> 00:30:23,960 THE POSSIBILITY OF JOINING THE 733 00:30:23,960 --> 00:30:28,200 BOARD AND SO HOPEFULLY BY JULY, 734 00:30:28,200 --> 00:30:30,000 WILL HAVE THAT TAKEN CARE OF AND 735 00:30:30,000 --> 00:30:34,400 WILL AT LEAST BE ABLE TO HAVE AN 736 00:30:34,400 --> 00:30:38,200 INITIAL ANNOUNCE NLT OF A NEW 737 00:30:38,200 --> 00:30:41,800 BOARD MEMBER WHO WILL WHO WILL 738 00:30:41,800 --> 00:30:44,800 REPRESENT THE VOICE OF A GREAT 739 00:30:44,800 --> 00:30:47,160 HEALTHCARE EXECUTIVE AND A PREOF 740 00:30:47,160 --> 00:30:48,080 THEIGEIOUS ORGANIZATION, BUT 741 00:30:48,080 --> 00:30:50,440 ALSO WILL BRING THE NURSING 742 00:30:50,440 --> 00:30:52,760 BACKGROUND TO THE BOARD AND I 743 00:30:52,760 --> 00:30:54,160 THINK THAT THAT'S VERY IMPORTANT 744 00:30:54,160 --> 00:30:56,400 IN THE CLINICAL CENTER. 745 00:30:56,400 --> 00:31:03,080 WHERE ABOUT A THIRD OF OUR STAFF 746 00:31:03,080 --> 00:31:04,040 ARE NURSES AND THEY ARE THE 1 747 00:31:04,040 --> 00:31:07,600 WHO IS ARE WITH OUR PATIENTS ALL 748 00:31:07,600 --> 00:31:09,360 THE TIME AND ARE VERY, VERY 749 00:31:09,360 --> 00:31:11,560 IMPORTANT FOR OUR PATIENTS 750 00:31:11,560 --> 00:31:12,120 SAFETY EFFORTS, EXTREMELY 751 00:31:12,120 --> 00:31:20,000 IMPORTANT FOR THE PATIENT 752 00:31:20,000 --> 00:31:22,400 EXPERIENCE EFFORTS AND HAVE BEEN 753 00:31:22,400 --> 00:31:23,600 GREAT SUPPORTERS OF THE CHANGES 754 00:31:23,600 --> 00:31:29,320 WE'VE BEEN MAKING SINCE 2017. 755 00:31:29,320 --> 00:31:30,400 OKAY, NEXT SLIDE. 756 00:31:30,400 --> 00:31:33,520 SO NOW, THEN, THAT GIVES ME A 757 00:31:33,520 --> 00:31:35,600 CHANCE TO BRAG ABOUT THE 758 00:31:35,600 --> 00:31:38,760 CLINICAL CENTER NURSING 759 00:31:38,760 --> 00:31:39,040 DEPARTMENT. 760 00:31:39,040 --> 00:31:43,440 SO THE PRESS GANEY AWARD FOR 761 00:31:43,440 --> 00:31:45,360 NDNQI FOR METRICS IN 2021 IS 762 00:31:45,360 --> 00:31:49,520 HERE IN THE CLINICAL CENTER AND 763 00:31:49,520 --> 00:31:53,160 WE ARE VERY, VERY PROUD OF THIS 764 00:31:53,160 --> 00:31:56,720 AND MANY HOSPITALS PARTICIPATE 765 00:31:56,720 --> 00:31:58,480 IN THIS EFFORT AND YOU CAN SEE 766 00:31:58,480 --> 00:32:03,800 THE PATIENT SAFETY METRICS THAT 767 00:32:03,800 --> 00:32:06,600 ARE INVOLVED HERE AND I WOULD 768 00:32:06,600 --> 00:32:22,840 SAY I HAVE 2 FOLKS FROM NCQA--IT 769 00:32:22,840 --> 00:32:24,160 IS SOMETHING WE'RE CELEBRATING 770 00:32:24,160 --> 00:32:26,400 AND IT IS 1 OF THE 6 HEGHT CARE 771 00:32:26,400 --> 00:32:27,600 ORGANIZATIONS TO RECEIVE THE 772 00:32:27,600 --> 00:32:30,320 AWARD AND WE RECEIVED THE AWARD 773 00:32:30,320 --> 00:32:31,520 FOR THE TOP TEACHING HOSPITAL 774 00:32:31,520 --> 00:32:33,600 AND JUST AS WE DID A FEW YEARS 775 00:32:33,600 --> 00:32:38,400 AGO WHEN WE HAD AN AWARD FROM 776 00:32:38,400 --> 00:32:41,880 THE NATIONAL RESEARCH NRC, 777 00:32:41,880 --> 00:32:45,760 NATIONAL RESEARCH GROUP OUT OF 778 00:32:45,760 --> 00:32:47,240 BOSTON WE WANTED TO MAKE SURE 779 00:32:47,240 --> 00:32:48,000 THAT EVERYTHING THAT HAD 780 00:32:48,000 --> 00:32:50,400 ANYTHING TO DO WITH THIS AWARD, 781 00:32:50,400 --> 00:32:52,880 WHICH BASICALLY MEANT ALL OF THE 782 00:32:52,880 --> 00:32:54,200 NURSING STAFF HAD A CHANCE TO 783 00:32:54,200 --> 00:32:55,720 SEE THE AWARD, HAD A CHANCE TO 784 00:32:55,720 --> 00:33:02,000 TOUCH IT AND HAD A CHANCE TO TO 785 00:33:02,000 --> 00:33:03,360 HAVE THEIR PICTURE TAKEN WITH IT 786 00:33:03,360 --> 00:33:05,800 AND THESE ARE A COUPLE OF THE 787 00:33:05,800 --> 00:33:07,600 PICTURES THAT ARE FROM THE TOUR. 788 00:33:07,600 --> 00:33:09,080 SO FOR THOSE WHO ARE SPORTS 789 00:33:09,080 --> 00:33:11,360 FANS, THIS IS SORT OF THE 790 00:33:11,360 --> 00:33:18,000 STANLEY CUP OR THE--OR THE 791 00:33:18,000 --> 00:33:18,960 [INDISCERNIBLE] FOR WINNING THE 792 00:33:18,960 --> 00:33:20,600 BRITISH OPEN AND IT'S OUR JOB TO 793 00:33:20,600 --> 00:33:22,200 MAKE SURE THAT ANYBODY WHO KNOWS 794 00:33:22,200 --> 00:33:25,800 AND HAD ANYTHING TO DO WITH THIS 795 00:33:25,800 --> 00:33:27,400 GRAND ACCOMPLISHMENT IT'S A 796 00:33:27,400 --> 00:33:31,360 CHANCE TO FEEL LIKE THEY'RE PART 797 00:33:31,360 --> 00:33:34,800 OF THIS AWARD RECEPTION. 798 00:33:34,800 --> 00:33:38,600 THANKS. 799 00:33:38,600 --> 00:33:39,480 NEXT SLIDE. 800 00:33:39,480 --> 00:33:41,360 WE ALSO HAVE SINCE THE LAST TIME 801 00:33:41,360 --> 00:33:44,160 WE MET, WE'VE HAD NIH DIRECTORS 802 00:33:44,160 --> 00:33:47,800 AWARDS, MORE THAN--AND THE NIH 803 00:33:47,800 --> 00:33:49,360 PROBABLY 40,000 STAFF MEMBERS 804 00:33:49,360 --> 00:33:52,000 WHO ARE ELIGIBLE FOR AWARDS AND 805 00:33:52,000 --> 00:33:53,400 YOU CAN SEE THAT THE CLINICAL 806 00:33:53,400 --> 00:33:54,840 CENTER WAS WELL REPRESENTED IN 807 00:33:54,840 --> 00:33:58,920 BOTH THE INDIVIDUAL AND GROUP 808 00:33:58,920 --> 00:34:04,440 AWARD CATEGORIES IN DECEMBER, WE 809 00:34:04,440 --> 00:34:06,000 DO THE CLINICAL CENTER CEO 810 00:34:06,000 --> 00:34:07,720 AWARDS AND I DESCRIBE THIS EVERY 811 00:34:07,720 --> 00:34:09,040 YEAR AND IT PERSISTS AS THE BEST 812 00:34:09,040 --> 00:34:10,200 DAY I HAVE IN THE CLINICAL 813 00:34:10,200 --> 00:34:11,800 STRRKS CAN YOU SEE THE NUMBER OF 814 00:34:11,800 --> 00:34:13,960 CLINICAL CENTER STAFF MEMBERS 815 00:34:13,960 --> 00:34:15,360 WHO ARE HONORED WITH INDIVIDUAL 816 00:34:15,360 --> 00:34:17,760 AND GROUP AWARDS AND THERE'S A 817 00:34:17,760 --> 00:34:19,960 NEW AWARD THAT'S BEEN DEVELOPED 818 00:34:19,960 --> 00:34:22,840 BY HHS, WHICH IS SORT OF 819 00:34:22,840 --> 00:34:24,240 SOMETHING BIGGER CALLED THE PART 820 00:34:24,240 --> 00:34:29,360 OF SOMETHING BIGGER AWARD AND IT 821 00:34:29,360 --> 00:34:30,640 WILL INVOLVE--IT BASICALLY 822 00:34:30,640 --> 00:34:32,600 INVOLVES THE ACTIVITIES OF NIH 823 00:34:32,600 --> 00:34:35,360 STAFF MEMBERS OR HHS STAFF 824 00:34:35,360 --> 00:34:37,000 MEMBERS WHEN THEY'RE AWAY FROM 825 00:34:37,000 --> 00:34:39,440 THE WORKPLACE BUT THEY'RE STILL 826 00:34:39,440 --> 00:34:43,360 CONTRIBUTING TO THE GOALS OF OF 827 00:34:43,360 --> 00:34:44,280 HEALTH AND HUMAN EVERYBODY'SS 828 00:34:44,280 --> 00:34:45,760 AND THIS GOES TO A COUPLE OF OUR 829 00:34:45,760 --> 00:34:50,160 STAFF MEMBER WHO IS IN THEIR OWN 830 00:34:50,160 --> 00:34:52,440 TIME WORKED WITH SOME OF THE 831 00:34:52,440 --> 00:34:54,320 MASS IMMUNIZATION SITES FOR 832 00:34:54,320 --> 00:34:57,920 COVID-19 VACCINES. 833 00:34:57,920 --> 00:34:59,520 AND SO, WE'RE--THERE ARE STILL 834 00:34:59,520 --> 00:35:01,080 SOME GLITCHES IN THIS AWARD AND 835 00:35:01,080 --> 00:35:05,000 THE RECOGNITION BUT WE HAVE 836 00:35:05,000 --> 00:35:06,000 WORKED OUT THE INDIVIDUAL 837 00:35:06,000 --> 00:35:06,600 RECOGNITION AND AGAIN, THERE 838 00:35:06,600 --> 00:35:10,400 WILL BE A WEBSITE AT HHS WHERE 839 00:35:10,400 --> 00:35:11,560 THEIR NAMES WILL LIVE FOR AS 840 00:35:11,560 --> 00:35:17,880 LONG AS THE WEBSITE'S THERE. 841 00:35:17,880 --> 00:35:18,400 NEXT SLIDE. 842 00:35:18,400 --> 00:35:24,400 IF YOU LOOK AT OUR STRAY --STRATEGIC 843 00:35:24,400 --> 00:35:25,480 PLAN, YOU WOULD KNOW THAT WE 844 00:35:25,480 --> 00:35:32,320 NEED TO DID A LOT OF RECRUITING 845 00:35:32,320 --> 00:35:33,480 TO REPLACE SENIOR RETIREMENT AGE 846 00:35:33,480 --> 00:35:34,680 STAFF MEMBER WHO IS ARE LEAVING 847 00:35:34,680 --> 00:35:35,760 THE CLINICAL CENTER AND IN 848 00:35:35,760 --> 00:35:37,280 ADDITION TO THAT, THERE ARE A 849 00:35:37,280 --> 00:35:38,880 COUPLE OF OTHER POSITIONS THAT 850 00:35:38,880 --> 00:35:41,400 HAVE OPENED UP THAT WE REALLY 851 00:35:41,400 --> 00:35:42,400 DIDN'T THINK WE WERE GOING TO 852 00:35:42,400 --> 00:35:44,160 HAVE TO DEAL WITH SO SOON BUT BE 853 00:35:44,160 --> 00:35:48,000 THAT AS IT MAY, WE HAVE TO. 854 00:35:48,000 --> 00:35:50,200 WE HAVE A NUMBER OF LEADERSHIP 855 00:35:50,200 --> 00:35:53,480 VACANCIES THAT WE'RE ACTIVELY 856 00:35:53,480 --> 00:35:54,600 RECRUITING FOR. 857 00:35:54,600 --> 00:35:59,600 THE USA JOBS HAS JUST POSTED THE 858 00:35:59,600 --> 00:36:04,440 ANNOUNCEMENT FOR THE CHIEF 859 00:36:04,440 --> 00:36:06,400 NURSING OFFICER. 860 00:36:06,400 --> 00:36:07,920 MARIE JOYCE AS RETIRED SINCE THE 861 00:36:07,920 --> 00:36:09,800 LAST TIME WE GOT TOGETHER, SHE 862 00:36:09,800 --> 00:36:11,000 WAS THE CFO FOR THE CLINICAL 863 00:36:11,000 --> 00:36:14,360 CENTER FOR A LONG TIME AND 864 00:36:14,360 --> 00:36:15,160 [INDISCERNIBLE] HAS ASSUMED THE 865 00:36:15,160 --> 00:36:15,800 RESPONSIBILITIES IN THE INTERIM 866 00:36:15,800 --> 00:36:18,400 BUT WE'RE IN THE PROCESS OF 867 00:36:18,400 --> 00:36:22,640 BEGINNING THE SEARCH FOR A NEW 868 00:36:22,640 --> 00:36:23,200 CFO. 869 00:36:23,200 --> 00:36:23,880 DR. RICK [INDISCERNIBLE] HAS 870 00:36:23,880 --> 00:36:26,200 DONE A GREAT JOB AS INTERIM 871 00:36:26,200 --> 00:36:27,280 CHIEF OF PHARMACY FOR 3 YEARS 872 00:36:27,280 --> 00:36:29,960 BUT IT'S NOW TIME TO BEGIN 873 00:36:29,960 --> 00:36:30,800 RECRUITING FOR THE PERMANENT 874 00:36:30,800 --> 00:36:31,040 POSITION. 875 00:36:31,040 --> 00:36:32,920 WE HAVE FILLED NOW THE CHIEF OF 876 00:36:32,920 --> 00:36:34,200 MATERIALS MANAGEMENT THAT 877 00:36:34,200 --> 00:36:39,240 ENVIRONMENTAL SERVICES AND THAT 878 00:36:39,240 --> 00:36:41,200 CAME FROM A PROMOTION IN HOUSE 879 00:36:41,200 --> 00:36:44,400 AND WE HAVE BOB LIMBO WHO RAN 880 00:36:44,400 --> 00:36:46,720 OUR OFFICE OF CLINICAL TRAINING 881 00:36:46,720 --> 00:36:47,760 AND MEDICAL EDUCATION FOR THE 882 00:36:47,760 --> 00:36:49,080 LAST SEVERAL YEARS THAT HAS 883 00:36:49,080 --> 00:36:55,600 RETIRED AND WE ARE IN THE 884 00:36:55,600 --> 00:36:57,320 PROCESS OF THAT SEARCH AS WELL. 885 00:36:57,320 --> 00:36:59,000 WE HAVE COMPLETED A SEARCH FOR 886 00:36:59,000 --> 00:37:00,240 THE DESIGNATED INSTIEWTIONZAL 887 00:37:00,240 --> 00:37:01,680 OFFICIAL AND ALL OF YOU KNOW 888 00:37:01,680 --> 00:37:03,800 THAT'S THE PERSON WHO INTERFACES 889 00:37:03,800 --> 00:37:05,400 WITH THE ACCREDITATION COUNCIL 890 00:37:05,400 --> 00:37:06,720 FOR GRADUATE MEDICAL EDUCATION 891 00:37:06,720 --> 00:37:07,480 FOR THOSE FELLOWSHIPS THAT WE 892 00:37:07,480 --> 00:37:11,200 HAVE HERE IN THE CLINICAL CENTER 893 00:37:11,200 --> 00:37:12,960 THAT ARE ACG ME RECOGNIZED. 894 00:37:12,960 --> 00:37:14,720 WE HAVE AN AWFUL LOT OF 895 00:37:14,720 --> 00:37:35,240 FELLOWSHIPS THAT ARE FAIRLY 896 00:37:35,240 --> 00:37:38,440 SPECIFIC--WE SPEND A LOT OF TIME 897 00:37:38,440 --> 00:37:39,520 WORKING ABOUT HOW WE WILL WORK 898 00:37:39,520 --> 00:37:41,760 IN THE NEW ENVIRONMENT, IN THE 899 00:37:41,760 --> 00:37:43,240 CLINICAL CENTER IT'S NOT AS MUCH 900 00:37:43,240 --> 00:37:45,120 AS SOME AREAS OF THE NIH WHERE 901 00:37:45,120 --> 00:37:46,520 PEOPLE REALLY CAN DO REMOTE WORK 902 00:37:46,520 --> 00:37:47,840 AN AWFUL LOT OF THE TIME. 903 00:37:47,840 --> 00:37:52,480 WE WILL BE DOING TELEWORK AND 904 00:37:52,480 --> 00:37:52,960 REMOTE WORK MORE. 905 00:37:52,960 --> 00:37:55,000 AND MORE STAFF MEMBERS WILL BE 906 00:37:55,000 --> 00:37:56,400 DOING IT FROM THE CLINICAL 907 00:37:56,400 --> 00:37:57,440 CENTER BUT MOST OF OUR WORK IS 908 00:37:57,440 --> 00:38:01,600 HERE IN THE BELLING AND SO THIS 909 00:38:01,600 --> 00:38:03,440 IS--IS ACTUALLY MORE I THINK OF 910 00:38:03,440 --> 00:38:06,400 AN ISSUE OF DISCUSSION AND 911 00:38:06,400 --> 00:38:07,960 DEBATE IN THE REST OF THE NIH 912 00:38:07,960 --> 00:38:11,280 THAN IT IS HERE. 913 00:38:11,280 --> 00:38:13,920 NEXT SLIDE. 914 00:38:13,920 --> 00:38:15,120 SO WE--ALL OF THAT YOU HAVE BEEN 915 00:38:15,120 --> 00:38:17,840 PART OF THIS GROUP FOR THE LAST 916 00:38:17,840 --> 00:38:21,320 5 YEARS, TO KNOW THAT I HELD A 917 00:38:21,320 --> 00:38:24,040 TOWN HALL WITHIN THE FIRST WEEK 918 00:38:24,040 --> 00:38:28,360 OF TAKING THE JOB IN 2017. 919 00:38:28,360 --> 00:38:30,600 WE HAD TO GO TO VIRTUAL TOWN 920 00:38:30,600 --> 00:38:32,200 HALLS DURING THE PANDEMIC AND WE 921 00:38:32,200 --> 00:38:37,120 ARE STILL IN A VIRTUAL TOWN HALL 922 00:38:37,120 --> 00:38:37,400 ENVIRONMENT. 923 00:38:37,400 --> 00:38:40,360 WE DID CHANGE THE FORMAT IN A 924 00:38:40,360 --> 00:38:42,640 PRETTY SIGNIFICANT WAY THIS 925 00:38:42,640 --> 00:38:43,720 QUARTER, SO IN JANUARY, WHICH 926 00:38:43,720 --> 00:38:47,840 WAS THE LAST TIME WE DID A TOWN 927 00:38:47,840 --> 00:38:49,720 HALL, AND WE INCORPORATED MORE 928 00:38:49,720 --> 00:38:54,000 OF THE EXECUTIVE LEADERSHIP FROM 929 00:38:54,000 --> 00:38:56,520 THE CLINICAL CENTER IN THE 930 00:38:56,520 --> 00:38:56,840 PRESENTATION. 931 00:38:56,840 --> 00:38:59,480 THAT WAS VERY WELL RECEIVED, WE 932 00:38:59,480 --> 00:39:00,600 DO SOLICIT QUESTIONS AHEAD OF 933 00:39:00,600 --> 00:39:02,800 TIME AND WE DO MAKE EVERY EFFORT 934 00:39:02,800 --> 00:39:07,640 TO RESPOND TO THOSE. 935 00:39:07,640 --> 00:39:09,320 AND SO I THINK IT WAS WELL 936 00:39:09,320 --> 00:39:09,600 RECEIVED. 937 00:39:09,600 --> 00:39:11,560 WE WILL USE THIS FORMAT FOR THE 938 00:39:11,560 --> 00:39:13,880 NEXT YEAR OR SO AND SEE HOW IT 939 00:39:13,880 --> 00:39:14,120 GOES. 940 00:39:14,120 --> 00:39:18,800 THE NEXT TOWN HALL WILL DEAL 941 00:39:18,800 --> 00:39:21,360 MOSTLY WITH DIVERSITY, EQUITY 942 00:39:21,360 --> 00:39:22,280 INCLUSION AND ACCESSIBILITY 943 00:39:22,280 --> 00:39:22,800 ISSUES. 944 00:39:22,800 --> 00:39:24,080 I MAY HAVE A LITTLE BIT MORE OF 945 00:39:24,080 --> 00:39:26,000 A SPEAKING PART AT THAT 1 THAN I 946 00:39:26,000 --> 00:39:33,280 HAD AT THE 1 IN JANUARY, BUT 947 00:39:33,280 --> 00:39:34,440 THESE ARE ISSUES THAT ARE VERY 948 00:39:34,440 --> 00:39:36,600 MUCH ON THE RADAR SCREEN AT THE 949 00:39:36,600 --> 00:39:37,880 CLINICAL CENTER OF THE THE NIH 950 00:39:37,880 --> 00:39:39,800 AND WE WILL BE WORKING ON THOSE. 951 00:39:39,800 --> 00:39:42,000 NEXT SLIDE. 952 00:39:42,000 --> 00:39:43,160 WE HOSTED--WE CO-HOSTED WITH 953 00:39:43,160 --> 00:39:44,600 NCATS THE RARE DISEASE, AGAIN 954 00:39:44,600 --> 00:39:47,640 THIS USED TO BE HELD IN-PERSON 955 00:39:47,640 --> 00:39:49,400 IN OUR LARGE AUDITORIUM HERE AND 956 00:39:49,400 --> 00:39:50,760 THEN IT GOT TOO BIG FOR THAT, 957 00:39:50,760 --> 00:39:54,600 AND MOVED OVER TO THE NATCHER 958 00:39:54,600 --> 00:39:56,600 BUILDING AND THE LARGER VENUE 959 00:39:56,600 --> 00:39:57,800 THAT WAS THERE AND THEN LAST 960 00:39:57,800 --> 00:40:02,160 YEAR AND THIS YEAR IT HAD TO BE 961 00:40:02,160 --> 00:40:04,200 A VIRTUAL CONFERENCE WHICH MADE 962 00:40:04,200 --> 00:40:05,920 SOME OF THE LOGISTICS EASIER, IT 963 00:40:05,920 --> 00:40:07,360 USED TO BE THE HARDEST DAY TO 964 00:40:07,360 --> 00:40:09,000 GET ON CAMPUS AT THE NIH BECAUSE 965 00:40:09,000 --> 00:40:12,320 WE HAD HUNDREDS OF PEOPLE TRYING 966 00:40:12,320 --> 00:40:14,280 TO DRIVE ON CAMPUS WHO WERE NOT 967 00:40:14,280 --> 00:40:18,280 USED TO COMING ON CAMPUS, AND 968 00:40:18,280 --> 00:40:22,640 SO, THE VIRTUAL MEETING HELPED 969 00:40:22,640 --> 00:40:26,080 US A LOT IN THAT REGARD BUT IT 970 00:40:26,080 --> 00:40:28,400 IS SOMETHING THAT THE CLINICAL 971 00:40:28,400 --> 00:40:30,480 CENTER HAS BEEN VERY PROUD TO 972 00:40:30,480 --> 00:40:34,360 CO-HOST FOR A NUMBER OF YEARS 973 00:40:34,360 --> 00:40:36,320 AND WAS A BIG SUCCESS. 974 00:40:36,320 --> 00:40:38,000 AGAIN, I THINK 3 OR 4 MEMBERS OF 975 00:40:38,000 --> 00:40:40,000 CONGRESS WHO ARE PART OF THE 976 00:40:40,000 --> 00:40:43,440 RARE DISEASE CAUCUS MADE 977 00:40:43,440 --> 00:40:43,760 APPEARANCES. 978 00:40:43,760 --> 00:40:47,280 IT'S REALLY BECOME QUITE AN 979 00:40:47,280 --> 00:40:49,480 EVENT. 980 00:40:49,480 --> 00:40:49,840 NEXT SLIDE. 981 00:40:49,840 --> 00:40:51,600 I WILL SHOW YOU A COUPLE SLIDES 982 00:40:51,600 --> 00:40:53,400 THAT SHOW YOU SOME CHANGES THAT 983 00:40:53,400 --> 00:40:55,720 OUR OFFICE OF COMMUNICATIONS AND 984 00:40:55,720 --> 00:40:58,600 MEDIA RELATIONS AND PATIENT 985 00:40:58,600 --> 00:41:00,080 RECRUITMENT OR OCMR HAVE MADE 986 00:41:00,080 --> 00:41:04,800 AND THESE HAVE TO DO WITH 987 00:41:04,800 --> 00:41:06,600 LEVERAGING SOCIAL MEDIA TO--IN 988 00:41:06,600 --> 00:41:11,760 AN EFFORT TO ADVERTISE OUR 989 00:41:11,760 --> 00:41:14,080 STUDIES TO GET AND FIND PATIENTS 990 00:41:14,080 --> 00:41:21,480 WHO MIGHT BE INTERESTED IN 991 00:41:21,480 --> 00:41:24,160 PARTICIPATING IN STUDIES AND 992 00:41:24,160 --> 00:41:27,200 IT'S MORE ACTIVE BUT STILL 993 00:41:27,200 --> 00:41:27,680 INTEREST BASED. 994 00:41:27,680 --> 00:41:32,640 PEOPLE CAN GO BY IT VERY QUICKLY 995 00:41:32,640 --> 00:41:34,640 IF THEY WANT TO AND WE ARE ABLE 996 00:41:34,640 --> 00:41:37,840 TO TARGET OUR FACEBOOK ADS AND 997 00:41:37,840 --> 00:41:39,200 OTHER SOCIAL MEDIA EFFORTS TO 998 00:41:39,200 --> 00:41:42,120 POPULATIONS THAT WE THINK MIGHT 999 00:41:42,120 --> 00:41:45,040 BE ENRICHED FOR THE KINDS OF 1000 00:41:45,040 --> 00:41:46,120 INTERESTS WE'RE LOOKING FOR. 1001 00:41:46,120 --> 00:41:50,160 THIS IS AN INCREDIBLY COST 1002 00:41:50,160 --> 00:41:55,400 EFFICIENT OR LOW COST EFFORT AND 1003 00:41:55,400 --> 00:41:56,760 WE--ALL OF THIS ACTIVITY FOR ALL 1004 00:41:56,760 --> 00:42:01,920 OF THE INSTITUTES THAT ARE ON 1005 00:42:01,920 --> 00:42:04,840 THEIR, I THINK IS COSTING US 1006 00:42:04,840 --> 00:42:06,320 LESS THAN $5000 PER YEAR AND 1007 00:42:06,320 --> 00:42:08,200 AGAIN WE CAN NARROWLY TARGET OR 1008 00:42:08,200 --> 00:42:12,640 WE CAN GO MUCH, MUCH MORE 1009 00:42:12,640 --> 00:42:12,920 BROADLY. 1010 00:42:12,920 --> 00:42:16,440 WE HAVE--WE'VE HAD AT LEAST A 1011 00:42:16,440 --> 00:42:19,200 HALF MILLION PEOPLE SEE OUR 1012 00:42:19,200 --> 00:42:20,520 FACEBOOK POSTS AND WE HAVE A 1013 00:42:20,520 --> 00:42:22,560 NUMBER OF POST ENGAGEMENTS AND 1014 00:42:22,560 --> 00:42:27,760 WE ARE NOW TRACKING THOSE 1015 00:42:27,760 --> 00:42:41,400 PATIENTS WHO ACTUALLY CALL US, 1016 00:42:41,400 --> 00:42:43,800 MEDIA EFFORTS TO TRY TO IMPROVE 1017 00:42:43,800 --> 00:42:45,520 OUR OUTREACH AND PATIENT 1018 00:42:45,520 --> 00:42:50,520 RECRUITMENT EFFORTS. 1019 00:42:50,520 --> 00:42:52,080 NEXT SLIDE. 1020 00:42:52,080 --> 00:42:55,040 AND AGAIN, WE LIKE FOR PEOPLE TO 1021 00:42:55,040 --> 00:42:59,520 KNOW THAT THE CLINICAL CENTER 1022 00:42:59,520 --> 00:43:00,040 IS 1023 00:43:00,040 --> 00:43:01,960 AT THE HOSPITAL AND IS AT THE 1024 00:43:01,960 --> 00:43:03,600 NIH AND WE'RE VERY PROUD OF WHAT 1025 00:43:03,600 --> 00:43:06,000 WE DO AND WE WANT PEOPLE TO KNOW 1026 00:43:06,000 --> 00:43:06,400 ABOUT IT. 1027 00:43:06,400 --> 00:43:08,640 WE HAVE A BIT OF AN IDENTITY 1028 00:43:08,640 --> 00:43:09,680 ISSUE IN THAT WE'RE A CENTER AND 1029 00:43:09,680 --> 00:43:14,800 WE'RE FOCUS ON THE CALLED A 1030 00:43:14,800 --> 00:43:17,400 HOSPITAL, SO THESE EFFORTS AGAIN 1031 00:43:17,400 --> 00:43:18,560 ARE ALSO LOW COST BUT THEY'RE 1032 00:43:18,560 --> 00:43:25,200 TRYING TO GET OUR PRESENCE AND 1033 00:43:25,200 --> 00:43:26,600 OUR EFFORTS OUT INTO THE 1034 00:43:26,600 --> 00:43:26,880 COMMUNITY. 1035 00:43:26,880 --> 00:43:27,680 NEXT SLIDE. 1036 00:43:27,680 --> 00:43:31,880 THIS IS OUR AVERAGE DAILY CENSUS 1037 00:43:31,880 --> 00:43:35,320 AND AS YOU MIGHT IMAGINE, WE 1038 00:43:35,320 --> 00:43:39,080 HAVE A 200 BED HOSPITAL. 1039 00:43:39,080 --> 00:43:40,720 WE'VE BEEN OPERATING AT A MUCH 1040 00:43:40,720 --> 00:43:41,920 LOWER CENSUS THROUGHOUT THE 1041 00:43:41,920 --> 00:43:53,920 PANDEMIC AND WITH THE OMICRON 1042 00:43:53,920 --> 00:43:55,280 VARIANT AND THE USUAL DROP IN 1043 00:43:55,280 --> 00:43:56,800 DECEMBER HIT AT THE SAME TIME, 1044 00:43:56,800 --> 00:43:58,080 WE ARE RECOVERING FROM AND WE 1045 00:43:58,080 --> 00:44:00,040 ARE IN A RECOVERY MODE. 1046 00:44:00,040 --> 00:44:00,880 OUR PATIENT POPULATION IS GOING 1047 00:44:00,880 --> 00:44:02,520 UP, YOU WILL SEE ON THE NEXT 1048 00:44:02,520 --> 00:44:03,440 SLIDE THAT OUR OUTPATIENT 1049 00:44:03,440 --> 00:44:05,040 NUMBERS ARE GOING UP AND OUR NEW 1050 00:44:05,040 --> 00:44:06,480 PATIENT NUMBERS ARE GOING UP 1051 00:44:06,480 --> 00:44:07,280 WHICH IS REALLY, REALLY 1052 00:44:07,280 --> 00:44:08,800 IMPORTANT TO US. 1053 00:44:08,800 --> 00:44:11,200 OBVIOUSLY 2021 WAS ALSO A 1054 00:44:11,200 --> 00:44:12,720 PANDEMIC YEAR AND WAS WELL BELOW 1055 00:44:12,720 --> 00:44:19,800 OUR 3 YEAR AVERAGE, IT'S SPOTTY. 1056 00:44:19,800 --> 00:44:22,240 OUR CANCER UNITS AND BONE MARROW 1057 00:44:22,240 --> 00:44:25,320 TRANSPLANT UNITS HAVE BEEN VERY 1058 00:44:25,320 --> 00:44:28,360 BUSY AND VERY FULL. 1059 00:44:28,360 --> 00:44:29,760 SOME OF THE OTHER UNITS THAT 1060 00:44:29,760 --> 00:44:36,040 TAKE CARE OF PATIENTS WHO CAN 1061 00:44:36,040 --> 00:44:37,600 WAIT FOR A LITTLE BIT MORE OF 1062 00:44:37,600 --> 00:44:42,200 THE RESOLUTION OF THE COVID-19 1063 00:44:42,200 --> 00:44:45,040 ACTIVITY ARE NOT AS BUSY. 1064 00:44:45,040 --> 00:44:47,880 WE JUST HEARD THIS MORNING THAT 1065 00:44:47,880 --> 00:44:53,680 IN MARCH, OUR O. R.s HAD THE 1066 00:44:53,680 --> 00:44:55,600 BUT BUSIEST MONTH WE'VE EVER 1067 00:44:55,600 --> 00:44:55,840 RECORDED. 1068 00:44:55,840 --> 00:45:00,040 SO OUR ACTIVITY IS COMING UP AND 1069 00:45:00,040 --> 00:45:05,680 WE LOOK FORWARD TO BEING BUSIER 1070 00:45:05,680 --> 00:45:07,000 DURING THE SUMMER MONTHS. 1071 00:45:07,000 --> 00:45:07,680 NEXT SLIDE. 1072 00:45:07,680 --> 00:45:10,280 SO THESE ARE IN PATIENT 1073 00:45:10,280 --> 00:45:11,360 ADMISSIONS, STILL DOWN ON 21, 1074 00:45:11,360 --> 00:45:13,840 BUT IF YOU GO DOWN AND LOOK AT 1075 00:45:13,840 --> 00:45:15,440 OUTPATIENT VISITS YOU CAN SEE 1076 00:45:15,440 --> 00:45:17,400 WOO HAVE A 20% INCREASE IN THE 1077 00:45:17,400 --> 00:45:20,840 NUMBER OF OUTPATIENT VISITS AND 1078 00:45:20,840 --> 00:45:22,800 ANOTHER--AND OUR NEW PATIENTS, 1079 00:45:22,800 --> 00:45:26,320 THE LAST SLIDE, THE LAST LINE ON 1080 00:45:26,320 --> 00:45:33,640 THE SLIDE THERE A 10% INCREASE. 1081 00:45:33,640 --> 00:45:34,000 NEXT SLIDE. 1082 00:45:34,000 --> 00:45:36,360 AS MANY OF YOU MAY BE AWARE 1083 00:45:36,360 --> 00:45:39,640 BEFORE THE PANDEMIC WE HAD NO 1084 00:45:39,640 --> 00:45:43,400 TELEHEALTH PRESENCE AND WE HAD 1085 00:45:43,400 --> 00:45:45,920 VERY LIMITED AND I WOULD SAY, 1086 00:45:45,920 --> 00:45:49,280 OUR VISION FOR THE USE OF 1087 00:45:49,280 --> 00:45:51,920 TELEHEALTH WAS SORT OF FOCUSED 1088 00:45:51,920 --> 00:45:53,920 ON THE RESEARCH ENVIRONMENT, BUT 1089 00:45:53,920 --> 00:45:55,560 WITH THE PANDEMIC, WE'VE FOUND 1090 00:45:55,560 --> 00:45:57,960 THAT WE NEEDED TO USE TELEHEALTH 1091 00:45:57,960 --> 00:46:00,480 TO A MUCH GREATER EXTENT. 1092 00:46:00,480 --> 00:46:01,400 OUR HEALTH INFORMATION 1093 00:46:01,400 --> 00:46:02,600 MANAGEMENT FOLKS AND THE 1094 00:46:02,600 --> 00:46:05,320 DEPARTMENT OF CLINICAL RESEARCH 1095 00:46:05,320 --> 00:46:06,560 INFORMATICS DEVELOPED A 1096 00:46:06,560 --> 00:46:09,800 PLATFORM. 1097 00:46:09,800 --> 00:46:11,000 WE DEVELOPED POLICY, AND YOU CAN 1098 00:46:11,000 --> 00:46:14,000 SEE AT THIS TIME, A YEAR AGO, WE 1099 00:46:14,000 --> 00:46:19,200 WERE SEEING OVER 1200 1100 00:46:19,200 --> 00:46:20,200 PATIENTS A 1101 00:46:20,200 --> 00:46:20,400 MONTH. 1102 00:46:20,400 --> 00:46:22,360 YOU CAN'T DRAW BLOOD IN A 1103 00:46:22,360 --> 00:46:23,840 TELEHEALTH VISIT, YOU CAN'T DO 1104 00:46:23,840 --> 00:46:25,960 AN IMAGING STUDY IN A TELEHEALTH 1105 00:46:25,960 --> 00:46:26,560 VISIT. 1106 00:46:26,560 --> 00:46:27,840 SO THERE ARE--CAN YOU DO A LOT 1107 00:46:27,840 --> 00:46:29,640 OF FOLLOW UP, BUT THERE ARE SOME 1108 00:46:29,640 --> 00:46:33,520 THINGS THAT YOU CANNOT DO AND 1109 00:46:33,520 --> 00:46:35,520 SO, AFTER THAT INITIAL SURGE, 1110 00:46:35,520 --> 00:46:36,920 THINGS DROPPED OFF A LITTLE BIT 1111 00:46:36,920 --> 00:46:42,920 BUT WE'RE STILL VERY MUCH IN THE 1112 00:46:42,920 --> 00:46:44,200 800-THOUSAND VISITS A MONTH 1113 00:46:44,200 --> 00:46:47,800 TELEHEALTH WORLD AND IT'S BEEN 1114 00:46:47,800 --> 00:46:51,200 VERY IMPORTANT TO US DURING THE 1115 00:46:51,200 --> 00:46:52,800 PANDEMIC. 1116 00:46:52,800 --> 00:46:53,200 NEXT SLIDE. 1117 00:46:53,200 --> 00:46:54,600 YOU'RE GOING TO HEAR A LOT FROM 1118 00:46:54,600 --> 00:46:56,240 CLIFF LANE A LITTLE BIT WHO WILL 1119 00:46:56,240 --> 00:46:59,360 TALK AND GIVE THE COVID-19 1120 00:46:59,360 --> 00:47:07,800 UPDATE, WE REMAIN AND OUR BASIC 1121 00:47:07,800 --> 00:47:11,360 POSTURE DURING THE PANDEMIC. 1122 00:47:11,360 --> 00:47:12,720 WE HAVE A HIGH PERCENT OF 1123 00:47:12,720 --> 00:47:15,200 PATIENT WHO IS ARE IMMUNO 1124 00:47:15,200 --> 00:47:15,800 SUPPRESSED AND IMMUNO 1125 00:47:15,800 --> 00:47:16,960 COMPROMISED AND WE HAVE A NUMBER 1126 00:47:16,960 --> 00:47:18,800 COME TO US THAT WAY BECAUSE OF 1127 00:47:18,800 --> 00:47:19,800 THEIR DISEASE AND WE HAVE A 1128 00:47:19,800 --> 00:47:24,000 NUMBER OF THEM THAT WAY BECAUSE 1129 00:47:24,000 --> 00:47:25,160 OF THE TREATMENTS WE RECEIVE 1130 00:47:25,160 --> 00:47:26,680 HERE IN THE CLINICAL CENTER. 1131 00:47:26,680 --> 00:47:30,600 AND SO, WE ARE ALWAYS--WE HAVE A 1132 00:47:30,600 --> 00:47:34,400 VERY HIGH FOCUS ON INFECTION, 1133 00:47:34,400 --> 00:47:35,800 CONTROL AND PREVENTION OF THE 1134 00:47:35,800 --> 00:47:50,160 SPREAD OF INFECTION FROM STAFF 1135 00:47:50,160 --> 00:47:51,760 TO PATIENT--COMMUNITY AND WE'RE 1136 00:47:51,760 --> 00:47:55,840 BEGINNING TO PEEL BACK ON THOSE 1137 00:47:55,840 --> 00:47:59,000 A LITTLE BIT NOW AND WE'RE DOING 1138 00:47:59,000 --> 00:48:01,200 THAT NOT BECAUSE WE THINK THE 1139 00:48:01,200 --> 00:48:02,280 PANDEMIC IS OVER, BUT BECAUSE WE 1140 00:48:02,280 --> 00:48:05,400 THINK FOR THE LAST 2 YEARS WE 1141 00:48:05,400 --> 00:48:06,920 DEMONSTRATED THAT WE CAN TAKE 1142 00:48:06,920 --> 00:48:08,360 CARE OF PATIENTS SAFELY DURING 1143 00:48:08,360 --> 00:48:10,000 THIS PANDEMIC AS LONG AS WE PAY 1144 00:48:10,000 --> 00:48:17,520 ATTENTION TO SOME FAIRLY BASIC 1145 00:48:17,520 --> 00:48:18,040 TENANTS. 1146 00:48:18,040 --> 00:48:20,400 SINCE 2 APRIL SO EXACTLY 2 YEARS 1147 00:48:20,400 --> 00:48:24,200 WE'VE ALL BEEN MASKED, EVEN WHEN 1148 00:48:24,200 --> 00:48:31,080 OTHERS BEGAN UNMASKING, WE KEPT 1149 00:48:31,080 --> 00:48:32,720 OURS ON AND WE'VE--WE STILL GIVE 1150 00:48:32,720 --> 00:48:34,080 YOU A CLEAN MASK WHEN YOU COME 1151 00:48:34,080 --> 00:48:34,560 IN THE HOSPITAL. 1152 00:48:34,560 --> 00:48:36,520 IT'S BEEN A LONG TIME SINCE 1153 00:48:36,520 --> 00:48:40,560 WE'VE--AND WE HAVE MAINTAINED 1154 00:48:40,560 --> 00:48:41,840 VERY DETAILED CAREFUL CONTACT 1155 00:48:41,840 --> 00:48:44,520 TRACING THROUGHOUT THE PANDEMIC. 1156 00:48:44,520 --> 00:48:47,240 BOTH TARA P A LMORE WHO IS OUR 1157 00:48:47,240 --> 00:48:48,640 CHIEF OF HOSPITAL EPIDEMIOLOGY 1158 00:48:48,640 --> 00:48:50,040 AND BROOK BECKER WHO IS 1159 00:48:50,040 --> 00:48:51,480 CURRENTLY OUR CHIEF OF HOSPITAL 1160 00:48:51,480 --> 00:48:53,600 EPIDEMIOLOGY AND THEIR STAFFS, 1161 00:48:53,600 --> 00:48:55,680 THEY HAVE DONE VERY METICULOUS 1162 00:48:55,680 --> 00:48:58,360 CONTRACT TRACING WITH THE 1163 00:48:58,360 --> 00:48:59,000 OCCUPATIONAL MEDICINE SERVICE 1164 00:48:59,000 --> 00:49:01,720 AND IT'S BEEN ALMOST 2 YEARS 1165 00:49:01,720 --> 00:49:02,760 SINCE WE'VE DOCUMENTED OUR 1166 00:49:02,760 --> 00:49:03,440 PATIENT TO STAFF TRANSMISSION 1167 00:49:03,440 --> 00:49:06,680 AND WE HAVE YET TO DOCUMENT A 1168 00:49:06,680 --> 00:49:08,720 SINGLE STAFF TO PATIENT 1169 00:49:08,720 --> 00:49:09,080 TRANSMISSION. 1170 00:49:09,080 --> 00:49:13,040 IT'S A TRACK RECORD, WE'RE VERY 1171 00:49:13,040 --> 00:49:15,240 PROUD OF BUT WE--IT'S ONLY 1172 00:49:15,240 --> 00:49:16,400 THROUGH THE DEDICATION OF THE 1173 00:49:16,400 --> 00:49:18,280 STAFF AND THEIR WILLINGNESS TO 1174 00:49:18,280 --> 00:49:21,480 PUT UP WITH ALL OF THE EXTRA 1175 00:49:21,480 --> 00:49:25,480 EFFORT INVOLVED IN TRYING TO 1176 00:49:25,480 --> 00:49:26,080 MAINTAIN THAT RECORD. 1177 00:49:26,080 --> 00:49:29,080 BUT NOW, WE ARE THE NIH AND IN 1178 00:49:29,080 --> 00:49:31,600 ORDER TO PROVE PATIENT TO STAFF 1179 00:49:31,600 --> 00:49:33,360 TRANSMISSION, IT REQUIRES 1180 00:49:33,360 --> 00:49:34,200 GENOMIC ANALYSIS TO INDICATE 1181 00:49:34,200 --> 00:49:36,800 THAT WE ARE DEALING WITH, YOU 1182 00:49:36,800 --> 00:49:38,960 KNOW THE SAME VIRUS. 1183 00:49:38,960 --> 00:49:40,280 BUT STILL, WE THINK OUR TRACK 1184 00:49:40,280 --> 00:49:42,080 RECORD IS PRETTY GOOD AND IT'S 1185 00:49:42,080 --> 00:49:43,400 BECAUSE THE STAFF HAVE BEEN 1186 00:49:43,400 --> 00:49:44,800 WILLING TO DEAL WITH ALL OF 1187 00:49:44,800 --> 00:49:47,120 THESE ISSUES AND PERIODICALLY, 1188 00:49:47,120 --> 00:49:49,440 WE HAVE LAPSES BUT, FOR THE MOST 1189 00:49:49,440 --> 00:49:52,560 PART, EVERYBODY'S BEEN VERY 1190 00:49:52,560 --> 00:49:55,200 COOPERATIVE. 1191 00:49:55,200 --> 00:49:55,920 NEXT SLIDE. 1192 00:49:55,920 --> 00:49:58,000 >> THESE ARE JUST SOME NUMBERS, 1193 00:49:58,000 --> 00:50:00,360 THE SCREENING WE'RE RAPIDLY 1194 00:50:00,360 --> 00:50:01,240 APPROACHING 3 MILLION PERSONS 1195 00:50:01,240 --> 00:50:06,440 WHO HAVE COME THROUGH THE DOOR 1196 00:50:06,440 --> 00:50:10,040 AND ASYMPTOMATIC TESTING AND 1197 00:50:10,040 --> 00:50:13,800 DURING THE OMICRON, THE DAYS OF 1198 00:50:13,800 --> 00:50:16,160 OMICRON, MAYBE 1 OUT OF 20 THAT 1199 00:50:16,160 --> 00:50:18,680 WE WERE TESTING WERE EITHER 1200 00:50:18,680 --> 00:50:20,320 ASYMPTOMATIC SITE WERE TESTING 1201 00:50:20,320 --> 00:50:21,600 POSITIVE, WE'RE NOW DOWN TO 1202 00:50:21,600 --> 00:50:27,800 ABOUT 1 OUT OF 700 OR 1 OUT OF A 1203 00:50:27,800 --> 00:50:28,040 THOUSAND. 1204 00:50:28,040 --> 00:50:28,400 NNEXT SLIDE. 1205 00:50:28,400 --> 00:50:29,400 AND THESE ARE STILL THE THINGS 1206 00:50:29,400 --> 00:50:36,800 WE DO AND WE EMPHASIZE REGULARLY 1207 00:50:36,800 --> 00:50:38,080 AND WE I WOULD SAY THE FACE 1208 00:50:38,080 --> 00:50:40,400 SHIELDS AND THE GOGGLES ARE THE 1209 00:50:40,400 --> 00:50:43,160 THING WE HAVE TO REMIND FOLKS 1210 00:50:43,160 --> 00:50:44,520 ABOUT THE MOST OFTEN. 1211 00:50:44,520 --> 00:50:44,800 NEXT SLIDE. 1212 00:50:44,800 --> 00:50:48,400 AS ALL OF YOU ARE AWARE, THIS 1213 00:50:48,400 --> 00:50:49,800 IS--THIS IS AN ISSUE FOR ALL OF 1214 00:50:49,800 --> 00:50:53,600 US AND IT'S AN ISSUE, IT'S A 1215 00:50:53,600 --> 00:50:54,640 NATIONAL ISSUE. 1216 00:50:54,640 --> 00:50:57,920 IT'S NOT LIMITED TO US IN 1217 00:50:57,920 --> 00:50:59,400 HEALTHCARE BUT IT'S A REALLY 1218 00:50:59,400 --> 00:51:01,320 IMPORTANT ISSUE TO THE NIH, IT'S 1219 00:51:01,320 --> 00:51:03,720 REALLY IMPORTANT ISSUE TO THE 1220 00:51:03,720 --> 00:51:07,920 CLINICAL CENTER AND SO, WE HAVE 1221 00:51:07,920 --> 00:51:09,880 LAUNCHED A COMPREHENSIVE 1222 00:51:09,880 --> 00:51:11,240 DIVERSITY EQUITY INCLUSION AND 1223 00:51:11,240 --> 00:51:13,760 ACCESSIBILITY PROGRAM WITH AN 1224 00:51:13,760 --> 00:51:16,160 ANOWNTMENT IN JANUARY. 1225 00:51:16,160 --> 00:51:18,600 WE HAVE--WE LOG OUR ACTIVITYS ON 1226 00:51:18,600 --> 00:51:22,600 A SPECIAL WEBPAGE AND WE HAVE 1227 00:51:22,600 --> 00:51:24,000 FORMED AN ADVISORY COMMITTEE 1228 00:51:24,000 --> 00:51:28,520 THAT REPORTS DIRECTLY TO ME ON 1229 00:51:28,520 --> 00:51:32,160 THESE ISSUES. 1230 00:51:32,160 --> 00:51:33,200 NEXT SLIDE. 1231 00:51:33,200 --> 00:51:34,720 WE POSTED A VIDEO THAT INCLUDED 1232 00:51:34,720 --> 00:51:37,040 A NUMBER OF OUR STAFF AND WE 1233 00:51:37,040 --> 00:51:41,360 HAVE SET ASIDE RESOURCES TO 1234 00:51:41,360 --> 00:51:43,520 SUPPORT THESE EFFORTS. 1235 00:51:43,520 --> 00:51:46,600 WE HAVE DONE SOME--HAVE REGULAR 1236 00:51:46,600 --> 00:51:51,040 ASSESSMENTS OF OUR CLINICAL 1237 00:51:51,040 --> 00:51:51,760 CENTER WORKFORCE DEMOGRAPHICS 1238 00:51:51,760 --> 00:51:53,080 AND IN ADDITION WE HAVE 1239 00:51:53,080 --> 00:51:55,200 COMPLETED A SURVEY THAT ABOUT A 1240 00:51:55,200 --> 00:51:56,560 THIRD OF THE CLINICAL CENTER 1241 00:51:56,560 --> 00:51:57,800 STAFF RESPONDED TO THAT WE HAVE 1242 00:51:57,800 --> 00:51:59,800 SEEN THE RESULTS OF AND WE KNOW 1243 00:51:59,800 --> 00:52:00,880 IT CLEARLY INDICATES THAT 1244 00:52:00,880 --> 00:52:04,600 THERE'S SOME AREAS WE NEED TO 1245 00:52:04,600 --> 00:52:05,200 WORK ON. 1246 00:52:05,200 --> 00:52:06,640 AND THAT SURVEY IS BEING 1247 00:52:06,640 --> 00:52:08,080 FOLLOWED UP WITH FOCUS GROUPS OR 1248 00:52:08,080 --> 00:52:10,480 WHAT I THINK IS HAS BEEN TERMED 1249 00:52:10,480 --> 00:52:15,200 LISTENING SESSIONS TO TRY TO 1250 00:52:15,200 --> 00:52:17,600 GAIN MORE INSIGHTS INTO 1251 00:52:17,600 --> 00:52:21,880 PERCEPTIONS AND AS WELL AS 1252 00:52:21,880 --> 00:52:26,400 REALITY AND WHAT IS BEHIND THEM. 1253 00:52:26,400 --> 00:52:28,080 TODAY IS 1 APRIL AND TODAY WAS 1254 00:52:28,080 --> 00:52:32,120 OUR DAY TO TURN IN OUR INITIAL 1255 00:52:32,120 --> 00:52:39,440 EFFORT AT NIH RACIAL AND ETHNIC 1256 00:52:39,440 --> 00:52:41,440 EQUITY PLAN OR REEP AND I'VE 1257 00:52:41,440 --> 00:52:42,200 BEEN WORKING DALE WEB CONNECTED 1258 00:52:42,200 --> 00:52:43,200 THE GROUP FROM THE CLINICAL 1259 00:52:43,200 --> 00:52:44,640 CENTER OVER THE COURSE OF THE 1260 00:52:44,640 --> 00:52:47,520 LAST 2 WEEKS TO GET THAT INTO 1261 00:52:47,520 --> 00:53:00,720 FINAL FORM AND WE'RE PRETTY 1262 00:53:00,720 --> 00:53:01,520 HAPPY--PLAN SO FAR. 1263 00:53:01,520 --> 00:53:02,720 IT'S A LIVING DOCUMENT. 1264 00:53:02,720 --> 00:53:03,520 WE'RE CERTAINLY NOT DONE. 1265 00:53:03,520 --> 00:53:05,040 IF WE DO EVERYTHING THAT WAS IN 1266 00:53:05,040 --> 00:53:06,480 THE PLAN, WE STILL WOULDN'T BE 1267 00:53:06,480 --> 00:53:09,240 DONE, THERE WILL BE MORE 1268 00:53:09,240 --> 00:53:10,120 INITIATIVES ADDED OVER TIME BUT 1269 00:53:10,120 --> 00:53:14,080 THIS WAS TURNED IN, ACTUALLY 1270 00:53:14,080 --> 00:53:16,360 IT'S DR. SCHWETZ, AND DR. TABAK 1271 00:53:16,360 --> 00:53:20,000 WHO ARE THE ARBITERS OF WHETHER 1272 00:53:20,000 --> 00:53:21,120 OUR PLAN MEETS THE MARK. 1273 00:53:21,120 --> 00:53:24,400 AND WE LOOK FORWARD TO THEIR 1274 00:53:24,400 --> 00:53:26,360 FEEDBACK AND I'M SURE THEY'LL 1275 00:53:26,360 --> 00:53:28,080 HAVE SOME AND WILL NEED TO GO 1276 00:53:28,080 --> 00:53:29,840 BACK AND MAKE SOME CHANGES. 1277 00:53:29,840 --> 00:53:31,760 AND WE'RE ALREADY RECEIVING SOME 1278 00:53:31,760 --> 00:53:32,960 FEEDBACK FROM OUR STAFF, BUT IN 1279 00:53:32,960 --> 00:53:35,000 GENERAL MOST OF THE FEEDBACK'S 1280 00:53:35,000 --> 00:53:38,840 BEEN PRETTY GOOD. 1281 00:53:38,840 --> 00:53:39,640 NEXT SLIDE. 1282 00:53:39,640 --> 00:53:41,000 WE HAD BLACK HISTORY MONTH LAST 1283 00:53:41,000 --> 00:53:44,640 MONTH AND THIS IS--WE JUST 1284 00:53:44,640 --> 00:53:46,160 FINISHED WOMEN'S HISTORY MONTH 1285 00:53:46,160 --> 00:53:47,480 AND THESE MONTHS, I THINK WE ARE 1286 00:53:47,480 --> 00:53:54,120 DOING A BETTER JOB OF 1287 00:53:54,120 --> 00:53:55,320 ACKNOWLEDGING AND RECOGNIZING AS 1288 00:53:55,320 --> 00:53:56,560 PART OF OUR OVERALL EFFORT, THIS 1289 00:53:56,560 --> 00:54:00,480 IS THE STUFF THAT'S EASY TO DO 1290 00:54:00,480 --> 00:54:03,520 WITH OUR RACIAL AND ETHNIC 1291 00:54:03,520 --> 00:54:04,240 EQUITY PLAN. 1292 00:54:04,240 --> 00:54:06,160 WE REALLY TRY TO GET TO THE 1293 00:54:06,160 --> 00:54:07,360 SUBSTANCE OF WHAT THE ISSUES 1294 00:54:07,360 --> 00:54:09,920 ARE, WE DID NOT LOOK FOR LOW 1295 00:54:09,920 --> 00:54:11,480 HANGING FRUIT. 1296 00:54:11,480 --> 00:54:14,400 WE TACKLED--WE DID A CAREFUL GAP 1297 00:54:14,400 --> 00:54:16,840 ANALYSIS WHERE THE BIGGEST 1298 00:54:16,840 --> 00:54:18,880 PROBLEMS WERE AND WE DESIGNED 1299 00:54:18,880 --> 00:54:22,600 INITIATIVES TO ADDRESS THE GAPS, 1300 00:54:22,600 --> 00:54:25,360 NOT JUST LOOK AT ACTIVITIES THAT 1301 00:54:25,360 --> 00:54:26,600 WOULD BE NONCONTROVERSIAL AND 1302 00:54:26,600 --> 00:54:30,000 EASY TO DO. 1303 00:54:30,000 --> 00:54:32,200 NEXT SLIDE. 1304 00:54:32,200 --> 00:54:33,720 FOR THE--THIS IS ESPECIALLY FOR 1305 00:54:33,720 --> 00:54:39,280 THE NEWER MEMBERS OF THE BOARD 1306 00:54:39,280 --> 00:54:40,960 BUT IN TWEBT 19 WE PUBLISHED 1307 00:54:40,960 --> 00:54:41,920 THIS DOCUMENT CALLED THE 1308 00:54:41,920 --> 00:54:44,400 STRATEGIC PLAN WHICH WAS THE NIH 1309 00:54:44,400 --> 00:54:46,640 CLINICAL CENTER AT 65 YEARS OF 1310 00:54:46,640 --> 00:54:47,120 EXISTENCE. 1311 00:54:47,120 --> 00:54:48,400 PEOPLE, PLACES, CAPABILITIES, IT 1312 00:54:48,400 --> 00:54:52,520 WILL BE THE FOCAL POINT FOR OUR 1313 00:54:52,520 --> 00:54:53,880 JULY PRESENTATIONS TO THE 1314 00:54:53,880 --> 00:54:56,280 CLINICAL CENTER RESEARCH 1315 00:54:56,280 --> 00:54:56,840 HOSPITAL BOARD. 1316 00:54:56,840 --> 00:54:58,920 AND I THINK IT WILL BE A GREAT 1317 00:54:58,920 --> 00:55:03,440 WAY FOR THE NEWER MEMBERS TO 1318 00:55:03,440 --> 00:55:05,000 FIND OUT WHAT WE'VE BEEN DOING 1319 00:55:05,000 --> 00:55:06,840 EVEN DURING THE PANDEMIC TO TRY 1320 00:55:06,840 --> 00:55:09,400 TO GET AT THE STRATEGIC ISSUES 1321 00:55:09,400 --> 00:55:12,600 AND AS WELL AS SOLICIT YOUR 1322 00:55:12,600 --> 00:55:16,880 THOUGHTS ON WHAT THE NEXT 1323 00:55:16,880 --> 00:55:18,280 DOCUMENT THAT'S GENERATED FOR 1324 00:55:18,280 --> 00:55:20,680 THE STRATEGIC DIRECTION SHOULD 1325 00:55:20,680 --> 00:55:31,200 LOOK LIKE. 1326 00:55:31,200 --> 00:55:31,760 NEXT SLIDE. 1327 00:55:31,760 --> 00:55:33,760 OKAY, THIS IS FOR TODAY'S AGENDA 1328 00:55:33,760 --> 00:55:35,240 AND WE'RE PRETTY MUCH ON TIME 1329 00:55:35,240 --> 00:55:35,920 WHICH GOOD. 1330 00:55:35,920 --> 00:55:38,800 THE NEXT PRESENTATION WILL BE 1331 00:55:38,800 --> 00:55:40,560 DAVID LANG CHIEF OF OFFICE 1332 00:55:40,560 --> 00:55:41,960 PATIENT SAFETY AND CLINICAL 1333 00:55:41,960 --> 00:55:43,520 QUALITY, AND DAVID WILL GIVE AN 1334 00:55:43,520 --> 00:55:44,960 UPDATE ON THE CLINICAL METRICS. 1335 00:55:44,960 --> 00:55:47,120 THESE ARE ALSO POSTED ON THE 1336 00:55:47,120 --> 00:55:48,200 CLINICAL CENTER WEBSITE. 1337 00:55:48,200 --> 00:55:50,080 AFTER DAVID PRESENTED LAST TIME, 1338 00:55:50,080 --> 00:55:51,960 HE'S PRESENTING THIS TIME, FOR 1339 00:55:51,960 --> 00:55:53,920 THE JULY MEETING, THE CHANCES 1340 00:55:53,920 --> 00:55:55,440 ARE THAT THESE WILL BE PROVIDED 1341 00:55:55,440 --> 00:55:57,400 TO YOU IN A PRESENTATION, BUT 1342 00:55:57,400 --> 00:56:00,800 MAY BE NOT ON THE AGENDA. 1343 00:56:00,800 --> 00:56:02,520 THIS HAS BEEN A ROUTINE 1344 00:56:02,520 --> 00:56:04,920 PRESENTATION AT JUST ABOUT EVERY 1345 00:56:04,920 --> 00:56:05,680 CLINICAL CENTER RESEARCH 1346 00:56:05,680 --> 00:56:06,040 HOSPITAL BOARD. 1347 00:56:06,040 --> 00:56:12,200 AND THEN WE WILL HAVE A 1348 00:56:12,200 --> 00:56:12,800 PRESENTATIONOT COVID-19 UPDATE. 1349 00:56:12,800 --> 00:56:13,760 I KEEP THINKING THIS SHOULD BE 1350 00:56:13,760 --> 00:56:16,920 THE LAST 1 OF THOSE, BUT YOU 1351 00:56:16,920 --> 00:56:17,560 NEVER KNOW. 1352 00:56:17,560 --> 00:56:21,480 WE'RE VERY GRATEFUL IN THE 1353 00:56:21,480 --> 00:56:23,000 CLINICAL CENTER TO HAVE 1354 00:56:23,000 --> 00:56:25,960 DR. CLIFF LANE WHO IS THE 1355 00:56:25,960 --> 00:56:27,520 CLINICAL DIRECTOR FOR NIAID WHO 1356 00:56:27,520 --> 00:56:32,800 WILL PROVIDE THAT FOR US. 1357 00:56:32,800 --> 00:56:41,080 AFTER DISCUSSION REGARDING THAT 1358 00:56:41,080 --> 00:56:42,200 PRESENTATION, MARILYN FARINRE HO 1359 00:56:42,200 --> 00:56:44,200 IS THE CHIEF OF PHARMACY FROM 1360 00:56:44,200 --> 00:56:45,640 THE PHARMAC SKPE BAKUGAN WE ARE 1361 00:56:45,640 --> 00:56:46,960 WITHIN THE PROCESS, WE ARE 1362 00:56:46,960 --> 00:56:48,720 WITHIN WEEKS OF MOVING BACK INTO 1363 00:56:48,720 --> 00:56:49,960 THE PERMANENT HOME OF THE 1364 00:56:49,960 --> 00:56:51,480 PHARMACY AND FOR THOSE OF YOU 1365 00:56:51,480 --> 00:56:57,960 THAT HAVE BEEN HERE FOR 5 OR 6 1366 00:56:57,960 --> 00:56:59,680 YEARS YOU WILL KNOW IT'S JUST 1367 00:56:59,680 --> 00:57:02,120 ABOUT HOW THE RED TEAM STARTED 1368 00:57:02,120 --> 00:57:03,320 BUT IT WASN'T JUST ABOUT THE 1369 00:57:03,320 --> 00:57:04,840 PHARMACY BUT IT WAS ABOUT THE 1370 00:57:04,840 --> 00:57:06,400 PHARMACY SO WITH THE MOVE BACK 1371 00:57:06,400 --> 00:57:08,760 WE BEGIN THE PROCESS OF REALLY 1372 00:57:08,760 --> 00:57:10,880 HAVING PHARMACY FACILITIES AND 1373 00:57:10,880 --> 00:57:13,960 PHARMACY OPERATIONS THAT THE 1374 00:57:13,960 --> 00:57:17,280 CLINICAL CENTER REALLY NEEDED. 1375 00:57:17,280 --> 00:57:19,400 THIS HAS BEEN--THIS HAS REALLY 1376 00:57:19,400 --> 00:57:21,360 BEEN--IF YOU COUNT THE PLANNING, 1377 00:57:21,360 --> 00:57:23,560 IT'S BEEN 7 YEARS IN THE 1378 00:57:23,560 --> 00:57:27,920 PLANNING, THE PHARMACY STAFF HAS 1379 00:57:27,920 --> 00:57:30,360 BEEN OPERATING OUT AT SWING 1380 00:57:30,360 --> 00:57:32,400 SPACE AND DOING A GREAT JOB OVER 1381 00:57:32,400 --> 00:57:33,840 THE COURSE OF THE LAST 3 OR 4 1382 00:57:33,840 --> 00:57:38,360 YEARS AND THEY'RE LOOKING 1383 00:57:38,360 --> 00:57:41,200 FORWARD TO GETTING BACK IN 1 1384 00:57:41,200 --> 00:57:41,840 LOCATION SO MARILYN WILL 1385 00:57:41,840 --> 00:57:46,120 DESCRIBE THAT FOR YOU. 1386 00:57:46,120 --> 00:57:49,280 AFTER THE BREAK, THEN DAN 1387 00:57:49,280 --> 00:57:51,880 WHEELAND WILL UPDATE YOU ON 1388 00:57:51,880 --> 00:57:53,280 IMPORTANT CLINICAL CENTERS 1389 00:57:53,280 --> 00:57:53,880 FACILITIES PROJECTS AND THEEN 1390 00:57:53,880 --> 00:57:56,920 WILL VERMEN INFECTED A 1391 00:57:56,920 --> 00:58:00,080 RERESEARCH PRESENTATION BY 1392 00:58:00,080 --> 00:58:01,800 DR. MARSTON LINEHAN KOOH IS THE 1393 00:58:01,800 --> 00:58:04,480 CHIEF OF THE UROLOGIC SURMINGRY 1394 00:58:04,480 --> 00:58:06,520 AND THE UROLOGIC ONCOLOGY 1395 00:58:06,520 --> 00:58:16,520 BRANCH, CENTER FOR CANCER 1396 00:58:16,520 --> 00:58:16,920 RESEARCH, NCI. 1397 00:58:16,920 --> 00:58:18,200 AND OVER A PERIOD OF YEARS WAS 1398 00:58:18,200 --> 00:58:19,960 THE LARGEST IN THE CLINICAL 1399 00:58:19,960 --> 00:58:23,800 CENTER AND HIS PRESENTATION 1400 00:58:23,800 --> 00:58:26,840 ILLUSTRATES WHAT THE CLINICAL 1401 00:58:26,840 --> 00:58:31,040 CENTER CAN DO WITH THE ABILITY 1402 00:58:31,040 --> 00:58:34,640 TO SUSTAIN THESE PROGRAMS OVER 1403 00:58:34,640 --> 00:58:36,400 LONG PERIOD OF TIME AND BRING 1404 00:58:36,400 --> 00:58:41,880 PATIENTS IN WITHOUT HAVING TO 1405 00:58:41,880 --> 00:58:43,200 WORRY ABOUT WHETHER THEIR 1406 00:58:43,200 --> 00:58:45,160 INSURANCE WILL HELP PAY THE 1407 00:58:45,160 --> 00:58:45,360 BILLS. 1408 00:58:45,360 --> 00:58:47,520 SO THAT'S WHAT WE HAVE BY THE 1409 00:58:47,520 --> 00:58:48,680 WAY FOR AGENDA TODAY. 1410 00:58:48,680 --> 00:58:55,480 SO LAURA I WILL NOW OPEN FOR 1411 00:58:55,480 --> 00:58:59,080 QUESTIONS AND/OR COMMENTS. 1412 00:58:59,080 --> 00:58:59,440 >> PERFECT. 1413 00:58:59,440 --> 00:59:00,040 THANK YOU JIM. 1414 00:59:00,040 --> 00:59:09,280 LET'S TAKE THE SLIDES DOWN IF WE 1415 00:59:09,280 --> 00:59:09,840 COULD. 1416 00:59:09,840 --> 00:59:12,480 LET ME SEE IF ANYBODY HAS A 1417 00:59:12,480 --> 00:59:16,960 QUESTION FOR JIM, I THINK IT 1418 00:59:16,960 --> 00:59:19,640 WILL BECOME OBVIOUSLY OVERTIME 1419 00:59:19,640 --> 00:59:22,160 AND I SEE JOHN GALLEN JOINED US, 1420 00:59:22,160 --> 00:59:26,480 GOOD TO SEE YOU AS ALWAYS. 1421 00:59:26,480 --> 00:59:28,720 ANTOINETTE, I SEE YOUR HAND IS 1422 00:59:28,720 --> 00:59:29,080 UP. 1423 00:59:29,080 --> 00:59:30,600 >> DR. GILMAN, I THINK YOU MAY 1424 00:59:30,600 --> 00:59:31,400 HAVE ALREADY ANSWERED THE 1425 00:59:31,400 --> 00:59:35,600 QUESTION BUT YOU MENTION TD ON 1426 00:59:35,600 --> 00:59:37,400 FACEBOOK THAT THAT'S ANOTHER 1427 00:59:37,400 --> 00:59:39,600 MEDIUM WHEREBY WE'RE TRYING TO 1428 00:59:39,600 --> 00:59:41,080 RECRUIT MORE PATIENTS. 1429 00:59:41,080 --> 00:59:44,800 AND ON THERE, I THOUGHT IT SAID 1430 00:59:44,800 --> 00:59:45,560 REMOTE CLINICAL STUDY? 1431 00:59:45,560 --> 00:59:51,800 WHAT EXACTLY IS THAT AGAIN? 1432 00:59:51,800 --> 00:59:52,120 AND--AHEAD. 1433 00:59:52,120 --> 00:59:56,800 >> SO REMOTE CLINICAL STUDIES 1434 00:59:56,800 --> 00:59:58,400 COULD VOLVE STUDIES WHERE THE 1435 00:59:58,400 --> 00:59:59,880 PATIENTS DON'T EACH HAVE TO COME 1436 00:59:59,880 --> 01:00:00,400 TO THE HOSPITAL. 1437 01:00:00,400 --> 01:00:02,680 >> SO WHAT IF THEY NEED BLOOD 1438 01:00:02,680 --> 01:00:05,080 WORK OR ULTRA SOUND OR JUST 1439 01:00:05,080 --> 01:00:06,400 STUDIES THAT DON'T REQUIRE BLOOD 1440 01:00:06,400 --> 01:00:06,600 WORK. 1441 01:00:06,600 --> 01:00:08,720 >> YEAH, SO IT COULD BE SURVEY 1442 01:00:08,720 --> 01:00:10,640 INFORMATION, OKAY AND YOU KNOW 1443 01:00:10,640 --> 01:00:20,000 THERE IS THE ABILITY TO HAVE OR 1444 01:00:20,000 --> 01:00:22,000 THE ABILITY FOR SOME STUDIES FOR 1445 01:00:22,000 --> 01:00:24,960 PATIENTS WHO NEED TO HAVE LAB 1446 01:00:24,960 --> 01:00:26,600 WORK GO TO LABCORP OR ANOTHER 1447 01:00:26,600 --> 01:00:28,000 COMMERCIAL PROVIDER AND HAVE 1448 01:00:28,000 --> 01:00:28,480 THEIR BLOOD DRAWN. 1449 01:00:28,480 --> 01:00:33,680 AGAIN, THIS IS NOT JUST AT THE 1450 01:00:33,680 --> 01:00:36,520 CLINICAL CENTER, THIS IS 1451 01:00:36,520 --> 01:00:39,200 BECOMING A THING AT LOTS OF 1452 01:00:39,200 --> 01:00:41,600 PLACES TO HAVE THE ABILITY TO DO 1453 01:00:41,600 --> 01:00:43,240 STUDIES OF THIS KIND AND AGAIN, 1454 01:00:43,240 --> 01:00:45,680 YOU HAVE TO HAVE THE RIGHT 1455 01:00:45,680 --> 01:00:47,080 DOCUMENTATION, YOU HAVE TO--I 1456 01:00:47,080 --> 01:00:49,080 MEAN, THEY HAVE TO MEET 1457 01:00:49,080 --> 01:00:51,200 INCLUSION CRITERIA, THEY HAVE BE 1458 01:00:51,200 --> 01:00:51,640 CAREFULLY SCREENED. 1459 01:00:51,640 --> 01:00:53,840 THEY HAVE TO FILL OUT AN 1460 01:00:53,840 --> 01:00:59,240 ELECTRONIC CONSENT, BUT THIS IS 1461 01:00:59,240 --> 01:01:00,520 STUDIES PATIENTS AND THEIR 1462 01:01:00,520 --> 01:01:09,000 ENVIRONMENT RATHER THAN OUR 1463 01:01:09,000 --> 01:01:09,280 ENVIRONMENT. 1464 01:01:09,280 --> 01:01:09,840 >> ALL RIGHT. 1465 01:01:09,840 --> 01:01:11,160 THANK YOU. 1466 01:01:11,160 --> 01:01:11,720 >> RICK? 1467 01:01:11,720 --> 01:01:12,000 >> RICK? 1468 01:01:12,000 --> 01:01:15,000 >> JIM, THANKS FOR A TERRIFIC 1469 01:01:15,000 --> 01:01:15,400 UPDATE, 2 COMMENTS. 1470 01:01:15,400 --> 01:01:19,200 AS YOU THINK ABOUT THE DNI ANDA 1471 01:01:19,200 --> 01:01:21,080 WORK, AND LOOKING AT THE 1472 01:01:21,080 --> 01:01:23,320 DEMOGRAPHICS OF THE NIH CLINICAL 1473 01:01:23,320 --> 01:01:26,800 CENTER, I HOPE WE WILL DO THAT 1474 01:01:26,800 --> 01:01:28,680 BY JOB CLASS. 1475 01:01:28,680 --> 01:01:30,560 THE AGGREGATE PICTURE IS 1 THING 1476 01:01:30,560 --> 01:01:32,480 BUT WHAT WE SEE OFTEN IS THAT 1477 01:01:32,480 --> 01:01:35,800 PEOPLE OF COLOR TEND TO BE 1478 01:01:35,800 --> 01:01:38,440 RELEGATED TO THE LOWER RANKS OF 1479 01:01:38,440 --> 01:01:42,080 THE INSTITUTION SO I THINK THAT 1480 01:01:42,080 --> 01:01:44,120 WILL BE HELPFUL AND OBVIOUSLY 1481 01:01:44,120 --> 01:01:45,240 WE'RE ALL KEENLY AWARE OF THE 1482 01:01:45,240 --> 01:01:48,480 GREAT WORK YOU AND JOHN GALLAN 1483 01:01:48,480 --> 01:01:50,320 HAVE DONE IN CREATING PIPELINES 1484 01:01:50,320 --> 01:01:53,200 FOR INVESTIGATORS FROM HBCUs 1485 01:01:53,200 --> 01:01:54,120 AND OTHER ORGANIZATIONS, SO I 1486 01:01:54,120 --> 01:01:56,200 WOULD BE VERY INTERESTED IN 1487 01:01:56,200 --> 01:01:58,560 SEEING HOW THAT WORK TRANSLATES 1488 01:01:58,560 --> 01:02:02,360 INTO THE DEMOGRAPHIC OF CERTAIN 1489 01:02:02,360 --> 01:02:03,120 JOB CLASSES. 1490 01:02:03,120 --> 01:02:04,920 >> YEAH, LET ME MAKE A COUPLE OF 1491 01:02:04,920 --> 01:02:07,240 COMMENTS, FIRST OF ALL WE HAVE 1492 01:02:07,240 --> 01:02:09,440 THAT INFORMATION BY THE KIND OF 1493 01:02:09,440 --> 01:02:11,720 JOB AND THE LEVEL. 1494 01:02:11,720 --> 01:02:14,520 AND THERE IS AN INITIATIVE THAT 1495 01:02:14,520 --> 01:02:15,720 IS FOCUSED SPECIFICALLY ON THE 1496 01:02:15,720 --> 01:02:21,760 ISSUE YOU POINTED OUT THAT IS IT 1497 01:02:21,760 --> 01:02:26,920 ISN'T ENOUGH JUST TO HAVE PEOPLE 1498 01:02:26,920 --> 01:02:31,800 OF COLOR OR HISPANIC STAFF IN 1499 01:02:31,800 --> 01:02:32,800 THE CLINICAL CENTER BUT YOU HAVE 1500 01:02:32,800 --> 01:02:36,800 TO LOOK AT NOT ONLY THE JOB 1501 01:02:36,800 --> 01:02:39,600 SERIES BUT ALSO THE LEVEL. 1502 01:02:39,600 --> 01:02:41,280 AND THAT'S WHERE WE COME UP 1503 01:02:41,280 --> 01:02:42,840 SHORT AND I DON'T THINK THAT 1504 01:02:42,840 --> 01:02:44,360 MAKES US UNIQUE, I THINK THERE 1505 01:02:44,360 --> 01:02:47,320 ARE AN AWFUL LOT OF GROUPS THAT 1506 01:02:47,320 --> 01:02:50,240 ARE LIKE THAT AND SO THERE IS 1 1507 01:02:50,240 --> 01:02:53,760 INITIATIVE WHERE WE ARE TRYING 1508 01:02:53,760 --> 01:02:55,480 TO TO GETTA THAT. 1509 01:02:55,480 --> 01:02:59,240 THAT'S NUMBER 1. 1510 01:02:59,240 --> 01:03:01,440 NUMBER 2 TARA IS IN THE MEETING 1511 01:03:01,440 --> 01:03:02,600 AND SHE'S HEARD LARRY TALK 1512 01:03:02,600 --> 01:03:04,840 ABOUT, YOU KNOW WE CAN'T BE 1513 01:03:04,840 --> 01:03:06,600 SATISFIED WITH PIPELINE INIT 1514 01:03:06,600 --> 01:03:08,000 WHYATIVES. 1515 01:03:08,000 --> 01:03:21,160 WE HAVE TO--PIPELINE INITIATIVES 1516 01:03:21,160 --> 01:03:22,800 ARE FINE--NO MORE THAN 5 OR 6 1517 01:03:22,800 --> 01:03:23,760 INITIATIVES TO BETO BEGIN WITH 1518 01:03:23,760 --> 01:03:24,800 BECAUSE THESE ARE THINGS WE'RE 1519 01:03:24,800 --> 01:03:26,200 REALLY GOING TO DO, THESE ARE 1520 01:03:26,200 --> 01:03:27,840 NOT THINGS WE ARE GOING TO TALK 1521 01:03:27,840 --> 01:03:30,960 ABOUT DOING SO IT WON'T BE A 1522 01:03:30,960 --> 01:03:36,840 BUNCH OF MOTION, WE WILL 1523 01:03:36,840 --> 01:03:38,000 ACTUALLY DO--WE ACTUALLY HAVE 1524 01:03:38,000 --> 01:03:39,120 THE SURPRISING THING TO ME IS WE 1525 01:03:39,120 --> 01:03:41,000 HAVE A LOT OF BASE LINE DATA AS 1526 01:03:41,000 --> 01:03:42,280 YOU KNOW, THE HARDEST PART OF 1527 01:03:42,280 --> 01:03:46,160 TRYING TO MAKE SOMETHING BETTER 1528 01:03:46,160 --> 01:03:46,880 IS BEING PATIENT WHILE YOU 1529 01:03:46,880 --> 01:03:48,000 FIGURE OUT WHAT THE BASE LINE 1530 01:03:48,000 --> 01:03:49,600 IS, BUT IT'S NOT PERFECT DATA, 1531 01:03:49,600 --> 01:03:51,240 IT'S NOT ALL THE DATA WE WOULD 1532 01:03:51,240 --> 01:03:53,280 WANT TO HAVE BUT WE HAVE PRETTY 1533 01:03:53,280 --> 01:03:55,400 GOOD DATA DISP AND WE HAVE DATAS 1534 01:03:55,400 --> 01:04:01,080 ABOUT REALITY AND WE HAVE DATA 1535 01:04:01,080 --> 01:04:08,400 ABOUT PERCEPTIONS AND SO, BUT I 1536 01:04:08,400 --> 01:04:10,320 SAID, LET'S LIMIT THE PIPELINE 1537 01:04:10,320 --> 01:04:11,320 INITTIAIVE ITS TO 1 BECAUSE 1538 01:04:11,320 --> 01:04:12,960 OTHERWISE WE WILL SPEND ALL OF 1539 01:04:12,960 --> 01:04:14,600 OUR TIME TALKING ABOUT THE 1540 01:04:14,600 --> 01:04:16,600 PIPELINE AND I'M NOT SAYING THE 1541 01:04:16,600 --> 01:04:17,920 PIPELINE ISN'T IMPORTANT, I'M 1542 01:04:17,920 --> 01:04:22,520 JUST SAYING, WORKING ON THE 1543 01:04:22,520 --> 01:04:23,360 PIPELINE ISN'T SUFFICIENT AND 1544 01:04:23,360 --> 01:04:25,240 THAT'S WHAT WE'VE DONE AND IT 1545 01:04:25,240 --> 01:04:29,200 DOES FOCUS A LITTLE BIT ON OUR 1546 01:04:29,200 --> 01:04:33,960 RELATIONSHIP HBCUs AND OTHER 1547 01:04:33,960 --> 01:04:34,640 MINORITY SERVING INSTITUTIONS 1548 01:04:34,640 --> 01:04:35,960 AND AMONG OTHER THINGS DOES A 1549 01:04:35,960 --> 01:04:39,040 BETTER JOB OF TRYING TO FIGURE 1550 01:04:39,040 --> 01:04:41,440 OUT WHETHER THAT IS WORKING. 1551 01:04:41,440 --> 01:04:44,320 AND SORT OF THE PROGRAM 1552 01:04:44,320 --> 01:04:45,800 EVALUATION PIECE BY BEING ABLE 1553 01:04:45,800 --> 01:04:48,040 TO TRACK THE CONTACT WE MAKE 1554 01:04:48,040 --> 01:04:53,600 WITH HBCUs AND MINORITY 1555 01:04:53,600 --> 01:04:54,240 SERVING INSTITUTIONS. 1556 01:04:54,240 --> 01:04:56,200 WE SPENT A LOT OF TIME TALKING 1557 01:04:56,200 --> 01:04:58,000 TO STUDENTS AND OTHERS IN THOSE 1558 01:04:58,000 --> 01:05:01,200 INSTITUTIONS BUT WE HAVE NO DATA 1559 01:05:01,200 --> 01:05:03,000 TO SHOW WHETHER THOSE FOLKS 1560 01:05:03,000 --> 01:05:04,360 ACTUALLY APPLY FOR NIH 1561 01:05:04,360 --> 01:05:06,920 OPPORTUNITIES OR ARE ACCEPTED 1562 01:05:06,920 --> 01:05:07,760 FOR NIH OPPORTUNITIES AND WE 1563 01:05:07,760 --> 01:05:11,400 NEED TO FIGURE THAT OUT. 1564 01:05:11,400 --> 01:05:12,040 HEY, CRAIG, THANKS. 1565 01:05:12,040 --> 01:05:14,240 >> LET'S GO TO CRAIG AND THEN 1566 01:05:14,240 --> 01:05:14,440 JOHN. 1567 01:05:14,440 --> 01:05:16,440 >> MORNING JIM AND LAURA, THANKS 1568 01:05:16,440 --> 01:05:20,560 FOR HAVING ME, I HAVE--I HAVE A 1569 01:05:20,560 --> 01:05:22,480 QUESTION ABOUT CENTER OCCUPANCY 1570 01:05:22,480 --> 01:05:23,920 FOR MANY HEALTH SYSTEMS AND 1571 01:05:23,920 --> 01:05:25,000 THERE ARE OTHERS ON THE CALL 1572 01:05:25,000 --> 01:05:30,400 THAT CAN ADDRESS THIS MORE 1573 01:05:30,400 --> 01:05:30,760 SPECIFICALLY. 1574 01:05:30,760 --> 01:05:34,600 WHEN YOU EXTRACT COVID RELATED 1575 01:05:34,600 --> 01:05:36,600 VOLUMES OF ADMISSIONS, IT LOOKS 1576 01:05:36,600 --> 01:05:38,720 LIKE HEALTH SYSTEMS ARE SETTLING 1577 01:05:38,720 --> 01:05:41,960 IN AT OCCUPANCY RATE THAT'S 1578 01:05:41,960 --> 01:05:43,520 LOWER THAN PRECOVID. 1579 01:05:43,520 --> 01:05:44,000 ANYWHERE FROM 10-15%. 1580 01:05:44,000 --> 01:05:46,200 SO HOW ARE YOU THINKING ABOUT 1581 01:05:46,200 --> 01:05:48,280 THAT FROM THE CENTER 1582 01:05:48,280 --> 01:05:48,640 PERSPECTIVE? 1583 01:05:48,640 --> 01:05:52,560 O. R.s ARE CLEARLY BUSY, NEW 1584 01:05:52,560 --> 01:05:55,320 MEMBERSHIP IS UP BUT DO YOU 1585 01:05:55,320 --> 01:05:56,160 PREDICT YOU'RE GOING TO SETTLE 1586 01:05:56,160 --> 01:05:58,800 INTO A NEW NORMAL WHERE 1587 01:05:58,800 --> 01:06:00,200 OCCUPANCY PER PATIENT OR PER 1588 01:06:00,200 --> 01:06:07,000 MEMBER IS LOWER THAN WE SAW 1589 01:06:07,000 --> 01:06:07,520 BEFORE COVID? 1590 01:06:07,520 --> 01:06:11,160 >> WHAT I THINK WILL HAPPEN, 1591 01:06:11,160 --> 01:06:14,720 CRAIG, IS THAT FIRST OF ALL, OUR 1592 01:06:14,720 --> 01:06:17,680 COVID-19 OCCUPANCY NEVER WAS 1593 01:06:17,680 --> 01:06:22,440 THAT OF A COMMUNITY HOSPITAL. 1594 01:06:22,440 --> 01:06:24,680 EVERY COVID PATIENT WAS ON A 1595 01:06:24,680 --> 01:06:26,080 RESEARCH PROTOCOL. 1596 01:06:26,080 --> 01:06:27,360 WE DID TAKE A VERY SMALL NUMBER 1597 01:06:27,360 --> 01:06:28,640 OF PATIENTS FROM THE STATE OF 1598 01:06:28,640 --> 01:06:32,600 MARYLAND WHEN THEY WERE OVERRUN 1599 01:06:32,600 --> 01:06:39,680 ESPECIALLY IN THE DECEMBER TIME 1600 01:06:39,680 --> 01:06:41,200 FRAME OF 2020. 1601 01:06:41,200 --> 01:06:45,400 SO THAT--BUT I THINK OUR 1602 01:06:45,400 --> 01:06:48,000 OCCUPANCY HAS BEEN DOWN BECAUSE 1603 01:06:48,000 --> 01:06:51,440 OF LIMITATIONS ON TRAVEL AND THE 1604 01:06:51,440 --> 01:06:55,800 FACT THAT YOU KNOW 50% OF OUR 1605 01:06:55,800 --> 01:06:59,600 RESEARCH PROTOCOLS ROUGHLY ARE 1606 01:06:59,600 --> 01:07:00,800 NATURAL HISTORY PROTOCOLS. 1607 01:07:00,800 --> 01:07:03,760 THEIR PATH ARE INTERVENTIONAL 1608 01:07:03,760 --> 01:07:05,320 PROTOCOLS, AND HALF ARE NATURAL 1609 01:07:05,320 --> 01:07:06,800 HISTORY PROTOCOLS, SO IF YOU ARE 1610 01:07:06,800 --> 01:07:08,360 ENROLL NOTHING AN NIH STUDY 1611 01:07:08,360 --> 01:07:10,640 WHICH WAS MORE OF A NATURAL 1612 01:07:10,640 --> 01:07:11,960 HISTORY PROTOCOL AND YOU--AND 1613 01:07:11,960 --> 01:07:15,840 YOU HAD TO TRAVEL A LONG WAY 1614 01:07:15,840 --> 01:07:16,760 INCLUDING INTERNATIONALLY, THEN 1615 01:07:16,760 --> 01:07:18,600 MAYBE THAT'S BEST TO PUSH THAT 1616 01:07:18,600 --> 01:07:18,760 OFF. 1617 01:07:18,760 --> 01:07:21,240 SO I THINK WE WILL GET BACK TO 1618 01:07:21,240 --> 01:07:24,320 WHERE WE ARE AS A RESEARCH 1619 01:07:24,320 --> 01:07:26,160 HOSPITAL. 1620 01:07:26,160 --> 01:07:28,320 WE WILL NEVER OCCUPY 80-85% OF 1621 01:07:28,320 --> 01:07:31,880 THE BEDS BECAUSE WE HAVE A 1622 01:07:31,880 --> 01:07:34,400 NUMBER OF SPECIALTY BEDS THAT 1623 01:07:34,400 --> 01:07:39,160 YOU CAN'T--IT'S NOT A GENERAL 1624 01:07:39,160 --> 01:07:40,000 MED SURGE POPULATION, BUT I 1625 01:07:40,000 --> 01:07:42,280 THINK WE WILL GET BACK TO THAT 3 1626 01:07:42,280 --> 01:07:43,400 YEAR AVERAGE OVER THE COURSE OF 1627 01:07:43,400 --> 01:07:51,200 THE NEXT YEAR OR SO GREAT, THANK 1628 01:07:51,200 --> 01:07:51,360 YOU. 1629 01:07:51,360 --> 01:07:51,760 >> THANK YOU. 1630 01:07:51,760 --> 01:07:53,320 >> THANK YOU, I JUST WANTED TO 1631 01:07:53,320 --> 01:07:56,600 EXPAND A LITTLE BIT ON THE 1632 01:07:56,600 --> 01:08:00,800 COMMENT ABOUT DIVERSITY ACROSS 1633 01:08:00,800 --> 01:08:04,800 THE RESEARCH PROGRAMS WE VIEW 1634 01:08:04,800 --> 01:08:06,600 OUR JOB AS MORE DIVERSITY WITHIN 1635 01:08:06,600 --> 01:08:07,640 THE CLINICAL CENTER ACTIVITIES 1636 01:08:07,640 --> 01:08:09,560 BUT REALLY ACROSS THE WHOLE 1637 01:08:09,560 --> 01:08:10,920 INTRAMURAL PROGRAM FOR CLINICAL 1638 01:08:10,920 --> 01:08:13,720 RESEARCH AND THE APPROACH OF 1639 01:08:13,720 --> 01:08:14,640 ESTABLISHING REGIONAL 1640 01:08:14,640 --> 01:08:17,240 PARTNERSHIPS WITH NOW 9 1641 01:08:17,240 --> 01:08:18,400 INSTITUTIONS IS HELPING, 1642 01:08:18,400 --> 01:08:30,240 PARTICULARLY OUR PARTNERSHIP 1643 01:08:30,240 --> 01:08:30,960 WITH HOWARD UNIVERSITY--THE 1644 01:08:30,960 --> 01:08:33,200 HEART LUNG AND BLOOD INSTITUTE, 1645 01:08:33,200 --> 01:08:37,000 THE CHILD HEALTH INSTITUTE AND 1646 01:08:37,000 --> 01:08:38,960 OTHERS AT NIAID HAVE REALLY 1647 01:08:38,960 --> 01:08:41,360 ESTABLISHED NEW PROGRAMS THAT 1648 01:08:41,360 --> 01:08:44,520 ARE BRINGING A WHOLE SPECTRUM OF 1649 01:08:44,520 --> 01:08:48,120 INVESTIGATORS TO THE NIH FROM 1650 01:08:48,120 --> 01:08:50,800 UNDERGRADUATE STUDENTS TO 1651 01:08:50,800 --> 01:08:52,320 MEDICAL STUDENTS TO DENTURED 1652 01:08:52,320 --> 01:08:53,880 TRACKS, ET CETERA AND SO I THINK 1653 01:08:53,880 --> 01:08:58,240 WHEN WE HAVE AN OPPORTUNITY TO 1654 01:08:58,240 --> 01:09:01,280 PRESENT HOW WE'VE DONE, YOU WILL 1655 01:09:01,280 --> 01:09:02,560 BE PLEASED, AT LEAST WE'RE 1656 01:09:02,560 --> 01:09:06,280 PLEASED THAT PROGRESS IS BEING 1657 01:09:06,280 --> 01:09:07,880 MADE THROUGH THESE PARTNERSHIPS 1658 01:09:07,880 --> 01:09:16,080 WITH OTHER INSTITUTIONS. 1659 01:09:16,080 --> 01:09:16,960 >> THANK YOU. 1660 01:09:16,960 --> 01:09:20,000 GOOD TO HEAR AND LOOK FORWARD TO 1661 01:09:20,000 --> 01:09:21,720 HEARING MORE OVER TIME. 1662 01:09:21,720 --> 01:09:22,920 I DON'T SEE ANYONE ELSE WITH A 1663 01:09:22,920 --> 01:09:24,480 HAND UP SO I THINK WE WILL TURN 1664 01:09:24,480 --> 01:09:25,920 IT OVER TO DAVID LANG. 1665 01:09:25,920 --> 01:09:27,840 >> HI, GOOD MORNING, I WILL 1666 01:09:27,840 --> 01:09:34,040 SHARE MY SCREEN REAL QUICK. 1667 01:09:34,040 --> 01:09:40,760 AND OKAY, THAT SHOULD DO IT. 1668 01:09:40,760 --> 01:09:41,160 ALL RIGHT. 1669 01:09:41,160 --> 01:09:46,160 >> ALL RIGHT, SO GOOD MORNING 1670 01:09:46,160 --> 01:09:50,120 EVERYBODY, I AM DAVID LANG, I AM 1671 01:09:50,120 --> 01:09:52,760 THE OFFICE OF PATIENT SAFETY AT 1672 01:09:52,760 --> 01:09:53,600 THE CLINICAL CENTER, I WOULD 1673 01:09:53,600 --> 01:09:54,880 LIKE TO THANK THE COLLEAGUES 1674 01:09:54,880 --> 01:09:56,200 ACROSS THE CLINICAL CENTER WHO 1675 01:09:56,200 --> 01:09:58,080 PROVIDED THIS DATA AND WHO ALSO 1676 01:09:58,080 --> 01:09:59,800 MORE IMPORTANTLY EVERY DAY ARE 1677 01:09:59,800 --> 01:10:02,080 WORKING HARD TO MAKE SURE THAT 1678 01:10:02,080 --> 01:10:06,600 THESE METRICS GO IN THE RIGHT 1679 01:10:06,600 --> 01:10:07,400 DIRECTION. 1680 01:10:07,400 --> 01:10:09,040 AS DR. GILMAN ALLUDED TO EVEN IF 1681 01:10:09,040 --> 01:10:11,840 WE ARE AT OR WHERE WE WANT TO BE 1682 01:10:11,840 --> 01:10:13,800 WITH OUR BENCHMARKS OR GOAL IS 1683 01:10:13,800 --> 01:10:15,560 ULTIMATELY 0 HARM SO WHETHER 1684 01:10:15,560 --> 01:10:16,800 HUNDRED PERCENT OR 0% DEPENDING 1685 01:10:16,800 --> 01:10:19,320 ON WHICH WAY THE METRIC IS 1686 01:10:19,320 --> 01:10:19,600 GOING. 1687 01:10:19,600 --> 01:10:21,400 THE FIRST TOPIC I WILL TALK 1688 01:10:21,400 --> 01:10:22,840 ABOUT IS EFFECTIVE CONTROL 1689 01:10:22,840 --> 01:10:24,080 METRIC. 1690 01:10:24,080 --> 01:10:28,760 WE SEE OUR HAND HYGIENE DATA 1691 01:10:28,760 --> 01:10:29,680 THESE ARE WHERE STATE REGULATOR 1692 01:10:29,680 --> 01:10:32,400 OF ARE ASKED TO JUST OBSERVE AS 1693 01:10:32,400 --> 01:10:33,600 YOU SEE ANYBODY GOING IN THE 1694 01:10:33,600 --> 01:10:36,880 ROOM, DID THEY WASH THEIR HANDS, 1695 01:10:36,880 --> 01:10:37,880 USE HAND HYGIENE AND THE SAME 1696 01:10:37,880 --> 01:10:39,400 WHEN THEY COME OUT AND TO ENTER 1697 01:10:39,400 --> 01:10:42,680 THESE IN AND WE ENCOURAGE STAFF 1698 01:10:42,680 --> 01:10:44,800 TO DO THIS, YOU KNOW AGAIN 1699 01:10:44,800 --> 01:10:46,240 WITHOUT OTHERS KNOWING SO IT'S 1700 01:10:46,240 --> 01:10:48,200 NOT A MATTER OF OH THEY'RE HERE, 1701 01:10:48,200 --> 01:10:50,000 LET'S TAKE A ELECTRIC AT IT AND 1702 01:10:50,000 --> 01:10:52,760 AND AS CAN YOU SEE, WE HAVE BEEN 1703 01:10:52,760 --> 01:10:53,760 CONSISTENT IN THE 95% AREA AND 1704 01:10:53,760 --> 01:10:59,920 OF COURSE WE WOULD LIKE TO BE A 1705 01:10:59,920 --> 01:11:03,440 AIAN HUNDRED PERCENT FOR THAT. 1706 01:11:03,440 --> 01:11:05,000 LOOKING AT RATES, AFTER HAVING 1707 01:11:05,000 --> 01:11:08,360 SEEN A REDUCTION IN THE PREVIOUS 1708 01:11:08,360 --> 01:11:09,600 5-QUARTERS WE DID SEE AN 1709 01:11:09,600 --> 01:11:10,560 INCREASE IN THE PAST 2. 1710 01:11:10,560 --> 01:11:13,520 I WOULD LIKE TO POINT OUT THAT 1711 01:11:13,520 --> 01:11:15,520 THIS INCREASE, THESE ARE LOW 1712 01:11:15,520 --> 01:11:18,600 NUMBERS, THE INCREASE REPRESENTS 1713 01:11:18,600 --> 01:11:21,160 1 ADDITIONAL CLABSI EACH QUARTER 1714 01:11:21,160 --> 01:11:21,880 COMBINED WITH DECREASED LINE 1715 01:11:21,880 --> 01:11:25,760 DAYS SO THAT THE PERCENTAGES YOU 1716 01:11:25,760 --> 01:11:27,480 KNOW SEEMS A LOT HIGHER, NOW 1717 01:11:27,480 --> 01:11:30,240 THAT SAID WHAT OUR HOSPITAL 1718 01:11:30,240 --> 01:11:32,600 ADVICES FOR EVERY CLABSI, 1719 01:11:32,600 --> 01:11:35,640 THERE'S INVESTIGATION, INCLUDING 1720 01:11:35,640 --> 01:11:36,680 NURSING AND HOSPITAL 1721 01:11:36,680 --> 01:11:38,760 EPIDEMIOLOGY SERVICE TO SEE BOTH 1722 01:11:38,760 --> 01:11:39,480 WHAT HAPPENED DURING THAT EVENT 1723 01:11:39,480 --> 01:11:41,760 AND ALSO SEE IF WE'RE SEEING 1724 01:11:41,760 --> 01:11:42,840 TRENDS. 1725 01:11:42,840 --> 01:11:44,800 AND WE HAVE IDENTIFIED 1726 01:11:44,800 --> 01:11:46,320 OPPORTUNITIES WHICH HAVE ALREADY 1727 01:11:46,320 --> 01:11:47,840 BEEN PLACED TO REEDUCATE AND 1728 01:11:47,840 --> 01:11:49,480 REDEDICATE THROUGH THE BEST 1729 01:11:49,480 --> 01:11:55,480 PRACTICES OF LINE CARE AND THESE 1730 01:11:55,480 --> 01:11:57,240 DATA, ALBEIT LOW, HELP US KNOW 1731 01:11:57,240 --> 01:11:59,160 THAT WE NEED TO KEEP PUSHING AND 1732 01:11:59,160 --> 01:12:00,800 MAKING SURE THOSE PRACTICES ARE 1733 01:12:00,800 --> 01:12:01,200 ALWAYS BEING USED. 1734 01:12:01,200 --> 01:12:04,520 OT NEXT SLIDE WE WILL SEE THE 1735 01:12:04,520 --> 01:12:06,000 IACU NUMBERS AND THESE AGAIN 1736 01:12:06,000 --> 01:12:08,520 WITH A SMALLER POPULATION, MORE 1737 01:12:08,520 --> 01:12:09,800 VARIABILITY, THEY HAD GONE UP A 1738 01:12:09,800 --> 01:12:11,800 BIT AND THEN CAME BACK DOWN, THE 1739 01:12:11,800 --> 01:12:15,800 BENCHMARK USED FOR THIS IS THE 1740 01:12:15,800 --> 01:12:18,160 NHSN NATIONAL HEALTHCARE SAFETY 1741 01:12:18,160 --> 01:12:20,240 NETWORK, WHICH YOU SEE ENDED 1742 01:12:20,240 --> 01:12:22,000 HERE, THERE'S NEW DATA COMING 1743 01:12:22,000 --> 01:12:25,880 OUT FOR 2022, BUT THOSE HAVEN'T 1744 01:12:25,880 --> 01:12:26,800 BEEN PUBLISHED YET, SO WE WILL 1745 01:12:26,800 --> 01:12:29,960 HAVE A NEW BENCHMARK COMING UP 1746 01:12:29,960 --> 01:12:30,520 FOR THAT. 1747 01:12:30,520 --> 01:12:36,200 STAYING IN THE ICU, WE SEE OUR 1748 01:12:36,200 --> 01:12:38,280 [INDISCERNIBLE] WHICH IS THE 1749 01:12:38,280 --> 01:12:39,560 URNANNY TRACT INFECTION RIGHT 1750 01:12:39,560 --> 01:12:42,480 AND THIS HAS GONE DOWN TO 0 AND 1751 01:12:42,480 --> 01:12:44,160 REMAINED AT 0 FOR 3-QUARTERS 1752 01:12:44,160 --> 01:12:48,000 WHICH IS OF COURSE WHAT OUR GOAL 1753 01:12:48,000 --> 01:12:48,400 IS. 1754 01:12:48,400 --> 01:12:51,480 AND SIMILARLY THE CAUTI, ON THE 1755 01:12:51,480 --> 01:12:58,440 SURGICAL ONCOLOGY UNITS HAD ALSO 1756 01:12:58,440 --> 01:12:59,520 COME DOWN TO 0. 1757 01:12:59,520 --> 01:13:01,080 AND STAYING WITH SURGERY FOR A 1758 01:13:01,080 --> 01:13:05,080 MINUTE, LOOKING AT SURGICAL SITE 1759 01:13:05,080 --> 01:13:06,840 INFECTIONS USING AS A COMPARISON 1760 01:13:06,840 --> 01:13:07,680 CLINICAL CENTER AVERAGE OVER THE 1761 01:13:07,680 --> 01:13:12,520 COURSE OF A COUPLE YEARS 2019 AS 1762 01:13:12,520 --> 01:13:13,680 A MARKER OF WHERE WE WERE AND 1763 01:13:13,680 --> 01:13:15,680 YOU SEE THAT AGAIN WITH LOW 1764 01:13:15,680 --> 01:13:18,200 NUMBERS HAD HAS BEEN MOVING 1765 01:13:18,200 --> 01:13:19,200 AROUND THE AVERAGE THERE FOR 1766 01:13:19,200 --> 01:13:20,960 WHERE WE ARE WITH THE SURGICAL 1767 01:13:20,960 --> 01:13:23,280 SITE AND AGAIN WITH EACH OF 1768 01:13:23,280 --> 01:13:23,760 THESE EVENTS, THERE'S 1769 01:13:23,760 --> 01:13:25,800 INVESTIGATION BOTH OF THE 1770 01:13:25,800 --> 01:13:28,080 INDIVIDUAL EVENTS AND THEN OF IF 1771 01:13:28,080 --> 01:13:29,600 THERE ARE ANY [INDISCERNIBLE] TO 1772 01:13:29,600 --> 01:13:58,880 SEE WHAT WE DO WITH THAT. 1773 01:13:58,880 --> 01:14:01,600 --AND WE ALSO LOOK AT FALLS OR 1774 01:14:01,600 --> 01:14:01,920 INJURIES. 1775 01:14:01,920 --> 01:14:03,440 THE RATES HAVE REMAINED AT OR 1776 01:14:03,440 --> 01:14:04,800 AROUND THE BASE LINE, SO THESE 1777 01:14:04,800 --> 01:14:07,800 SORT OF GRAY AND BLACK ARE THE 1778 01:14:07,800 --> 01:14:08,600 NDNQI BENCHMARKS AND THEN YOU 1779 01:14:08,600 --> 01:14:14,400 WILL SEE OUR RATES. 1780 01:14:14,400 --> 01:14:15,640 AGAIN IN VARIABILITY IN OUR RATE 1781 01:14:15,640 --> 01:14:17,320 AND BELOW THE BASE LINE THERE 1782 01:14:17,320 --> 01:14:18,440 AND PLEASE SAY WE'VE REMAINED 1783 01:14:18,440 --> 01:14:20,400 LOW AND FALSE WITH INJURIES. 1784 01:14:20,400 --> 01:14:24,240 AND EACH OF THOSE ARE LOOKED AT. 1785 01:14:24,240 --> 01:14:25,840 NOW OUR ORGANIZATION IS LOOKING 1786 01:14:25,840 --> 01:14:28,040 AT STRATEGIES TO EVEN OF COURSE, 1787 01:14:28,040 --> 01:14:29,120 REDUCE THESE FURTHER AND 1788 01:14:29,120 --> 01:14:30,760 SOMETHING THAT'S BEEN NEWLY 1789 01:14:30,760 --> 01:14:33,400 IMPLEMENTED IS SOMETHING CALLED 1790 01:14:33,400 --> 01:14:34,600 THE BEDSIDE MOBILITY ASSESSMENT 1791 01:14:34,600 --> 01:14:36,480 TOOL, THE AIM OF WHICH IS TO 1792 01:14:36,480 --> 01:14:39,800 REDUCE OCCUPATIONAL INJURIES AS 1793 01:14:39,800 --> 01:14:41,400 WELL AS HAVING POTENTIAL 1794 01:14:41,400 --> 01:14:43,880 REDUCING IN PATIENT INJURIES AND 1795 01:14:43,880 --> 01:14:44,520 PATIENT FALLS. 1796 01:14:44,520 --> 01:14:46,000 SO WE'LL HOPE TO SEE THESE 1797 01:14:46,000 --> 01:14:49,120 NUMBERS CONTINUE TO STAY LOW AND 1798 01:14:49,120 --> 01:14:50,960 GO EVEN LOWER. 1799 01:14:50,960 --> 01:14:52,560 AND THEN THE PRESSURE INJURY 1800 01:14:52,560 --> 01:14:54,200 PREVALENCE, YOU WILL SEE SORT OF 1801 01:14:54,200 --> 01:14:55,960 AGAIN, SORT OF EBBING AND 1802 01:14:55,960 --> 01:14:58,840 FLOWING RIGHT AROUND THE NDNQI 1803 01:14:58,840 --> 01:15:00,920 MEAN AND PLEASE TO SAY THAT FOR 1804 01:15:00,920 --> 01:15:02,600 MANY QUARTERS IN A ROW, THE MORE 1805 01:15:02,600 --> 01:15:06,760 SEVERE STAGE 3 AND 4 PRESSURE 1806 01:15:06,760 --> 01:15:08,200 INJURIES HAVE BEEN AT 0 WHICH IS 1807 01:15:08,200 --> 01:15:14,560 OF COURSE WHERE WE WANT THEM TO 1808 01:15:14,560 --> 01:15:14,720 BE. 1809 01:15:14,720 --> 01:15:17,080 OKAY, THIS IS A METRIC OF 1810 01:15:17,080 --> 01:15:19,200 PROCESS, MEANING IS THE PROCESS 1811 01:15:19,200 --> 01:15:20,240 OF MEDICATION ADMINISTRATION BAR 1812 01:15:20,240 --> 01:15:23,640 CODING BEING USED WHICH IS A WAY 1813 01:15:23,640 --> 01:15:24,760 TO INSURE PATIENT, THE CORRECT 1814 01:15:24,760 --> 01:15:26,040 MEDICATION IS GOING TO THE 1815 01:15:26,040 --> 01:15:28,280 CORRECT PATIENT. 1816 01:15:28,280 --> 01:15:31,200 OUR GOAL IS 100% USE OF WHAT'S 1817 01:15:31,200 --> 01:15:34,000 CALLED KBMA WHICH IS THE NAME OF 1818 01:15:34,000 --> 01:15:35,920 OUR BAR CODING SYSTEM AND YOU 1819 01:15:35,920 --> 01:15:38,680 WILL SEE WE'RE CONSISTENTLY UP 1820 01:15:38,680 --> 01:15:41,360 AROUND 90, 99%, SO IT'S A 1821 01:15:41,360 --> 01:15:42,840 HANDFUL OF IERK TEMS, THERE ARE 1822 01:15:42,840 --> 01:15:45,640 A SMALL NUMBER OF CIRCUMSTANCES 1823 01:15:45,640 --> 01:15:46,920 WHERE THE KBMA CAN NOT BE USED 1824 01:15:46,920 --> 01:15:48,600 AND THOSE ARE KNOWN AND THE 1825 01:15:48,600 --> 01:15:49,640 STAFF TAKE ADDITIONAL CARE IN 1826 01:15:49,640 --> 01:15:53,240 THOSE CIRCUMSTANCES BUT AGAIN, 1827 01:15:53,240 --> 01:15:54,560 WHATEVER IS NOT USED OUR NURSING 1828 01:15:54,560 --> 01:15:55,800 QUALITY OF PEOPLE ARE ALERTED TO 1829 01:15:55,800 --> 01:15:57,360 THAT AND SEE WHAT THE 1830 01:15:57,360 --> 01:16:00,560 CIRCUMSTANCE WAS TO INSURE THAT 1831 01:16:00,560 --> 01:16:07,240 IT'S BEING USED, ALWAYS OR 1832 01:16:07,240 --> 01:16:08,200 ALWAYS WHEN POSSIBLE. 1833 01:16:08,200 --> 01:16:10,440 I'M SWITCHING NOW TO EMERGENCY 1834 01:16:10,440 --> 01:16:12,240 RESPONSE DATA WHICH IS A RAPID 1835 01:16:12,240 --> 01:16:13,880 RESPONSE SYSTEM AND I WILL 1836 01:16:13,880 --> 01:16:15,400 REMIND THE PANEL FOR THE MEMBERS 1837 01:16:15,400 --> 01:16:17,400 AND NEW MEMBERS YOU KNOW WE 1838 01:16:17,400 --> 01:16:19,600 DON'T HAVE AN EMERGENCY ROOM SO 1839 01:16:19,600 --> 01:16:21,000 OUR CODE BLUE TEAM IS CALLED TO 1840 01:16:21,000 --> 01:16:23,680 ALL TYPES OF EMERGENCIES IN 1841 01:16:23,680 --> 01:16:24,400 ADDITION TO CARDIAC AARREST. 1842 01:16:24,400 --> 01:16:26,080 WHEN WE WILL SEE HERE AND THIS 1843 01:16:26,080 --> 01:16:30,640 ALSO WOULD INCLUDE PATIENTS BUT 1844 01:16:30,640 --> 01:16:32,120 VISITORS AND EMPLOYEES. 1845 01:16:32,120 --> 01:16:35,320 SO SORT OF ANYBODY WHO'S FOUND 1846 01:16:35,320 --> 01:16:36,680 WHO NEEDS ACUTE EMERGENCY CARE 1847 01:16:36,680 --> 01:16:38,760 IF SOMEBODY CALLS A CODE BLUE 1848 01:16:38,760 --> 01:16:41,040 THAT'S WHO WOULD COME. 1849 01:16:41,040 --> 01:16:44,000 SO I'M LOOKING HERE AT THE 1850 01:16:44,000 --> 01:16:45,800 NUMBERS FOR THE YEAR AND EACH 1851 01:16:45,800 --> 01:16:47,600 QUARTER OF 2021 AND AGAIN, THESE 1852 01:16:47,600 --> 01:16:49,760 ARE ABSOLUTE NUMBERS RATHER THAN 1853 01:16:49,760 --> 01:16:51,640 A RATE, SO THERE WOULD BE 1854 01:16:51,640 --> 01:16:52,640 VARIABILITY BASED ON THE CENSUS 1855 01:16:52,640 --> 01:16:55,240 THAT WE HAVE HERE. 1856 01:16:55,240 --> 01:16:56,640 AS WE'VE BEEN ABLE TO WELCOME 1857 01:16:56,640 --> 01:16:58,200 MORE PEOPLE BACK TO THE CLINICAL 1858 01:16:58,200 --> 01:16:59,680 CENTER, THERE HAVE BEEN SOME 1859 01:16:59,680 --> 01:17:00,600 SHIFT IN PROPORTIONS ABOUT YOU 1860 01:17:00,600 --> 01:17:02,600 TO GET A COMPARISON, I THINK I 1861 01:17:02,600 --> 01:17:05,760 MENTIONED THIS LAST TIME, I 1862 01:17:05,760 --> 01:17:07,600 LOOKEDDA THE 4-QUARTERS FOR 1863 01:17:07,600 --> 01:17:08,800 CALENDAR YEAR OF 2019, THAT 1864 01:17:08,800 --> 01:17:10,200 BEING THE LAST FULL YEAR BEFORE 1865 01:17:10,200 --> 01:17:11,840 THE PANDEMIC AND ACTUALLY THE 1866 01:17:11,840 --> 01:17:13,520 TOTAL NUMBER OF CODE BLUES 1867 01:17:13,520 --> 01:17:16,160 CALLED IN 2021, VERSUS 2019 WAS 1868 01:17:16,160 --> 01:17:16,600 ALMOST IDENTICAL. 1869 01:17:16,600 --> 01:17:19,920 IT WAS OFF BY 1 AS WAS WE WILL 1870 01:17:19,920 --> 01:17:22,160 SEE ON THE NEXT 1 THE TYPE OF 1871 01:17:22,160 --> 01:17:22,360 CODE. 1872 01:17:22,360 --> 01:17:27,000 BUT WE WILL SEE THAT HALF OF 1873 01:17:27,000 --> 01:17:28,360 THEM ARE FOR IN-PATIENTS AND 1874 01:17:28,360 --> 01:17:30,400 THEN ANOTHER THIRD MAY BE IN 1875 01:17:30,400 --> 01:17:31,840 OUT-PATIENTS AND THEN VISITORS 1876 01:17:31,840 --> 01:17:35,520 AND EMPLOYEES MAKING UP THE REST 1877 01:17:35,520 --> 01:17:35,840 OF THEM. 1878 01:17:35,840 --> 01:17:37,800 AND HEAR THE NUMBERS ARE BROKEN 1879 01:17:37,800 --> 01:17:40,240 UP BY TYPE OF EVENT AND AS I 1880 01:17:40,240 --> 01:17:43,000 MENTIONED, THE CARDIAC ARREST 1881 01:17:43,000 --> 01:17:44,480 RATE IS ABOUT 15%. 1882 01:17:44,480 --> 01:17:48,600 SO ABOUT 15% ARE, YOU KNOW A 1883 01:17:48,600 --> 01:17:50,800 CARDIAC ARREST BUT MANY ACUTE 1884 01:17:50,800 --> 01:17:52,480 EMERGENCIES AND MANY ACTUALLY 1885 01:17:52,480 --> 01:17:54,920 ARE WHERE THEY DEEMED TO BE 1886 01:17:54,920 --> 01:17:56,160 STABLE EVENTS, MAYBE SOMEBODY 1887 01:17:56,160 --> 01:17:57,720 SAW SOMEBODY TRIP AND FALL AND 1888 01:17:57,720 --> 01:17:59,000 THOUGHT THEY NEED ASSISTANCE AND 1889 01:17:59,000 --> 01:18:01,360 THE CODE TEAM COMES, EVALUATES 1890 01:18:01,360 --> 01:18:08,600 THEM OF COURSE AND DEEMS THEM TO 1891 01:18:08,600 --> 01:18:10,920 BE STABLE EVENT. 1892 01:18:10,920 --> 01:18:12,080 THE CODE BLUE DISPOSITION AS WE 1893 01:18:12,080 --> 01:18:14,000 SEE ABOUT A QUARTER OF THEM GO 1894 01:18:14,000 --> 01:18:17,680 TO THE ICU AFTER THE CODE BLUE 1895 01:18:17,680 --> 01:18:19,200 AND ABOUT A THIRD WIND UP 1896 01:18:19,200 --> 01:18:20,200 STAYING ON THE UNIT. 1897 01:18:20,200 --> 01:18:22,240 THE BLUE IS A TRANSFER TO THE 1898 01:18:22,240 --> 01:18:25,280 OUTSIDE HOSPITAL THAT WOULD BE 1899 01:18:25,280 --> 01:18:25,880 MOST--THE ALMOST EXCLUSIVELY 1900 01:18:25,880 --> 01:18:28,840 GOING TO BE A VISIT ON OR AN 1901 01:18:28,840 --> 01:18:30,800 EMPLOYEE WHO THE CODE TEAM 1902 01:18:30,800 --> 01:18:33,800 EVALUATES AND THEN DEEMS TO NEED 1903 01:18:33,800 --> 01:18:35,760 MORE CARE RATHER THAN GOING TO 1904 01:18:35,760 --> 01:18:37,600 AN OUTSIDE HOSPITAL FOR THAT. 1905 01:18:37,600 --> 01:18:39,040 JUMPING FROM CODE BLUE TO RAPID 1906 01:18:39,040 --> 01:18:52,240 RESPONSE, I THINK WE 1907 01:18:52,240 --> 01:18:53,840 KNOW--RESPONSE TEAM AND THAT'S 1908 01:18:53,840 --> 01:18:54,920 SOMETHING ANYBODY CAN CALL FOR 1909 01:18:54,920 --> 01:18:56,440 BUT LOOKING AT WHAT HAPPENED TO 1910 01:18:56,440 --> 01:18:58,720 THE PEOPLE FROM THE RAPID 1911 01:18:58,720 --> 01:19:02,720 RESPONSES, WHICH SOMETIMES CAN 1912 01:19:02,720 --> 01:19:04,800 BE AN INDICATOR OF MAYBE A CODE 1913 01:19:04,800 --> 01:19:07,200 BLUE SHOULD HAVE BEEN CALLED 1914 01:19:07,200 --> 01:19:09,320 INSTEAD, WE SEE HERE THAT MOST 1915 01:19:09,320 --> 01:19:14,120 DO GET EVALUATED AND CARE FOR 1916 01:19:14,120 --> 01:19:15,000 RECOMMENDATIONS ARE GIVEN, MAYBE 1917 01:19:15,000 --> 01:19:16,760 GO TO ANOTHER UNIT OR SWITCH TO 1918 01:19:16,760 --> 01:19:18,160 ANOTHER AUTOPSY SERIES, THIS 1919 01:19:18,160 --> 01:19:20,480 MIGHT BE A OUT PATIENT, HEY, YOU 1920 01:19:20,480 --> 01:19:21,640 SHOULD BE ADMITTED BUT WE'RE NOT 1921 01:19:21,640 --> 01:19:22,960 GOING TO HAVE TO NECESSARILY 1922 01:19:22,960 --> 01:19:24,760 ADMIT YOU TO THE ICU, YOU WILL 1923 01:19:24,760 --> 01:19:26,840 GO TO AN IN-PATIENT UNIT AND 1924 01:19:26,840 --> 01:19:31,120 THEN LIKE I SAID, ABOUT 20% ARE 1925 01:19:31,120 --> 01:19:32,040 GOING TO THE--ABOUT 15% ARE 1926 01:19:32,040 --> 01:19:34,480 GOING TO THE ICU. 1927 01:19:34,480 --> 01:19:37,400 ONE OF THE THINGS WE LOOK AT AS 1928 01:19:37,400 --> 01:19:41,000 A TEAM AFTER EACH CODE BLUE IT'S 1929 01:19:41,000 --> 01:19:42,400 DEBRIEFED BY THE CODE TEAM IN 1930 01:19:42,400 --> 01:19:46,040 THE ICU AND THEN IT'S LOOKED AT 1931 01:19:46,040 --> 01:19:47,000 A MULTIDISCIPLINARY GROUP IN 1932 01:19:47,000 --> 01:19:48,360 ADDITION TO THAT 1 LOOKED AT AS 1933 01:19:48,360 --> 01:19:51,480 THE GROUP OF CODE BLUES ARE 1934 01:19:51,480 --> 01:19:53,600 LOOKED AT, BY A MULTIPLE CODE 1935 01:19:53,600 --> 01:19:55,320 BLUE COMMITTEE, THOSE THINGS ARE 1936 01:19:55,320 --> 01:19:57,320 LOOKED AT AGAIN, NOT JUST FOR 1937 01:19:57,320 --> 01:19:59,000 TRENDS BUT ANY PROCESS ISSUES 1938 01:19:59,000 --> 01:20:01,120 AND THEN WITH RAPID RESPONSE, 1939 01:20:01,120 --> 01:20:03,160 ONCE AGAIN WE ASKED IS THIS 1940 01:20:03,160 --> 01:20:04,440 SOMETHING THAT MAY BE THEY 1941 01:20:04,440 --> 01:20:06,760 SHOULD HAVE CALLED A CODE BLUE 1942 01:20:06,760 --> 01:20:07,720 FOR AND MAYBE AN OPPORTUNITY TO 1943 01:20:07,720 --> 01:20:09,360 DO THAT AND WE WOULD SEE, YOU 1944 01:20:09,360 --> 01:20:13,080 KNOW WHY ARE PEOPLE CALLING, 1945 01:20:13,080 --> 01:20:15,200 CHOOSING TO PICK THE KIND THAT 1946 01:20:15,200 --> 01:20:16,160 THEY DO. 1947 01:20:16,160 --> 01:20:18,000 MOVING NOW TO TRANSFUSION 1948 01:20:18,000 --> 01:20:22,600 MEDICINE METHODS INVOLVING BLOOD 1949 01:20:22,600 --> 01:20:23,080 PRODUCTS. 1950 01:20:23,080 --> 01:20:26,200 LOOKING AT THE CROSS MATCH TO 1951 01:20:26,200 --> 01:20:27,240 TRANSFUSION RATIO, THIS WOULD BE 1952 01:20:27,240 --> 01:20:28,480 THE LOWER IS THE BETTER BECAUSE 1953 01:20:28,480 --> 01:20:30,080 THAT WOULD MEAN THAT THE BLOOD 1954 01:20:30,080 --> 01:20:31,480 THAT WAS CROSS MATCHED WAS 1955 01:20:31,480 --> 01:20:33,360 INDEED USED SO IT'S A MATTER OF 1956 01:20:33,360 --> 01:20:35,000 HOW MUCH AND HOW TO RESERVE 1957 01:20:35,000 --> 01:20:36,680 VERSUS GOING TO THE PATIENT AND 1958 01:20:36,680 --> 01:20:41,160 WE SEE THAT OUR GOAL IS A RATIO 1959 01:20:41,160 --> 01:20:43,040 OF 2-1 AND WE'RE WELL BELOW 1960 01:20:43,040 --> 01:20:45,240 THAT, AND THOSE NUMBERS HAVE 1961 01:20:45,240 --> 01:20:46,200 BEEN PRETTY STABLE OVER THE 1962 01:20:46,200 --> 01:20:50,360 COURSE OF THIS PAST YEAR. 1963 01:20:50,360 --> 01:20:52,000 LOOKING AT TRANSFUSION REACTIONS 1964 01:20:52,000 --> 01:20:55,720 BY CLASS, THIS IS OVERALL BEEN 1965 01:20:55,720 --> 01:20:59,600 ABOUT 1% OR BELOW 1% FOR THE 1966 01:20:59,600 --> 01:20:59,800 YEAR. 1967 01:20:59,800 --> 01:21:02,360 MAJORITY OF THESE ARE FEVER 1968 01:21:02,360 --> 01:21:03,200 WITHOUT HEMOLYTIC REACTION AND 1969 01:21:03,200 --> 01:21:06,080 YOU WILL SEE WE ACTUALLY DO NOT 1970 01:21:06,080 --> 01:21:07,240 HAVE ANY OF THE GRAY WHICH WOULD 1971 01:21:07,240 --> 01:21:11,040 BE SOME OF THE MORE SEVERE 1972 01:21:11,040 --> 01:21:13,200 REACTIONS THAT MAY INDICATE THAT 1973 01:21:13,200 --> 01:21:15,040 THE PERSON GOT AND NOT PROPERLY 1974 01:21:15,040 --> 01:21:17,560 MATCHED UNIT AND WE DON'T HAVE 1975 01:21:17,560 --> 01:21:19,880 ANY OF THOSE IN THESE--YOU KNOW 1976 01:21:19,880 --> 01:21:21,720 WITH SMALLER NUMBERS, THERE'S A 1977 01:21:21,720 --> 01:21:24,280 LITTLE BIT OF A JACKED LINE BUT 1978 01:21:24,280 --> 01:21:27,520 PRETTY CONSISTENT AND ALWAYS 1979 01:21:27,520 --> 01:21:28,080 BELOW 1% TURNOVER. 1980 01:21:28,080 --> 01:21:30,640 SO LOOKING AT UNACCEPTABLE BLOOD 1981 01:21:30,640 --> 01:21:32,760 BANK SPECIMENS, THIS JUST IS AN 1982 01:21:32,760 --> 01:21:34,160 INDICATOR IF THE TYPE AND SCREEN 1983 01:21:34,160 --> 01:21:36,200 IS SENT AND THERE'S SOMETHING 1984 01:21:36,200 --> 01:21:38,280 SUCH THAT IT CANNOT BE USED, 1985 01:21:38,280 --> 01:21:41,040 THAT WOULD ALWAYS BE THEN 1986 01:21:41,040 --> 01:21:42,400 DECLINED BECAUSE OF COURSE, THE 1987 01:21:42,400 --> 01:21:43,840 TYPE AND SCREEN OF HAVING THE 1988 01:21:43,840 --> 01:21:44,920 PROPER LABELING ON IT AND 1989 01:21:44,920 --> 01:21:46,640 MATCHING WITH THE PATIENT IS 1 1990 01:21:46,640 --> 01:21:48,400 OF THE CRUCIAL STEPS OF INSURING 1991 01:21:48,400 --> 01:21:52,560 THAT A PERSON DOES NOT 1992 01:21:52,560 --> 01:21:53,880 INADVERTENTLY RECEIVE MISMATCHED 1993 01:21:53,880 --> 01:21:54,080 BLOOD. 1994 01:21:54,080 --> 01:21:58,000 BUT WE ALSO WANT TO SEE, EVEN, 1995 01:21:58,000 --> 01:22:02,040 ARE THESE UNACCEPTABLE PESMENS 1996 01:22:02,040 --> 01:22:02,280 COMING. 1997 01:22:02,280 --> 01:22:04,880 THREE% BEING THE GOAL, WE'VE 1998 01:22:04,880 --> 01:22:06,320 BEEN WELL BELOW THAT AGAIN, 1999 01:22:06,320 --> 01:22:07,720 EVERY SINGLE 1 OF THESE WOULD 2000 01:22:07,720 --> 01:22:11,360 THEN BE DISCARDED AND ASKED FOR 2001 01:22:11,360 --> 01:22:11,840 A NEW SPECIMEN. 2002 01:22:11,840 --> 01:22:13,040 FOR THE NEXT SLIDE WE WILL TALK 2003 01:22:13,040 --> 01:22:15,080 ABOUT SOME OF OUR CLINICAL COCK 2004 01:22:15,080 --> 01:22:16,640 DOCUMENTATIONS, OUR THE NEXT SET 2005 01:22:16,640 --> 01:22:18,360 OF SLIDES ARE CLINICAL 2006 01:22:18,360 --> 01:22:20,200 DOCUMENTATION METRICS. 2007 01:22:20,200 --> 01:22:21,440 LOOKING AT DELINQUENT RECORDS 2008 01:22:21,440 --> 01:22:22,880 WHICH IS DEFINED AS GREATER THAT 2009 01:22:22,880 --> 01:22:25,640 KNOW 30 DAYS POST DISCHARGE 2010 01:22:25,640 --> 01:22:27,720 UNTIL THE DOCUMENTATION IS IN 2011 01:22:27,720 --> 01:22:28,080 ORDER. 2012 01:22:28,080 --> 01:22:31,200 WE RUN AROUND 5, 6, 7%, WITH 2013 01:22:31,200 --> 01:22:34,800 ACTUALLY THE JOINT COMMISSION 2014 01:22:34,800 --> 01:22:36,600 BENCHMARK BEING 50% SO OBVIOUSLY 2015 01:22:36,600 --> 01:22:38,000 WE HAVE THAT, ABOUT YOU WE DO 2016 01:22:38,000 --> 01:22:40,760 WANT TO STAY STABLY DOWN HERE AS 2017 01:22:40,760 --> 01:22:41,840 CLOSE TO 0 AS POSSIBLE 2018 01:22:41,840 --> 01:22:44,800 ESPECIALLY AS WE GO TO A POINT 2019 01:22:44,800 --> 01:22:46,320 WHERE PEOPLE MIGHT BE BEING 2020 01:22:46,320 --> 01:22:47,960 TRANSFERRED, THERE MIGHT BE SOME 2021 01:22:47,960 --> 01:22:49,960 CARE THAT'S AT VARIOUS DIFFERENT 2022 01:22:49,960 --> 01:22:51,360 PLACES, WE WANT TO BE SURE THAT 2023 01:22:51,360 --> 01:22:55,320 THE DOCUMENTATION IS ALL IN 2024 01:22:55,320 --> 01:22:57,560 ORDER. 2025 01:22:57,560 --> 01:22:59,440 AND LOOKING FOR AGENT 4 COUNTER 2026 01:22:59,440 --> 01:22:59,760 PROCEDURES. 2027 01:22:59,760 --> 01:23:01,600 SO WE HAVE A STRICT POLICY ON 2028 01:23:01,600 --> 01:23:04,600 WHAT TYPES OF THINGS CAN HAVE A 2029 01:23:04,600 --> 01:23:08,640 VERBAL ORDER OR AN AGENT FOR 2030 01:23:08,640 --> 01:23:12,920 ORDER WHERE 1 PERSON PRESENTS 2031 01:23:12,920 --> 01:23:14,440 THE ORDER AND WITH THE 2032 01:23:14,440 --> 01:23:16,000 PHYSICIAN'S APPROVAL AND SHOWING 2033 01:23:16,000 --> 01:23:18,200 IT HAS TO BE SIGNED BUT THEN IT 2034 01:23:18,200 --> 01:23:19,920 HAS TO BE SIGNED WITHIN 72 2035 01:23:19,920 --> 01:23:22,600 HOURS, OUR GOAL IS 100% MEETING 2036 01:23:22,600 --> 01:23:26,200 THAT AND WE SORT OF KEEP UP IN 2037 01:23:26,200 --> 01:23:26,480 THAT MID90S. 2038 01:23:26,480 --> 01:23:30,160 SOME OF THE STEPS THAT ARE TAKEN 2039 01:23:30,160 --> 01:23:32,800 IS THAT THE PERSON FOR WHOM THE 2040 01:23:32,800 --> 01:23:34,440 ORDER WAS PLACED GETS AN E-MAIL 2041 01:23:34,440 --> 01:23:36,000 ALERT AND EVERY TIME THAT PERSON 2042 01:23:36,000 --> 01:23:41,120 LOGS ON TO OUR COMPUTER ENTRY 2043 01:23:41,120 --> 01:23:42,800 SYSTEM CALLED C RES, THEY WILL 2044 01:23:42,800 --> 01:23:45,000 BE TOLD YOU HAVE UNSIGNED ORDERS 2045 01:23:45,000 --> 01:23:47,560 SO GO AHEAD AND DO THAT. 2046 01:23:47,560 --> 01:23:49,880 IFINEALLY DO NOT USE 2047 01:23:49,880 --> 01:24:03,200 ABBREVIATION ADHERENCE, THIS IS 2048 01:24:03,200 --> 01:24:04,200 SOMETHING THAT 2049 01:24:04,200 --> 01:24:04,640 WOULD--UNACCEPTABLE 2050 01:24:04,640 --> 01:24:06,680 ABBREVIATIONS WHERE THERE COULD 2051 01:24:06,680 --> 01:24:08,440 BE CONFUSED GRAPHICALLY LIKE A U 2052 01:24:08,440 --> 01:24:10,360 FOR UNITS LOOKING LIKE A 0, 2053 01:24:10,360 --> 01:24:13,640 MEANING WHICH MAKES IT 10 FOLD 2054 01:24:13,640 --> 01:24:15,520 ERROR OR SOMETHING, YOU KNOW 2055 01:24:15,520 --> 01:24:17,960 SHORT ABBREVIATION THAT BEING BE 2056 01:24:17,960 --> 01:24:18,320 MULTIPLE THINGS. 2057 01:24:18,320 --> 01:24:21,800 SO WE HAVE OUR DO NOT USE, AGAIN 2058 01:24:21,800 --> 01:24:24,800 WITH THE GOAL OF 100% IN OUR 2059 01:24:24,800 --> 01:24:25,960 ORDER ENTRY, THESE THINGS YOU 2060 01:24:25,960 --> 01:24:27,800 WON'T BE ABLE TO PLACE MOST OF 2061 01:24:27,800 --> 01:24:30,560 THESE THINGS BUT IN SOME OF THE 2062 01:24:30,560 --> 01:24:31,520 FREE CHECKS AREAS, SOMETIMES 2063 01:24:31,520 --> 01:24:33,240 PEOPLE ARE ABLE TO SO WE NEED TO 2064 01:24:33,240 --> 01:24:34,640 BE VIGILANT ABOUT THAT ASK 2065 01:24:34,640 --> 01:24:36,520 KEEPING THIS NUMBER AS CLOSE TO 2066 01:24:36,520 --> 01:24:44,080 100% OR IN THAT CASE, 0% USE OF 2067 01:24:44,080 --> 01:24:45,280 THEM RATHER I SHOULD SAY AS 2068 01:24:45,280 --> 01:24:45,600 POSSIBLE. 2069 01:24:45,600 --> 01:24:47,320 AND THEN THE ACCURACY OF RECORD 2070 01:24:47,320 --> 01:24:49,840 CLEARING, THIS IS DONE BY AUDIT, 2071 01:24:49,840 --> 01:24:52,720 BY HEALTH INFORMATION MANAGEMENT 2072 01:24:52,720 --> 01:24:54,000 SYSTEM, AND ACCURACY OF CODING 2073 01:24:54,000 --> 01:24:55,800 HAS BEEN IN THE MID TO HIGH 90S 2074 01:24:55,800 --> 01:24:57,320 WITH THE HOSPITAL SETTING A GOAL 2075 01:24:57,320 --> 01:25:00,520 OF AT LEAST 90% AND WE'VE 2076 01:25:00,520 --> 01:25:01,680 REMAINED BOTH STABLE AND ABOVE 2077 01:25:01,680 --> 01:25:03,760 THAT. 2078 01:25:03,760 --> 01:25:05,240 THE LAST TOPIC, LAST BUT NOT 2079 01:25:05,240 --> 01:25:07,440 LEAST IS EMPLOYEE SAFETY. 2080 01:25:07,440 --> 01:25:08,640 TALKING ABOUT OCCUPATIONAL 2081 01:25:08,640 --> 01:25:09,640 INJURIES AND ILLNESSES, 2082 01:25:09,640 --> 01:25:10,760 COMPARING TO OTHER U.S. 2083 01:25:10,760 --> 01:25:11,000 HOSPITALS. 2084 01:25:11,000 --> 01:25:13,440 SO AT THE LAST MEETING WHEN I 2085 01:25:13,440 --> 01:25:17,200 SHOWED DATA THERE WAS A REQUEST 2086 01:25:17,200 --> 01:25:18,480 FOR SOME BENCHMARKS AGAINST U.S. 2087 01:25:18,480 --> 01:25:22,120 HOSPITALS, I WILL SAY THAT THE 2088 01:25:22,120 --> 01:25:24,160 BURRO OF LABOR AND STATISTICS 2089 01:25:24,160 --> 01:25:27,000 WHO PROVIDES THIS DATA, THE 2021 2090 01:25:27,000 --> 01:25:29,360 DATA ARE NOT FULLY COMPILED, 2091 01:25:29,360 --> 01:25:31,200 EXCUSE ME, SO THE BLUE IS THE 2092 01:25:31,200 --> 01:25:35,200 DATA FOR U.S. HOSPITALS ACROSS 2093 01:25:35,200 --> 01:25:36,640 THE LAST SEVERAL YEARS I WILL 2094 01:25:36,640 --> 01:25:37,800 SAY IT'S USUALLY PRETTY STABLE 2095 01:25:37,800 --> 01:25:39,400 BUT WE DON'T KNOW WHAT THE 21 2096 01:25:39,400 --> 01:25:41,280 WOULD BE BUT THAT SAID, WHERE 2097 01:25:41,280 --> 01:25:42,800 ARE WE WITH TOTAL REPORTABLE 2098 01:25:42,800 --> 01:25:45,200 CASES AND OTHER REPORTABLE CASES 2099 01:25:45,200 --> 01:25:45,800 FREQUENTLY AND CERTAINLY THIS 2100 01:25:45,800 --> 01:25:48,080 YEAR AND THE LAST YEAR'S BELOW 2101 01:25:48,080 --> 01:25:51,840 THE NATIONAL AVERAGE FOR A 2102 01:25:51,840 --> 01:25:52,240 HOSPITAL OUR SIZE. 2103 01:25:52,240 --> 01:25:53,840 AND AS WE WILL MOVE ON TO SOME 2104 01:25:53,840 --> 01:25:56,760 OF THE OTHER THINGS, DAYS OF JOB 2105 01:25:56,760 --> 01:26:00,360 TRANSFER, RESTRICTION OR DAYS 2106 01:26:00,360 --> 01:26:04,760 AWAY FROM WORK. 2107 01:26:04,760 --> 01:26:05,600 WHERE WE ARE. 2108 01:26:05,600 --> 01:26:08,600 AND LOOKING AT A COMBINED CALLED 2109 01:26:08,600 --> 01:26:10,040 DAYS AWAY OR RESTRICTED OR 2110 01:26:10,040 --> 01:26:10,360 TRANSFERRED. 2111 01:26:10,360 --> 01:26:13,200 I WILL SAY THAT THE MAJORITY OF 2112 01:26:13,200 --> 01:26:15,360 OUR DARTS, DAYS AWAY OR 2113 01:26:15,360 --> 01:26:18,720 RESTRICTED OR TRANSFERS ARE E 2114 01:26:18,720 --> 01:26:19,760 LIEWCIALLY DUE TO 2115 01:26:19,760 --> 01:26:20,360 MUSCULOSKELETAL INJURIES AND 2116 01:26:20,360 --> 01:26:21,880 THIS GOES BACK TO SOMETHING I 2117 01:26:21,880 --> 01:26:22,760 MENTIONED EARLIER THAT OUR 2118 01:26:22,760 --> 01:26:24,360 HOSPITAL IS TAKING STEPS TO PUT 2119 01:26:24,360 --> 01:26:26,000 IN PROCESSES THAT WOULD HELP 2120 01:26:26,000 --> 01:26:28,000 REDUCE SOME OF THOSE ERRORS, I 2121 01:26:28,000 --> 01:26:30,240 MENTIONED THE BEDSIDE MOBILITY 2122 01:26:30,240 --> 01:26:31,600 ASSESS WILL TOOL, 1 OTHER THING 2123 01:26:31,600 --> 01:26:33,800 THEY PUT INTO PLACE IS AN AIR 2124 01:26:33,800 --> 01:26:34,640 MATTRESS SYSTEM FOR MOVING 2125 01:26:34,640 --> 01:26:36,960 PATIENTS FROM BED TO BED. 2126 01:26:36,960 --> 01:26:38,360 THIS CAN HELP REDUCE STAFF 2127 01:26:38,360 --> 01:26:40,360 INJURIES, IT CAN ALSO HELP 2128 01:26:40,360 --> 01:26:42,600 REDUCE PATIENT INJURIES AND 2129 01:26:42,600 --> 01:26:44,040 DISCOMFORT, YOU KNOW A PATIENT 2130 01:26:44,040 --> 01:26:45,760 MOVE FRIDAY 1 BED TO ANOTHER 2131 01:26:45,760 --> 01:26:46,680 RATHER THAN SOMEBODY LIFTING 2132 01:26:46,680 --> 01:26:49,880 THEM OR MAYBE GETTING TWISTED A 2133 01:26:49,880 --> 01:26:51,360 LITTLE BIT, THE AIR MATTRESS 2134 01:26:51,360 --> 01:26:53,200 JUST LIED THAT PERSON OVER. 2135 01:26:53,200 --> 01:26:55,400 SO 1 OF THE THINGS WE WANT TO DO 2136 01:26:55,400 --> 01:26:56,960 IS INSURE THIS IS USED AS MUCH 2137 01:26:56,960 --> 01:26:58,360 AS POSSIBLE IN ANY OF THESE 2138 01:26:58,360 --> 01:26:59,920 STEPS, BOTH TO KEEP OUR PATIENTS 2139 01:26:59,920 --> 01:27:01,560 SAFE BUT ALSO TO KEEP OUR 2140 01:27:01,560 --> 01:27:04,200 EMPLOYEES SAFE FROM INJURY. 2141 01:27:04,200 --> 01:27:06,600 THAT WAS THE FINAL METRIC I HAD. 2142 01:27:06,600 --> 01:27:12,200 AND I WILL SEE IF THERE'S ANY 2143 01:27:12,200 --> 01:27:12,440 QUESTIONS? 2144 01:27:12,440 --> 01:27:15,800 I WILL GET MY--TRY TO STOP 2145 01:27:15,800 --> 01:27:16,000 SHARING. 2146 01:27:16,000 --> 01:27:19,480 >> THANK YOU DAVID AND RIGHT NOW 2147 01:27:19,480 --> 01:27:26,240 I FEEL PAUL O'NEIL SMILING DOWN 2148 01:27:26,240 --> 01:27:29,760 ON US FOR NEW MEMBERS OF THE 2149 01:27:29,760 --> 01:27:30,000 BOARD. 2150 01:27:30,000 --> 01:27:32,640 PAUL O'NEIL WAS 1 OF OUR 2151 01:27:32,640 --> 01:27:34,920 ORIGINAL BOARD MEMBERS AND WAS 2152 01:27:34,920 --> 01:27:36,000 VERY FOCUSED THROUGHOUT HIS 2153 01:27:36,000 --> 01:27:38,760 CAREER ON TEAM MEMBER SAFETY. 2154 01:27:38,760 --> 01:27:41,400 AND SO AS WE'VE TALKED ABOUT 2155 01:27:41,400 --> 01:27:42,680 PATIENT SAFETY, HE WOULD ALWAYS 2156 01:27:42,680 --> 01:27:43,360 RIGHT THERE. 2157 01:27:43,360 --> 01:27:46,640 SO IT'S GREAT TO SEE THE FOCUS 2158 01:27:46,640 --> 01:27:47,040 ON THAT. 2159 01:27:47,040 --> 01:27:50,040 LET ME SEE IF ANYBODY WANTS TO 2160 01:27:50,040 --> 01:28:02,200 ASK A QUESTION, MAKE A COMMENT? 2161 01:28:02,200 --> 01:28:02,560 ANTOINETTE. 2162 01:28:02,560 --> 01:28:03,600 >> JUST A QUICK QUESTION 2163 01:28:03,600 --> 01:28:11,200 DR. LANG, YOU SAID THERE WAS A 2164 01:28:11,200 --> 01:28:12,600 0% UTI INFECTION RATE. 2165 01:28:12,600 --> 01:28:14,800 HOW WERE YOU ALL ABLE TO 2166 01:28:14,800 --> 01:28:17,200 ACCOMPLISH THAT? 2167 01:28:17,200 --> 01:28:20,360 WAS IT DUE TO THE NURSES WERE 2168 01:28:20,360 --> 01:28:23,560 DOING OR IS IT SOME SORT OF THE 2169 01:28:23,560 --> 01:28:26,120 CATHETER TYPE DEVICES THAT ARE 2170 01:28:26,120 --> 01:28:28,480 USED NOW DAYS? 2171 01:28:28,480 --> 01:28:30,600 >> YEAH THAT'S A GREAT QUESTION. 2172 01:28:30,600 --> 01:28:32,240 THE 0% UTI ASSOCIATED WITH A 2173 01:28:32,240 --> 01:28:35,120 CATHETER AND I THINK IT'S 2174 01:28:35,120 --> 01:28:36,080 CERTAIN PRACTICES, CERTAIN 2175 01:28:36,080 --> 01:28:39,400 NURSING PRACTICES THAT ARE PUT 2176 01:28:39,400 --> 01:28:41,200 IN AND IN FOLLOWING THOSE BEST 2177 01:28:41,200 --> 01:28:42,720 PRACTICES ARE THE THINGS THAT 2178 01:28:42,720 --> 01:28:44,200 HELP KEEP THAT VALUE LOW. 2179 01:28:44,200 --> 01:28:52,360 SO THANK YOU FOR ASKING. 2180 01:28:52,360 --> 01:28:52,800 >> VERY IMPRESSIVE. 2181 01:28:52,800 --> 01:28:55,040 >> I WOULD LIKE TO ASK 1 OTHER 2182 01:28:55,040 --> 01:28:56,640 QUESTION AND I'M NOT SURE TO 2183 01:28:56,640 --> 01:28:59,120 WHICH TEAM MEMBERS I'M DIRECTING 2184 01:28:59,120 --> 01:29:16,000 THIS TO BUT PERHAPS SEVERAL, 2185 01:29:16,000 --> 01:29:17,920 VANDERBILT JUST 10 DAYS OR SO 2186 01:29:17,920 --> 01:29:19,920 AGO, I KNOW IN MY AREA, IT'S 2187 01:29:19,920 --> 01:29:22,200 BEEN A HUGE TOPIC OF 2188 01:29:22,200 --> 01:29:22,840 CONVERSATION AROUND SUPPORTING 2189 01:29:22,840 --> 01:29:25,280 OUR STAFF, I THINK THE STORY 2190 01:29:25,280 --> 01:29:26,120 ITSELF IS COMPLICATED, WE'VE 2191 01:29:26,120 --> 01:29:27,760 TRIED TO STAY AWAY FROM THAT BUT 2192 01:29:27,760 --> 01:29:30,960 SUPPORTING OUR STAFF AND FOR 2193 01:29:30,960 --> 01:29:32,240 BARBARA OR DAVEED COLLEEN, 2194 01:29:32,240 --> 01:29:35,280 SOMEWHERE IN THERE, IS THERE 2195 01:29:35,280 --> 01:29:36,240 CONVERSATION NOW GOING ON WITH 2196 01:29:36,240 --> 01:29:38,000 YOUR TEAM AND HOW ARE YOU THINK 2197 01:29:38,000 --> 01:29:43,560 BEING APPROACHING SOME OF THAT? 2198 01:29:43,560 --> 01:29:46,280 >> YEAH, SO, THANK YOU FOR THAT 2199 01:29:46,280 --> 01:29:47,760 QUESTION. 2200 01:29:47,760 --> 01:29:49,360 I SHARED WITH THE NURSES, 2201 01:29:49,360 --> 01:29:50,400 THROUGHOUT THE NURSING 2202 01:29:50,400 --> 01:29:54,000 DEPARTMENT AS WELL AS OUR EXTRA 2203 01:29:54,000 --> 01:29:54,480 DEPARTMENTMENTAL NURSES, 2204 01:29:54,480 --> 01:29:59,120 FORWARDED THE STATEMENTS FROM 2205 01:29:59,120 --> 01:30:00,160 THE MARYLAND NURSE'S ASSOCIATION 2206 01:30:00,160 --> 01:30:01,520 AND THE AMERICAN NURSE'S 2207 01:30:01,520 --> 01:30:03,440 ASSOCIATION ALONG WITH MY 2208 01:30:03,440 --> 01:30:06,960 COMMENTS TO CONTINUE TO SUPPORT 2209 01:30:06,960 --> 01:30:09,040 1 ANOTHER AND TO REACH OUT. 2210 01:30:09,040 --> 01:30:10,520 AND I RECEIVED VERY FAVORABLE 2211 01:30:10,520 --> 01:30:20,560 RESPONSES BUT IT IS A CONCERN 2212 01:30:20,560 --> 01:30:24,600 AND WE WANT PEOPLE TO NOT FEAR 2213 01:30:24,600 --> 01:30:26,760 RETALIATION, BUT OVER THE PAST 2214 01:30:26,760 --> 01:30:28,040 SEVERAL YEARS WE'VE FOCUSED ON A 2215 01:30:28,040 --> 01:30:30,120 JUST CULTURE, THE OPEN 2216 01:30:30,120 --> 01:30:32,120 DISCUSSION OF EVENTS AND WORK TO 2217 01:30:32,120 --> 01:30:38,120 RESOLVE ISSUES AND OUR FOCUS ON 2218 01:30:38,120 --> 01:30:38,360 SAFETY. 2219 01:30:38,360 --> 01:30:40,120 HOPEFULLY PEOPLE FEEL THAT 2220 01:30:40,120 --> 01:30:43,120 SUPPORT AND CAN COME FORWARD IF 2221 01:30:43,120 --> 01:30:44,560 THEY HAVE CONCERNS OR ISSUES. 2222 01:30:44,560 --> 01:30:50,200 WE HAVE TO REALLY FOCUS ON A 2223 01:30:50,200 --> 01:30:51,920 NONPUNITIVE ENVIRONMENT AND WE 2224 01:30:51,920 --> 01:30:53,560 HAVE TO MODULATE OUR RESPONSES, 2225 01:30:53,560 --> 01:30:56,000 YOU KNOW WHEN EVENTS OCCUR BUT 2226 01:30:56,000 --> 01:31:01,920 AGAIN TO BE VERY SUPPORTIVE OF 2227 01:31:01,920 --> 01:31:02,800 THE STAFF. 2228 01:31:02,800 --> 01:31:03,320 >> THANK YOU. 2229 01:31:03,320 --> 01:31:05,560 STEVE, I SEE YOUR HAND GOING UP 2230 01:31:05,560 --> 01:31:06,000 THERE. 2231 01:31:06,000 --> 01:31:07,320 >> YEAH, I WOULD JUST COMMENT, 2232 01:31:07,320 --> 01:31:08,880 WE ACTUALLY STARTED THE DISTRICT 2233 01:31:08,880 --> 01:31:09,800 ATTORNEY AT 6:30 THIS MORNING 2234 01:31:09,800 --> 01:31:17,000 WITH A MEETING ON THIS SUBJECT. 2235 01:31:17,000 --> 01:31:18,160 THERE ARE PECULIARITIES OF THE 2236 01:31:18,160 --> 01:31:22,800 TENNESSEE LAW WHICH OBVIOUSLY 2237 01:31:22,800 --> 01:31:26,840 PLAY INTO THIS AND THE ISSUE OF 2238 01:31:26,840 --> 01:31:28,000 OVERRIDE PICKS US PARTICULARLY 2239 01:31:28,000 --> 01:31:29,400 WHEN WHAT YOU HAVE RECEIVED, IF 2240 01:31:29,400 --> 01:31:31,040 THE LOOK AT THE FACTS OF THE 2241 01:31:31,040 --> 01:31:32,920 CASE THAT HAS WARNINGS ON IT 2242 01:31:32,920 --> 01:31:33,840 THAT WERE IGNORED. 2243 01:31:33,840 --> 01:31:40,920 SO I--THAT LED US TO DO IS TO 2244 01:31:40,920 --> 01:31:44,000 ACTUALLY FORM A GROUP 2245 01:31:44,000 --> 01:31:44,560 PREDOMINANTLY COMPRISED OF 2246 01:31:44,560 --> 01:31:47,240 NURSES THAT ARE LOOKING WITH OUR 2247 01:31:47,240 --> 01:31:48,360 RCA SYSTEM AROUND THE ISSUES OF 2248 01:31:48,360 --> 01:31:50,880 WHETHER OR NOT THERE ARE CHECKS 2249 01:31:50,880 --> 01:31:55,400 AND BALANCES THAT NEED TO BE 2250 01:31:55,400 --> 01:31:58,920 INITIATED FURTHER THAT WILL 2251 01:31:58,920 --> 01:32:01,360 ENHANCE THE ABILITY OF A STAFF 2252 01:32:01,360 --> 01:32:03,400 MEMBER NOT TO MAKE A MENTAL 2253 01:32:03,400 --> 01:32:06,960 ERROR AT AN IMPORTANT TIME 2254 01:32:06,960 --> 01:32:08,360 BECAUSE THESE THINGS, AS WE KNOW 2255 01:32:08,360 --> 01:32:09,680 THESE THINGS WILL HAPPEN. 2256 01:32:09,680 --> 01:32:10,720 NOW THERE'S NO CASE LAW IN 2257 01:32:10,720 --> 01:32:13,120 NEW YORK STATE THAT WE'VE HAD 2258 01:32:13,120 --> 01:32:14,960 OTHER CASES AND IF FACT WE 2259 01:32:14,960 --> 01:32:16,560 COULDN'T FIND ANY OTHER CASES 2260 01:32:16,560 --> 01:32:19,760 NATURALLY BUT THIS IS VERY 2261 01:32:19,760 --> 01:32:21,040 PARTICULAR AND I DO THINK IT 2262 01:32:21,040 --> 01:32:28,760 GOES TO THE ISSUE OF OVERRIDE, 2263 01:32:28,760 --> 01:32:29,720 OF [INDISCERNIBLE] AND HOW DO 2264 01:32:29,720 --> 01:32:30,920 YOU RECEIVE THE CHECK OF WHAT 2265 01:32:30,920 --> 01:32:32,560 YOU WANTED AND THEN YOU GET INTO 2266 01:32:32,560 --> 01:32:37,840 A WHOLE ISSUE OF PATIENT 2267 01:32:37,840 --> 01:32:38,920 MONITORING, ET CETERA. 2268 01:32:38,920 --> 01:32:40,040 SO IT'S REALLY--I DON'T KNOW 2269 01:32:40,040 --> 01:32:41,600 THIS GOES BACK TO 2017 SO I 2270 01:32:41,600 --> 01:32:43,600 DON'T KNOW THE RESPONSE OF 2271 01:32:43,600 --> 01:32:45,400 VANDERBILT AT THAT TIME AND 2272 01:32:45,400 --> 01:32:47,480 WHERE THEY CHOSE TO PURSUE IT 2273 01:32:47,480 --> 01:32:49,000 THE WAY THEY DID. 2274 01:32:49,000 --> 01:32:50,400 >> YES, JUST TO BE VERY CLEAR, I 2275 01:32:50,400 --> 01:32:52,200 DIDN'T WANT TO GET INTO THAT, I 2276 01:32:52,200 --> 01:32:55,480 REALLY WAS JUST WANTING TO HEAR 2277 01:32:55,480 --> 01:33:00,800 AND BARBARA I THINK YOU SHARED 2278 01:33:00,800 --> 01:33:02,560 IT AND I KNOW YOU ARE SUPPORTING 2279 01:33:02,560 --> 01:33:04,200 YOUR STAFF SO I KNOW PEOPLE ARE 2280 01:33:04,200 --> 01:33:05,920 TALKING ABOUT IT. 2281 01:33:05,920 --> 01:33:06,800 GOOD, THANK YOU. 2282 01:33:06,800 --> 01:33:09,000 I SEE STEPHANIE AND THEN RICK. 2283 01:33:09,000 --> 01:33:09,720 >> THANKS, LAURA. 2284 01:33:09,720 --> 01:33:11,280 SO MY COMMENT IS ALSO JUST 2285 01:33:11,280 --> 01:33:12,800 DIRECTED, I GUESS AT THE WHOLE 2286 01:33:12,800 --> 01:33:14,720 TEAM OR MAYBE IN GENERAL 2287 01:33:14,720 --> 01:33:15,040 COMMENT. 2288 01:33:15,040 --> 01:33:17,240 IT SEEMS AS THOUGH WE'RE SEEING 2289 01:33:17,240 --> 01:33:18,880 LEVELS OF FATIGUE, ALL KINDS OF 2290 01:33:18,880 --> 01:33:22,120 FATIGUE AMONG OUR TEAMS, MENTAL 2291 01:33:22,120 --> 01:33:23,520 HEALTH ISSUES BUT PERHAPS NOT 2292 01:33:23,520 --> 01:33:27,000 QUITE THAT SERIOUS ISSUES JUST 2293 01:33:27,000 --> 01:33:28,280 INCREDIBLE FATIGUE AND I CAN'T 2294 01:33:28,280 --> 01:33:29,760 HELP BUT THINK IT HAS AN IMPACT 2295 01:33:29,760 --> 01:33:31,240 ON EVERYTHING WE DO, 2296 01:33:31,240 --> 01:33:32,080 SAFETYENTIOUS SPECIALLY OR AT 2297 01:33:32,080 --> 01:33:36,200 LEAST IT HAS THE POTENTIAL OF 2298 01:33:36,200 --> 01:33:38,600 THAT SO WONDERING, ARE 2299 01:33:38,600 --> 01:33:40,320 YOU--THERE'S BEEN SO MUCH 2300 01:33:40,320 --> 01:33:41,800 OPTIMISM SHARED TODAY WHICH IS 2301 01:33:41,800 --> 01:33:43,800 SO HELPFUL FOR ALL OF US AND OUR 2302 01:33:43,800 --> 01:33:46,920 MENTAL HEALTH BUT I WONDER, ARE 2303 01:33:46,920 --> 01:33:48,560 YOU ALSO SEEING JUST THIS 2304 01:33:48,560 --> 01:33:49,960 INCREDIBLE LEVEL OF FATIGUE THAT 2305 01:33:49,960 --> 01:33:55,960 WE SEEM TO BE SENSING ELSEWHERE? 2306 01:33:55,960 --> 01:33:57,920 >> I WOULD SAY YES THAT WAS A 2307 01:33:57,920 --> 01:34:01,800 TOPIC OF CONVERSATION AT OUR 2308 01:34:01,800 --> 01:34:02,320 NURSE EXECUTIVE COMMITTEE 2309 01:34:02,320 --> 01:34:04,000 MEETING YESTERDAY IS JUST, WE 2310 01:34:04,000 --> 01:34:07,960 HAVE TO KEEP FOCUSING ON MAKING 2311 01:34:07,960 --> 01:34:24,200 SURE WE ARE OUT AND AVAILABLE 2312 01:34:24,200 --> 01:34:25,800 WITH OUR WITH SCHEDULING AND 2313 01:34:25,800 --> 01:34:27,600 STAFFING AND JUST MAKING 2314 01:34:27,600 --> 01:34:29,080 SURE--YOU KNOW WE HAVE PEOPLE 2315 01:34:29,080 --> 01:34:30,760 THAT WORK HERE AND LIVE PRETTY 2316 01:34:30,760 --> 01:34:32,520 FAR AWAY AND THEY LIKE TO BUNCH 2317 01:34:32,520 --> 01:34:33,440 ALL THEIR SHIFTS TOGETHER AND 2318 01:34:33,440 --> 01:34:36,000 IT'S LIKE, WE LOOK AT THINGS 2319 01:34:36,000 --> 01:34:40,000 FROM PATIENT SAFETY AND THE 2320 01:34:40,000 --> 01:34:41,600 STAFF SAFETY PERSPECTIVE BUT WE 2321 01:34:41,600 --> 01:34:44,240 ARE SEEING THE SIGNS OF FATIGUE 2322 01:34:44,240 --> 01:34:46,080 AS ELSEWHERE ACROSS THE COUNTRY 2323 01:34:46,080 --> 01:34:50,000 AND SO, YOU KNOW WE'RE VERY 2324 01:34:50,000 --> 01:34:55,160 FOCUSED ON WHAT WE DO AND THE 2325 01:34:55,160 --> 01:34:56,800 CLINICAL CENTER AND DR. GILMAN 2326 01:34:56,800 --> 01:35:01,760 MAY WANT TO SPEAK MORE TO AGAIN, 2327 01:35:01,760 --> 01:35:03,040 WE'VE--WE HAD REOPENED THE 2328 01:35:03,040 --> 01:35:08,640 CRISIS LINE, THE HOT LINE FOR 2329 01:35:08,640 --> 01:35:10,600 PEOPLE TO CALL TO GET SUPPORT TO 2330 01:35:10,600 --> 01:35:12,440 HAVE SOMEBODY TO SPEAK WITH 2331 01:35:12,440 --> 01:35:13,720 BECAUSE, YOU KNOW WE'RE STILL 2332 01:35:13,720 --> 01:35:16,200 FEELING IT AS OUR PEOPLE BUT 2333 01:35:16,200 --> 01:35:24,160 ALSO AS HEALTHCARE INSTITUTIONS. 2334 01:35:24,160 --> 01:35:26,360 YEAH, I THINK LIKE DR. FORESE, 2335 01:35:26,360 --> 01:35:28,200 WITHOUT GETTING INTO THE DETAILS 2336 01:35:28,200 --> 01:35:29,360 OF THE VANDERBILT CASE, 1 THING 2337 01:35:29,360 --> 01:35:31,200 WE LOOK AT IS 1 MAKING SURE WE 2338 01:35:31,200 --> 01:35:32,800 HAVE PROCESSES THAT HELP PREVENT 2339 01:35:32,800 --> 01:35:34,320 PEOPLE FROM DOING ERRORS BUT 2340 01:35:34,320 --> 01:35:35,360 THEN IF PEOPLE DON'T FOLLOW 2341 01:35:35,360 --> 01:35:36,800 THOSE, THE QUESTION IS WHY ARE 2342 01:35:36,800 --> 01:35:39,840 THEY NOT FOLLOWING THEM? 2343 01:35:39,840 --> 01:35:41,480 AND GIVING THE ASSUMPTION IT'S 2344 01:35:41,480 --> 01:35:43,600 GOING TO BE EXTREMELY, EXTREMELY 2345 01:35:43,600 --> 01:35:45,520 OUTLYING CASE WHERE SOMEBODY'S 2346 01:35:45,520 --> 01:35:46,160 INTENTIONALLY TRYING TO HARM 2347 01:35:46,160 --> 01:35:48,800 SOMEBODY SO WE'RE SETTING THAT 2348 01:35:48,800 --> 01:35:51,600 ASIDE, WHY ARE THEY NOT 2349 01:35:51,600 --> 01:35:52,000 FOLLOWING THESE? 2350 01:35:52,000 --> 01:35:52,880 IT'S INTERFERING WITH SOME OTHER 2351 01:35:52,880 --> 01:35:55,240 THING WHETHER IT'S THE NEED--THE 2352 01:35:55,240 --> 01:35:57,880 PERCEIVED NEED FOR RUSHING OR 2353 01:35:57,880 --> 01:35:59,360 FEELING SO FATIGUED THAT IT'S 2354 01:35:59,360 --> 01:36:01,360 LIKE, WELL I HAVE 17 MEDICINES 2355 01:36:01,360 --> 01:36:03,720 TO USE SO I'M JUST GOING TO--I 2356 01:36:03,720 --> 01:36:04,800 DIDN'T MEAN TO GRAB THE FIRST 1 2357 01:36:04,800 --> 01:36:06,800 THAT WAS THERE BUT I HAD TO THAT 2358 01:36:06,800 --> 01:36:08,800 KIND OF THING, I THINK ALL THOSE 2359 01:36:08,800 --> 01:36:10,600 THINGS TIE IN TOGETHER. 2360 01:36:10,600 --> 01:36:12,080 >> YEAH, THANK YOU. 2361 01:36:12,080 --> 01:36:13,880 THANK YOU. 2362 01:36:13,880 --> 01:36:14,960 >> OKAY, WE WILL TAKE 1 MORE AND 2363 01:36:14,960 --> 01:36:17,280 THEN WE WILL GET OVER ON CLIFF, 2364 01:36:17,280 --> 01:36:18,760 GREAT CONVERSATION, GREAT 2365 01:36:18,760 --> 01:36:21,160 REPORT, DAVID. 2366 01:36:21,160 --> 01:36:21,840 >> RICK? 2367 01:36:21,840 --> 01:36:22,880 >> YES, THANK YOU DAVID AND 2368 01:36:22,880 --> 01:36:29,160 MAYBE THIS IS FOR BARBARA, 2369 01:36:29,160 --> 01:36:31,520 OBVIOUSLY THE FATIGUE AT THE 2370 01:36:31,520 --> 01:36:33,440 CLINICAL CENTER ISN'T DUE TO 2371 01:36:33,440 --> 01:36:35,240 COVID, MEANING YOU DON'T HAVE 2372 01:36:35,240 --> 01:36:35,680 COVID CASES. 2373 01:36:35,680 --> 01:36:37,920 YOUR CENSUS IS WAY DOWN SO THE 2374 01:36:37,920 --> 01:36:39,600 IDEA OF BEING OVERBURDENED ALSO 2375 01:36:39,600 --> 01:36:41,640 AT LEAST FROM THE NUMBERS ISN'T 2376 01:36:41,640 --> 01:36:42,080 THE ISSUE. 2377 01:36:42,080 --> 01:36:45,360 MY QUESTION IS WHAT ABOUT 2378 01:36:45,360 --> 01:36:45,640 TURNOVER? 2379 01:36:45,640 --> 01:36:47,960 AND ARE YOU SEEING THE SAME 2380 01:36:47,960 --> 01:36:49,680 CHALLENGES EITHER WITH RESPECT 2381 01:36:49,680 --> 01:36:51,200 TO STAFF SHORTAGES OR WITH 2382 01:36:51,200 --> 01:36:53,960 RESPECT TO TURNOVER AND NEW 2383 01:36:53,960 --> 01:36:56,640 NURSES CAN WHICH LEAD TO DRIFT 2384 01:36:56,640 --> 01:36:58,760 ASK THEREFORE MORE SAFETY 2385 01:36:58,760 --> 01:36:59,000 EVENTS? 2386 01:36:59,000 --> 01:37:03,520 >> YES, TO ALL OF THE ABOVE. 2387 01:37:03,520 --> 01:37:05,000 SO WE'VE HAD--WE'VE HAD TURNOVER 2388 01:37:05,000 --> 01:37:08,640 JUST AS ANY OTHER ORGANIZATION 2389 01:37:08,640 --> 01:37:12,240 HAS HAD AND ALSO WHAT WE SAW, WE 2390 01:37:12,240 --> 01:37:14,800 DO USE SOME CONTRACT STAFF TO 2391 01:37:14,800 --> 01:37:18,080 SUPPLEMENT BUT WE HAD GREAT 2392 01:37:18,080 --> 01:37:19,160 DIFFICULTY IN FILLING THOSE 2393 01:37:19,160 --> 01:37:24,800 NEEDS BECAUSE OF THE EXORBITANT 2394 01:37:24,800 --> 01:37:26,760 COSTS AND/OR THE MONEY THAT 2395 01:37:26,760 --> 01:37:30,840 PEOPLE CAN MAKE EITHER GOING TO 2396 01:37:30,840 --> 01:37:34,200 THE HIGHLY HIT PANDEMIC AREAS. 2397 01:37:34,200 --> 01:37:38,160 BUT THE FATIGUE, THE PATIENTS AS 2398 01:37:38,160 --> 01:37:40,760 DR. GILMAN PRESENTED, THE 1S 2399 01:37:40,760 --> 01:37:42,160 THAT CONTINUE TO COME DURING ALL 2400 01:37:42,160 --> 01:37:45,200 THIS TIME ARE VERY ACUTE, VERY 2401 01:37:45,200 --> 01:37:45,560 COMPLEX. 2402 01:37:45,560 --> 01:37:49,000 OUR PATIENT ACUITY IS VERY HIGH 2403 01:37:49,000 --> 01:37:52,280 AND SO THAT AGAIN, THE 2404 01:37:52,280 --> 01:37:53,800 DAY-TO-DAY, BUT OUR, THE FATIGUE 2405 01:37:53,800 --> 01:37:56,720 JUST COMES FROM LIVING IN THIS 2406 01:37:56,720 --> 01:37:58,480 DIFFERENT WORLD AND TAKING CARE 2407 01:37:58,480 --> 01:38:01,120 OF PATIENTS BUT THEN HAVING TO 2408 01:38:01,120 --> 01:38:02,520 GO HOME AND, YOU KNOW HOME 2409 01:38:02,520 --> 01:38:03,920 SCHOOL YOUR CHILDREN THAT YOU 2410 01:38:03,920 --> 01:38:05,920 WEREN'T PLANNING TO DO ALL THOSE 2411 01:38:05,920 --> 01:38:07,200 KINDS OF THINGS SO WE'VE SEEN 2412 01:38:07,200 --> 01:38:08,880 THE SAME THINGS HERE AS OTHERS, 2413 01:38:08,880 --> 01:38:12,680 YOU KNOW IN THE COUNTRY. 2414 01:38:12,680 --> 01:38:14,640 >> ABSOLUTELY, I THINK WE ALSO 2415 01:38:14,640 --> 01:38:16,680 HAVE--YOU KNOW PEOPLE NEEDING TO 2416 01:38:16,680 --> 01:38:18,680 MASK, PEOPLE NEEDING TO NOT BE 2417 01:38:18,680 --> 01:38:19,840 ABLE TO EAT TOGETHER, PATIENTS 2418 01:38:19,840 --> 01:38:21,520 NONAPOPTOTIC THE HAVING 2419 01:38:21,520 --> 01:38:23,280 VISITORS, SO THINGS THAT ARE 2420 01:38:23,280 --> 01:38:24,520 COVID SECOND ORDER OF 2421 01:38:24,520 --> 01:38:25,720 CONSEQUENCES EVER COVID ARE 2422 01:38:25,720 --> 01:38:26,320 DEFINITELY AFFECTING OUR STAFF 2423 01:38:26,320 --> 01:38:28,000 IN ADDITION TO THE COVID 2424 01:38:28,000 --> 01:38:30,760 PATIENTS THEMSELVES. 2425 01:38:30,760 --> 01:38:31,160 SO, YEAH. 2426 01:38:31,160 --> 01:38:38,800 JUST I DO THINK COVID IS PART OF 2427 01:38:38,800 --> 01:38:39,720 IT. 2428 01:38:39,720 --> 01:38:41,040 >> SO EVERYTHING THAT BARBARA 2429 01:38:41,040 --> 01:38:42,360 JUST SAID. 2430 01:38:42,360 --> 01:38:43,960 WE HAVE EXPERIENCED THE IMPACT 2431 01:38:43,960 --> 01:38:45,800 OF THE GREAT RESIGNATION AS WE 2432 01:38:45,800 --> 01:38:49,080 TALKED ABOUT IN OUR OCTOBER 2433 01:38:49,080 --> 01:38:51,520 MEETING AND WE DO OPERATE IN A 2434 01:38:51,520 --> 01:38:53,440 PERSONNEL SYSTEM THAT MAKES IT 2435 01:38:53,440 --> 01:38:56,800 EASY TO LEAVE IN A COUPLE WEEKS 2436 01:38:56,800 --> 01:39:00,440 AND VERY HARD TO COME AND IT 2437 01:39:00,440 --> 01:39:03,600 TAKES MONTHS TO BRING THE NEW 2438 01:39:03,600 --> 01:39:05,240 STAFF ONLINE. 2439 01:39:05,240 --> 01:39:08,040 AND THERE A INFLEXIBILITIES THAT 2440 01:39:08,040 --> 01:39:10,600 I THINK MANY OTHER PLACES DON'T 2441 01:39:10,600 --> 01:39:13,720 HAVE TO DEAL WITH. 2442 01:39:13,720 --> 01:39:16,400 WE DO WORK UNDER--WE DO 2443 01:39:16,400 --> 01:39:19,600 EMPHASIZE THE JUST CULTURE, WE 2444 01:39:19,600 --> 01:39:20,480 ALSO EMPHASIZE REPEATEDLY THAT 2445 01:39:20,480 --> 01:39:33,440 HELP SEEKING IS A SIGN OF--AND 2446 01:39:33,440 --> 01:39:36,880 WE'VE DONE A FAIR AMOUNT OF 2447 01:39:36,880 --> 01:39:37,080 THAT. 2448 01:39:37,080 --> 01:39:38,960 WE ARE--WE DO AT THE PRESENT 2449 01:39:38,960 --> 01:39:41,600 TIME DEAL WITH SORT OF THE PUSH 2450 01:39:41,600 --> 01:39:44,200 AND THE PULL OF INVESTIGATORS 2451 01:39:44,200 --> 01:39:46,520 WHO WANT TO REENERGIZE THEIR 2452 01:39:46,520 --> 01:39:48,000 CLINICAL PROGRAMS THAT 2453 01:39:48,000 --> 01:39:49,200 HAVE--THAT HAVE BEEN ON LOW 2454 01:39:49,200 --> 01:39:50,760 SPEED FOR THE LAST COUPLE OF 2455 01:39:50,760 --> 01:39:54,160 YEARS AND WHO WANT TO--WE HAVE 2456 01:39:54,160 --> 01:39:55,240 INVESTIGATORS THAT ARE ON 2457 01:39:55,240 --> 01:39:57,200 TENURED TRACK WHEN THERE'S A 2458 01:39:57,200 --> 01:40:02,000 CLOCK TICKING AND DR. GOTTESMAN 2459 01:40:02,000 --> 01:40:02,840 DOESIS BEST TO REASSURE THEM 2460 01:40:02,840 --> 01:40:04,040 THAT THEY WILL GET THE EXTRA 2461 01:40:04,040 --> 01:40:06,560 TIME THEY NEED BUT I KNOW THEY 2462 01:40:06,560 --> 01:40:08,600 ARE STILL FEELING, THEY NEVER 2463 01:40:08,600 --> 01:40:09,600 ARE SURE WHEN THEIR EXTRA TIME 2464 01:40:09,600 --> 01:40:14,520 WILL BE UP AND SO THERE'S A LOT 2465 01:40:14,520 --> 01:40:17,200 OF STRESS IN AND AMONG THE 2466 01:40:17,200 --> 01:40:18,480 INVESTIGATORS AND I THINK IN THE 2467 01:40:18,480 --> 01:40:26,400 PAST, IT MIGHT HAVE LED TO MAYBE 2468 01:40:26,400 --> 01:40:28,120 TOO MANY--MORE PATIENTS THAN WE 2469 01:40:28,120 --> 01:40:29,440 CAN REALLY TAKE GOOD CARE OF IN 2470 01:40:29,440 --> 01:40:31,800 THE CLINICAL CENTER, I 2471 01:40:31,800 --> 01:40:32,840 THINK--WHILE IT'S A BALANCING 2472 01:40:32,840 --> 01:40:34,160 ACT EVERY DAY, TRYING TO TAKE 2473 01:40:34,160 --> 01:40:38,480 CARE OF AS MANY PATIENTS AS WE 2474 01:40:38,480 --> 01:40:42,080 CAN SAFELY, THEN I THINK--BUT 2475 01:40:42,080 --> 01:40:45,400 IT'S A CONSTANT TOPIC OF 2476 01:40:45,400 --> 01:40:48,080 DISCUSSION AND SOMETIMES THE 2477 01:40:48,080 --> 01:40:48,800 DISCUSSIONS GET A LITTLE WARM 2478 01:40:48,800 --> 01:40:53,600 BUT I THINK WE'RE DOING THE BEST 2479 01:40:53,600 --> 01:40:55,000 WE CAN. 2480 01:40:55,000 --> 01:40:56,200 >> GREAT. 2481 01:40:56,200 --> 01:40:56,800 WELL, THANK YOU. 2482 01:40:56,800 --> 01:41:00,480 RICK JUST PUT A LINK INTO THE 2483 01:41:00,480 --> 01:41:01,160 CHAT AS WELL. 2484 01:41:01,160 --> 01:41:02,080 THANK YOU RICK. 2485 01:41:02,080 --> 01:41:04,000 WELL, THANK YOU ALL. 2486 01:41:04,000 --> 01:41:07,000 THIS IS A GREAT CONVERSATION AND 2487 01:41:07,000 --> 01:41:10,520 THERE'S SOME THINGS THAT ARE 2488 01:41:10,520 --> 01:41:13,480 UNIVERSAL HERE THAT WE CAN 2489 01:41:13,480 --> 01:41:15,400 CERTAINLY ALL RELATE TO ALL 2490 01:41:15,400 --> 01:41:15,640 RIGHT. 2491 01:41:15,640 --> 01:41:19,280 WE'RE GOING TO SWITCH GEARS NOW, 2492 01:41:19,280 --> 01:41:19,840 A BIT. 2493 01:41:19,840 --> 01:41:21,920 AND GO OVER TO CLIFF. 2494 01:41:21,920 --> 01:41:23,920 CLIFF SORRY TO KEEP YOU WAITING. 2495 01:41:23,920 --> 01:41:24,960 THANKS VERY MUCH FOR BEING HERE 2496 01:41:24,960 --> 01:41:31,360 AND WE'RE LOOKING FORWARD TO 2497 01:41:31,360 --> 01:41:35,520 HEARING YOUR COMMENTS. 2498 01:41:35,520 --> 01:41:36,120 >> GREAT. 2499 01:41:36,120 --> 01:41:36,920 THANKS, VERY MUCH. 2500 01:41:36,920 --> 01:41:38,480 ARE MY SLIDES SHOWING ALL RIGHT? 2501 01:41:38,480 --> 01:41:43,680 AND GOOD, YOU CAN HEAR ME? 2502 01:41:43,680 --> 01:41:44,200 OKAY. 2503 01:41:44,200 --> 01:41:46,200 SO THANKS FOR THE OPPORTUNITY TO 2504 01:41:46,200 --> 01:41:48,320 PROVIDE WHAT I THINK MUST BE NOW 2505 01:41:48,320 --> 01:41:51,600 THE THIRD UPDATE TO THE GROUP ON 2506 01:41:51,600 --> 01:41:54,840 SOME THINGS GOING ON HERE AND 2507 01:41:54,840 --> 01:41:56,040 OBVIOUSLY GLOBALLY WITH REGARD 2508 01:41:56,040 --> 01:41:56,360 TO COVID-19. 2509 01:41:56,360 --> 01:41:58,680 I KNOW YOU HAVE COPIES OF THE 2510 01:41:58,680 --> 01:42:00,360 SLIDES AND I KNOW WHERE YOU ARE 2511 01:42:00,360 --> 01:42:01,760 IN TERMS OF SCHEDULE SO SOME OF 2512 01:42:01,760 --> 01:42:03,200 THE STUFF I WILL GO THROUGH 2513 01:42:03,200 --> 01:42:04,600 PRETTY QUICKLY, SO THIS IS JUST 2514 01:42:04,600 --> 01:42:06,200 SORT OF THE OUTBREAK AS A COUPLE 2515 01:42:06,200 --> 01:42:09,560 OF DAYS AGO, I WILL COME BACK TO 2516 01:42:09,560 --> 01:42:12,000 THIS LAST PEAK IN A MINUTE 2517 01:42:12,000 --> 01:42:14,440 BECAUSE IT OBVIOUSLY REPRESENTS 2518 01:42:14,440 --> 01:42:17,000 OMICRON, IT DOESN'T SHOW ANY 2519 01:42:17,000 --> 01:42:20,160 IMPACT YET IN THE U.S. OF THE 2520 01:42:20,160 --> 01:42:20,560 BA.2 VARIANT. 2521 01:42:20,560 --> 01:42:21,960 SOPHISTICATED I WILL TALK ABOUT 2522 01:42:21,960 --> 01:42:24,640 THE NORG OZIOMATION AT THE 2523 01:42:24,640 --> 01:42:27,800 NATIONAL LEVEL AND THEN TALK 2524 01:42:27,800 --> 01:42:30,080 ABOUT PATHOGENESIS, DIAGNOSTIC, 2525 01:42:30,080 --> 01:42:35,040 THERAPEUTICS, PREVENTION AND 2526 01:42:35,040 --> 01:42:36,040 POST ACUTE SEQUELAE. 2527 01:42:36,040 --> 01:42:38,920 SO ANDY CANNED WHAT WAS THE 2528 01:42:38,920 --> 01:42:41,600 SENIOR ADVISOR AT WHITE HOUSE, 2529 01:42:41,600 --> 01:42:43,320 HE HAS LEFT. 2530 01:42:43,320 --> 01:42:46,000 JEFF ZIENTS, WHO IS CURRENTLY 2531 01:42:46,000 --> 01:42:46,840 THE CORONAVIRUS RESPONSE 2532 01:42:46,840 --> 01:42:48,080 COORDINATOR WILL BE LEAVING IN A 2533 01:42:48,080 --> 01:42:50,200 FEW DAYS. 2534 01:42:50,200 --> 01:43:01,600 HE WILL JEFF WILL BE REPLACED 2535 01:43:01,600 --> 01:43:02,880 BY--WHOOPS, S 2536 01:43:02,880 --> 01:43:04,600 ORRY--DR. ASHISH JHA, AND 2537 01:43:04,600 --> 01:43:05,640 NOUNSING HIS APPOINTMENT THE 2538 01:43:05,640 --> 01:43:07,520 PRESIDENT NOTED HE IS 1 OF THE 2539 01:43:07,520 --> 01:43:09,440 LEADING PUBLIC HEALTH EXPERTS IN 2540 01:43:09,440 --> 01:43:11,280 AMERICA AND WELL KNOWN FIGURE TO 2541 01:43:11,280 --> 01:43:12,360 MANY AMERICANS FROM HIGHS 2542 01:43:12,360 --> 01:43:14,800 WEDNESDAY AND CALMING PRESENCE 2543 01:43:14,800 --> 01:43:16,200 STRESSING THE LAT LATTER PHRASE 2544 01:43:16,200 --> 01:43:16,520 THERE. 2545 01:43:16,520 --> 01:43:17,920 I KNOW THOSE OF YOU WHO KNOW HIM 2546 01:43:17,920 --> 01:43:19,880 AND SEEN HIM ON CNN WILL 2547 01:43:19,880 --> 01:43:21,120 PROBABLY AGREE WITH THAT 2548 01:43:21,120 --> 01:43:21,600 SENTIMENT. 2549 01:43:21,600 --> 01:43:23,600 THERE ARE TRANSITIONS THAT BEEN 2550 01:43:23,600 --> 01:43:26,800 TAKING PLACE AT THE LEVEL OF 2551 01:43:26,800 --> 01:43:29,040 HHS, REGARDING THE COVID-19 2552 01:43:29,040 --> 01:43:32,200 RESPONSE VENLT THE INITIAL 2553 01:43:32,200 --> 01:43:34,360 RESPONSE KNOWN AFFECTATELY AS 2554 01:43:34,360 --> 01:43:36,000 OPERATION WARP SPEED WAS REALLY 2555 01:43:36,000 --> 01:43:37,000 A COMBINED EFFORT BETWEEN THE 2556 01:43:37,000 --> 01:43:37,920 DEPARTMENT OF DEFENSE AND THE 2557 01:43:37,920 --> 01:43:40,120 DEPARTMENT OF HEALTH AND HUMAN 2558 01:43:40,120 --> 01:43:42,640 SERVICES THAT WAS UNDERAN MOU 2559 01:43:42,640 --> 01:43:44,800 THAT EXPIRED AT THE END OF LAST 2560 01:43:44,800 --> 01:43:47,000 YEAR AND OPERATION WARP SPEED 2561 01:43:47,000 --> 01:43:49,080 THEN TRANSITIONED OVER TO 2562 01:43:49,080 --> 01:43:50,840 SOMETHING CALLED H-CORE, OR HHS 2563 01:43:50,840 --> 01:43:57,120 ACCORD NATION OPERATIONS AND 2564 01:43:57,120 --> 01:43:57,640 RESPONSE ELEMENT. 2565 01:43:57,640 --> 01:43:59,200 THIS COMES OUT OF THE OFFICE OF 2566 01:43:59,200 --> 01:44:00,520 SECTIONAL ANALYSIS FOR 2567 01:44:00,520 --> 01:44:02,600 PREPAREDNESS AND RESPONSE WHICH 2568 01:44:02,600 --> 01:44:07,520 IS DON O'CONNELL, AND ITS LED BY 2569 01:44:07,520 --> 01:44:09,200 DR. JASON ROOS, CHIEF OPERATING 2570 01:44:09,200 --> 01:44:12,760 OFFICER AND DR. DAVID KESSLER 2571 01:44:12,760 --> 01:44:16,320 WHO WAS THE HHS CHIEF SCIENCE 2572 01:44:16,320 --> 01:44:16,800 OFFICER FOR COVID-19. 2573 01:44:16,800 --> 01:44:18,200 I MENTION THESE THING BECAUSE 2574 01:44:18,200 --> 01:44:19,840 IT'S HELPFUL TO KNOW WHO THE 2575 01:44:19,840 --> 01:44:20,960 PLAYERS ARE AND WHERE THE 2576 01:44:20,960 --> 01:44:24,880 DECISIONS ARE BEING MADE. 2577 01:44:24,880 --> 01:44:27,280 THE WHITE HOUSE RELEASE THE 2578 01:44:27,280 --> 01:44:28,800 NATIONAL COVID-19 PREPAREDNESS 2579 01:44:28,800 --> 01:44:31,440 PLAN ON MARCH 2nd. 2580 01:44:31,440 --> 01:44:43,720 IT HAS 4 MAIN ELEMENTS. 2581 01:44:43,720 --> 01:44:45,520 THE FUNDING WAS IN THE COVID-19 2582 01:44:45,520 --> 01:44:47,160 SUPPLEMENT THAT DID NOT GET 2583 01:44:47,160 --> 01:44:47,480 PASSED. 2584 01:44:47,480 --> 01:44:49,320 SO AGAIN, THERE'S A LOT OF 2585 01:44:49,320 --> 01:44:50,840 UNCERTAINTY RIGHT NOW ABOUT WHAT 2586 01:44:50,840 --> 01:44:51,960 ELEMENTS OF THIS PLAN IN FACT 2587 01:44:51,960 --> 01:44:56,040 ARE GOING TO COME INTO BEING OR 2588 01:44:56,040 --> 01:44:56,200 NOT. 2589 01:44:56,200 --> 01:44:58,480 SO JUST TO GIVE A FEW COMMENTS 2590 01:44:58,480 --> 01:44:59,360 ABOUT PATHOGENESIS, THIS IS A 2591 01:44:59,360 --> 01:45:02,280 SLIDE I USED IN THE EARLIER 2592 01:45:02,280 --> 01:45:03,640 PRESENTATION TO THE GROUP 2593 01:45:03,640 --> 01:45:06,880 UTALKING ABOUT SORT OF THE 2594 01:45:06,880 --> 01:45:08,720 CONVENTIONAL WISDOM ABOUT THIS 2595 01:45:08,720 --> 01:45:11,200 DEC THAT THERE'S, YOU KNOW 2596 01:45:11,200 --> 01:45:13,240 RANGING FROM ASYMPTOMATIC TO 2597 01:45:13,240 --> 01:45:14,200 MECHANICAL VENTILATION AND 2598 01:45:14,200 --> 01:45:14,400 DEATH. 2599 01:45:14,400 --> 01:45:16,160 THAT THAT EARLY PHASE APPEARS TO 2600 01:45:16,160 --> 01:45:19,120 BE DRIVEN LARGELY BY THE VIRUS 2601 01:45:19,120 --> 01:45:20,360 FOR WHICH ANTIVIRAL STRATEGIES 2602 01:45:20,360 --> 01:45:22,560 SEEM TO HAVE THE BIGGEST IMPACT, 2603 01:45:22,560 --> 01:45:23,920 THE LATTER STAGES PERHAPS THE 2604 01:45:23,920 --> 01:45:25,840 IMMUNE RESPONSE TO THE VIRUS AND 2605 01:45:25,840 --> 01:45:28,120 ASSOCIATE ANY INFLAMMATION WHERE 2606 01:45:28,120 --> 01:45:28,920 IMMUNO MODLATTORY STRATEGY VS 2607 01:45:28,920 --> 01:45:30,320 THE BEST EFFECT AND THEN AGAIN 2608 01:45:30,320 --> 01:45:34,040 LOOKING AT THE ROLE OF 2609 01:45:34,040 --> 01:45:34,840 COAGULATION THROUGHOUT. 2610 01:45:34,840 --> 01:45:37,000 SOME MORE RECENT DATA THAT'S 2611 01:45:37,000 --> 01:45:37,800 EMERGING IT'S REALLY NOT OUT 2612 01:45:37,800 --> 01:45:39,160 THERE VERY MUCH BUT I WANTED TO 2613 01:45:39,160 --> 01:45:40,680 MENTION IT TO THE GROUP, HAS 2614 01:45:40,680 --> 01:45:43,160 SUGGESTED THAT THERE MAY BE 2615 01:45:43,160 --> 01:45:44,080 VIRAL LOGIC ELEMENTS THROUGHOUT 2616 01:45:44,080 --> 01:45:45,720 THE COURSE OF ILLNESS AND IN 2617 01:45:45,720 --> 01:45:47,920 PARTICULAR, NOW THAT WE'RE USING 2618 01:45:47,920 --> 01:45:49,360 SUCH IMOWN O SUPPRESSION IN THE 2619 01:45:49,360 --> 01:45:50,800 ADVANCED STAGES THAT THE VIRUS 2620 01:45:50,800 --> 01:45:52,400 ACTUALLY MAY BE PLAYING A ROLE 2621 01:45:52,400 --> 01:45:53,520 THROUGHOUT THE COURSE OF 2622 01:45:53,520 --> 01:45:54,080 INFECTION. 2623 01:45:54,080 --> 01:45:57,480 WE'RE USING THIS TECHNOLOGY 2624 01:45:57,480 --> 01:45:58,880 DEVELOPED BY QUANTERIX, IT'S A 2625 01:45:58,880 --> 01:46:01,440 NANO TECHNOLOGY USING TINY 2626 01:46:01,440 --> 01:46:02,600 MAGNETIC BEADS CODED WITH 2627 01:46:02,600 --> 01:46:04,480 ANTIBODIES TO THE CORE PROTEIN 2628 01:46:04,480 --> 01:46:05,800 OF SARS-COV-2 SO CAN YOU MEASURE 2629 01:46:05,800 --> 01:46:11,800 DOWN TO THE PICOGRAM LEVELS OF 2630 01:46:11,800 --> 01:46:12,640 CIRCULATING SARS-COV-2 NUCLEOCAP 2631 01:46:12,640 --> 01:46:15,240 SID PROTEIN IN THE PLASMA OR 2632 01:46:15,240 --> 01:46:16,520 SERUM OF INFECTED INDIVIDUALS. 2633 01:46:16,520 --> 01:46:17,720 AND HERE WE'RE LOOKING AT THE 2634 01:46:17,720 --> 01:46:18,680 COHORT OF PATIENTS WHO ARE 2635 01:46:18,680 --> 01:46:21,160 ENROLLED IN THE ACTIVE 3 2636 01:46:21,160 --> 01:46:22,360 THERAPEUTIC TRIALS, THESE ARE 2637 01:46:22,360 --> 01:46:24,840 PATIENTS WHO ARE HOSPITALIZED 2638 01:46:24,840 --> 01:46:26,240 WITH COVID-19 AND WHAT YOU SEE 2639 01:46:26,240 --> 01:46:29,200 AS YOU GO FROM PATIENTS WITH 2640 01:46:29,200 --> 01:46:31,280 MILD DISEASE, ONLY ON ROOM AIR 2641 01:46:31,280 --> 01:46:33,400 THROUGH PROGRESSIVE LEVELS OF 2642 01:46:33,400 --> 01:46:35,720 OXYGEN SUPPORT UP TO NONINVASIVE 2643 01:46:35,720 --> 01:46:36,560 VENTILATION OR HIGH FLOW, CAN 2644 01:46:36,560 --> 01:46:38,960 YOU SEE THAT THE PLASMA LEVELS 2645 01:46:38,960 --> 01:46:41,240 OF ANTIGEN ACTUALLY 2646 01:46:41,240 --> 01:46:41,920 PROGRESSIVELY INCREASE 2647 01:46:41,920 --> 01:46:43,320 SUGGESTING THAT THESE MORE 2648 01:46:43,320 --> 01:46:44,360 SEVERELY ILL PATIENTS ACTUALLY 2649 01:46:44,360 --> 01:46:46,600 HAVE HIGHER LEVELS OF 2650 01:46:46,600 --> 01:46:48,000 CIRCULATING PLASMA ANTIGEN, HOW 2651 01:46:48,000 --> 01:46:50,000 THIS PRECISELY RELATES TO VIRAL 2652 01:46:50,000 --> 01:46:50,960 REPLICATION, WE'RE NOT SURE BUT 2653 01:46:50,960 --> 01:46:52,360 I THINK IT DOES RAISE THE 2654 01:46:52,360 --> 01:46:54,560 QUESTION ABOUT WHETHER OR NOT WE 2655 01:46:54,560 --> 01:46:56,880 MIGHT BE FOCUSING ADDITIONAL 2656 01:46:56,880 --> 01:46:57,760 ANTIVIRAL THERAPIES IN THIS 2657 01:46:57,760 --> 01:46:59,800 ADVANCED GROUP AS I MENTIONED 2658 01:46:59,800 --> 01:47:02,000 EARLIER, PARTICULARLY GIVEN THE 2659 01:47:02,000 --> 01:47:03,800 AMOUNT OF IMMUNO SUPPRESSION 2660 01:47:03,800 --> 01:47:04,760 WE'RE CURRENTLY GIVING THEM SO 2661 01:47:04,760 --> 01:47:06,880 BEAN IT MAY BE THAT WE NEED TO 2662 01:47:06,880 --> 01:47:07,800 ELECTRIC AT ANTIVIRAL STRATEGIES 2663 01:47:07,800 --> 01:47:09,360 THROUGHOUT THE COURSE OF 2664 01:47:09,360 --> 01:47:09,600 COVID-19. 2665 01:47:09,600 --> 01:47:12,000 YOU KNOW WOOF THE BIG WORRIES 2666 01:47:12,000 --> 01:47:13,480 AND--1 OF THE BIG WORRIES AND 2667 01:47:13,480 --> 01:47:15,360 AREAS OF FOLK SUS LOOKING AT THE 2668 01:47:15,360 --> 01:47:17,480 NEW VARIANTS AS THEY COME UP, 2669 01:47:17,480 --> 01:47:19,640 THE MOST RECENT 1 BEING OMICRON, 2670 01:47:19,640 --> 01:47:22,000 THAT I THINK MOST OF YOU ARE 2671 01:47:22,000 --> 01:47:26,120 PRETTY AWARE AS A WHOLE ARRAY OF 2672 01:47:26,120 --> 01:47:28,000 ADDITIONAL CHANGES FROM ITS 2673 01:47:28,000 --> 01:47:29,120 PREDECESSOR DELTA AND EVEN MORE 2674 01:47:29,120 --> 01:47:30,800 SO FROM THE ANCESTRAL STRAINS. 2675 01:47:30,800 --> 01:47:33,360 AGAIN THIS HAS BIG TIME 2676 01:47:33,360 --> 01:47:35,320 IMPLICATIONS IN TERMS OF 2677 01:47:35,320 --> 01:47:36,280 PATHOGENESIS, WHERE IT DOESN'T 2678 01:47:36,280 --> 01:47:39,160 APPEAR TO BE AS PATHOGENIC AS 2679 01:47:39,160 --> 01:47:41,480 SAY DELTA, BUT ALSO IN TERMS OF 2680 01:47:41,480 --> 01:47:43,400 THE ABILITY OF COUNTERMEASURES 2681 01:47:43,400 --> 01:47:45,360 PARTICULARLY THE MONOCLONAL 2682 01:47:45,360 --> 01:47:46,800 ANTIBODIES TO EXERT THEIR 2683 01:47:46,800 --> 01:47:47,280 EFFECT. 2684 01:47:47,280 --> 01:47:49,200 THIS JUST SHOWS THE MOST RECENT 2685 01:47:49,200 --> 01:47:51,160 DATA FROM CDC LOOKING AT THE 2686 01:47:51,160 --> 01:47:52,000 EVOLUTION OF DIFFERENT VALID AND 2687 01:47:52,000 --> 01:47:55,360 RELIABLE YABTS, WITHIN THE U.S. 2688 01:47:55,360 --> 01:47:57,200 POPULATION, THE FIRST BARS UP TO 2689 01:47:57,200 --> 01:47:59,280 THE LAST 2 ARE ACTUAL DATA, THE 2690 01:47:59,280 --> 01:48:04,040 LAST 2 BARS ARE WHAT CDC 2691 01:48:04,040 --> 01:48:05,680 PROJECTIONS WILL BE THE CASE IN 2692 01:48:05,680 --> 01:48:07,000 THE NEXT 2 WEEKS. 2693 01:48:07,000 --> 01:48:09,000 ONCE THE DAILY BASIS AT FROM THE 2694 01:48:09,000 --> 01:48:10,200 PRIOR 2 WEEKS ARE AVAILABLE, AND 2695 01:48:10,200 --> 01:48:12,720 YOU CAN SEE GOING BACK HERE 2696 01:48:12,720 --> 01:48:14,000 THIS, IS JUST GOING BACK TO 2697 01:48:14,000 --> 01:48:15,800 DECEMBER, THE END OF DECEMBER OF 2698 01:48:15,800 --> 01:48:18,360 2021, WHERE YOU STILL HAD SOME 2699 01:48:18,360 --> 01:48:22,600 ELEMENT OF DELTA, AND YOU HAD 2700 01:48:22,600 --> 01:48:26,360 BA.1 JUST SHOWING UP AS 1 OF THE 2701 01:48:26,360 --> 01:48:30,800 VARIANTS WITHIN OMICRON, AND 2702 01:48:30,800 --> 01:48:31,880 OMICRON, RANGING FROM DARK 2703 01:48:31,880 --> 01:48:32,960 PURPLE TO LIGHT PURPLE AND YOU 2704 01:48:32,960 --> 01:48:34,480 CAN SEE IT TOOK OVER IN A 2705 01:48:34,480 --> 01:48:35,800 MONTH'S TIME AND THE TREND IS 2706 01:48:35,800 --> 01:48:40,120 NOW FOR THE EMERGENCE OF BA.2, 2707 01:48:40,120 --> 01:48:41,320 SUBVARIANT OF OMICRON IS, THE 2708 01:48:41,320 --> 01:48:42,680 REASON THIS IS IMPORTANT IS 2709 01:48:42,680 --> 01:48:44,360 BECAUSE THIS DOES REFLECT 2710 01:48:44,360 --> 01:48:46,200 CHAIMPLES AND THE ABILITY OF THE 2711 01:48:46,200 --> 01:48:51,000 MONOCLONAL ANTIBODIES TO WORK. 2712 01:48:51,000 --> 01:48:51,600 [INDISCERNIBLE] THE MAIN 2713 01:48:51,600 --> 01:48:54,680 ANTIBODY OUT THERE WITH EFFICACY 2714 01:48:54,680 --> 01:48:56,440 AGAINST OMICRON, DOES NOT SEEM 2715 01:48:56,440 --> 01:48:59,320 TO HAVE EFFICACY AGAINST BA.2. 2716 01:48:59,320 --> 01:49:03,880 THE ONLY THING AVAILABLE IS 2717 01:49:03,880 --> 01:49:04,320 METRICS TIEWZ MAB. 2718 01:49:04,320 --> 01:49:06,200 BUT THIS I THOUGHT WAS AN 2719 01:49:06,200 --> 01:49:07,360 INTERESTING THING TO LOOK AT AND 2720 01:49:07,360 --> 01:49:09,000 THIS ISN'T IN THE SLIDE DECK. 2721 01:49:09,000 --> 01:49:11,400 I JUST PUT THIS TOGETHER EARLIER 2722 01:49:11,400 --> 01:49:15,840 TODAY, LOOKING AT THE CHANGES IN 2723 01:49:15,840 --> 01:49:17,200 NEW CASES IN FRANCE COMPARED TO 2724 01:49:17,200 --> 01:49:18,600 THE U.S., AGAIN THIS IS TRYING 2725 01:49:18,600 --> 01:49:19,440 TO GET UNDERSTANDING OF WHAT'S 2726 01:49:19,440 --> 01:49:22,360 GOING TO HAPPEN IN THE U.S. WITH 2727 01:49:22,360 --> 01:49:22,880 BA.2. 2728 01:49:22,880 --> 01:49:24,360 I THINK MOST PEOPLE ARE 2729 01:49:24,360 --> 01:49:26,360 ANTICIPATING WE WILL SEE A SURGE 2730 01:49:26,360 --> 01:49:27,000 WITH BA.2. 2731 01:49:27,000 --> 01:49:29,120 WE ARE CERTAINLY SEEING A SHIFT 2732 01:49:29,120 --> 01:49:30,960 TO BA.2, BUT THUS FAR THERE 2733 01:49:30,960 --> 01:49:32,600 AREN'T A LOT OF DATA TO SUPPORT 2734 01:49:32,600 --> 01:49:34,800 THAT AND THAT LOOKS LIKE THAT 2735 01:49:34,800 --> 01:49:36,800 EPIDEMIOLOGY MAY BE END UP BEING 2736 01:49:36,800 --> 01:49:38,600 DIFFERENT IN THE U.S. THAN IT IS 2737 01:49:38,600 --> 01:49:39,680 SHOWN HERE IN FRANCE. 2738 01:49:39,680 --> 01:49:52,920 AGAIN, I THINK THIS MOST LIKELY 2739 01:49:52,920 --> 01:49:53,880 REFLECTS DIFFERENCES SOMETHING 2740 01:49:53,880 --> 01:49:57,600 THAT NCATS SUPPORTS AND IT'S A 2741 01:49:57,600 --> 01:49:58,800 VERY NIFTY COMPILATION OF DATA 2742 01:49:58,800 --> 01:50:01,360 THAT ALLOWS YOU TO LOOK AT THE 2743 01:50:01,360 --> 01:50:06,080 EFFICACY OF ALL DIFFERENT 2744 01:50:06,080 --> 01:50:08,240 COUNTERMEASURES, SERUM FROM 2745 01:50:08,240 --> 01:50:09,600 VEHICLEINATED INDIVIDUALS, 2746 01:50:09,600 --> 01:50:11,280 DIFFERENT MONOCLONAL ANTIBODIES, 2747 01:50:11,280 --> 01:50:12,960 THE DIFFERENT ANTIVIRALS, OR 2748 01:50:12,960 --> 01:50:13,800 CONVALESCENT PLAZ MIDS PLACENTA 2749 01:50:13,800 --> 01:50:16,200 OR SERUM, AND IF YOU CLICK ON 2750 01:50:16,200 --> 01:50:17,000 OMICOON, CAN YOU GET WHAT YOU 2751 01:50:17,000 --> 01:50:17,680 SEE ON THE RIGHT AND YOU SLEEP 2752 01:50:17,680 --> 01:50:18,800 APNEA AND OBESITYY ALL THOSE 2753 01:50:18,800 --> 01:50:20,880 YELLOW DOTS OVER THE TO RIGHT 2754 01:50:20,880 --> 01:50:24,960 FOR MONOCLONAL SHOWING THAT THEY 2755 01:50:24,960 --> 01:50:28,000 ARE NOW MUCH LESS ACTIVE AGAINST 2756 01:50:28,000 --> 01:50:28,760 TD OMICRON VARIANT. 2757 01:50:28,760 --> 01:50:30,520 IN EMERGINGS OF DIAGNOSTICS 2758 01:50:30,520 --> 01:50:33,040 THINGS HAVEN'T CHANGED SO MUCH, 2759 01:50:33,040 --> 01:50:34,800 RTPC R REMAINS THE MOST 2760 01:50:34,800 --> 01:50:36,360 SENSITIVE TOOL AND IT REMAIN 2761 01:50:36,360 --> 01:50:37,320 POSITIVE FOR A PROLONGED PERIOD 2762 01:50:37,320 --> 01:50:38,720 OF TIME AND LOOKING AT WHETHER 2763 01:50:38,720 --> 01:50:41,240 OR NOT YOU'RE GETTING 2764 01:50:41,240 --> 01:50:42,720 AMPLIFICATION OF THE S-GENE AND 2765 01:50:42,720 --> 01:50:45,360 TO IDEPT BIFY VARIANTS AND 2766 01:50:45,360 --> 01:50:47,920 SUBVARIANTS OF OMICRORKS ON, 2767 01:50:47,920 --> 01:50:48,960 ANTIGEN TESTING WHILE LESS 2768 01:50:48,960 --> 01:50:51,880 SENSITIVE IT DOES TYPICALLY 2769 01:50:51,880 --> 01:50:52,600 REPRESENT A HIGHERVILLEERAL LOAD 2770 01:50:52,600 --> 01:50:54,280 AND IT'S VERY EASILY USED IN THE 2771 01:50:54,280 --> 01:50:56,960 HOME, THESE ARE ALL AVAILABLE 2772 01:50:56,960 --> 01:50:57,360 UNDER EMERGENCY USE 2773 01:50:57,360 --> 01:50:58,440 AUTHORIZATION, BUT IF WE DO GET 2774 01:50:58,440 --> 01:51:00,360 TO THE END OF THE PUBLIC HEALTH 2775 01:51:00,360 --> 01:51:01,400 EMERGENCY, THEY WILL NEED TO 2776 01:51:01,400 --> 01:51:03,360 HAVE SOME SORT OF MORE FORMAL 2777 01:51:03,360 --> 01:51:07,080 FDA APPROVAL TO CONTINUING USE. 2778 01:51:07,080 --> 01:51:09,280 IN TALKING ABOUT THERAPEUTICS 2779 01:51:09,280 --> 01:51:14,000 AND THE REMAINS A VERY EXTENSIVE 2780 01:51:14,000 --> 01:51:15,680 CLINICAL TRIALS INFRASTRUCTURE 2781 01:51:15,680 --> 01:51:18,200 THAT'S BEEN PUT TOGETHER TO LOOK 2782 01:51:18,200 --> 01:51:20,360 AT DIFFERENT THERAPEUTIC 2783 01:51:20,360 --> 01:51:23,640 STRATEGIES AND AMPLATTORY AND 2784 01:51:23,640 --> 01:51:26,680 HOSPITALIZED PATIENTS, THE 2785 01:51:26,680 --> 01:51:27,400 ACCELERATING COVID-19 2786 01:51:27,400 --> 01:51:28,200 THERAPEUTIC INTERVENTION 2787 01:51:28,200 --> 01:51:29,000 VACCINE, PUBLIC PRIVATE 2788 01:51:29,000 --> 01:51:30,040 PARTNERSHIP IS DOING MUCH OF 2789 01:51:30,040 --> 01:51:32,600 THIS WORK FOR NIH. 2790 01:51:32,600 --> 01:51:34,840 ACTIVES 1, 3, 4, A AND 5, LOOK 2791 01:51:34,840 --> 01:51:36,800 AT HOST DIRECTED THERAPIES AND 2792 01:51:36,800 --> 01:51:38,280 ANTIVIRALS AND HOSPITALIZED 2793 01:51:38,280 --> 01:51:40,000 PATIENTS. 2794 01:51:40,000 --> 01:51:41,880 ACTIVE 2 LOOKING AT AMBULATORY 2795 01:51:41,880 --> 01:51:46,440 PATIENTS AND ACTIVE 6 LOOKING AT 2796 01:51:46,440 --> 01:51:49,600 REPURPOSES DRUGS SUCH AS 2797 01:51:49,600 --> 01:51:51,280 IVERMECTIN AND [INDISCERNIBLE] 2798 01:51:51,280 --> 01:51:51,920 IN PATIENTS. 2799 01:51:51,920 --> 01:51:52,880 IT'S AN AMAZING LABD SCAPE WHEN 2800 01:51:52,880 --> 01:51:55,000 YOU LOOK AT WHAT'S REPORTED AND 2801 01:51:55,000 --> 01:51:56,400 WHAT'S AVAILABLE FOR TREATING 2802 01:51:56,400 --> 01:51:56,920 PATIENTS WITH COVID-19. 2803 01:51:56,920 --> 01:51:59,840 IF YOU DO A SEARCH OF 2804 01:51:59,840 --> 01:52:01,080 CLINICALTRIALS.GOV, YOU GET OVER 2805 01:52:01,080 --> 01:52:01,520 4000 HITS. 2806 01:52:01,520 --> 01:52:04,280 IF YOU LOOK FOR ARTICLES ON 2807 01:52:04,280 --> 01:52:05,600 PUBMED IT'S OVER 5000 HITS AND 2808 01:52:05,600 --> 01:52:07,600 IF YOU DO A GOOGLE SEARCH IT'S 2809 01:52:07,600 --> 01:52:08,600 OVER 4 BILLION HITS 2810 01:52:08,600 --> 01:52:09,240 SOPHISTICATEDY TRYING TO KEEP 2811 01:52:09,240 --> 01:52:13,960 TRACK OF ALL OF THIS IS 2812 01:52:13,960 --> 01:52:14,680 EXTREMELY DIFFICULT. 2813 01:52:14,680 --> 01:52:17,360 FORTUNATELY THERE ARE A SEER OF 2814 01:52:17,360 --> 01:52:18,280 DIFFERENT TREATMENT GUIDELINES, 2815 01:52:18,280 --> 01:52:22,200 WE HAVE 1 THAT COMES OUT OF NIH 2816 01:52:22,200 --> 01:52:23,200 THAT BEBAN, ORIGINS WERE IN 2817 01:52:23,200 --> 01:52:24,720 MARCH, IT WAS A REQUEST FROM THE 2818 01:52:24,720 --> 01:52:26,560 WHITE HOUSE TASK FORCE AND THEN 2819 01:52:26,560 --> 01:52:27,800 FROM SECRETARY AZAR TO PUT 2820 01:52:27,800 --> 01:52:29,160 TOGETHER A GROUP TO ISSUE A 2821 01:52:29,160 --> 01:52:34,040 LIVING SET OF GUIDELINES THE 2822 01:52:34,040 --> 01:52:35,360 FIRST RELEASE CAME OUT IN APRIL 2823 01:52:35,360 --> 01:52:39,240 OF 2020 FOR THAT TYPO, AS OF 2824 01:52:39,240 --> 01:52:41,360 JUST THIS WEEK, WE'VE HAD 48 2825 01:52:41,360 --> 01:52:42,760 UPDATES, THERE MAY BE ANOTHER 1 2826 01:52:42,760 --> 01:52:46,720 TODAY OR MONDAY AND OVER 2827 01:52:46,720 --> 01:52:48,240 34 MILLION PAGE VIEWS. 2828 01:52:48,240 --> 01:52:50,920 THE LIED LINES PROVIDE 2 TYPES 2829 01:52:50,920 --> 01:52:51,520 OF RATINGS. 2830 01:52:51,520 --> 01:52:54,480 ONE IS THE STRENGTH OF THE 2831 01:52:54,480 --> 01:52:55,360 RECOMMENDATION, STRONG, MODERATE 2832 01:52:55,360 --> 01:52:56,800 OR WEAK AND THE SECOND IS THE 2833 01:52:56,800 --> 01:52:58,680 STRENGTH OF THE EVIDENCE SUPPORT 2834 01:52:58,680 --> 01:52:59,240 THAGOREAN RECOMMENDATION, 1 2835 01:52:59,240 --> 01:53:01,840 BEING DATA FROM ROBUST, OR 2836 01:53:01,840 --> 01:53:02,440 RANDOMIZED CONTROL TRIALS, 2837 01:53:02,440 --> 01:53:04,040 SECOND BEING DAT FROM OTHER 2838 01:53:04,040 --> 01:53:05,720 TRIALS OR OBSERVATIONAL STUDIES, 2839 01:53:05,720 --> 01:53:09,600 OR SUBSET OF RANDOMIZED TRIALS 2840 01:53:09,600 --> 01:53:11,000 AND THEN THE THIRD BEING EXPERT 2841 01:53:11,000 --> 01:53:11,240 OPINION. 2842 01:53:11,240 --> 01:53:13,120 SO WITHIN THE GUIDELINES WE 2843 01:53:13,120 --> 01:53:15,120 BREAK IT OUT INTO 2844 01:53:15,120 --> 01:53:17,080 RECOMMENDATIONS FOR 2845 01:53:17,080 --> 01:53:17,720 NONHOSPITALLIZED PATIENTS, THIS 2846 01:53:17,720 --> 01:53:19,480 IS IN THE PROCESS OF BEING 2847 01:53:19,480 --> 01:53:21,360 UPDATED, THE BOTTOM LINE FROM 2848 01:53:21,360 --> 01:53:24,360 THE CURRENT RECOMMENDATION, THAT 2849 01:53:24,360 --> 01:53:26,400 WE FEEL IS PROBABLY THE GO TO 2850 01:53:26,400 --> 01:53:28,680 THERAPY FOR PATIENTS WHO ARE 2851 01:53:28,680 --> 01:53:30,600 PATIENTS WHO ARE AMPLATTORY WITH 2852 01:53:30,600 --> 01:53:32,360 PILED MODEL CITIZEN MODERATE 2853 01:53:32,360 --> 01:53:33,840 COVID-19 AT HIGH RISK FOR 2854 01:53:33,840 --> 01:53:34,480 DISEASE PROGRESSION. 2855 01:53:34,480 --> 01:53:37,280 IN TERMS OF MONOCLONALS AS BA.2 2856 01:53:37,280 --> 01:53:40,720 COMES INTO PLACE, THE ONLY 1 IS 2857 01:53:40,720 --> 01:53:42,120 BEBTELOVIMAB AND THAT WILL BE 2858 01:53:42,120 --> 01:53:44,720 REFLECTED IN THE NEXT UPDATE, 2859 01:53:44,720 --> 01:53:47,120 REMDESIVIR CAN BE GIVEN LOOKING 2860 01:53:47,120 --> 01:53:49,600 GOOD BUT IT'S A INFUSION, IT'S 2861 01:53:49,600 --> 01:53:50,840 REQUIRED FOR 3 CONSECUTIVE DAYS 2862 01:53:50,840 --> 01:53:54,080 AND VERY IMPORTANT IN AMBULATORY 2863 01:53:54,080 --> 01:53:56,040 PATIENTS WHO DO NOT NEED 2864 01:53:56,040 --> 01:53:57,160 STEROIDS, IT'S THE DATA ARE 2865 01:53:57,160 --> 01:53:59,720 CLEAR THAT GIVING STEROIDS TO 2866 01:53:59,720 --> 01:54:00,920 THIS POPULATION RESULTS IN WORSE 2867 01:54:00,920 --> 01:54:02,680 OUTCOMES THAN NOT GIVINGSTER 2868 01:54:02,680 --> 01:54:03,120 OITDS. 2869 01:54:03,120 --> 01:54:04,960 NERMALS OF HOSPITALIZED 2870 01:54:04,960 --> 01:54:07,240 PATIENTS, THERE ALSO IS AN 2871 01:54:07,240 --> 01:54:09,680 ENORMOUS AMOUNT OF DAT AAGAIN IF 2872 01:54:09,680 --> 01:54:12,000 THEY DON'T REQUIRE SUPPLEMENTAL 2873 01:54:12,000 --> 01:54:14,520 OXYGEN, IF AVOID STEROIDS IF 2874 01:54:14,520 --> 01:54:16,800 THEY DO REQUIRE OXYGEN AMONG THE 2875 01:54:16,800 --> 01:54:20,800 DRUGS THAT HAVE SHOWN EFFICACY, 2876 01:54:20,800 --> 01:54:23,720 REMDESIVIR, DEXAMETHA SEWN, 2877 01:54:23,720 --> 01:54:25,160 BARICITINIB, AND USE THESE ALONE 2878 01:54:25,160 --> 01:54:27,120 OR IN COMBINATION AND WE TRY TO 2879 01:54:27,120 --> 01:54:28,400 PROVIDE THAT TYPE OF GUIDANCE 2880 01:54:28,400 --> 01:54:33,040 AND GUIDE LINES WITH THE 2881 01:54:33,040 --> 01:54:33,800 ASSOCIATED CAVEAT. 2882 01:54:33,800 --> 01:54:35,720 THE CLINICAL TRIALS DAILY BASIS 2883 01:54:35,720 --> 01:54:38,280 THEA SHOULD SUGGESTS THAT 2884 01:54:38,280 --> 01:54:40,000 EVERYONE SHOULD BE 2885 01:54:40,000 --> 01:54:47,120 [INDISCERNIBLE] AND THEN PLUS OR 2886 01:54:47,120 --> 01:54:48,800 MINUS BARI CITINIB, BLOCKADE, SO 2887 01:54:48,800 --> 01:54:50,480 THE U.S. GOVERNMENT HAS BEEN 2888 01:54:50,480 --> 01:54:56,160 INVOLVED HEAVILY IN THE 2889 01:54:56,160 --> 01:55:06,560 DEVELOPMENT OF 6 OF--THERE AN 2890 01:55:06,560 --> 01:55:09,880 EUA ON THE PFIZER VACCINE FOR 2891 01:55:09,880 --> 01:55:13,920 AGES 5-15. 2892 01:55:13,920 --> 01:55:15,600 JOHNSONS & JOHNSONS ADENO 26 2893 01:55:15,600 --> 01:55:17,720 PLATFORM AS BEEN AVAILABLE UNDER 2894 01:55:17,720 --> 01:55:19,720 EMERGENCY USE IN THE U.S., IT'S 2895 01:55:19,720 --> 01:55:23,000 NOT CLEAR WHERE ASTRAZENECA, 2896 01:55:23,000 --> 01:55:26,200 WHETHER OR NOT THEY'RE GOING TO 2897 01:55:26,200 --> 01:55:27,200 BE PURSUING OPERATION IN THE 2898 01:55:27,200 --> 01:55:30,400 U.S. AND THEN TO RECOMBIN ANT 2899 01:55:30,400 --> 01:55:32,440 PROTEIN AND ADJUVANT VACCINES 2900 01:55:32,440 --> 01:55:34,040 HAVE UA REQUESTS IN AND THEY 2901 01:55:34,040 --> 01:55:35,960 PROBABLY WOULD BE USED MORE 2902 01:55:35,960 --> 01:55:37,640 LIKELY IN BOOSTER REGIMENS. 2903 01:55:37,640 --> 01:55:39,360 THOSE 6 ARE JUST A SUBSET OF THE 2904 01:55:39,360 --> 01:55:40,760 10 VACCINES THAT HAVE BEEN 2905 01:55:40,760 --> 01:55:42,840 APPROVED FOR USE BY W. H. O. 2906 01:55:42,840 --> 01:55:47,680 AGAIN, W. H. O. HAS APPROVED 2 2907 01:55:47,680 --> 01:55:49,440 OR AUTHORIZED 2 PROTEIN 2908 01:55:49,440 --> 01:55:55,240 VACCINES, 2 RNA VACCINES, 3 ADEN 2909 01:55:55,240 --> 01:55:58,400 O VIRUS BASED VACCINES AND THEN 2910 01:55:58,400 --> 01:55:59,720 3 ENACTIVATED VIRUS VACCINES. 2911 01:55:59,720 --> 01:56:01,600 JUST TO TALK FOR A FEW MOMENTS 2912 01:56:01,600 --> 01:56:02,680 OF THE EFFICACY FROM THE 2913 01:56:02,680 --> 01:56:03,760 VACCINES FROM THE U.S. 2914 01:56:03,760 --> 01:56:08,360 POPULATION, THESE I THINK ARE 2915 01:56:08,360 --> 01:56:09,120 EXTRAORDINARILY COMPELLING 2916 01:56:09,120 --> 01:56:10,800 DATAOT IMPACT OF VACCINATION, 2917 01:56:10,800 --> 01:56:13,600 THIS IS LOOKING AT AGE ADJUSTED 2918 01:56:13,600 --> 01:56:16,360 RATINGS OF CONFIRMATION 19 2919 01:56:16,360 --> 01:56:18,000 HOSPITALIZED BY VACCINE STATUS 2920 01:56:18,000 --> 01:56:19,240 OCTOBER 21st TO JANUARY OF 2921 01:56:19,240 --> 01:56:19,440 2022. 2922 01:56:19,440 --> 01:56:21,960 YOU CAN SEE THOSE, FULLY 2923 01:56:21,960 --> 01:56:24,000 VACCINATED THAT MEANS 1 DOSE OF 2924 01:56:24,000 --> 01:56:28,280 J& J OR 2 DOSES OF RNA, 9.8 PER 2925 01:56:28,280 --> 01:56:30,360 HUNDRED THOUSAND WITH A BOOSTER, 2926 01:56:30,360 --> 01:56:34,160 WITHOUT A BOOST ARE 35.2 AND 2927 01:56:34,160 --> 01:56:35,080 WITHOUT ANY VACCINE, 145. 2928 01:56:35,080 --> 01:56:37,640 SO THE ABILITY OF THESE VACCINES 2929 01:56:37,640 --> 01:56:39,600 TO PREVENT HOSPITALIZATION IS 2930 01:56:39,600 --> 01:56:40,240 PRETTY SECURE. 2931 01:56:40,240 --> 01:56:41,680 THE QUESTION ABOUT A BOOSTER AND 2932 01:56:41,680 --> 01:56:43,600 NOW WE'RE TALKING ABOUT A SECOND 2933 01:56:43,600 --> 01:56:45,680 BOOSTER, OR A FOURTH DOSE OF 2934 01:56:45,680 --> 01:56:47,960 RNA, IS A VERY HOT TOPIC AT THE 2935 01:56:47,960 --> 01:56:48,400 MOMENT. 2936 01:56:48,400 --> 01:56:49,600 THERE ARE REALLY, REALLY GOOD 2937 01:56:49,600 --> 01:56:51,560 DATA, I THINK ON THE THIRD SHOT 2938 01:56:51,560 --> 01:56:54,600 OR THE FIRST BOOSTER FOR RNA, 2939 01:56:54,600 --> 01:56:55,440 THESE ARE RANDOMIZED CONTROL 2940 01:56:55,440 --> 01:56:57,200 TRIAL DATA FROM PFIZER TAKING 2941 01:56:57,200 --> 01:56:59,400 THEIR INITIAL PHASE 3 COHORT AND 2942 01:56:59,400 --> 01:57:00,800 RANDOMIZING THEM TO AN 2943 01:57:00,800 --> 01:57:02,640 ADDITIONAL SHOT OR BOOSTER AS 2944 01:57:02,640 --> 01:57:04,520 ARE OPPOSE TO NOT GETTING 2945 01:57:04,520 --> 01:57:06,600 ADDITIONAL SHOT WHICH IS THE 2946 01:57:06,600 --> 01:57:07,680 RED. 2947 01:57:07,680 --> 01:57:12,880 YOU CAN SEE THE IMPACT OF THAT 2948 01:57:12,880 --> 01:57:14,920 ADDITIONAL SHOT ON INCIDENCE OF 2949 01:57:14,920 --> 01:57:16,680 NEW CASES, IT REALLY IS THE 2950 01:57:16,680 --> 01:57:19,400 THIRD SHOT AS A LOT IN TERMS OF 2951 01:57:19,400 --> 01:57:20,000 EFFICACY. 2952 01:57:20,000 --> 01:57:21,600 THOSE DISA OF COURSE ARE 2953 01:57:21,600 --> 01:57:23,400 GENERATED PRIOR TO OMICRON, SO 2954 01:57:23,400 --> 01:57:26,360 THE QUESTION IS WELL, YOU KNOW I 2955 01:57:26,360 --> 01:57:28,200 WAS VOCINATED WITH ANCESTRAL 2956 01:57:28,200 --> 01:57:30,440 STRAIN, SPIKE PROTEIN, WHAT WILL 2957 01:57:30,440 --> 01:57:33,480 THAT DO FOR OMICOON THESE DATA 2958 01:57:33,480 --> 01:57:34,760 SHOW THAT EACH THOUGH YOU'RE 2959 01:57:34,760 --> 01:57:37,440 BOOSTED WITH A VACCINE DIRECTED 2960 01:57:37,440 --> 01:57:39,120 PERIODS THE ANCESTRAL, IT GIVES 2961 01:57:39,120 --> 01:57:40,640 YOU INCREASE IN IMMUNITY TO THE 2962 01:57:40,640 --> 01:57:42,720 VARIANTS AS WELL, SO HERE WE'RE 2963 01:57:42,720 --> 01:57:43,960 LOOKINGA THE NEUTRALIZING 2964 01:57:43,960 --> 01:57:48,280 ANTIBODY TO EITHER THE WILD TYPE 2965 01:57:48,280 --> 01:57:49,600 OR TO OMICRON, CAN YOU SEE HERE 2966 01:57:49,600 --> 01:57:54,480 IN THE FAR LEFT WHICH SHOWS 2967 01:57:54,480 --> 01:57:55,760 TITER SEVERAL MONTHS AFTER THE 2968 01:57:55,760 --> 01:57:57,640 RNA, MODEL CITIZEN DENERVATA AND 2969 01:57:57,640 --> 01:57:59,280 BEFORE THE BOOSTER, YOU CAN SEE 2970 01:57:59,280 --> 01:58:02,400 THE TITERS ARE LOWER AND YOU 2971 01:58:02,400 --> 01:58:04,480 GIVE THE BOOST AND TITERS GO UP, 2972 01:58:04,480 --> 01:58:07,520 SO AGAIN BOOSTING WITH ANCESTRAL 2973 01:58:07,520 --> 01:58:09,960 DOES INCREASE TITERS OF ANTIBODY 2974 01:58:09,960 --> 01:58:11,680 TO OMICOON, SO THIS IS A VERY 2975 01:58:11,680 --> 01:58:13,520 IMPORTANT PIECE OF LABORATORY 2976 01:58:13,520 --> 01:58:13,720 DATA. 2977 01:58:13,720 --> 01:58:17,000 THE BOOSTING THAT YOU SEE, CAN 2978 01:58:17,000 --> 01:58:18,400 YOU SEE REGARDLESS OF WHAT BOOST 2979 01:58:18,400 --> 01:58:20,280 YOU GIVE, SO THESE ARE LOOKING 2980 01:58:20,280 --> 01:58:24,320 AT PATIENTS WHO ARE INITIALLY 2981 01:58:24,320 --> 01:58:27,720 IMMUNIZED WITH EITHER AD26, THE 2982 01:58:27,720 --> 01:58:28,520 JNJ, MRNA, MODEL CITIZEN 2983 01:58:28,520 --> 01:58:33,840 DENERVATA OR THE PFIZER RNA, AND 2984 01:58:33,840 --> 01:58:36,760 THEN BOOSTED FROM MODERNA, THE 2985 01:58:36,760 --> 01:58:38,840 JNJ AND THE PFIZER, CAN YOU SEE 2986 01:58:38,840 --> 01:58:39,640 IN EACH INSTANCE IT DOESN'T 2987 01:58:39,640 --> 01:58:40,600 MATTER WHAT YOU GOT IPT GREATER 2988 01:58:40,600 --> 01:58:42,040 I SHALY THAT IN FACT ANY OF 2989 01:58:42,040 --> 01:58:44,200 THESE SCRAK SEENS WILL GIVE YOU 2990 01:58:44,200 --> 01:58:45,040 A GOOD BOOST. 2991 01:58:45,040 --> 01:58:47,480 YOU CAN TELL EVEN THOUGH THIS IS 2992 01:58:47,480 --> 01:58:48,920 NOT A RANDOMIZED CONTROL TRIAL, 2993 01:58:48,920 --> 01:58:50,600 THESE DATA WERE DEVELOPED 2994 01:58:50,600 --> 01:58:52,400 LONGITUDINALLY SO THERE ARE A 2995 01:58:52,400 --> 01:58:53,400 LOT OF CONFOUNDERS BUT BY AND 2996 01:58:53,400 --> 01:58:55,080 LARGE YOU ARE GETTING HIGHER 2997 01:58:55,080 --> 01:58:57,040 ANTIBODY TITERS WITH A BOOST 2998 01:58:57,040 --> 01:58:58,600 WITH RNA THAT DOESN'T TELL YOU 2999 01:58:58,600 --> 01:58:59,600 ABOUT DURABILITY AND AS I 3000 01:58:59,600 --> 01:59:00,600 MENTION INDEED A MOMENT THAT'S 3001 01:59:00,600 --> 01:59:02,160 STILL 1 OF OUR UNANSWERED 3002 01:59:02,160 --> 01:59:02,680 QUESTIONS. 3003 01:59:02,680 --> 01:59:05,880 SO WHAT WE DO KNOW IS THAT IN 3004 01:59:05,880 --> 01:59:07,200 ADULTS THESE VACCINES LOOK 3005 01:59:07,200 --> 01:59:08,160 REALLY SAFE, REALLY EFFECTIVE 3006 01:59:08,160 --> 01:59:10,600 AND THERE'S CLEAR ADDITIONAL 3007 01:59:10,600 --> 01:59:12,000 PROTECTION FROM A THIRD DOSE, IN 3008 01:59:12,000 --> 01:59:14,320 CHILDREN, AT LEAST FOR PFIZER, 3009 01:59:14,320 --> 01:59:15,960 WHERE WE HAVE EMERGENCY 3010 01:59:15,960 --> 01:59:16,800 AUTHORIZATION, THEY APPEAR SAFE 3011 01:59:16,800 --> 01:59:19,520 AND EFFECTIVE IN AGES 5-17. 3012 01:59:19,520 --> 01:59:21,880 WE DON'T HAVE ANY GOOD 3013 01:59:21,880 --> 01:59:23,800 LABORATORY CORRELATES PROTECTION 3014 01:59:23,800 --> 01:59:25,800 THAT COULD HELP THEN INFORM HOW 3015 01:59:25,800 --> 01:59:27,840 OFTEN 1 MIGHT NEED A BOOST, WE 3016 01:59:27,840 --> 01:59:29,240 DON'T KNOW THEN, DURATION OF 3017 01:59:29,240 --> 01:59:31,800 PROTECTION FROM EITHER 3018 01:59:31,800 --> 01:59:33,960 INFECTION, SYMPTOMATIC DISEASE, 3019 01:59:33,960 --> 01:59:35,000 HOSPITALIZES OR DEATH AND IT'S 3020 01:59:35,000 --> 01:59:37,080 UNCLEAR THIS FAR WHAT IS THE 3021 01:59:37,080 --> 01:59:39,040 BEST REGIMEN FOR CONCERN UNDER 5 3022 01:59:39,040 --> 01:59:40,400 YEARS OF AGE ALTHOUGH THERE ARE 3023 01:59:40,400 --> 01:59:42,800 DATA BEING REVIEWED AT THE 3024 01:59:42,800 --> 01:59:43,040 MOMENT. 3025 01:59:43,040 --> 01:59:46,280 SO EARLIER THIS WEEK, THE FDA 3026 01:59:46,280 --> 01:59:48,240 AUTHORIZED A FOURTH DOSE FOR 3027 01:59:48,240 --> 01:59:49,480 ADDITIONAL INDIVIDUALS OR A 3028 01:59:49,480 --> 01:59:51,360 SECOND BOOSTER THIS, IS FOR 3029 01:59:51,360 --> 01:59:52,920 ANYONE 50 YEARS OF AGE OR OLDER 3030 01:59:52,920 --> 01:59:54,680 AND AT LEAST 4 MONTHS AFTER 3031 01:59:54,680 --> 01:59:57,840 RECEIPT OF A FIRST BOOSTER DOSE, 3032 01:59:57,840 --> 01:59:59,440 FORRIFIES THERAPY AND INCLUDES 3033 01:59:59,440 --> 02:00:01,400 PEOPLE, AGAIN, 50 YEARS OF AGE 3034 02:00:01,400 --> 02:00:14,200 AND OLDER AND ANYONE 12 AND 3035 02:00:14,200 --> 02:00:15,240 OLDER PRETTY EXTENSIVE FROM A 3036 02:00:15,240 --> 02:00:16,560 LOT OF THE WORK THEY'VE DONE IN 3037 02:00:16,560 --> 02:00:18,240 PARTICULAR, SOME OF THE WORK IN 3038 02:00:18,240 --> 02:00:20,800 ISRAEL, THEY HAVE SAFETY DATA 3039 02:00:20,800 --> 02:00:22,320 NOW IN 700,000 PERSONS. 3040 02:00:22,320 --> 02:00:25,520 THERE'S NOT AS MUCH SAFETY DAT 3041 02:00:25,520 --> 02:00:27,200 ON MODERNA ON THE FOURTH DOSE SO 3042 02:00:27,200 --> 02:00:28,480 THAT'S A SMALLER SOMEBODY, IT'S 3043 02:00:28,480 --> 02:00:30,080 VERY CLEAR WHERE PEOPLE HAVE 3044 02:00:30,080 --> 02:00:32,080 LOOKED AT ANTIBODY TITERS AFTER 3045 02:00:32,080 --> 02:00:33,520 A SECOND BOOSTER THAT ANTIBODY 3046 02:00:33,520 --> 02:00:35,480 TITERS GO UP AND DATA THAT HAS 3047 02:00:35,480 --> 02:00:37,760 GOTTEN A LOT OF PLAY COMING FROM 3048 02:00:37,760 --> 02:00:39,720 ISRAEL AND I THOUGHT IT WAS 3049 02:00:39,720 --> 02:00:41,680 IMPORTANT TO TRY TO GIVE DETAIL 3050 02:00:41,680 --> 02:00:42,640 ON THAT. 3051 02:00:42,640 --> 02:00:46,600 SO THIS--THESE DATA COME FROM A 3052 02:00:46,600 --> 02:00:50,560 NONRANDOMMIZED COHORT OF 500,000 3053 02:00:50,560 --> 02:00:51,960 INDIVIDUALS AGES 60-100 WHO WERE 3054 02:00:51,960 --> 02:00:52,720 FOLLOWED FOR 40 DAYS. 3055 02:00:52,720 --> 02:00:55,000 SO WHAT HAPPEN INDEED IN COHORT, 3056 02:00:55,000 --> 02:00:56,320 THEY WERE GETTING A FOURTHS 3057 02:00:56,320 --> 02:00:57,480 SHOT, SO WHAT THE INVESTIGATORS 3058 02:00:57,480 --> 02:01:00,040 DID HERE, THEY LOOKED AT THE 3059 02:01:00,040 --> 02:01:03,200 RATES OF DEATH IN THE 3060 02:01:03,200 --> 02:01:04,360 INDIVIDUALS WHO HAD ALREADY 3061 02:01:04,360 --> 02:01:06,000 GOTTEN THE FOURTH SHOT VERSUS 3062 02:01:06,000 --> 02:01:06,800 THOSE WHO HAD NOT. 3063 02:01:06,800 --> 02:01:09,360 SO IT'S SORT OF AN IMMEDIATE, 3064 02:01:09,360 --> 02:01:11,240 VERUS DEFERRED LOOK, AGAIN THERE 3065 02:01:11,240 --> 02:01:13,360 ARE ENORMOUS CONFOUNDERS IN THIS 3066 02:01:13,360 --> 02:01:14,960 TYPE OF ANALYSIS, BECAUSE OFTEN 3067 02:01:14,960 --> 02:01:17,800 THOSE WHO SHOW UP FIRST TO GET 3068 02:01:17,800 --> 02:01:19,120 THE ADDITIONAL DOSE HAVE HEALTH 3069 02:01:19,120 --> 02:01:20,400 SEEKING BEHAVIOR AND OTHER 3070 02:01:20,400 --> 02:01:22,160 REASONS WHY THEY MIGHT NOT GET 3071 02:01:22,160 --> 02:01:25,800 INFECTED, MIGHT NOT DIE. 3072 02:01:25,800 --> 02:01:29,240 IN ANY EVENT WITH THOSE CAVEATS 3073 02:01:29,240 --> 02:01:30,200 THERE WERE 232 DEATHS AND THOSE 3074 02:01:30,200 --> 02:01:33,600 THAT DID NOT RECEIVE THE FOURTH 3075 02:01:33,600 --> 02:01:35,800 DOSE, THOSE RIENCHLING FROM 3076 02:01:35,800 --> 02:01:37,400 12,000 TO 328,000. 3077 02:01:37,400 --> 02:01:39,840 AND THERE WERE 92 DEATHS IN 3078 02:01:39,840 --> 02:01:42,840 THOSE WHO DERECEIVE A FOURTH 3079 02:01:42,840 --> 02:01:45,240 DOSE, FROM 550,000 TO 233,000. 3080 02:01:45,240 --> 02:01:48,240 SO THE ADJUSTED HAZARD RATIO FOR 3081 02:01:48,240 --> 02:01:50,240 DEATH, SO THE DECREASE IN 3082 02:01:50,240 --> 02:01:52,560 MORTALITY FROM THOSE OVERALL IN 3083 02:01:52,560 --> 02:01:54,920 THIS STUDY, WAS .22 SO THATIA A 3084 02:01:54,920 --> 02:01:56,560 PRETTY REDUCTION IN DEATH BASED 3085 02:01:56,560 --> 02:01:57,960 ON GETTING A FOURTH DOSE. 3086 02:01:57,960 --> 02:02:03,960 LAST FEW WORDINGS ON POST ACUTE 3087 02:02:03,960 --> 02:02:05,600 SEQUELAE OF COVID-19 OR P A SC, 3088 02:02:05,600 --> 02:02:07,240 THIS IS BEING STUDIED LARGELY 3089 02:02:07,240 --> 02:02:09,160 THROUGH THE RESEARCH AND COVID 3090 02:02:09,160 --> 02:02:11,240 TO ENHANCE RECOVERY INITIATIVE 3091 02:02:11,240 --> 02:02:12,000 OR RECOVER. 3092 02:02:12,000 --> 02:02:13,840 THIS IS BEING PREDOMINANTLY CO 3093 02:02:13,840 --> 02:02:15,640 LED BY HEART LUNG AND BLOOD AND 3094 02:02:15,640 --> 02:02:18,440 UROLOGY AND SEEKS TO UNDERSTAND 3095 02:02:18,440 --> 02:02:20,360 PREVENT AND TREAT P A SC 3096 02:02:20,360 --> 02:02:21,240 INCLUDING LONG COVID. 3097 02:02:21,240 --> 02:02:22,800 THERE ARE ALSO 3 PROTOCOLS AT 3098 02:02:22,800 --> 02:02:23,880 THE NIH CLINICAL CENTER, GO 3099 02:02:23,880 --> 02:02:25,080 GOING ON RIGHT HERE IN THE 3100 02:02:25,080 --> 02:02:25,360 HOSPITAL. 3101 02:02:25,360 --> 02:02:26,560 I JUST TELL YOU A LITTLE BIT 3102 02:02:26,560 --> 02:02:28,800 ABOUT THE 1 STUDY HERE IN THE 3103 02:02:28,800 --> 02:02:30,960 HOSPITAL. 3104 02:02:30,960 --> 02:02:34,000 IT'S LOOKING AT 3 COHORTS THAT 3105 02:02:34,000 --> 02:02:34,240 NIAID. 3106 02:02:34,240 --> 02:02:36,760 AND MIKE SNELLER S&P THE PI, 3107 02:02:36,760 --> 02:02:37,800 LOOKING AT ADULTS OF INDIVIDUAL 3108 02:02:37,800 --> 02:02:40,200 WITH A HISTORY OF COVID AND 3109 02:02:40,200 --> 02:02:41,920 PERSISTENT SYMPTOMS, HISTORY OF 3110 02:02:41,920 --> 02:02:43,320 COVID AND NO PERSISTENT SYMPTOMS 3111 02:02:43,320 --> 02:02:44,680 AND AN INDIVIDUAL WITHOUT A 3112 02:02:44,680 --> 02:02:46,800 HISTORY OF COVID WHO HAD BEEN IN 3113 02:02:46,800 --> 02:02:49,680 CONTACT WITH SOMEONE WHO HAD. 3114 02:02:49,680 --> 02:02:52,000 DATA COLLECTION IS PRETTY 3115 02:02:52,000 --> 02:02:53,320 EXTENSIVE, INDIVIDUAL HISTORIES 3116 02:02:53,320 --> 02:02:56,480 AND PHYSICALS, ROUTINE LABS, 3117 02:02:56,480 --> 02:02:57,800 MARKERS OF INFLAMMATION, 3118 02:02:57,800 --> 02:03:00,080 COAGULATION, DIRECTED STUDIES OF 3119 02:03:00,080 --> 02:03:02,600 SARS-COV-2 IMMUNOLOGY AND I 3120 02:03:02,600 --> 02:03:04,800 HAVEROLOGY. 3121 02:03:04,800 --> 02:03:06,800 MENTAL HEALTH EVALUATION, EKG, 3122 02:03:06,800 --> 02:03:11,000 ECHO CARDIO GRAMS AND A PET AND 3123 02:03:11,000 --> 02:03:12,000 6 MINUTE WALKING TEST. 3124 02:03:12,000 --> 02:03:13,960 THESE ARE SYMPTOMS THAT ARE MORE 3125 02:03:13,960 --> 02:03:16,520 PREPTULENT IN THE SURVIVORS AND 3126 02:03:16,520 --> 02:03:18,240 CONTROL GROUP AND YIEF SEEN FROM 3127 02:03:18,240 --> 02:03:20,600 MANY OTHER STUDIES ARE A BIT 3128 02:03:20,600 --> 02:03:22,040 MORE ANECDOTA BECAUSE THEY'RE 3129 02:03:22,040 --> 02:03:23,920 OFTEN FROM LARGE HOSPITAL BASED 3130 02:03:23,920 --> 02:03:25,240 RECORDS BUT AT LEAST WE HAVE A 3131 02:03:25,240 --> 02:03:30,560 CONTROL GROUP TO LOOK AT, 3132 02:03:30,560 --> 02:03:32,520 FATIGUE, DISNIA, 3133 02:03:32,520 --> 02:03:36,080 CONCENTRATIONING, ANOSMIA, 3134 02:03:36,080 --> 02:03:38,480 TROUBLE SLEEPING, CHEST PAIN AND 3135 02:03:38,480 --> 02:03:39,800 DISCOMFORT ARE ALL SIGNIFICANTLY 3136 02:03:39,800 --> 02:03:41,800 GREATER IN THE COVID-19 COHORT. 3137 02:03:41,800 --> 02:03:43,600 IF YOU THEN LOOK AT ALL THE 3138 02:03:43,600 --> 02:03:45,400 SURVIVORS AND COMPARE THOSE WHO 3139 02:03:45,400 --> 02:03:49,160 HAVE SYMPTOMS FOR THOSE WHO DO 3140 02:03:49,160 --> 02:03:49,400 NOT. 3141 02:03:49,400 --> 02:03:50,760 NOTED A LOT FALLS OUT FOR US 3142 02:03:50,760 --> 02:03:53,120 ISSUES THE 2 THINGS THAT FALL 3143 02:03:53,120 --> 02:03:53,840 OUT WERE FEMALE GENDER 3144 02:03:53,840 --> 02:03:55,600 IDENTITIER AND HISTORY OF AN 3145 02:03:55,600 --> 02:03:56,000 ANXIETY DISORDER. 3146 02:03:56,000 --> 02:03:57,840 IF YOU LOOK AT THE ANTIBODY 3147 02:03:57,840 --> 02:03:59,840 TITERS IN THESE COHORTS, I THINK 3148 02:03:59,840 --> 02:04:00,680 IT'S REALLY QUITE INTERESTING, 3149 02:04:00,680 --> 02:04:02,760 YOU HEAR A LOST DISCUSSION OF 3150 02:04:02,760 --> 02:04:06,800 WHETHER WELL I WAS INFECTED, I'M 3151 02:04:06,800 --> 02:04:09,080 PROTECTED I DON'T NEED GOAT 3152 02:04:09,080 --> 02:04:10,120 VACCINATED. 3153 02:04:10,120 --> 02:04:13,360 HERE WE'RE USING AN ASSAY AS A 3154 02:04:13,360 --> 02:04:14,400 SURROGATE FOR NEUTRALIZATION. 3155 02:04:14,400 --> 02:04:16,200 LOOKINGA THE INHIBITION OF THE 3156 02:04:16,200 --> 02:04:18,120 SPIKE PROTEIN BIND TO ACE 2, YOU 3157 02:04:18,120 --> 02:04:19,520 CAN SEE FOR NONVACCINATED 3158 02:04:19,520 --> 02:04:20,800 INDIVIDUALS WHERE PART OF OUR 3159 02:04:20,800 --> 02:04:22,320 CONTROL GROUP, AGAIN THIS STUDY 3160 02:04:22,320 --> 02:04:26,400 STARTED IN JUNE OF 2020. 3161 02:04:26,400 --> 02:04:30,160 NO 1 WITH ANTIBODY LEVELS TO 3162 02:04:30,160 --> 02:04:30,440 SARS-COV-2. 3163 02:04:30,440 --> 02:04:31,760 WHEN THAT GROUP, THE VACCINATED 3164 02:04:31,760 --> 02:04:33,920 1 YOU SEE THE ANTIBODY TITERS GO 3165 02:04:33,920 --> 02:04:35,680 UP, IF YOU LOOK AT THE SURVIVORS 3166 02:04:35,680 --> 02:04:37,320 THAT ARE NOT VACCINATED YOU SEE 3167 02:04:37,320 --> 02:04:40,040 AN AMAZING ARRAY OF ANTIBODY 3168 02:04:40,040 --> 02:04:41,760 TITERS WITH A LARGE PERCENTAGE 3169 02:04:41,760 --> 02:04:43,480 OF THEM NOT HAVING WHAT WOULD BE 3170 02:04:43,480 --> 02:04:45,200 CONSIDERED A POSITIVE ANTIBODY 3171 02:04:45,200 --> 02:04:46,720 RESPONSE, SO IN OTHER WORDS AS 3172 02:04:46,720 --> 02:04:50,040 HAS BEEN SEEN WITH OTHER 3173 02:04:50,040 --> 02:04:51,440 CORONAVIRUSS, THE HOST IMMUNE 3174 02:04:51,440 --> 02:04:52,720 SYSTEM DOESN'T NECESSARILY KICK 3175 02:04:52,720 --> 02:04:53,640 INTO HIGH GEAR. 3176 02:04:53,640 --> 02:04:57,360 IN CONTRAST, THE INFECTED 3177 02:04:57,360 --> 02:04:57,960 INDIVIDUALS WERE VACCINATED 3178 02:04:57,960 --> 02:04:59,280 ARGUE LEEBL HAVE THE HIGHEST 3179 02:04:59,280 --> 02:05:00,360 ANTIBODY TITERS AND THIS IS THE 3180 02:05:00,360 --> 02:05:03,600 GROUP WE LOOK TO DEVELOP HYPER 3181 02:05:03,600 --> 02:05:04,840 IMMUNE IMMUNO GLOBUE LYNN FOR 3182 02:05:04,840 --> 02:05:06,000 OTHER STUDIES. 3183 02:05:06,000 --> 02:05:07,240 LOOKING AT DECLINE IN ANTIBODY 3184 02:05:07,240 --> 02:05:09,400 LEVELS OVER TIME IN THE INFECTED 3185 02:05:09,400 --> 02:05:10,960 INDIVIDUALS INTERESTINGLY THAT 3186 02:05:10,960 --> 02:05:11,920 RATE OF DECLINE DOESN'T APPEAR 3187 02:05:11,920 --> 02:05:24,080 TO BE QUITE AS RAPID AS WHAT WE 3188 02:05:24,080 --> 02:05:25,400 SEE WITH SO IN TUMRY THEN ON 3189 02:05:25,400 --> 02:05:27,760 THAT STUDY FROM THE INTRAMURAL 3190 02:05:27,760 --> 02:05:29,280 PROGRAM, PARTICIPANTS IN THE 3191 02:05:29,280 --> 02:05:30,800 COVID-19 GROUP REPORTED MORE 3192 02:05:30,800 --> 02:05:32,040 SYMPTOMS THAN THOSE OF THE 3193 02:05:32,040 --> 02:05:41,200 CONTROL GROUP, FACAS TIGER 3194 02:05:41,200 --> 02:05:43,240 DATABASE, DISNEYA, INSOMNIA, 3195 02:05:43,240 --> 02:05:44,880 IMPAIRMENT, CHEST DISCOMFORT AND 3196 02:05:44,880 --> 02:05:46,160 AGENT, HOWEVER FINDING THIS ON 3197 02:05:46,160 --> 02:05:48,280 THE LAB EXAM UNCOMMON TO FIND 3198 02:05:48,280 --> 02:05:49,120 THEM THERE, THEY WERE 3199 02:05:49,120 --> 02:05:49,880 NONAPOPTOTICET ASSOCIATE WIDE 3200 02:05:49,880 --> 02:05:51,000 THOSE INDIVIDUAL WHO IS WERE 3201 02:05:51,000 --> 02:05:52,720 SURVIVORS AND HAD SYMPTOMS SO 3202 02:05:52,720 --> 02:05:54,800 JUST IN MY LAST SLIDE TO GIVE 3203 02:05:54,800 --> 02:05:55,960 YOU THOSE 2 WEBSITES I THINK 3204 02:05:55,960 --> 02:05:57,920 WERE IMPORTANT TO KNOW, 1 NEAR 3205 02:05:57,920 --> 02:06:00,240 THE NIH TREATMENT GUIDELINE THE 3206 02:06:00,240 --> 02:06:02,120 OTHER FOR THE NCATS WEBSITE THAT 3207 02:06:02,120 --> 02:06:03,720 TALKS ABOUT VARIANTS AND THE 3208 02:06:03,720 --> 02:06:04,760 ACTIVITY OF THE DIFFERENT 3209 02:06:04,760 --> 02:06:05,720 COUNTERMEASURES SO I KNOW THAT 3210 02:06:05,720 --> 02:06:07,480 WAS FAST. 3211 02:06:07,480 --> 02:06:08,120 I APOLOGIZE BUT THANK YOU VERY 3212 02:06:08,120 --> 02:06:14,920 MUCH FOR YOUR ATTENTION EMPLOY. 3213 02:06:14,920 --> 02:06:16,320 >> WELL, AS ALWAYS IT'S A MASTER 3214 02:06:16,320 --> 02:06:17,160 CLASS AND EVERYTHING THAT'S 3215 02:06:17,160 --> 02:06:18,680 GOING ON AND THANK YOU FOR THE 3216 02:06:18,680 --> 02:06:20,080 GREAT SUMMARY. 3217 02:06:20,080 --> 02:06:20,440 CRAIG? 3218 02:06:20,440 --> 02:06:25,400 >> THANKS CLIFF, GREAT 3219 02:06:25,400 --> 02:06:26,680 PRESENTATION SO I HIGHLIGHTED 3220 02:06:26,680 --> 02:06:30,560 THAT BA2 IS THE DOMAIN NABT 3221 02:06:30,560 --> 02:06:31,000 OMIKRON SUBVARIANT. 3222 02:06:31,000 --> 02:06:32,960 MY QUESTION IS ABOUT FUTURE 3223 02:06:32,960 --> 02:06:35,800 POTENTIAL INTEL ABOUT FUTURE 3224 02:06:35,800 --> 02:06:36,760 POTENTIAL VARIANTS. 3225 02:06:36,760 --> 02:06:39,040 WHAT'S THE SURVEILLANCE 3226 02:06:39,040 --> 02:06:40,600 MECHANISM, I ASSUME IT'S AN 3227 02:06:40,600 --> 02:06:43,760 INTERNATIONAL SURVEILLANCE FOR 3228 02:06:43,760 --> 02:06:45,840 NEW VARIANTS AND IS THERE ANY 3229 02:06:45,840 --> 02:06:47,120 CONCERN OR INTEL ABOUT ABOUT 3230 02:06:47,120 --> 02:06:50,400 SOMETHING COMING ON THE HORIZON? 3231 02:06:50,400 --> 02:06:52,040 >> SO THERE ISN'T ANYTHING I'M 3232 02:06:52,040 --> 02:06:54,560 AWARE OF ON THE HORIZON. 3233 02:06:54,560 --> 02:06:59,400 THE BULK OF THE DATA THAT ARE 3234 02:06:59,400 --> 02:07:02,720 GENERATED YOU KNOW COME FROM A 3235 02:07:02,720 --> 02:07:04,360 VARIETY OF RESOURCES. 3236 02:07:04,360 --> 02:07:06,360 NCATS THROUGH THEIR PORTAL I 3237 02:07:06,360 --> 02:07:07,960 SHOWED HAS BEEN TRYING TO 3238 02:07:07,960 --> 02:07:08,920 COLLECT DATA FROM ANY SOURCE 3239 02:07:08,920 --> 02:07:09,400 THEY CAN. 3240 02:07:09,400 --> 02:07:11,160 SO THEY WILL ACTUALLY GET DATA 3241 02:07:11,160 --> 02:07:12,760 FROM COMPANIES WHO ARE VERY 3242 02:07:12,760 --> 02:07:14,080 INTERESTED IN THEIR OWN 3243 02:07:14,080 --> 02:07:14,400 PRODUCTS. 3244 02:07:14,400 --> 02:07:17,280 THEY WILL GET DATA FROM THE CDC 3245 02:07:17,280 --> 02:07:18,400 SURVEILLANCE, EFFORTS THAT GOES 3246 02:07:18,400 --> 02:07:21,440 ON, THEY WILL TRY TO GET 3247 02:07:21,440 --> 02:07:24,760 SURVEILLANCE FROM THE GROUP IN 3248 02:07:24,760 --> 02:07:25,880 GERMANY THAT'S COLLECTING 3249 02:07:25,880 --> 02:07:27,480 VARIANTS SO THEY'RE TRYING TO 3250 02:07:27,480 --> 02:07:28,600 PULL IN EVERYTHAT THEY CAN, 3251 02:07:28,600 --> 02:07:29,880 WITHIN THE U.S. GOVERNMENT 3252 02:07:29,880 --> 02:07:31,800 THERE'S A GROUP LOOKING AT THAT 3253 02:07:31,800 --> 02:07:32,480 SPECIFICALLY FROM ALL DIFFERENT 3254 02:07:32,480 --> 02:07:34,680 AREAS TO TRY TO GET AHEAD OF 3255 02:07:34,680 --> 02:07:34,920 THINGS. 3256 02:07:34,920 --> 02:07:36,200 THE 1 THING THAT GETS A LITTLE 3257 02:07:36,200 --> 02:07:39,080 BIT OF BUZZ IS SOMETHING THAT'S 3258 02:07:39,080 --> 02:07:42,800 KAWLTED DELTA CRON, A VARIANT OF 3259 02:07:42,800 --> 02:07:45,160 DELTA AND OMICRON, SO FOR 3260 02:07:45,160 --> 02:07:45,840 THERE'S NOTHING BIOLOGIC 3261 02:07:45,840 --> 02:07:46,960 ASSOCIATED WITH THAT, THE 3262 02:07:46,960 --> 02:07:48,120 DISCUSSION GOES FROM YOU KNOW WE 3263 02:07:48,120 --> 02:07:49,760 NEED TO KEEP AN EYE ON IT ON 3264 02:07:49,760 --> 02:07:52,800 SOME OF THIS IS JUST PC R 3265 02:07:52,800 --> 02:07:54,080 ARTIFACT AND CONTAMINATION, SO 3266 02:07:54,080 --> 02:07:55,600 IT'S INTERESTING BECAUSE OMICRON 3267 02:07:55,600 --> 02:07:57,200 IS SUCH A VARIANT FROM DEALTA 3268 02:07:57,200 --> 02:07:58,800 AND YOU KNOW THE SPECULATION IS 3269 02:07:58,800 --> 02:08:00,600 THAT THIS MIGHT HAVE BEEN 3270 02:08:00,600 --> 02:08:02,680 SOMETHING THAT JUST WAS BREWING 3271 02:08:02,680 --> 02:08:04,200 IN A PATIENT FOR A VERY, VERY 3272 02:08:04,200 --> 02:08:05,720 LONG PERIOD OF TIME THAT THEN 3273 02:08:05,720 --> 02:08:08,280 GOT INTO THE GENERAL POPULATION. 3274 02:08:08,280 --> 02:08:09,400 BUT THAT'S, YOU KNOW 3275 02:08:09,400 --> 02:08:09,720 SPECULATIVE. 3276 02:08:09,720 --> 02:08:11,680 I HAVE TO SAY IT'S STILL PRETTY 3277 02:08:11,680 --> 02:08:13,080 AMAZING TO ME THAT WE'RE NOT 3278 02:08:13,080 --> 02:08:15,440 SEEING A BUMP IN BA2 REFLECTED 3279 02:08:15,440 --> 02:08:18,800 IN THE NUMBERS OF CASES AND YOU 3280 02:08:18,800 --> 02:08:19,920 KNOW EVERYONE SORT OF WATCHING, 3281 02:08:19,920 --> 02:08:21,560 YOU KNOW AND HOLDING THEIR 3282 02:08:21,560 --> 02:08:27,240 BREATH TO SEE WHAT WILL HAPPEN 3283 02:08:27,240 --> 02:08:29,200 THERE. 3284 02:08:29,200 --> 02:08:31,200 >> THANK YOU. 3285 02:08:31,200 --> 02:08:32,520 THANK YOU. 3286 02:08:32,520 --> 02:08:33,560 STEPHANIE. 3287 02:08:33,560 --> 02:08:34,560 >> EASY QUESTION, THAT'S A JOKE. 3288 02:08:34,560 --> 02:08:35,960 DO YOU THINK WE'RE BETTER 3289 02:08:35,960 --> 02:08:40,600 PREPARED AS A NATION OR AS A 3290 02:08:40,600 --> 02:08:42,400 PLANET FOR THE NEXT PANDEMIC 3291 02:08:42,400 --> 02:08:45,160 BASED ON EVERYTHING WE'VE LEARN 3292 02:08:45,160 --> 02:08:45,600 FRIDAY THIS 1? 3293 02:08:45,600 --> 02:08:51,600 >> I THINK WE'RE BETTER AWARE OF 3294 02:08:51,600 --> 02:08:53,080 HOW DIFFICULT IT CAN BE TO DEAL 3295 02:08:53,080 --> 02:08:55,400 WITH SOMETHING LIKE THIS AND 3296 02:08:55,400 --> 02:08:57,440 THERE'S A LOT OF TALK ABOUT HOW 3297 02:08:57,440 --> 02:09:00,200 WE NEED TO BE BETTER PREPARED 3298 02:09:00,200 --> 02:09:02,200 AND THERE'S A LOT OF EFFORT 3299 02:09:02,200 --> 02:09:03,280 GOING INTO LESSONS LEARNED THAT 3300 02:09:03,280 --> 02:09:07,920 WE COULD TAKE INTO THE NEXT 3301 02:09:07,920 --> 02:09:09,000 OUTBREAK BUT THE ACTUAL ACTIVITY 3302 02:09:09,000 --> 02:09:10,080 THAT I THINK NEEDS TO TAKE PLACE 3303 02:09:10,080 --> 02:09:14,840 TO BE ABLE TO DO THAT IS STILL 3304 02:09:14,840 --> 02:09:19,600 IN THE FUTURE. 3305 02:09:19,600 --> 02:09:20,920 >> THANK YOU. 3306 02:09:20,920 --> 02:09:25,920 >> ELEGANTLY PUT. 3307 02:09:25,920 --> 02:09:27,440 ANY OTHER QUESTIONS? 3308 02:09:27,440 --> 02:09:29,000 CLIFF, AGAIN, THANK YOU SO MUCH. 3309 02:09:29,000 --> 02:09:32,000 AS LARRY SAID OR JIM SAID, KEY 3310 02:09:32,000 --> 02:09:33,720 KEEP THINKING IT'S THE LAST TIME 3311 02:09:33,720 --> 02:09:35,560 WE WILL NEED TO BE UPDATED BUT 3312 02:09:35,560 --> 02:09:39,000 WE ARE VERY APPRECIATIVE OF ALL 3313 02:09:39,000 --> 02:09:39,920 OF THE WORK. 3314 02:09:39,920 --> 02:09:41,640 THANK YOU. 3315 02:09:41,640 --> 02:09:43,160 >> ALL RIGHT, LET'S SWITCH GEARS 3316 02:09:43,160 --> 02:09:45,960 AGAIN AND GO OVER TO MARILYN 3317 02:09:45,960 --> 02:09:50,240 FRINRE WHO IS OUR SERVICE CHIEF 3318 02:09:50,240 --> 02:09:52,920 IN PHARMACY OPs AND MARILYN 3319 02:09:52,920 --> 02:09:54,400 WILL TURN DIRECTLY TO YOU. 3320 02:09:54,400 --> 02:09:54,760 THANK YOU. 3321 02:09:54,760 --> 02:09:58,320 GOOD MORNING IT YOU HEAR ME 3322 02:09:58,320 --> 02:09:58,960 OKAY? 3323 02:09:58,960 --> 02:09:59,280 >> WE CAN. 3324 02:09:59,280 --> 02:10:03,840 >> CAN YOU SEE MY SLIDES 3325 02:10:03,840 --> 02:10:04,200 HOPEFULLY? 3326 02:10:04,200 --> 02:10:05,160 OKAY, THANK YOU. 3327 02:10:05,160 --> 02:10:08,680 SO GOOD MORNING EVERYONE. 3328 02:10:08,680 --> 02:10:10,800 I'M MARILYN FARINRE, AND I AM 3329 02:10:10,800 --> 02:10:12,360 CHIEF OF OERATIONS HERE AT THE 3330 02:10:12,360 --> 02:10:13,320 FARNLACY AT THE CLINICAL, IT'S 3331 02:10:13,320 --> 02:10:14,960 MY PLEASURE TO BE WITH YOU THIS 3332 02:10:14,960 --> 02:10:18,000 MORNING AND MY PRESENTATION, THE 3333 02:10:18,000 --> 02:10:19,040 PERMANENT PHARMACY PLACEMENT 3334 02:10:19,040 --> 02:10:21,320 PROJECT, THAT I WILL REFER TO AS 3335 02:10:21,320 --> 02:10:35,440 THE P4 PROJECT WILL PROVIDE AN 3336 02:10:35,440 --> 02:10:37,520 OVERVIEW OF THE--THE FDA CAUSE 3337 02:10:37,520 --> 02:10:39,400 INSPECTION SET UP A SERIES OF 3338 02:10:39,400 --> 02:10:40,880 EVENTS THAT BEGAN WITH THE 3339 02:10:40,880 --> 02:10:42,760 SUSPENSION OF ACTIVITIES IN THE 3340 02:10:42,760 --> 02:10:43,320 PHARMACEUTICAL DEVELOPMENT 3341 02:10:43,320 --> 02:10:47,480 SECTION OF THE PHARMACY. 3342 02:10:47,480 --> 02:10:48,720 IN APRIL 2016, THE ADVISORY 3343 02:10:48,720 --> 02:10:51,360 COMMITTEE TO THE DIRECTOR AND 3344 02:10:51,360 --> 02:10:52,800 THE CLINICAL CENTER WORKING 3345 02:10:52,800 --> 02:10:55,280 GROUP QUAIM OUT WITH A RED TEAM 3346 02:10:55,280 --> 02:10:55,520 REPORT. 3347 02:10:55,520 --> 02:10:59,360 AND THAT REPORT IT WAS FOUND 3348 02:10:59,360 --> 02:11:01,600 THAT PHARMACY FACILITIES 3349 02:11:01,600 --> 02:11:02,680 PERFORMING CELL PRODUCING 3350 02:11:02,680 --> 02:11:06,040 OPERATIONS WERE OUT DATED AND 3351 02:11:06,040 --> 02:11:08,000 FULL REMEDIATION WAS 3352 02:11:08,000 --> 02:11:08,280 RECOMMENDED. 3353 02:11:08,280 --> 02:11:09,560 THIS REQUIRED ALL OF OPERATIONS 3354 02:11:09,560 --> 02:11:14,320 TO MOVE INTO TEMPORARY SPACES. 3355 02:11:14,320 --> 02:11:18,040 IN APRIL OF 2017 THE INTRAVENOUS 3356 02:11:18,040 --> 02:11:19,880 ADMIXTURE UNIT MOVED INTO THEIR 3357 02:11:19,880 --> 02:11:25,560 TEMPORARY SPACE AND IN 2019 THE 3358 02:11:25,560 --> 02:11:26,760 OUTPATIENT AND UNIT DOSE 3359 02:11:26,760 --> 02:11:28,200 PHARMACIES MOVED INTO SPACES OF 3360 02:11:28,200 --> 02:11:29,200 THEIR OWN. 3361 02:11:29,200 --> 02:11:33,320 RENOVATION OF THE OUTDATED 3362 02:11:33,320 --> 02:11:34,600 FACILITY BEGAN IN 2021. 3363 02:11:34,600 --> 02:11:36,720 SO THROUGHOUT THE P4 PROJECT, 3364 02:11:36,720 --> 02:11:39,400 THE PHARMACY STAFF AS A GROUP 3365 02:11:39,400 --> 02:11:40,840 HAVE REALLY HELD TRUE TO THEIR 3366 02:11:40,840 --> 02:11:41,080 MISSION. 3367 02:11:41,080 --> 02:11:43,800 NOW OUR MISSION IS TO SUPPORT 3368 02:11:43,800 --> 02:11:46,160 AND CONDUCT CLINICAL RESEARCH BY 3369 02:11:46,160 --> 02:11:48,880 PROVIDING SPACE, HIGH QUALITY 3370 02:11:48,880 --> 02:11:53,560 CARE, 1 PATIENT, 1 MEDICATION AT 3371 02:11:53,560 --> 02:11:54,080 A TIME. 3372 02:11:54,080 --> 02:11:56,560 SO THE TIMELINE FOR THE PROJECT, 3373 02:11:56,560 --> 02:11:59,000 IT'S DISCIPLINARY VOIDED INTO 3 3374 02:11:59,000 --> 02:12:00,200 MAIN PHASES. 3375 02:12:00,200 --> 02:12:01,480 THE OUTPATIENT PHARMACY WILL 3376 02:12:01,480 --> 02:12:03,000 MOVE INTO THEIR SCHEDULED 3377 02:12:03,000 --> 02:12:05,560 LOCATION OR INTO THEIR SCHEDULED 3378 02:12:05,560 --> 02:12:07,080 SPACES ON THE SECOND OF MAY. 3379 02:12:07,080 --> 02:12:09,480 THIS WILL BE FOLLOWED CLOSELY BY 3380 02:12:09,480 --> 02:12:11,000 THE UNIT DOSE PHARMAC SKPE 3381 02:12:11,000 --> 02:12:15,400 BAKUGAN THEY WILL START 3382 02:12:15,400 --> 02:12:18,080 OPERATING ON MAY 24th. 3383 02:12:18,080 --> 02:12:20,040 INTRAVENOUS ADMIX TOUR UNIT WILL 3384 02:12:20,040 --> 02:12:24,800 BEGIN OPERATIONS IN THE FALL OF 3385 02:12:24,800 --> 02:12:25,600 THIS YEAR. 3386 02:12:25,600 --> 02:12:28,440 SO THE P4 PROJECT IS COMPLICATED 3387 02:12:28,440 --> 02:12:29,760 WITH MANY MOVING PARTS. 3388 02:12:29,760 --> 02:12:32,200 AND SO THERE'S HEIGHTENED 3389 02:12:32,200 --> 02:12:34,400 AWARENESS OF WHAT THE 4 MAIN 3390 02:12:34,400 --> 02:12:35,800 GOALS OFLET OPERATIONS ARE. 3391 02:12:35,800 --> 02:12:38,000 AND THAT IS WHEN WE MOVE, WE 3392 02:12:38,000 --> 02:12:41,280 WANT TO MAKE SURE WE CONTINUE 3393 02:12:41,280 --> 02:12:42,080 OPERATIONS WITH UNINTERRUPTED 3394 02:12:42,080 --> 02:12:43,040 PHARMACEUTICAL CARE AND WE WANT 3395 02:12:43,040 --> 02:12:44,920 TO DO SO SAFELY. 3396 02:12:44,920 --> 02:12:47,440 WE ALSO WANT TO SUCCESSFULLY 3397 02:12:47,440 --> 02:12:51,640 IMPLEMENT AND INTEGRATE ALL 3398 02:12:51,640 --> 02:12:52,120 PHARMACY AUTOMATION. 3399 02:12:52,120 --> 02:12:53,600 IN ADDITION WE WANT TO MAKE SURE 3400 02:12:53,600 --> 02:12:56,080 THAT ALL OF OUR SUPPLIES, 3401 02:12:56,080 --> 02:12:57,400 MEDICATIONS AND SUPPLIES ARE 3402 02:12:57,400 --> 02:13:01,320 RELOCATED TO THE NEW SPACES AS 3403 02:13:01,320 --> 02:13:01,800 EFFICIENTLY AS POSSIBLE. 3404 02:13:01,800 --> 02:13:03,200 AND WE WANT TO MAKE SURE THAT 3405 02:13:03,200 --> 02:13:05,160 ALL OF OUR STAFF ARE TRAINED AND 3406 02:13:05,160 --> 02:13:12,680 THAT THEY REMAIN ENGAGED. 3407 02:13:12,680 --> 02:13:14,800 SO THE RENOVATED PHARMAC SEA 3408 02:13:14,800 --> 02:13:16,320 LITTLE OVER 10,000 SQUARE FEET. 3409 02:13:16,320 --> 02:13:18,000 THE OUTPATIENT FAMILIES ARNLACY 3410 02:13:18,000 --> 02:13:22,400 IS IN YELLOW HERE IN THE SCREEN, 3411 02:13:22,400 --> 02:13:24,240 THE UNIT DOSE SECTION IS IN THE 3412 02:13:24,240 --> 02:13:26,320 MIDDLE AND IT OCCUPIES THE BLUE 3413 02:13:26,320 --> 02:13:30,000 SECTION OF THE FLOOR PLAN. 3414 02:13:30,000 --> 02:13:31,280 THE IVAU IS THE LARGEST SECTION 3415 02:13:31,280 --> 02:13:33,800 OF THEM ALL AND THAT OCCUPIES 3416 02:13:33,800 --> 02:13:37,880 ALL OF THE WHITE AREA ON THE 3417 02:13:37,880 --> 02:13:38,800 FLOOR PLAN. 3418 02:13:38,800 --> 02:13:41,480 WE'RE FORTUNATE TO HAVE A BANK 3419 02:13:41,480 --> 02:13:46,640 GRADE VAULT FOR ALL OF OUR 3420 02:13:46,640 --> 02:13:47,360 CONTROLLED MEDICATION STORAGE 3421 02:13:47,360 --> 02:13:49,560 AND WE ALSO HAVE A PHARMACY 3422 02:13:49,560 --> 02:13:51,760 LOUNGE THAT IS A RELAXING SPACE 3423 02:13:51,760 --> 02:13:59,600 FOR STAFF TO TAKE SOME BREAKS. 3424 02:13:59,600 --> 02:14:01,000 SO THE RENOVATED PHARMACY IS 3425 02:14:01,000 --> 02:14:02,200 IMPRESSIVE BUT MORE IMPORTANTLY 3426 02:14:02,200 --> 02:14:03,920 IT DOES PROVIDE ALL COMPLIANCE 3427 02:14:03,920 --> 02:14:07,240 WITH ALL OF REGULATIONS AT THE 3428 02:14:07,240 --> 02:14:08,800 MOMENT FOR ALL CURRENT 3429 02:14:08,800 --> 02:14:10,200 REGULATIONS. 3430 02:14:10,200 --> 02:14:13,200 THE NEW FEATURES INVOLVE 3431 02:14:13,200 --> 02:14:14,160 SEGREGATED COMPOUNDING AREAS, 3432 02:14:14,160 --> 02:14:15,800 ENGINEERING CONTROLS TO,A LOW 3433 02:14:15,800 --> 02:14:17,320 FOR THE PROCESSING OF BOTH 3434 02:14:17,320 --> 02:14:19,160 HEALTH BENEFITS AND 3435 02:14:19,160 --> 02:14:19,720 ACTUARIALITANTS AS WELL AS 3436 02:14:19,720 --> 02:14:20,800 HEALTH BENEFITS AND 3437 02:14:20,800 --> 02:14:23,080 ACTUARIALITANT MEDICATION, LOSS 3438 02:14:23,080 --> 02:14:25,840 OF AUTOMATION TO PROVIDE SAFE 3439 02:14:25,840 --> 02:14:29,360 PROCESSES, STREAMLINED WORK 3440 02:14:29,360 --> 02:14:32,200 FLOWS, AND COMPREHENSIVE 3441 02:14:32,200 --> 02:14:33,680 INVENTORY MANAGEMENT. 3442 02:14:33,680 --> 02:14:35,040 THERE'S ALSO INCREASED CAPACITY 3443 02:14:35,040 --> 02:14:37,280 IN THE NEW FACILITY AS WELL AS 3444 02:14:37,280 --> 02:14:38,920 CAPABILITY OF ELECTRONIC 3445 02:14:38,920 --> 02:14:41,000 DOCUMENTATION THAT PROVIDES FOR 3446 02:14:41,000 --> 02:14:46,520 ACCURATE AND COMPLETE RECORD 3447 02:14:46,520 --> 02:14:47,080 KEEPING. 3448 02:14:47,080 --> 02:14:49,000 A TOTAL OF 5 CAR O CELLS WERE 3449 02:14:49,000 --> 02:14:51,320 ADDED TO THE OPERATION, 1 IN THE 3450 02:14:51,320 --> 02:14:53,000 OUTPATIENT FACILITY, 2 IN THE 3451 02:14:53,000 --> 02:14:59,000 UNIT DOSE FACILITIES AND 2 IN 3452 02:14:59,000 --> 02:15:00,400 THE IVAU MIX TERAREA. 3453 02:15:00,400 --> 02:15:02,240 SO THE PIXELSATURE SHOWS 1 OF 3454 02:15:02,240 --> 02:15:03,720 THE CAR O CELLS IN THE UNIT DOSE 3455 02:15:03,720 --> 02:15:05,600 AREA AND RIGHT NOW THE WINDOW IS 3456 02:15:05,600 --> 02:15:05,800 SHET. 3457 02:15:05,800 --> 02:15:07,640 BUT WHEN IT'S OPEN, YOU WOULD BE 3458 02:15:07,640 --> 02:15:12,200 ABLE TO SEE THE ROWS AND ROWS OF 3459 02:15:12,200 --> 02:15:13,800 MEDICATION BINS, THAT'S FOR ALL 3460 02:15:13,800 --> 02:15:15,000 OF OUR MEDICATION. 3461 02:15:15,000 --> 02:15:18,800 THIS PROVIDES HIGH DENSITY 3462 02:15:18,800 --> 02:15:22,000 STORAGE, AS WELL AS INVENTORY 3463 02:15:22,000 --> 02:15:22,600 SECURITY. 3464 02:15:22,600 --> 02:15:27,000 BAR CODE SCANNING PROVIDES FOR 3465 02:15:27,000 --> 02:15:28,000 ACCURATE MEDICATION SELECTION, 3466 02:15:28,000 --> 02:15:34,400 AND THE INVENTORY CAN BE 3467 02:15:34,400 --> 02:15:49,400 MONITORED PER MANAGEMENT OF--AND 3468 02:15:49,400 --> 02:15:51,200 THIS IS ALSO DEPICTED IN THE 3469 02:15:51,200 --> 02:16:00,880 PICTURE, THIS IS WHAT IT LOOKS 3470 02:16:00,880 --> 02:16:01,360 LIKE. 3471 02:16:01,360 --> 02:16:03,200 THEY WILL CHECK IN WHERE THE 3472 02:16:03,200 --> 02:16:04,640 ARROW IS PLACED, THEY WILL CHECK 3473 02:16:04,640 --> 02:16:06,280 IN FOR THEIR VISIT AND THEN THEY 3474 02:16:06,280 --> 02:16:07,680 WILL PROCEED TO ENTER INTO THE 3475 02:16:07,680 --> 02:16:08,960 PHARMACY TO BE MET BY A 3476 02:16:08,960 --> 02:16:20,720 PHARMACIST AT 1 OF THE 3 3477 02:16:20,720 --> 02:16:21,640 TRANSACTION WINDOWS. 3478 02:16:21,640 --> 02:16:23,800 --AS WELL AS ROBOTIC DISPENSZING 3479 02:16:23,800 --> 02:16:24,120 SYSTEM. 3480 02:16:24,120 --> 02:16:26,120 SO THE STORAGE AND RETRIEVAL 3481 02:16:26,120 --> 02:16:28,160 SYSTEM IS REALLY IMPORTANT TO 3482 02:16:28,160 --> 02:16:29,920 PROVIDE ACCURATE AND COMPLETE 3483 02:16:29,920 --> 02:16:31,560 RETRIEVAL OF PRESCRIPTIONS FOR 3484 02:16:31,560 --> 02:16:34,560 MEDICATIONS DURING PICK UP. 3485 02:16:34,560 --> 02:16:36,040 USERS ARE PROMPTED TO MAKE SURE 3486 02:16:36,040 --> 02:16:38,920 THAT THEY COLLECT ALL OF THE 3487 02:16:38,920 --> 02:16:39,640 PATIENTS PRESCRIPTIONS AND 3488 02:16:39,640 --> 02:16:41,080 THANKED OVER DURING THE 3489 02:16:41,080 --> 02:16:44,720 DISPENSING PROCESS, IT ALSO 3490 02:16:44,720 --> 02:16:46,240 PROVIDES TO ENHANCE SECURITY AND 3491 02:16:46,240 --> 02:16:48,440 CHAIN OF CUSTODY REQUIREMENTS 3492 02:16:48,440 --> 02:16:49,640 FOR BOTH CONTROLLED MEDICATIONS 3493 02:16:49,640 --> 02:16:53,600 AS WELL AS INVESTIGATIONAL 3494 02:16:53,600 --> 02:16:54,160 MEDICATION. 3495 02:16:54,160 --> 02:16:55,800 THE ROBOT AUTOMATES THE FILLING 3496 02:16:55,800 --> 02:16:57,560 PROCESS AND LIABLES VILES MAKING 3497 02:16:57,560 --> 02:16:59,000 IT READY FOR DISPENSING AND 3498 02:16:59,000 --> 02:17:00,400 MAKING TIME FOR THE PHARMACIST 3499 02:17:00,400 --> 02:17:09,040 TO SPEND ON MORE CLINICAL 3500 02:17:09,040 --> 02:17:09,680 RESPONSIBILITY HERE'S PICTURES 3501 02:17:09,680 --> 02:17:11,040 OF WHAT IT LOOKS LIKE NOW, SO 3502 02:17:11,040 --> 02:17:12,800 THE FIRST PATIENTS IN THE CLINIC 3503 02:17:12,800 --> 02:17:14,600 UPPER SHOWS THE INTANS INTO THE 3504 02:17:14,600 --> 02:17:16,000 OUTPATIENT PHARMACY, YOU CAN SEE 3505 02:17:16,000 --> 02:17:18,320 THE FROSTED GLASS DIVIDERS, THAT 3506 02:17:18,320 --> 02:17:19,800 SEPARATE THE DIFFERENT 3507 02:17:19,800 --> 02:17:20,600 TRANSACTION WINDOWS. 3508 02:17:20,600 --> 02:17:24,000 THE SECOND PICTURE IS OF A NOISE 3509 02:17:24,000 --> 02:17:26,320 ABSORBING WALL, THAT'S DESIGNED 3510 02:17:26,320 --> 02:17:28,120 TO DAMPEN SOUND AND THE THIRD 3511 02:17:28,120 --> 02:17:30,320 PICTURE OF THESE FROM THE INSIDE 3512 02:17:30,320 --> 02:17:33,920 OF THE PHARMACY AT 1 OF OUR ADA 3513 02:17:33,920 --> 02:17:35,360 COMPLIANT TRANSACTION WINDOWS. 3514 02:17:35,360 --> 02:17:37,280 THERE'S ACCESS TO A COMPUTER 3515 02:17:37,280 --> 02:17:38,760 MONITOR OR COMPUTER SCREEN FOR 3516 02:17:38,760 --> 02:17:44,080 THE PHARMACIST TO BE ABLE TO BE 3517 02:17:44,080 --> 02:17:45,520 ABLE TO REVIEW COUNSELING AND 3518 02:17:45,520 --> 02:17:53,360 TALKING WITH THE PATIENTS. 3519 02:17:53,360 --> 02:17:56,960 THE PICTUREOT LEFT SHOWS THE 3520 02:17:56,960 --> 02:17:59,440 ROBOT, THE DISPENSING ROBOT IN 3521 02:17:59,440 --> 02:18:02,600 THE FACILITY AND THERE'S A 3522 02:18:02,600 --> 02:18:05,200 MONITOR TO MONITOR THE WORK FLOW 3523 02:18:05,200 --> 02:18:06,160 AND PRIORITIZE PATIENTS WORKING 3524 02:18:06,160 --> 02:18:07,240 ON PRESCRIPTIONS. 3525 02:18:07,240 --> 02:18:09,840 WE HAVE ADDITIONAL STORAGE FOR 3526 02:18:09,840 --> 02:18:12,160 BULKY ITEMS AND A LOT OF UNITS 3527 02:18:12,160 --> 02:18:16,840 BOTH REFREJERATED AND FREEZERS 3528 02:18:16,840 --> 02:18:17,680 IN THIS SPACE. 3529 02:18:17,680 --> 02:18:19,040 THIS PHARMACIST SHOWS THE 3530 02:18:19,040 --> 02:18:20,720 VERIFICATION WORKING STATION OR 3531 02:18:20,720 --> 02:18:22,440 FORM CYST REVIEW ORDERS AND 3532 02:18:22,440 --> 02:18:27,960 VERIFY THEM FOR PROCESSING. 3533 02:18:27,960 --> 02:18:29,280 SO THE MAILING OF PRESCRIPTIONS 3534 02:18:29,280 --> 02:18:31,520 HAS BEEN A BIG PART OF THE 3535 02:18:31,520 --> 02:18:33,000 PHARMACY OPERATIONS FOR SOMETIME 3536 02:18:33,000 --> 02:18:34,800 BUT THE PANDEMIC MADE IT OFTEN 3537 02:18:34,800 --> 02:18:35,280 MORE SO. 3538 02:18:35,280 --> 02:18:38,640 SO THE FIRST PICTURE SHOWS THE 3539 02:18:38,640 --> 02:18:40,200 MAIL PACKAGE STATION WHERE 3540 02:18:40,200 --> 02:18:42,360 PRESTRIPGZS ARE PACKAGED AND 3541 02:18:42,360 --> 02:18:48,240 READY FOR PICK UP BY MAIL 3542 02:18:48,240 --> 02:18:48,520 CARRIERS. 3543 02:18:48,520 --> 02:18:52,160 SO THIS SECOND PICTURE SHOWS 2 3544 02:18:52,160 --> 02:18:53,720 CABINETS WHERE PACKAGES ARE 3545 02:18:53,720 --> 02:18:54,320 TEMPORARILY STORED BEFORE 3546 02:18:54,320 --> 02:18:56,160 THEY'RE PICKED UP AND THE THIRD 3547 02:18:56,160 --> 02:18:57,880 PICTURE SHOWS THESE DOORS THAT 3548 02:18:57,880 --> 02:19:00,920 ARE LEAD INTO THOSE CABINETS BUT 3549 02:19:00,920 --> 02:19:01,720 FROM THE OUTSIDE. 3550 02:19:01,720 --> 02:19:03,360 THIS IS WHERE MAIL CARRIERS WILL 3551 02:19:03,360 --> 02:19:06,320 COMMUNICATE WITH STAFF IN THE 3552 02:19:06,320 --> 02:19:07,560 PHARMACY VIA VIDEO INTERCOM AND 3553 02:19:07,560 --> 02:19:09,520 ARE GRANTED ACCESS TO 1 OF THE 2 3554 02:19:09,520 --> 02:19:15,160 CABINETS TO PICK UP THOSE PACK 3555 02:19:15,160 --> 02:19:16,000 PACKAGES. 3556 02:19:16,000 --> 02:19:19,760 BUT THE UNIT DOSE PHARMACY 3557 02:19:19,760 --> 02:19:24,800 TOTALS ABOUT 2346 SQUARE FEET. 3558 02:19:24,800 --> 02:19:28,000 THERE'S A BULL PEN AREA FOR 3559 02:19:28,000 --> 02:19:30,920 TECHNICIAN AND PHARMACIST WORK 3560 02:19:30,920 --> 02:19:31,400 STATIONS. 3561 02:19:31,400 --> 02:19:33,600 THERE'S A PREPARATION AREA FOR 3562 02:19:33,600 --> 02:19:37,480 PACKAGING OF ORAL SOLUTIONS AND 3563 02:19:37,480 --> 02:19:37,840 SUSPENSIONS. 3564 02:19:37,840 --> 02:19:40,040 AND THEN THERE'S A STAGING AREA 3565 02:19:40,040 --> 02:19:41,360 FOR MEDICATIONS THAT ARE 3566 02:19:41,360 --> 02:19:44,400 AWAITING DELIVERY TO THE NURSING 3567 02:19:44,400 --> 02:19:44,960 UNITS FOR ADMINISTRATION. 3568 02:19:44,960 --> 02:19:46,240 AND OF COURSE, THERE'S ALSO LOTS 3569 02:19:46,240 --> 02:19:49,000 OF ROOM FOR ALL OF THE 3570 02:19:49,000 --> 02:19:49,320 AUTOMATION. 3571 02:19:49,320 --> 02:19:50,440 THERE'S 1 OF THE CAR O CELLS 3572 02:19:50,440 --> 02:19:53,520 HERE AND THEN THE SECOND 3573 02:19:53,520 --> 02:19:57,200 CAROUSEL IS IN THE CORNER. 3574 02:19:57,200 --> 02:19:58,880 SOIE ROBOT AND MEDICATION 3575 02:19:58,880 --> 02:20:01,600 PACKAGER WAS ADDED TO THE UNIT 3576 02:20:01,600 --> 02:20:02,920 DOSE SECTION. 3577 02:20:02,920 --> 02:20:05,280 THE AUTOMATED CENTRAL PHARMACY 3578 02:20:05,280 --> 02:20:08,720 SYSTEM OR THE XR2 ROBOT 3579 02:20:08,720 --> 02:20:10,000 AUTOMATES THE MEDICATION FILLING 3580 02:20:10,000 --> 02:20:11,600 PROCESS, IT FILLS AND LABELS 3581 02:20:11,600 --> 02:20:14,960 MEDICATION IF A FORM READY FOR 3582 02:20:14,960 --> 02:20:16,040 DELIVERY. 3583 02:20:16,040 --> 02:20:17,680 THE MEDICATION PACKAGER 3584 02:20:17,680 --> 02:20:19,480 BASICALLY DOES WHAT YOU WOULD 3585 02:20:19,480 --> 02:20:20,920 THINK A PACKAGER DOES. 3586 02:20:20,920 --> 02:20:22,640 IT TAKES MEDICATION FROM BOTH 3587 02:20:22,640 --> 02:20:25,280 PACKAGES, AND PUTS THEM INTO 3588 02:20:25,280 --> 02:20:29,120 SINGLE UNITS OF USE FOR 3589 02:20:29,120 --> 02:20:29,760 DISPENSING TO PATIENTS. 3590 02:20:29,760 --> 02:20:32,120 BOTH PIECES OF AUTOMATION MAKE 3591 02:20:32,120 --> 02:20:33,160 THE DISPENSING PROCESS SAFER AND 3592 02:20:33,160 --> 02:20:37,000 A LOT MORE EFFICIENT FOR OUR 3593 02:20:37,000 --> 02:20:37,240 STAFF. 3594 02:20:37,240 --> 02:20:39,600 SO HERE ARE PICTURES OF THE 3595 02:20:39,600 --> 02:20:40,240 ACTUAL AUTOMATION. 3596 02:20:40,240 --> 02:20:48,200 SO THE FIRST PICTURE ON THE LEFT 3597 02:20:48,200 --> 02:20:59,320 SHOWS THE ROBOT. 3598 02:20:59,320 --> 02:21:00,760 THE MIDDLE OF THE PICTURE SHOWED 3599 02:21:00,760 --> 02:21:02,200 THE WALKWAY AND THE ROBOT IS 3600 02:21:02,200 --> 02:21:04,680 ACTUALLY WAY IN THE BACKGROUND 3601 02:21:04,680 --> 02:21:06,920 AND THIS, THE BODY OF THE ROBOT 3602 02:21:06,920 --> 02:21:08,920 SLIDES UP AND DOWN THIS WALKWAY 3603 02:21:08,920 --> 02:21:11,000 TO RETRIEVE MEDICATIONS FROM 3604 02:21:11,000 --> 02:21:12,720 THESE TRAYS TO THE LEFT. 3605 02:21:12,720 --> 02:21:15,240 IT HAS A ROBOTIC ARM THAT WILL 3606 02:21:15,240 --> 02:21:16,280 RETRIEVE OR RETURN MEDICATIONS 3607 02:21:16,280 --> 02:21:20,040 TO 1 OF THOSE TRAYS. 3608 02:21:20,040 --> 02:21:21,000 AND THEN THE THIRD PICTURE IS 3609 02:21:21,000 --> 02:21:25,640 THAT OF THE MEDICATION PACKAGER. 3610 02:21:25,640 --> 02:21:29,160 SO HERE ARE MORE PICTURES OF THE 3611 02:21:29,160 --> 02:21:30,400 ACTUAL PHARMACY SPACE. 3612 02:21:30,400 --> 02:21:32,240 THE FIRST PICTURES OF THE ORDER 3613 02:21:32,240 --> 02:21:33,000 VERIFICATION STATION, THAT'S THE 3614 02:21:33,000 --> 02:21:35,120 BULL PEN WITH THE WORK STATIONS 3615 02:21:35,120 --> 02:21:38,000 FOR BOTH PHARMACISTSAs WELL AS 3616 02:21:38,000 --> 02:21:38,800 TECHNICIANS. 3617 02:21:38,800 --> 02:21:41,120 THIS IS WHAT THE ORAL DOSE FAC 3618 02:21:41,120 --> 02:21:43,000 PAGS STATION LOOKS LIKE AND THIS 3619 02:21:43,000 --> 02:21:45,520 IS WHERE LIQUID MEDICATIONS ARE 3620 02:21:45,520 --> 02:21:48,480 DRAWN UP INTO DOSE SPECIFIC 3621 02:21:48,480 --> 02:21:49,640 SYRINGES OR CUPS. 3622 02:21:49,640 --> 02:21:51,920 AND THE THIRD PICTURE OF THE 3623 02:21:51,920 --> 02:21:54,400 INVENTORY PROCESSING STATION, 3624 02:21:54,400 --> 02:21:55,640 ARE MEDICATIONS ARE RECEIVED 3625 02:21:55,640 --> 02:21:57,600 FROM THE BHOAL SALER AND SORTED 3626 02:21:57,600 --> 02:21:58,360 OR DISTRIBUTIONS BEFORE SORTED 3627 02:21:58,360 --> 02:22:03,880 TO THE CAR O CELL, ROBOTS OR 3628 02:22:03,880 --> 02:22:04,200 PACKAGER. 3629 02:22:04,200 --> 02:22:08,000 SO THE IV, OR THE INTRAVENOUS 3630 02:22:08,000 --> 02:22:13,800 ADMIXTURE UNIT HAS THE LARGEST 3631 02:22:13,800 --> 02:22:14,000 LARGEST 3632 02:22:14,000 --> 02:22:17,280 LAY OUT OF THE THE FACILITY IT 3633 02:22:17,280 --> 02:22:18,960 IS 12,570 SQUARE FEET AND IT 3634 02:22:18,960 --> 02:22:20,720 OCCUPIES THE WHITE AREA. 3635 02:22:20,720 --> 02:22:23,200 SO IT'S IMPORTANT TO HAPPENED 3636 02:22:23,200 --> 02:22:24,440 THAT THERE'S UNIDIRECTIONAL FLOW 3637 02:22:24,440 --> 02:22:26,960 OF BOTH PEOPLE AND MATERIALS 3638 02:22:26,960 --> 02:22:31,000 THROUGH THE CLEAN ROOM OR THE 3639 02:22:31,000 --> 02:22:31,560 IVAU. 3640 02:22:31,560 --> 02:22:32,200 THE INTRAVENOUS ADMIXTURE UNIT 3641 02:22:32,200 --> 02:22:34,320 AND I WILL START WITH BY GOING 3642 02:22:34,320 --> 02:22:35,400 OVER THESE FLOW OF PEOPLE AND 3643 02:22:35,400 --> 02:22:39,600 THEN I WILL GO OVER THE FLOW OF 3644 02:22:39,600 --> 02:22:39,880 MATERIALS. 3645 02:22:39,880 --> 02:22:43,880 SO STAFF WILL ENTER INTO THE 3646 02:22:43,880 --> 02:22:46,720 PERMANENT IVAU FACILITY INTO A 3647 02:22:46,720 --> 02:22:47,680 COMPOUNDING VESTIBLE THAT IS 3648 02:22:47,680 --> 02:22:49,400 SHOWN HERE. 3649 02:22:49,400 --> 02:22:51,920 HERE THEY WILL RETRIEVE SCRUBS 3650 02:22:51,920 --> 02:22:53,080 FROM A VENDING MACHINE. 3651 02:22:53,080 --> 02:22:54,840 HAY WILL THEN PROCEED INTO A 3652 02:22:54,840 --> 02:22:56,640 LOCKER ROOM WHERE THEY WILL 3653 02:22:56,640 --> 02:22:58,840 CHANGE INTO THE SCRUBS AND STATE 3654 02:22:58,840 --> 02:23:03,880 OF EMERGENCY AWAY THEIR STREET 3655 02:23:03,880 --> 02:23:05,200 CLOTHES IN LOCKERS. 3656 02:23:05,200 --> 02:23:08,280 THEY PERFORM HAND HYGIENE IN THE 3657 02:23:08,280 --> 02:23:11,640 SINK ROOM AND DON ADDITIONAL 3658 02:23:11,640 --> 02:23:12,360 PERSONAL PROTECTIVE EQUIPMENT 3659 02:23:12,360 --> 02:23:16,440 SUCH AS HAIR NETS, BOOTIES AND 3660 02:23:16,440 --> 02:23:19,840 SUITS BEFORE THEY WALK INTO THE 3661 02:23:19,840 --> 02:23:21,240 CLEAN ROOM. 3662 02:23:21,240 --> 02:23:23,280 THE IVAU IS DIVIDED INTO 2 3663 02:23:23,280 --> 02:23:23,720 SECTIONS. 3664 02:23:23,720 --> 02:23:26,200 SO THE TOP SECTION WITH THE 5 3665 02:23:26,200 --> 02:23:27,680 STARS, IS THE NONHAZARDOUS 3666 02:23:27,680 --> 02:23:29,800 SECTION OF THE FACILITY, AND IT 3667 02:23:29,800 --> 02:23:32,560 HAS A TOTAL OF 6 COMPOUNDING 3668 02:23:32,560 --> 02:23:35,200 ROOMS, SO STAFF WILL WALK INTO 3669 02:23:35,200 --> 02:23:37,400 THIS ENTRANCE HERE AND PROCEED 3670 02:23:37,400 --> 02:23:38,640 INTO THE NONHAZARDOUS CORRIDOR 3671 02:23:38,640 --> 02:23:40,560 HERE AND THEY CAN EITHER ACCESS 3672 02:23:40,560 --> 02:23:43,120 1 OF THE ROOMS THROUGH THIS 3673 02:23:43,120 --> 02:23:43,880 CORRIDOR. 3674 02:23:43,880 --> 02:23:46,640 AGAIN THERE ARE A TOTAL OF 6 3675 02:23:46,640 --> 02:23:46,840 ROOMS. 3676 02:23:46,840 --> 02:23:49,880 IT'S IMPORTANT TO NOTE THAT WHEN 3677 02:23:49,880 --> 02:23:51,280 THEY'RE EXITING THE FACILITY, 3678 02:23:51,280 --> 02:23:53,680 THEY DON'T GO BACKWARDS BUT THEY 3679 02:23:53,680 --> 02:23:54,960 GO DOWN THE CORRIDOR AND THROUGH 3680 02:23:54,960 --> 02:23:59,440 THIS EXIT HERE FOLLOWING THE 3681 02:23:59,440 --> 02:23:59,920 PLURIBU ARROW. 3682 02:23:59,920 --> 02:24:01,600 THE OTHER SIDE OF THE FACILITY 3683 02:24:01,600 --> 02:24:03,120 WHICH IS THE BOTTOM HALF OF THE 3684 02:24:03,120 --> 02:24:07,400 FACILITY IS FOR THE HAZARDOUS 3685 02:24:07,400 --> 02:24:08,000 COMPOUNDING. 3686 02:24:08,000 --> 02:24:09,800 THERE ARE A TOTAL OF 6 ROOMS ON 3687 02:24:09,800 --> 02:24:11,200 THE FACILITY AS WELL AND STAFF 3688 02:24:11,200 --> 02:24:13,600 IN THIS CASE WILL ENTER THROUGH 3689 02:24:13,600 --> 02:24:16,200 THIS ENTRANCE SHOWN BY THE RED 3690 02:24:16,200 --> 02:24:17,400 ARROW HERE. 3691 02:24:17,400 --> 02:24:18,400 THEY WILL COME INTO THIS 3692 02:24:18,400 --> 02:24:21,480 ENTRANCE AND EITHER ACCESS THIS 3693 02:24:21,480 --> 02:24:23,200 CORRIDOR TO THE ACCESS THESE 4 3694 02:24:23,200 --> 02:24:25,040 ROOMS OR ACCESS THIS CORRIDOR TO 3695 02:24:25,040 --> 02:24:28,880 ACCESS THESE 2 ROOMS. 3696 02:24:28,880 --> 02:24:30,160 WHEN LEAVING THE FACILITY THEY 3697 02:24:30,160 --> 02:24:32,000 WILL LEAVE THROUGH THIS 3698 02:24:32,000 --> 02:24:33,400 CORRIDOR, OUT THROUGH THE 3699 02:24:33,400 --> 02:24:37,040 ENTRANCE, AND BACK INTO THE MAIN 3700 02:24:37,040 --> 02:24:37,320 CORRIDOR. 3701 02:24:37,320 --> 02:24:40,120 FOR THESE 2 ROOMS ON THIS SIDE, 3702 02:24:40,120 --> 02:24:42,320 THEY WILL EXIT THE FACILITY 3703 02:24:42,320 --> 02:24:48,000 THROUGH THIS CORRIDOR AND INTO 3704 02:24:48,000 --> 02:24:49,400 THE MAIN CORRIDOR. 3705 02:24:49,400 --> 02:24:51,400 IN TERMS OF PRODUCT AND 3706 02:24:51,400 --> 02:24:52,680 MATERIALS AND CLEAN ROOM, THEY 3707 02:24:52,680 --> 02:24:57,200 FOLLOW A DIFFERENT ROUTE. 3708 02:24:57,200 --> 02:24:59,480 EACH PRODUCT OR SUPPLY IS 3709 02:24:59,480 --> 02:25:01,640 THOROUGHLY WIPED DOWN WITH 3710 02:25:01,640 --> 02:25:02,920 DISINFACT ANT BEFORE BEING 3711 02:25:02,920 --> 02:25:04,760 PASSED INTO THE CLEAN ROOM. 3712 02:25:04,760 --> 02:25:07,640 WE HAVE 2 CLEAN ROOMS, WE HAVE 2 3713 02:25:07,640 --> 02:25:10,680 CLEAN UP SET UP ROOMS, 1 IS 1 3714 02:25:10,680 --> 02:25:11,320 FOR THE HAZARDOUS SECTION AND 3715 02:25:11,320 --> 02:25:13,240 THE OTHER IS FOR THE 3716 02:25:13,240 --> 02:25:14,600 NONHAZARDOUS SECTION. 3717 02:25:14,600 --> 02:25:15,320 SO HAZARDOUS MEDICATIONS ARE 3718 02:25:15,320 --> 02:25:18,320 PASSED THROUGH IN THE HAZARDOUS 3719 02:25:18,320 --> 02:25:21,240 SET UP AND NONHAZARDOUS 3720 02:25:21,240 --> 02:25:23,000 MEDICATIONS ARE PASSED INTO THE 3721 02:25:23,000 --> 02:25:26,440 NONHAZARDOUS SET UP ROOM. 3722 02:25:26,440 --> 02:25:28,240 SO WHAT HAPPENS IN A PRODUCT HAS 3723 02:25:28,240 --> 02:25:29,000 TO BE MADE? 3724 02:25:29,000 --> 02:25:31,080 SO THE Xs ON THE SCREEN DENOTE 3725 02:25:31,080 --> 02:25:33,400 THE PASS THROUGH THROUGHOUT THE 3726 02:25:33,400 --> 02:25:33,840 FACILITY. 3727 02:25:33,840 --> 02:25:35,200 EACH COMPOUNDING ROOM HAS A 3728 02:25:35,200 --> 02:25:38,760 TOTAL OF 2 PASS THROUGHS. 3729 02:25:38,760 --> 02:25:40,720 THEY PASS THROUGH AND AN OUT 3730 02:25:40,720 --> 02:25:41,080 PASS THROUGH. 3731 02:25:41,080 --> 02:25:44,520 SO IF A MEDICATION HAS TO BE 3732 02:25:44,520 --> 02:25:46,880 MADE, DEPENDING ON IF IT'S A 3733 02:25:46,880 --> 02:25:49,040 HAZARDOUS MEDICATION OR A 3734 02:25:49,040 --> 02:25:50,240 NONHAZARDOUS MEDICATION THAT 3735 02:25:50,240 --> 02:25:51,200 WILL ORIGINATE FROM 1 OF THESE 2 3736 02:25:51,200 --> 02:25:53,160 ROOMS WHICH IS THE SET UP ROOM, 3737 02:25:53,160 --> 02:26:07,720 THOSE MEDICATIONS WILL THEN BE 3738 02:26:07,720 --> 02:26:10,320 TAKEN TO--ONCE THE MEDICATION 3739 02:26:10,320 --> 02:26:11,520 HAS BEEN COMPOUNDED AND THE 3740 02:26:11,520 --> 02:26:14,600 FINAL PRODUCT IS READY FOR 3741 02:26:14,600 --> 02:26:15,720 PHARMACIST VERIFICATION, THE 3742 02:26:15,720 --> 02:26:18,200 TECHNICIAN WILL PLACE THE ITEM 3743 02:26:18,200 --> 02:26:19,280 INTO AN OUT PASS THROUGH AND 3744 02:26:19,280 --> 02:26:22,000 WILL BE PICKED UP AND TAKEN TO 3745 02:26:22,000 --> 02:26:23,760 THIS PASS THROUGH OVER HERE AND 3746 02:26:23,760 --> 02:26:27,520 THEN IT WILL BE DELIVERED 3747 02:26:27,520 --> 02:26:31,760 THROUGH NURSING UNITS OR THE 3748 02:26:31,760 --> 02:26:35,440 PATIENT CARE UNITS. 3749 02:26:35,440 --> 02:26:38,160 SO THE IVAU AND THE FACILITY HAS 3750 02:26:38,160 --> 02:26:38,800 SIGNIFICANT DIFFERENCES AND ALL 3751 02:26:38,800 --> 02:26:42,320 OF THOSE ARE TO MAKE THE 3752 02:26:42,320 --> 02:26:43,960 FACILITY SAFER AND MORE 3753 02:26:43,960 --> 02:26:44,200 EFFICIENT. 3754 02:26:44,200 --> 02:26:45,520 THERE ARE 12 COMPOUNDING ROOMS 3755 02:26:45,520 --> 02:26:47,000 IN CONTRAST TO THE 3 COMPOUNDING 3756 02:26:47,000 --> 02:26:50,200 ROOMS THAT WE HAVE IN THE OLD 3757 02:26:50,200 --> 02:26:50,440 FACILITY. 3758 02:26:50,440 --> 02:26:54,240 WE HAVE 10 BIOLOGICAL SAFETY 3759 02:26:54,240 --> 02:26:56,360 CABINETS, 2 ISOLATORS, WE HAVE A 3760 02:26:56,360 --> 02:26:58,360 SIGNIFICANT NUMBER OF HIGH 3761 02:26:58,360 --> 02:27:00,000 NUMBER OF PASS THROUGH CHAMBERS, 3762 02:27:00,000 --> 02:27:02,600 38 AS COMPARED TO 6, AND ALL OF 3763 02:27:02,600 --> 02:27:04,920 THE PASS THROUGH CHAMBERS IN THE 3764 02:27:04,920 --> 02:27:06,160 NEW FACILITY HAVE HEPA FILTERS 3765 02:27:06,160 --> 02:27:08,400 TO FILTER THE AIR. 3766 02:27:08,400 --> 02:27:11,360 ALL OF THE WORK FLOW WILL BE 3767 02:27:11,360 --> 02:27:13,960 AUTOMATED A HUNDRED% AND IT 3768 02:27:13,960 --> 02:27:14,920 PROVIDES FOR PREMOTE PRODUCT 3769 02:27:14,920 --> 02:27:16,280 VERIFICATION BY ALL OF OUR 3770 02:27:16,280 --> 02:27:16,600 PHARMACISTS. 3771 02:27:16,600 --> 02:27:19,280 THAT MEANS A PHARMACIST COULD 3772 02:27:19,280 --> 02:27:20,120 POTENTIALLY VERIFY PRESCRIPTION 3773 02:27:20,120 --> 02:27:21,440 OR MEDICATION HAS BEEN PREPARED 3774 02:27:21,440 --> 02:27:27,080 FROM ANYWHERE IN THE FACILITY. 3775 02:27:27,080 --> 02:27:28,680 SO THE AUTOMATION THAT WILL 3776 02:27:28,680 --> 02:27:33,680 SUPPORT THE PERMANENT IVAU OR 3777 02:27:33,680 --> 02:27:37,920 INTRAVENOUS ADMIXTURE UNIT IS 3778 02:27:37,920 --> 02:27:40,200 THE OMINICELL IVX, THIS IS USED 3779 02:27:40,200 --> 02:27:40,920 DURING THE COMPOUNDING PROCESS 3780 02:27:40,920 --> 02:27:43,440 TO GUIDE THE PREPARATION OF EACH 3781 02:27:43,440 --> 02:27:43,920 PRODUCT. 3782 02:27:43,920 --> 02:27:45,320 PICTURES ARE TAKEN AT EACH STEP 3783 02:27:45,320 --> 02:27:50,600 OF THE PROCESS AND BAR CODE 3784 02:27:50,600 --> 02:27:53,600 SCANNING IS USED WITH VOLUMETRIC 3785 02:27:53,600 --> 02:27:55,120 MEDICATION SOPHISTICATED INSURE 3786 02:27:55,120 --> 02:28:00,480 MEDICATIONS ARE PREPARED 3787 02:28:00,480 --> 02:28:01,160 ACCURATELY AND PROPERLY. 3788 02:28:01,160 --> 02:28:06,400 HERE ARE SOME PICTURES OF THE 3789 02:28:06,400 --> 02:28:06,720 IVAU. 3790 02:28:06,720 --> 02:28:08,240 THIS FIRST PICTURE SHOWS THE 3791 02:28:08,240 --> 02:28:10,200 MAIN CORRIDOR THAT SEPARATES THE 3792 02:28:10,200 --> 02:28:12,320 HAZARDOUS SIDE FROM THE 3793 02:28:12,320 --> 02:28:13,000 NONHAZARDOUS SIDE. 3794 02:28:13,000 --> 02:28:15,640 THE SECOND PICTURE OF THE LOCKER 3795 02:28:15,640 --> 02:28:21,680 ROOM WITH A VIEW INTO THE SINK 3796 02:28:21,680 --> 02:28:21,880 ROOM. 3797 02:28:21,880 --> 02:28:24,560 THAL THIRD PICTURE IS THE 3798 02:28:24,560 --> 02:28:25,600 NONHAZARDOUS CORRIDOR OF WHICH 3799 02:28:25,600 --> 02:28:33,920 EACH DOOR LEADS INTO A 3800 02:28:33,920 --> 02:28:34,640 NONHAZARDOUS COMPOUNDING ROOM. 3801 02:28:34,640 --> 02:28:36,920 THESE 2 PICTURES ARE OF 3802 02:28:36,920 --> 02:28:39,000 BIOLOGICAL SAFETY CABINETS, 1 IS 3803 02:28:39,000 --> 02:28:40,280 IN THE NONHAZARDOUS COMPOUNDING 3804 02:28:40,280 --> 02:28:44,920 ROOM AND THIS 1 IS IN THE 3805 02:28:44,920 --> 02:28:45,520 HAZARDOUS BUFFER ROOM. 3806 02:28:45,520 --> 02:28:47,320 SO IT DOES TAKE A VILLAGE. 3807 02:28:47,320 --> 02:28:49,360 THERE'S BEEN A LOT OF PLANNING, 3808 02:28:49,360 --> 02:28:51,520 ACCORD NATION AND HARD WORK TO 3809 02:28:51,520 --> 02:28:53,240 MAKE THE PEOPLE AND PROJECT 3810 02:28:53,240 --> 02:28:54,800 SUCCESSFUL AND THIS TEAM WORK 3811 02:28:54,800 --> 02:28:55,800 HAS BEEN INCREDIBLE. 3812 02:28:55,800 --> 02:28:59,480 IT REALLY TAKES A VILLAGE. 3813 02:28:59,480 --> 02:29:02,200 AND THE PARM PHARMACY DOESN'T 3814 02:29:02,200 --> 02:29:03,600 WANTS TO GIVE OUT A SPECIAL 3815 02:29:03,600 --> 02:29:05,160 THANKS TO THE CONSTRUCTION TEAM 3816 02:29:05,160 --> 02:29:06,120 FOR THE BEAUTIFUL FACILITY. 3817 02:29:06,120 --> 02:29:07,840 THANK YOU SO MUCH. 3818 02:29:07,840 --> 02:29:09,280 AND WE HAVE COME A LONG WAY. 3819 02:29:09,280 --> 02:29:11,360 SO THIS IS THE WAY IT WAS. 3820 02:29:11,360 --> 02:29:14,760 SO THESE ARE PICTURES FROM THE 3821 02:29:14,760 --> 02:29:15,280 ARCHIVES. 3822 02:29:15,280 --> 02:29:18,600 THE 2 ON THE FAR LEFT ARE FROM A 3823 02:29:18,600 --> 02:29:22,000 1954 ARTICLE IN THE JOURNAL OF 3824 02:29:22,000 --> 02:29:23,080 THE AMERICAN PHARMACEUTICAL 3825 02:29:23,080 --> 02:29:23,400 ASSOCIATION. 3826 02:29:23,400 --> 02:29:24,960 AND THIS PICTURE ON THE TOP 3827 02:29:24,960 --> 02:29:28,440 RIGHT HAND CORNER IS FROM THE 3828 02:29:28,440 --> 02:29:31,200 1968 ARTICLE HIGHLIGHTING THE 3829 02:29:31,200 --> 02:29:32,200 IVAU AT THE TIME. 3830 02:29:32,200 --> 02:29:33,880 THE OTHER 2 PICTURES ARE UNDATED 3831 02:29:33,880 --> 02:29:35,400 BUT OBVIOUSLY IN THE PAST. 3832 02:29:35,400 --> 02:29:36,800 WE'VE DEFINITELY COME A LONG 3833 02:29:36,800 --> 02:29:37,480 WAY. 3834 02:29:37,480 --> 02:29:38,520 AND WITH THAT, THANKS FOR YOUR 3835 02:29:38,520 --> 02:29:43,200 ATTENTION AND I WILL TAKE ANY 3836 02:29:43,200 --> 02:29:43,440 QUESTIONS. 3837 02:29:43,440 --> 02:29:45,280 >> MARILYN, THANK YOU SO MUCH, 3838 02:29:45,280 --> 02:29:47,600 IT'S A GORGEOUS FACILITY, I MEAN 3839 02:29:47,600 --> 02:29:48,800 IT JUST PUT IN THE CHAT. 3840 02:29:48,800 --> 02:29:49,880 YOU MUST BE THRILLED. 3841 02:29:49,880 --> 02:29:55,680 CAN WE PULL THE SLIDES DOWN. 3842 02:29:55,680 --> 02:29:58,200 >> SURE, THANK YOU. 3843 02:29:58,200 --> 02:29:59,200 YOU AND YOUR TEAM MUST BE 3844 02:29:59,200 --> 02:30:00,760 THRILLED TO BE IN THAT NEW SPACE 3845 02:30:00,760 --> 02:30:03,560 WHERE NOT ONLY DO YOU HAVE 3846 02:30:03,560 --> 02:30:06,760 EFFICIENT SPACE BUT YOU HAVE A 3847 02:30:06,760 --> 02:30:09,240 LOT OF SAFETY IN THERE IN TERMS 3848 02:30:09,240 --> 02:30:09,880 OF SYSTEMS. 3849 02:30:09,880 --> 02:30:11,280 NOW MUCH PLANNING DID THE ACTUAL 3850 02:30:11,280 --> 02:30:13,640 TEAM ON THE GROUND, HOW MUCH 3851 02:30:13,640 --> 02:30:14,880 WERE YOUR TEAM MEMBERS ABLE TO 3852 02:30:14,880 --> 02:30:19,720 CONTRIBUTE TO THE DESIGN? 3853 02:30:19,720 --> 02:30:21,760 >> SO THE--SO I'VE BEEN IN MY 3854 02:30:21,760 --> 02:30:23,800 POSITION SINCE 2019 SO I CAME IN 3855 02:30:23,800 --> 02:30:26,320 DURING THE TRANSITION, SO 3856 02:30:26,320 --> 02:30:28,400 WE--MOST OF THE PHARMACY STAFF 3857 02:30:28,400 --> 02:30:31,800 AND LEADERSHIP AS WELL AS STAFF 3858 02:30:31,800 --> 02:30:32,720 INHERITED THE DESIGNS, WELL, 3859 02:30:32,720 --> 02:30:34,400 WE'VE DONE A LOT OF WORK IN 3860 02:30:34,400 --> 02:30:36,960 TERMS OF TRYING TO UNDERSTAND 3861 02:30:36,960 --> 02:30:38,200 THE INTENT OF THE DESIGN AND TO 3862 02:30:38,200 --> 02:30:40,960 MAKE SURE THAT WE HAVE 3863 02:30:40,960 --> 02:30:47,520 ACCOMMODATED A LOT OF THE MEANS 3864 02:30:47,520 --> 02:30:49,600 OF OUR STAFF AS WELL AS THE 3865 02:30:49,600 --> 02:30:50,200 FACILITY. 3866 02:30:50,200 --> 02:30:51,960 SO WE WEREN'T INVOLVED IN THE 3867 02:30:51,960 --> 02:30:53,560 ORIGINAL DESIGN BUT WE'VE 3868 02:30:53,560 --> 02:30:54,480 DEFINITELY TAKEN THE DESIGN AND 3869 02:30:54,480 --> 02:30:58,800 MADE IT OUR OWN SO TO SPEAK. 3870 02:30:58,800 --> 02:30:59,560 >> GOOD. 3871 02:30:59,560 --> 02:31:00,160 JIM? 3872 02:31:00,160 --> 02:31:02,760 >> I THINK MARILYN SAID IT RIGHT 3873 02:31:02,760 --> 02:31:04,600 AND SO, THOSE OF YOU THAT HAVE 3874 02:31:04,600 --> 02:31:17,240 BEEN ON THE BOARD FOR A WHILE, 3875 02:31:17,240 --> 02:31:24,480 THE FDA CAME IN 2015 AND 2016 3876 02:31:24,480 --> 02:31:31,400 AND IT WAS IN 2019 THAT MARILYN 3877 02:31:31,400 --> 02:31:38,000 AND THEY CAME AND SAID, 3878 02:31:38,000 --> 02:31:39,040 DR. GILMAN, THIS--THE DESIGN, 3879 02:31:39,040 --> 02:31:40,560 THAT THE OLD GROUP PUT TOGETHER 3880 02:31:40,560 --> 02:31:42,120 IS, YOU KNOW SOLVES A LOT OF 3881 02:31:42,120 --> 02:31:45,720 PROBLEMS BUT IT'S NOT THE WAY WE 3882 02:31:45,720 --> 02:31:47,560 THINK IT SHOULD BE DESIGNED. 3883 02:31:47,560 --> 02:31:48,760 WELL, THAT LEADER SHN TEAM WAS 3884 02:31:48,760 --> 02:31:52,600 GONE AND SO IT WAS A DIFFICULT 3885 02:31:52,600 --> 02:31:56,160 DECISION TO SAY, OKAY, WE'RE 3886 02:31:56,160 --> 02:31:58,800 GOING TO POSTPONE--WE'RE GOING 3887 02:31:58,800 --> 02:31:59,080 TO STOP. 3888 02:31:59,080 --> 02:32:00,640 THERE HAS TO BE MORE MONEY 3889 02:32:00,640 --> 02:32:03,680 THAT'S ADDED TO THE PROJECT AND 3890 02:32:03,680 --> 02:32:06,000 IN ORDER TO GO AND TO DO IT THE 3891 02:32:06,000 --> 02:32:08,840 WAY THE CURRENT PHARMACY 3892 02:32:08,840 --> 02:32:12,880 LEADERSHIP TEAM SAYS THAT IT 3893 02:32:12,880 --> 02:32:15,080 WOULD FUNCTION THE BEST, AND NOT 3894 02:32:15,080 --> 02:32:17,000 TO THROW ANYBODY THAT USED TO BE 3895 02:32:17,000 --> 02:32:18,880 HERE UNDER THE BUS BUT THEY 3896 02:32:18,880 --> 02:32:20,800 SAID, THIS IS THE WAY WE THINK 3897 02:32:20,800 --> 02:32:26,480 IT SHOULD BE DESIGNED AND DAN 3898 02:32:26,480 --> 02:32:27,840 WHEELAND AND YOU SAW RICK'S NAME 3899 02:32:27,840 --> 02:32:30,120 AT THE TOP OF THE SLIDE, RICK 3900 02:32:30,120 --> 02:32:33,920 WAS THE PROJECT OFFICER, PROGRAM 3901 02:32:33,920 --> 02:32:36,400 MANAGER FOR THIS AND SO, WE HAD 3902 02:32:36,400 --> 02:32:37,360 TO TAKE A PAUSE. 3903 02:32:37,360 --> 02:32:39,760 WE HAD TO GO BACK AND REDO THE 3904 02:32:39,760 --> 02:32:43,400 DESIGN AND MORE MONEY HAD TO BE 3905 02:32:43,400 --> 02:32:45,000 ADDED BUT YOU CAN SEE THE WAY 3906 02:32:45,000 --> 02:32:49,840 IT'S TURNED OUT AND I THINK THAT 3907 02:32:49,840 --> 02:32:55,440 ALL OF THOSE MEASURES WERE AT 3908 02:32:55,440 --> 02:32:59,400 LEAST IMPORTANT IF NOT 3909 02:32:59,400 --> 02:33:03,840 NECESSARY, THANKS. 3910 02:33:03,840 --> 02:33:04,160 >> GREAT. 3911 02:33:04,160 --> 02:33:04,600 >> WELL, WELCOME. 3912 02:33:04,600 --> 02:33:07,720 >> ALL RIGHT, SO I'M GOING TO 3913 02:33:07,720 --> 02:33:08,880 TAKE THE CHAIR'S PREROGATIVE NOW 3914 02:33:08,880 --> 02:33:14,160 AND WE'RE GOING TO GO INTO A 3915 02:33:14,160 --> 02:33:15,040 BREAK. 3916 02:33:15,040 --> 02:33:17,000 LET'S COME BACK AT ACTUALLY DAN, 3917 02:33:17,000 --> 02:33:20,680 YOU'RE STILL ON HERE, DAN 3918 02:33:20,680 --> 02:33:22,280 WHEELAND, CAN WE SKINNY YOURS 3919 02:33:22,280 --> 02:33:24,600 DOWN JUST A LITTLE BIT. 3920 02:33:24,600 --> 02:33:31,880 LET'S COME BACK AT 5 OF 12 AND 3921 02:33:31,880 --> 02:33:38,000 WE WILL THEN STILL AIM FOR OUR 3922 02:33:38,000 --> 02:33:40,040 KD--SALLY BY 1:00 O'CLOCK, DAN 3923 02:33:40,040 --> 02:33:42,400 ARE YOU OKAY WITH THAT? 3924 02:33:42,400 --> 02:33:42,960 >> YES MA'AM. 3925 02:33:42,960 --> 02:33:43,400 >> ALL RIGHT. 3926 02:33:43,400 --> 02:33:45,000 THANKS SO MUCH AND WE WILL SEE 3927 02:33:45,000 --> 02:33:48,440 EVERYBODY AT 5 OF THE HOUR. 3928 02:33:48,440 --> 02:33:51,240 WELCOME BACK EVERYBODY, 3929 02:33:51,240 --> 02:33:55,000 AND WE WILL GO AHEAD AND GET 3930 02:33:55,000 --> 02:33:55,240 STARTED. 3931 02:33:55,240 --> 02:33:59,080 DAN, THANKS SO MUCH FOR BEING SO 3932 02:33:59,080 --> 02:34:01,600 FLEXIBLE AND WE GOING TO GO TO 3933 02:34:01,600 --> 02:34:03,920 YOU TO HEAR IN MORE UPDATES ON 3934 02:34:03,920 --> 02:34:07,480 FACILITIES AND THEN WE'RE GOING 3935 02:34:07,480 --> 02:34:08,840 OVER TO MARSTON, SO WE'RE 3936 02:34:08,840 --> 02:34:11,520 LOOKING FORWARD TO IT AND I AM 3937 02:34:11,520 --> 02:34:13,120 COMMITTED TO EVERYONE THAT WE 3938 02:34:13,120 --> 02:34:15,080 WILL FINISH BY 1:00 O'CLOCK SO I 3939 02:34:15,080 --> 02:34:15,840 VERY MUCH APPRECIATE EVERYBODY 3940 02:34:15,840 --> 02:34:17,920 HANGING IN THERE WITH US TO GET 3941 02:34:17,920 --> 02:34:21,760 SOME GOOD TOPICS LEFT. 3942 02:34:21,760 --> 02:34:24,640 DAN? 3943 02:34:24,640 --> 02:34:25,960 >> THANK YOU MA'AM. 3944 02:34:25,960 --> 02:34:27,880 NEXT SLIDE, PLEASE, CARLY. 3945 02:34:27,880 --> 02:34:31,240 SO WE'RE GOING TO TALK ABOUT 3946 02:34:31,240 --> 02:34:32,640 PROJECTS RECENTLY AWARDED, THOSE 3947 02:34:32,640 --> 02:34:34,920 THAT HAVE BEEN SUBSTANTIALLY 3948 02:34:34,920 --> 02:34:36,360 COMPLETED RECENTLY AND THOSE 3949 02:34:36,360 --> 02:34:38,040 UNDERCONSTRUCTION IN JUST A 3950 02:34:38,040 --> 02:34:38,960 BRIEF ANNOUNCEMENT REGARDING 3951 02:34:38,960 --> 02:34:40,640 POSITIVE RESULTS FROM THE 3952 02:34:40,640 --> 02:34:41,880 QUARTERLY MEETINGS CONDUCTED 3953 02:34:41,880 --> 02:34:45,240 WITH THE APPROPRIATIONS 3954 02:34:45,240 --> 02:34:47,000 COMMITTEE STAFF, 2 GOOD 3955 02:34:47,000 --> 02:34:48,840 DEVELOPMENTS, 1 IS THAT THE 3956 02:34:48,840 --> 02:34:51,240 FISCAL YEAR 22 BUILDINGS AND 3957 02:34:51,240 --> 02:34:53,360 FACILITIES APPROPRIATION WAS 3958 02:34:53,360 --> 02:34:56,000 INCREASED FROM THE PREVIOUS 3959 02:34:56,000 --> 02:34:58,720 AMOUNT OF $200 MILLION TO 3960 02:34:58,720 --> 02:34:59,760 $250 MILLION REPRESENTING A 25% 3961 02:34:59,760 --> 02:35:04,240 INCREASE WHICH WAS THE LARGEST 3962 02:35:04,240 --> 02:35:05,440 PERCENT CANCER CENTER INCREASE 3963 02:35:05,440 --> 02:35:06,920 OF ALL, ALL APPROPRIATIONS AND 3964 02:35:06,920 --> 02:35:10,440 NOW REPRESENTS THE BASE FOR 3965 02:35:10,440 --> 02:35:12,880 FUTURE YEAR APPROPRIATIONS. 3966 02:35:12,880 --> 02:35:14,960 SECONDLY, THE INCREASE IN 3967 02:35:14,960 --> 02:35:18,560 SPECIAL AUTHORITY WHICH ENABLES 3968 02:35:18,560 --> 02:35:23,000 US TO TAKE IC APPROPRIATIONS AND 3969 02:35:23,000 --> 02:35:26,680 USE THEM FOR REPAIRS AND 3970 02:35:26,680 --> 02:35:28,640 IMPROVEMENTS THAT THRESHOLD WAS 3971 02:35:28,640 --> 02:35:31,200 MOVED FROM 3.5 TO $5 MILLION PER 3972 02:35:31,200 --> 02:35:35,160 PROJECT AND IN AGGREGATE FROM 3973 02:35:35,160 --> 02:35:36,040 $40 MILLION TO $100 MILLION AND 3974 02:35:36,040 --> 02:35:39,640 I THINK AS EVERYONE MAY RECALL 3975 02:35:39,640 --> 02:35:40,600 THESE ENGAGEMENTS RESULTED IN 3976 02:35:40,600 --> 02:35:44,200 THE AFTERMATH OF THE NATIONAL 3977 02:35:44,200 --> 02:35:46,720 ACADEMIES CONSENSUS STUDY 3978 02:35:46,720 --> 02:35:48,360 REGARDING OUR BACK LOG OF 3979 02:35:48,360 --> 02:35:49,880 MAINTENANCE AND REPAIR SO WE'RE 3980 02:35:49,880 --> 02:35:53,200 STARTING TO SEE SOME VERY 3981 02:35:53,200 --> 02:35:54,800 POSITIVE DEVELOPMENTS FROM THIS 3982 02:35:54,800 --> 02:35:56,240 AND THE OTHER THING I WOULD JUST 3983 02:35:56,240 --> 02:35:59,320 ADD IS THE PRESIDENT'S BUDGET AS 3984 02:35:59,320 --> 02:36:00,520 DR. TABAK AS JUST RELAYED 3985 02:36:00,520 --> 02:36:02,040 EARLIER WAS JUST ANOWBSED FOR 3986 02:36:02,040 --> 02:36:05,240 FISCAL YEAR 23 AND IN THE 3987 02:36:05,240 --> 02:36:07,040 PRESIDENT'S BUDGET, THE 3988 02:36:07,040 --> 02:36:07,920 BUILDINGS AND FACILITIES 3989 02:36:07,920 --> 02:36:15,280 APPROPRIATION WOULD INCREASE 3990 02:36:15,280 --> 02:36:18,960 FURTHER FROM 250 TO $3 BILLION, 3991 02:36:18,960 --> 02:36:22,360 SO POSITIVE AN ACTMENTS DUE TO 3992 02:36:22,360 --> 02:36:22,640 RESOURCES. 3993 02:36:22,640 --> 02:36:23,360 NEXT SLIDE. 3994 02:36:23,360 --> 02:36:27,080 SO AS DR. TABAK SHARED WITH YOU, 3995 02:36:27,080 --> 02:36:28,640 WE RECENTLY AWARDED LAST TUESDAY 3996 02:36:28,640 --> 02:36:31,520 SPECIFICALLY THIS VERY IMPORTANT 3997 02:36:31,520 --> 02:36:33,960 PROJECT FOR SURGERY, RADIOLOGY, 3998 02:36:33,960 --> 02:36:39,240 LABORATORY MEDICINE, AND 3999 02:36:39,240 --> 02:36:40,640 INCLUDING CATHETERIZATION 4000 02:36:40,640 --> 02:36:43,240 LABORATORY AND INTERVENTIONAL 4001 02:36:43,240 --> 02:36:49,200 RADIOLOGY. 4002 02:36:49,200 --> 02:36:51,640 NEXT SLIDE. 4003 02:36:51,640 --> 02:36:54,160 --AND THEN THE IN THE LOWER 4004 02:36:54,160 --> 02:36:57,640 VIEW, YOU CAN SEE A VIEW FROM 4005 02:36:57,640 --> 02:37:00,560 THE STREET PERSPECTIVE FROM WEST 4006 02:37:00,560 --> 02:37:04,320 LOOKING TO THE EAST. 4007 02:37:04,320 --> 02:37:05,960 NEXT SLIDE. 4008 02:37:05,960 --> 02:37:07,440 THIS IS THE DESIGN BUILD TEAM 4009 02:37:07,440 --> 02:37:13,440 THAT WAS AWARDED THE PROJECT LED 4010 02:37:13,440 --> 02:37:17,600 BY HENSEL, PHELPS, WHO WAS THE 4011 02:37:17,600 --> 02:37:19,560 CONSTRUCTOR, ZGF WAS THE 4012 02:37:19,560 --> 02:37:21,640 ARCHITECT OF THE RECORD AND THE 4013 02:37:21,640 --> 02:37:23,680 CRC AND FAMILIAR WITH THE 4014 02:37:23,680 --> 02:37:26,240 EXISTING BUILDING AND THEN THE 4015 02:37:26,240 --> 02:37:27,640 PLUMING AND ELECTRICAL DESIGN 4016 02:37:27,640 --> 02:37:29,760 HAS ELABORATE EXPERIENCE WORKING 4017 02:37:29,760 --> 02:37:33,200 ON NIH'S SITES, SO WE BELIEVE 4018 02:37:33,200 --> 02:37:35,160 WE'VE GOT A WORLD CLASS TEAM 4019 02:37:35,160 --> 02:37:40,480 HERE, THE AMOUNT OF THE AWARD 4020 02:37:40,480 --> 02:37:42,440 WAS APPROXIMATELY $638 MILLION. 4021 02:37:42,440 --> 02:37:45,360 SO, WE ARE INVESTING HEAVILY IN 4022 02:37:45,360 --> 02:37:48,520 THESE KEY AREAS AND WE WANT TO 4023 02:37:48,520 --> 02:37:50,920 THANK THE BOARD FOR THEIR 4024 02:37:50,920 --> 02:37:53,240 SUPPORT, I RECALL THAT YOU WROTE 4025 02:37:53,240 --> 02:37:55,240 AN IMPORTANT LETTER THAT WAS 4026 02:37:55,240 --> 02:37:56,040 INSTRUMENTAL IN ENABLINGITOUS 4027 02:37:56,040 --> 02:38:19,120 GET TO THIS CRUCIAL MILESTONE. 4028 02:38:19,120 --> 02:38:22,320 NEXT SLIDE. 4029 02:38:22,320 --> 02:38:25,800 --STAFF ALIKE NEXT SLIDE. 4030 02:38:25,800 --> 02:38:27,520 ANOTHER PROJECT WHICH MAY NOT BE 4031 02:38:27,520 --> 02:38:29,840 HIGHLY VISIBLE, BUT IS 4032 02:38:29,840 --> 02:38:32,480 ABSOLUTELY CRUCIAL TO PATIENT 4033 02:38:32,480 --> 02:38:34,240 SAFETY, WE REPLACED ALMOST A 4034 02:38:34,240 --> 02:38:37,760 QUARTER OF A MILE OF PIPING IN 4035 02:38:37,760 --> 02:38:42,960 THE BASEMENT OF THE CLINICAL 4036 02:38:42,960 --> 02:38:44,840 RESEARCH CENTER MUCH THE 4037 02:38:44,840 --> 02:38:45,840 EXISTING PIPING WAS OVERICIZED 4038 02:38:45,840 --> 02:38:47,960 AND THAT MIGHT SEEM LIKE AN 4039 02:38:47,960 --> 02:38:49,400 ADVANTAGE BUT ACTUALLY IT SLOWED 4040 02:38:49,400 --> 02:38:51,120 DOWN THE VELOCITY OF WATER 4041 02:38:51,120 --> 02:38:54,640 ENABLING THE CREATION OF 4042 02:38:54,640 --> 02:38:56,200 SEDIMENT AND BIOFILM AND 4043 02:38:56,200 --> 02:38:58,600 SECONDLY WAS CONSTRUCTED OUT OF 4044 02:38:58,600 --> 02:39:01,440 GALVANIZED PIPE WHICH HAD 4045 02:39:01,440 --> 02:39:04,520 EXPERIENCED SOME COROCEAN AND SO 4046 02:39:04,520 --> 02:39:05,920 WE RE--CORROSION AND WE REPLACED 4047 02:39:05,920 --> 02:39:08,120 IT WITH A SMALLER DIAMETER 4048 02:39:08,120 --> 02:39:11,240 COPPER PIPE AND THAT INVOLVED A 4049 02:39:11,240 --> 02:39:12,440 20 HOUR WATER OUTAGE THROUGHOUT 4050 02:39:12,440 --> 02:39:13,320 THE ENTIRE HOSPITAL AND I WANT 4051 02:39:13,320 --> 02:39:17,720 TO THANK THE CLINICAL CENTER FOR 4052 02:39:17,720 --> 02:39:18,680 THEIR EXCEPTIONAL COLLABORATION 4053 02:39:18,680 --> 02:39:21,000 IN SCHEDULING AND PULLING OFF 4054 02:39:21,000 --> 02:39:22,040 THAT IMPORTANT OUTAGE TO IMPROVE 4055 02:39:22,040 --> 02:39:25,440 THE QUALITY OF THE WATER FOR OUR 4056 02:39:25,440 --> 02:39:26,240 PATIENTS. 4057 02:39:26,240 --> 02:39:29,200 NEXT SLIDE. 4058 02:39:29,200 --> 02:39:32,360 WE ALSO COMPLETED A STERILITY 4059 02:39:32,360 --> 02:39:34,600 LAB FOR THE LABORATORY OF 4060 02:39:34,600 --> 02:39:36,840 MEDICINE THAT WILL PROVIDE 4061 02:39:36,840 --> 02:39:37,280 DRAMATICALLY ENHANCED 4062 02:39:37,280 --> 02:39:38,960 CAPABILITIES TO LOOK AT THE 4063 02:39:38,960 --> 02:39:42,440 STATUS OF VARIOUS PRODUCTS 4064 02:39:42,440 --> 02:39:45,720 WITHIN THE CLINICAL CENTER AND 4065 02:39:45,720 --> 02:39:47,840 INSURE THERE THEY'RE OF THE 4066 02:39:47,840 --> 02:39:53,440 PROPER STERILITY, NEXT SLIDE. 4067 02:39:53,440 --> 02:39:55,280 WE ALSO COMPLETED A SIGNIFICANT 4068 02:39:55,280 --> 02:39:57,920 PROJECT FOR THE CENTER FOR 4069 02:39:57,920 --> 02:40:01,960 CELLULAR ENGINEERING, CELL 4070 02:40:01,960 --> 02:40:03,240 PROCESSING FACILITY, THE 4071 02:40:03,240 --> 02:40:04,440 COMMISSIONING QUALIFICATION AND 4072 02:40:04,440 --> 02:40:07,240 VALIDATION WERE COMPLETED OR ARE 4073 02:40:07,240 --> 02:40:08,880 SCHEDULED FOR COMPLETION THIS 4074 02:40:08,880 --> 02:40:12,240 MONTH AND THERE WILL BE 4075 02:40:12,240 --> 02:40:13,120 ENVIRONMENTAL MONITORING, 4076 02:40:13,120 --> 02:40:15,280 PERFORMANCE QUALIFICATION IN 4077 02:40:15,280 --> 02:40:18,280 JUNE, ENABLING THE OPERATION OF 4078 02:40:18,280 --> 02:40:21,280 THIS CRITICAL FACILITY. 4079 02:40:21,280 --> 02:40:21,920 NEXT SLIDE. 4080 02:40:21,920 --> 02:40:24,880 SO WE'VE GOT SOME PROJECTS THAT 4081 02:40:24,880 --> 02:40:26,360 ARE IN VARIOUS PHASES OF 4082 02:40:26,360 --> 02:40:26,840 CONSTRUCTION. 4083 02:40:26,840 --> 02:40:30,800 NEXT SLIDE, PLEASE, CARLY. 4084 02:40:30,800 --> 02:40:32,080 WE'RE CONDUCTING IMPROVEMENTS 4085 02:40:32,080 --> 02:40:33,480 RELATIVE TO STERILE PROCESSING 4086 02:40:33,480 --> 02:40:36,880 IN BOTH THE B1 LEVEL AND ON 4087 02:40:36,880 --> 02:40:41,600 LEVEL 2 TO PROVIDE THE IMPROVED 4088 02:40:41,600 --> 02:40:45,160 SAFETY PRODUCTION WORK FLOW AND 4089 02:40:45,160 --> 02:40:50,320 REGULATORY COMPLIANCE RELATIVE 4090 02:40:50,320 --> 02:40:51,040 TO THE STERILEAISATION PROCESS. 4091 02:40:51,040 --> 02:40:53,880 IN ADDITION I SHOULD ADD THERE'S 4092 02:40:53,880 --> 02:40:54,440 A ROBUST STERILIZATION 4093 02:40:54,440 --> 02:40:56,040 CAPABILITY IN THE BASEMENT OF 4094 02:40:56,040 --> 02:40:58,760 THE NEW ADDITION THAT I REFERRED 4095 02:40:58,760 --> 02:41:03,320 TO EARLIER, SO THESE ARE GOING 4096 02:41:03,320 --> 02:41:05,280 TO BE IMPORTANT NEAR TERM 4097 02:41:05,280 --> 02:41:07,560 IMPROVEMENTS THAT WILL BE EVEN 4098 02:41:07,560 --> 02:41:09,920 BUILT UPON WHEN WE CONSTRUCT THE 4099 02:41:09,920 --> 02:41:12,920 NEW ADDITION. 4100 02:41:12,920 --> 02:41:13,680 NEXT SLIDE. 4101 02:41:13,680 --> 02:41:16,440 WE CONTINUE WITH THE RENOVATION 4102 02:41:16,440 --> 02:41:19,200 OF THE EWING WHICH IS SHOWN WITH 4103 02:41:19,200 --> 02:41:24,840 THE MRI WOOD COVERED WINDOWS, 4104 02:41:24,840 --> 02:41:28,760 STILL IN CONSTRUCTION AND WILL 4105 02:41:28,760 --> 02:41:30,400 PROVIDE A DRAMATICALLY IMPROVED 4106 02:41:30,400 --> 02:41:32,640 CAPABILITY FOR THE DEPARTMENT OF 4107 02:41:32,640 --> 02:41:34,520 TRANSFUSION MEDICINE WHICH IN 4108 02:41:34,520 --> 02:41:37,640 2011 WAS IDENTIFIED AT THE 4109 02:41:37,640 --> 02:41:42,640 DEPARTMENT THAT WAS NOT 4110 02:41:42,640 --> 02:41:44,600 RELOCATED INTO THE CRC THAT 4111 02:41:44,600 --> 02:41:46,640 NEEDED THE MOST ATTENTION AND 4112 02:41:46,640 --> 02:41:47,720 HENCE THEY CAME FIRST IN LINE 4113 02:41:47,720 --> 02:41:48,920 AND THIS WILL PROVIDE CELL 4114 02:41:48,920 --> 02:41:55,240 PROCESSING AS WELL AS THE BLOOD 4115 02:41:55,240 --> 02:42:03,240 BANK AND OTHER KEY--AND THIS 4116 02:42:03,240 --> 02:42:04,440 JUST SHOWS YOU A CROSS SECTION 4117 02:42:04,440 --> 02:42:10,320 OF THE BUILDING AND THE CLINICAL 4118 02:42:10,320 --> 02:42:12,600 CENTER RELATED OCCUPANCIES ARE 4119 02:42:12,600 --> 02:42:15,720 HIGHLIGHTED IN GREEN. 4120 02:42:15,720 --> 02:42:17,160 NEXT SLIDE. 4121 02:42:17,160 --> 02:42:19,000 THIS PROJECT AGAIN IS SORT OF 4122 02:42:19,000 --> 02:42:20,760 BEHIND THE CURTAIN BUT IT WILL 4123 02:42:20,760 --> 02:42:25,960 ENABLE US TO OPERATE MORE 4124 02:42:25,960 --> 02:42:28,440 AUTONOMOUSLY RELATIVE TO THE 4125 02:42:28,440 --> 02:42:34,080 POWER FOR OUR CENTRAL UTILITY 4126 02:42:34,080 --> 02:42:36,520 PLAN WHICH WILL INDEED ENABLE US 4127 02:42:36,520 --> 02:42:38,360 TO GENERATE STEAM AND CHILLED 4128 02:42:38,360 --> 02:42:40,600 WATER ENOUGH TO TREAT THE MOST 4129 02:42:40,600 --> 02:42:42,600 CRITICAL FUNCTIONS ON CAMPUS 4130 02:42:42,600 --> 02:42:46,440 INCLUSIVE OF PATIENT OPERATIONS 4131 02:42:46,440 --> 02:42:47,920 AND GIVEN CLIMATE CHANGE AND 4132 02:42:47,920 --> 02:42:49,000 EXTREME WEATHER, SOME OF WHICH 4133 02:42:49,000 --> 02:42:52,160 WE JUST TALKED ABOUT, WE ARE 4134 02:42:52,160 --> 02:42:55,080 KEENLY AWARE OF THE CRITICALITY 4135 02:42:55,080 --> 02:42:55,960 TO DEVELOP RESILIENT 4136 02:42:55,960 --> 02:42:56,560 INFRASTRUCTURE. 4137 02:42:56,560 --> 02:42:58,640 THIS IS FULLY FUNDED AND 4138 02:42:58,640 --> 02:42:59,320 SCHEDULES FOR COMPLETION A 4139 02:42:59,320 --> 02:43:05,080 LITTLE OVER A YEAR FROM NOW. 4140 02:43:05,080 --> 02:43:05,640 NEXT SLIDE. 4141 02:43:05,640 --> 02:43:08,880 ON THE SAME TOPIC OF RESILIENT 4142 02:43:08,880 --> 02:43:10,280 INFRASTRUCTURE, WE'RE INVEST FLG 4143 02:43:10,280 --> 02:43:12,240 A NEW UTILITY VAULT FOR ALL OF 4144 02:43:12,240 --> 02:43:15,720 THE ELECTRICAL EQUIPMENT SERVING 4145 02:43:15,720 --> 02:43:16,440 THE EXISTING BUILDING 10 COMPLEX 4146 02:43:16,440 --> 02:43:20,840 AS WELL AS THE ADDITION AND 4147 02:43:20,840 --> 02:43:22,160 WE'RE ALSO INVESTING IN A 4148 02:43:22,160 --> 02:43:23,920 PATIENT PARKING GARAGE WHICH 4149 02:43:23,920 --> 02:43:27,840 WILL EVENTUALLY ENABLE US TO 4150 02:43:27,840 --> 02:43:29,080 REMOVE OR DECOMITION THE 4151 02:43:29,080 --> 02:43:31,880 UNDERGROUND PARKING WHICH IS 4152 02:43:31,880 --> 02:43:32,720 SUFFERING FROM DETERIORATED 4153 02:43:32,720 --> 02:43:36,680 CONCRETE AND ALSO CONSTITUTES TO 4154 02:43:36,680 --> 02:43:39,240 SOME EXTENT SECURITY RISK AND 4155 02:43:39,240 --> 02:43:41,360 REQUIRES A HUNDRED PERCENT OF 4156 02:43:41,360 --> 02:43:43,880 INSPECTION OF ALL THOSE 4157 02:43:43,880 --> 02:43:44,160 VEHICLES. 4158 02:43:44,160 --> 02:43:44,440 NEXT SLIDE. 4159 02:43:44,440 --> 02:43:48,040 THIS IS A PICTURE OF THE PARKING 4160 02:43:48,040 --> 02:43:48,240 GARAGE. 4161 02:43:48,240 --> 02:43:48,880 NEXT SLIDE. 4162 02:43:48,880 --> 02:43:51,320 THIS PICTURE IS THE UTILITY 4163 02:43:51,320 --> 02:43:53,520 VAULT WHICH WILL HOWES ALL OF 4164 02:43:53,520 --> 02:43:55,280 THE ELECTRICAL EQUIPMENT SERVING 4165 02:43:55,280 --> 02:43:58,600 THE ENTIRE BUILDING 10 COMPLEX, 4166 02:43:58,600 --> 02:44:01,040 NEXT SLIDE. 4167 02:44:01,040 --> 02:44:02,600 ANOTHER PROJECT INITIATED BY 4168 02:44:02,600 --> 02:44:04,680 DR. GILMAN IS THE ADDITIONAL 4169 02:44:04,680 --> 02:44:05,840 PROTECTIVE ISOLATION PATIENT 4170 02:44:05,840 --> 02:44:09,840 CARE IN THE PEDIATRICS WARD AND 4171 02:44:09,840 --> 02:44:13,160 WE ARE APPROXIMATELY 50% OF THE 4172 02:44:13,160 --> 02:44:16,160 WAY THROUGH THAT HAVING WORKED 4173 02:44:16,160 --> 02:44:18,240 ON THE SOUTHERN PORTION AND 4174 02:44:18,240 --> 02:44:19,760 COMPLETED THAT AND NOW WE'RE 4175 02:44:19,760 --> 02:44:22,520 WORKING ON THE NORTHERN PORTION 4176 02:44:22,520 --> 02:44:25,800 OF THAT WARD. 4177 02:44:25,800 --> 02:44:26,480 NEXT SLIDE. 4178 02:44:26,480 --> 02:44:29,240 THIS DESCRIBES A LITTLE BIT OF 4179 02:44:29,240 --> 02:44:31,920 THE STATISTICS IN TERMS OF THE 4180 02:44:31,920 --> 02:44:33,240 NUMBER OF ROOMS THAT ARE 4181 02:44:33,240 --> 02:44:36,040 INVOLVED IN THE CONVERSION OF 4182 02:44:36,040 --> 02:44:37,760 THOSE INTO THE PROTECTIVE 4183 02:44:37,760 --> 02:44:40,400 ENVIRONMENT AND AIR BORN 4184 02:44:40,400 --> 02:44:42,760 INFECTION ISOLATION ROOMS. 4185 02:44:42,760 --> 02:44:43,400 NEXT SLIDE. 4186 02:44:43,400 --> 02:44:45,720 THIS JUST GIVES YOU A FLOOR PLAN 4187 02:44:45,720 --> 02:44:47,640 OF THE SAME. 4188 02:44:47,640 --> 02:44:49,440 NEXT SLIDE. 4189 02:44:49,440 --> 02:44:52,800 SO IN SUMMARY, THE INCREASE IN 4190 02:44:52,800 --> 02:44:53,720 THE BUILDINGS AND FACILITIES 4191 02:44:53,720 --> 02:44:55,000 APPROPRIATION AND THE SPECIAL 4192 02:44:55,000 --> 02:44:57,480 AUTHORITY WILL PROVIDE MORE 4193 02:44:57,480 --> 02:44:58,440 RESOURCES FOR FACILITIES, LIKELY 4194 02:44:58,440 --> 02:45:00,640 RESULT OF THE NATIONAL ACADEMIES 4195 02:45:00,640 --> 02:45:03,520 OF CONSENSUS REPORT AND THE 4196 02:45:03,520 --> 02:45:06,600 RESULT IN QUARTERLY MEETINGS 4197 02:45:06,600 --> 02:45:07,640 WITH THE APPROPRIATIONS STAFF. 4198 02:45:07,640 --> 02:45:11,080 THE MOST NOTE WORTHY DEVELOPMENT 4199 02:45:11,080 --> 02:45:12,720 THIS PRESENTATION OF COURSE IS 4200 02:45:12,720 --> 02:45:15,240 THE AWARD OF THE SURGERY 4201 02:45:15,240 --> 02:45:16,040 RADIOLOGY AND LABORATORY 4202 02:45:16,040 --> 02:45:18,200 MEDICINE PROJECT, WHICH YOU 4203 02:45:18,200 --> 02:45:20,840 HELPED ADVOCATE FOR AND YOUR 4204 02:45:20,840 --> 02:45:21,640 SUPPORT IS SIGNIFICANTLY 4205 02:45:21,640 --> 02:45:23,320 APPRECIATED AND SO THIS 4206 02:45:23,320 --> 02:45:24,480 CONCLUDES MY PRESENTATION AND 4207 02:45:24,480 --> 02:45:31,760 SUBJECT TO YOUR QUESTIONS. 4208 02:45:31,760 --> 02:45:33,840 THANK YOU. 4209 02:45:33,840 --> 02:45:35,280 >> TERRIFIC, THANK YOU. 4210 02:45:35,280 --> 02:45:39,800 YEAH, SOMEONE WAS JUST PRIVATELY 4211 02:45:39,800 --> 02:45:40,840 CHATTING ME THAT IT WAS SEVERAL 4212 02:45:40,840 --> 02:45:42,200 YEARS AGO THAT THE BOARD HAD A 4213 02:45:42,200 --> 02:45:47,720 CHANCE TO DO A TOUR OF THE 4214 02:45:47,720 --> 02:45:48,240 CLINICAL CENTER, OBVIOUSLY 4215 02:45:48,240 --> 02:45:49,840 SELECT PARTS OF IT WAS HUGE BUT 4216 02:45:49,840 --> 02:45:50,880 IT WAS REALLY GREAT TO SEE. 4217 02:45:50,880 --> 02:45:52,680 I HOPE THAT WILL BE SOMETHING 4218 02:45:52,680 --> 02:45:56,040 THAT THE BOARD CAN RETURN TO IN 4219 02:45:56,040 --> 02:45:57,040 THE FUTURE. 4220 02:45:57,040 --> 02:45:58,080 NOTHING LIKE SEEING SOMETHING. 4221 02:45:58,080 --> 02:46:01,040 LOTS OF GREAT THINGS ON THE 4222 02:46:01,040 --> 02:46:01,280 HORIZON. 4223 02:46:01,280 --> 02:46:02,920 ANY QUESTIONS FOR DAN? 4224 02:46:02,920 --> 02:46:11,480 OR THE REST OF THE TEAM? 4225 02:46:11,480 --> 02:46:12,840 OKAY, LET'S KEEP MOVING. 4226 02:46:12,840 --> 02:46:14,040 ALL RIGHT. 4227 02:46:14,040 --> 02:46:19,320 SO, SIEM SORRY, RICK, GO AHEAD. 4228 02:46:19,320 --> 02:46:24,080 >> SO LAURA, I THINK THIS IS 4229 02:46:24,080 --> 02:46:26,080 REALLY EXTRAORDINARY PROGRESS 4230 02:46:26,080 --> 02:46:27,680 AND PARTICULARLY THE NEW 4231 02:46:27,680 --> 02:46:29,840 SURGICAL MEDICAL LAB MEDICINE 4232 02:46:29,840 --> 02:46:32,280 BUILDING AND THE RENOVATIONS TO 4233 02:46:32,280 --> 02:46:35,160 THE PEDIATRIC SPACE, VERY MUCH 4234 02:46:35,160 --> 02:46:37,760 CONSISTENT WITH THE RESEARCH 4235 02:46:37,760 --> 02:46:39,120 DIRECTIONS AROUND BOTH CELL 4236 02:46:39,120 --> 02:46:39,960 BASED THERAPIES AND GENETICS 4237 02:46:39,960 --> 02:46:41,840 THAT I THINK WILL LIKELY BECOME 4238 02:46:41,840 --> 02:46:44,880 AN INCREASING PART OF THE 4239 02:46:44,880 --> 02:46:49,360 CLINICAL RESEARCH PORTFOLIO OF 4240 02:46:49,360 --> 02:46:51,280 THE HOSPITAL, SO, THESE ARE I 4241 02:46:51,280 --> 02:46:53,760 THINK ARE REALLY, REALLY 4242 02:46:53,760 --> 02:46:54,720 IMPORTANT AND IT'S REALLY GREAT 4243 02:46:54,720 --> 02:46:57,400 TO SEE THEM COME TO FRUITION 4244 02:46:57,400 --> 02:47:14,560 OVER THE LAST, YOU KNOW 6 YEARS. 4245 02:47:14,560 --> 02:47:16,840 >> GREAT STUFF AND NOTHING LIKE 4246 02:47:16,840 --> 02:47:18,080 NEW, RIGHT? 4247 02:47:18,080 --> 02:47:18,640 MOVING ON. 4248 02:47:18,640 --> 02:47:19,200 THANK YOU. 4249 02:47:19,200 --> 02:47:24,560 WE WILL HEAR FROM DR. MARSTON 4250 02:47:24,560 --> 02:47:28,040 LINEHAN WHO IS CHIEF THE 4251 02:47:28,040 --> 02:47:29,840 UROLOGIC SURGERY AND UROLOGIC 4252 02:47:29,840 --> 02:47:30,400 ONCOLOGY SECTION. 4253 02:47:30,400 --> 02:47:32,040 THIS IS A REAL TREAT, I HAVE TO 4254 02:47:32,040 --> 02:47:36,560 SAY FOR US, TO GET TO HEAR SOME 4255 02:47:36,560 --> 02:47:38,040 OF THE SCIENCE THAT CONNECTS ALL 4256 02:47:38,040 --> 02:47:40,000 OF US. 4257 02:47:40,000 --> 02:47:41,400 SO MARSTON, OVER TO YOU. 4258 02:47:41,400 --> 02:47:42,600 THANK YOU VERY MUCH FOR BEING 4259 02:47:42,600 --> 02:47:42,800 HERE. 4260 02:47:42,800 --> 02:47:43,880 >> THANK YOU VERY MUCH FOR 4261 02:47:43,880 --> 02:47:46,720 INVITING PLEA, IT'S A REAL 4262 02:47:46,720 --> 02:47:46,920 HONOR. 4263 02:47:46,920 --> 02:47:51,000 --INVITING ME, - IT IS A REAL 4264 02:47:51,000 --> 02:47:51,440 HONOR. 4265 02:47:51,440 --> 02:47:51,640 OKAY. 4266 02:47:51,640 --> 02:47:56,960 CAN YOU ALL SEE MY SCREEN OKAY. 4267 02:47:56,960 --> 02:47:57,800 >> YES. 4268 02:47:57,800 --> 02:47:58,040 >> OKAY. 4269 02:47:58,040 --> 02:47:58,840 WELL, THANK YOU VERY MUCH. 4270 02:47:58,840 --> 02:48:02,360 IT'S A REAL HONOR AND I CAN'T 4271 02:48:02,360 --> 02:48:05,000 TELL YOU HOW MUCH THE INTRAMURAL 4272 02:48:05,000 --> 02:48:05,600 SCIENTISTS APPRECIATE ALL THE 4273 02:48:05,600 --> 02:48:07,600 EFFORT AND WORK THAT YOU DO TO 4274 02:48:07,600 --> 02:48:10,840 SUPPORT THE WORK THAT WE DO AT 4275 02:48:10,840 --> 02:48:13,640 THIS MARVELOUS CLINICAL CENTER 4276 02:48:13,640 --> 02:48:14,120 RESEARCH HOSPITAL. 4277 02:48:14,120 --> 02:48:15,640 THIS AFTERNOON, I WILL SPEAK 4278 02:48:15,640 --> 02:48:20,840 ABOUT THE IDENTIFICATION OF THE 4279 02:48:20,840 --> 02:48:23,440 VHL KIDNEY CANCER GENE. 4280 02:48:23,440 --> 02:48:27,040 HOW IT LED TO MOLECULAR 4281 02:48:27,040 --> 02:48:29,760 DIAGNOSIS, UNDERSTANDING OXYGEN 4282 02:48:29,760 --> 02:48:38,600 SENSING AND PRECISION THERAPY. 4283 02:48:38,600 --> 02:48:41,040 NIWHEN WE START OUR WORK ON 4284 02:48:41,040 --> 02:48:43,000 KIDNEY CANCER HERE AT THE 4285 02:48:43,000 --> 02:48:45,040 CLINICAL CENTER, RESEARCH 4286 02:48:45,040 --> 02:48:47,400 HOSPITAL IN THE EARLY 1980S, 4287 02:48:47,400 --> 02:48:48,840 KIDNEY CANCER WAS THOUGHT TO BE 4288 02:48:48,840 --> 02:48:50,240 A SINGLE DISEASE, WE DID THE 4289 02:48:50,240 --> 02:48:52,440 SAME SURGERY ON EACH PATIENT, WE 4290 02:48:52,440 --> 02:48:53,840 TREATED PATES WITH METASTATIC 4291 02:48:53,840 --> 02:48:56,840 DISEASE ALL WITH THE SAME DRUGS, 4292 02:48:56,840 --> 02:48:58,240 NONE OF WHICH WERE EFFECTIVE, 4293 02:48:58,240 --> 02:48:59,880 NOW WE KNOW THAT KIDNEY CANCER 4294 02:48:59,880 --> 02:49:01,560 IS NOT A SINGLE DISEASE, IT'S 4295 02:49:01,560 --> 02:49:03,440 MADE UP OF A NUMBER OF DIFFERENT 4296 02:49:03,440 --> 02:49:06,200 TYPES OF CANCER, EACH WITH 4297 02:49:06,200 --> 02:49:07,440 DIFFERENT HISTOLOGYYS SHOWN 4298 02:49:07,440 --> 02:49:11,120 HERE, DIFFERENT CLINICAL 4299 02:49:11,120 --> 02:49:14,840 COURSES, RESPONDING DIFFERENTLY 4300 02:49:14,840 --> 02:49:16,840 TO THERAPY AND AS I WILL SHOW 4301 02:49:16,840 --> 02:49:22,120 YOU CAUSED BY DIFFERENT GENES. 4302 02:49:22,120 --> 02:49:23,960 WE NOW KNOW OF 18 DIFFERENT 4303 02:49:23,960 --> 02:49:27,840 GENES THAT CAUSE KIDNEY CANCER. 4304 02:49:27,840 --> 02:49:33,240 AND AS OF 2 DAYS AGO, WE KNOW OF 4305 02:49:33,240 --> 02:49:36,960 14 DIFFERENT GENETICALLY DEFINED 4306 02:49:36,960 --> 02:49:40,360 TYPES OF HEREDITARY KIDNEY 4307 02:49:40,360 --> 02:49:40,600 CANCER. 4308 02:49:40,600 --> 02:49:43,160 NOW MOST OF WHAT WE KNOW REALLY 4309 02:49:43,160 --> 02:49:45,440 ABOUT THE GENETIC BASIS OF 4310 02:49:45,440 --> 02:49:53,040 KIDNEY CANCER, WE'VE LEARNED 4311 02:49:53,040 --> 02:49:54,760 FROM STUDYING FAMILIES. 4312 02:49:54,760 --> 02:49:56,360 WITH THIS MARVELOUS RESEARCH 4313 02:49:56,360 --> 02:49:58,120 CLINICAL CENTER, WE FOLLOW OVER 4314 02:49:58,120 --> 02:50:00,320 3000 PATIENTS FROM NEARLY 1500 4315 02:50:00,320 --> 02:50:01,640 FAMILIES, THE LARGEST EXPERIENCE 4316 02:50:01,640 --> 02:50:08,800 FOR SURE IN THE WORLD WITH CLEAR 4317 02:50:08,800 --> 02:50:12,440 CELL APPLIED ILLEGALSARY CHROMO, 4318 02:50:12,440 --> 02:50:14,240 AND ONCOCYTIC RENAL CELL CANCER. 4319 02:50:14,240 --> 02:50:21,080 NOW, HERE OVER THE PAST 38 YEARS 4320 02:50:21,080 --> 02:50:25,400 WE'VE DESCRIBED 8 NOVEL DISEASES 4321 02:50:25,400 --> 02:50:29,640 AT THE CLINICAL CENTER AND WE 4322 02:50:29,640 --> 02:50:35,480 HAVE IDENTIFIED 9 DISEASE GENES 4323 02:50:35,480 --> 02:50:37,440 HERE FOR A NUMBER OF DIFFERENT 4324 02:50:37,440 --> 02:50:42,240 KINDS OF CANCER AND DIFFERENT 4325 02:50:42,240 --> 02:50:42,480 DISEASES. 4326 02:50:42,480 --> 02:50:43,720 WE STARTED, OUR WORK BEGAN WITH 4327 02:50:43,720 --> 02:50:45,960 A PAPER WHICH WE PUBLISHED IN 4328 02:50:45,960 --> 02:50:48,600 NATURE AND IN THE MIDDLE 80S IN 4329 02:50:48,600 --> 02:50:51,880 WHICH WE SHOWED CONSISTENT LOSS 4330 02:50:51,880 --> 02:50:55,840 OF A SEGMENT OF CHROMOSOME 3, 4331 02:50:55,840 --> 02:50:57,520 THE THIRD CHROMOSOME IN TUMORS 4332 02:50:57,520 --> 02:50:59,240 FROM PATIENTS WITH CLEAR CELL 4333 02:50:59,240 --> 02:51:01,200 KIDNEY CANCER THAN WE WERE 4334 02:51:01,200 --> 02:51:01,720 SEEING HERE. 4335 02:51:01,720 --> 02:51:04,560 AND I WILL SAY, I WILL TELL YOU 4336 02:51:04,560 --> 02:51:05,920 THIS, THERE'S NO WAY WE COULD 4337 02:51:05,920 --> 02:51:07,800 HAVE DONE THIS WORK ANYWHERE 4338 02:51:07,800 --> 02:51:10,040 ELSE OTHER THAN HERE AT THE 4339 02:51:10,040 --> 02:51:11,040 CLINICAL CENTER, I MEAN IT JUST 4340 02:51:11,040 --> 02:51:14,800 WOULD NOT HAVE BEEN POSSIBLE. 4341 02:51:14,800 --> 02:51:16,760 AND THIS WORK SUGGESTED THAT 4342 02:51:16,760 --> 02:51:21,200 THERE WAS A KIDNEY CANCER GENE 4343 02:51:21,200 --> 02:51:21,680 IN THIS LOCATION. 4344 02:51:21,680 --> 02:51:26,000 NOW THIS WORK BEGAN 17 YEARS 4345 02:51:26,000 --> 02:51:28,320 BEFORE THE HUMAN GENOME WAS 4346 02:51:28,320 --> 02:51:29,400 SEQUENCED THERE WAS NO MAP OF 4347 02:51:29,400 --> 02:51:30,920 THE REGION TO SEARCH, THERE'S NO 4348 02:51:30,920 --> 02:51:32,480 WAY WE COULD DO THIS BY MAPPING. 4349 02:51:32,480 --> 02:51:35,720 SO WE TURNED TO THE STUDY OF 4350 02:51:35,720 --> 02:51:37,360 HEREDITARY KIDNEY CANCERS TO USE 4351 02:51:37,360 --> 02:51:41,680 THE POWER OF GENETICS TO 4352 02:51:41,680 --> 02:51:45,440 LOCALIZE AND IDENTIFY KIDNEY 4353 02:51:45,440 --> 02:51:45,800 CANCER GENES. 4354 02:51:45,800 --> 02:51:47,920 OUR HOPE WAS THAT THAT WILL 4355 02:51:47,920 --> 02:51:54,560 ENABLE US TO A-DEVELOP PRECISION 4356 02:51:54,560 --> 02:51:56,600 DIAGNOSIS, PRECISION SURGERY, 4357 02:51:56,600 --> 02:51:58,160 PRECISION THERAPY AND TO PROVIDE 4358 02:51:58,160 --> 02:51:59,600 THE FOUNDATION FOR THE 4359 02:51:59,600 --> 02:52:00,320 DEVELOPMENT OF TARGETED THERAPY 4360 02:52:00,320 --> 02:52:02,000 FOR THESE PATIENTS AND I WILL 4361 02:52:02,000 --> 02:52:05,480 SHOW YOU 1 STORY ON THAT, SO, WE 4362 02:52:05,480 --> 02:52:16,000 STARTED WITH THE STUDY OF A 4363 02:52:16,000 --> 02:52:19,960 VON HIPPEL-LINDAU, A HEREDITARY 4364 02:52:19,960 --> 02:52:24,760 CANCER IN WHICH PATIENTS 4365 02:52:24,760 --> 02:52:26,440 ARE--MULTIFOCUS CLEAR CELL 4366 02:52:26,440 --> 02:52:27,040 KIDNEY CANCER. 4367 02:52:27,040 --> 02:52:29,320 WE ESTIMATE THESE PATIENTS ARE 4368 02:52:29,320 --> 02:52:32,520 ACTUALLY AT RISK FOR THE 4369 02:52:32,520 --> 02:52:35,520 DEVELOPMENT OF UP TO 800 TUMORS 4370 02:52:35,520 --> 02:52:36,160 FOR KIDNEY. 4371 02:52:36,160 --> 02:52:38,680 THESE WERE CANCER, THESE ARE 4372 02:52:38,680 --> 02:52:39,640 ADDRESSIVE CANCERS, THEY CAN 4373 02:52:39,640 --> 02:52:41,440 SPREAD AND KILL THESE PATIENTS, 4374 02:52:41,440 --> 02:52:41,640 SADLY. 4375 02:52:41,640 --> 02:52:43,240 WE'VE HAD 63 PATIENTS OVER THE 4376 02:52:43,240 --> 02:52:46,400 LASTER 38 YEARS WHO'VE DEVELOPED 4377 02:52:46,400 --> 02:52:48,040 METASTATIC DISEASE, NOW TO 4378 02:52:48,040 --> 02:52:51,160 PREVENT THAT WE PERFORMED OVER 4379 02:52:51,160 --> 02:52:52,640 800 PROCEDURES ON VHL PATIENTS 4380 02:52:52,640 --> 02:52:56,320 WITH KIDNEY CANCER HERE ADDED 4381 02:52:56,320 --> 02:52:57,360 THE CLINICAL CENTER. 4382 02:52:57,360 --> 02:53:00,880 AND WE'VE DEVELOPED A PRECISION 4383 02:53:00,880 --> 02:53:01,960 CLINICAL MANAGEMENT APPROACH FOR 4384 02:53:01,960 --> 02:53:06,640 EACH TYPE OF GENETICALLY DEFINED 4385 02:53:06,640 --> 02:53:07,920 KIDNEY CANCER. 4386 02:53:07,920 --> 02:53:09,960 FOR VL FOR EXAMPLE, INSTEAD OF 4387 02:53:09,960 --> 02:53:11,640 REMOVING THE ENTIRE KIDNEY WHICH 4388 02:53:11,640 --> 02:53:13,840 THEN WOULD HAVE BEEN DONE PRIOR 4389 02:53:13,840 --> 02:53:15,600 TO THAT TIME WE DEVELOPED AN 4390 02:53:15,600 --> 02:53:16,840 APPROACH OF ACTIVE SURVEILLANCE, 4391 02:53:16,840 --> 02:53:23,720 WHICH AT THE TIME WAS CONSIDERED 4392 02:53:23,720 --> 02:53:30,040 HEARASSY BY MY FIELD, WE 4393 02:53:30,040 --> 02:53:30,920 RECOMMEND PARTIAL NEFF RECTIFIED 4394 02:53:30,920 --> 02:53:31,080 ME. 4395 02:53:31,080 --> 02:53:33,640 NOW AS I MENTIONED WE HAD A 4396 02:53:33,640 --> 02:53:34,680 NUMBER OF PEOPLE DEVELOP, A 4397 02:53:34,680 --> 02:53:36,680 NUMBER OF POWER PATIENTS DEVELOP 4398 02:53:36,680 --> 02:53:37,800 METASTATIC DISEASE OVER THE PAST 4399 02:53:37,800 --> 02:53:40,080 34 YEARS WHEN WE INSTITUTED TO 4400 02:53:40,080 --> 02:53:43,000 APPROACH, WE HAVE NOT YET HAD A 4401 02:53:43,000 --> 02:53:45,720 SINGLE PATIENT, NOT 1 YET 4402 02:53:45,720 --> 02:53:46,640 DEVELOP METASTATIC DISEASE WHEN 4403 02:53:46,640 --> 02:53:51,880 MANAGED IN THIS FASHION. 4404 02:53:51,880 --> 02:53:53,600 I WANTED TO SHOW YOU THIS. 4405 02:53:53,600 --> 02:53:55,840 THIS IS A VIDEO 4406 02:53:55,840 --> 02:53:59,160 OF ROBOTIC PARTIAL 4407 02:53:59,160 --> 02:54:01,880 NEPHRECTIFIED ME, AND IN WHICH 4408 02:54:01,880 --> 02:54:03,920 WE ENUCLE8 THIS TUMOR WE COME 4409 02:54:03,920 --> 02:54:05,360 RIGHT OROUND AND NUCLE8 IT AND 4410 02:54:05,360 --> 02:54:06,840 TAKE THESE TUMORS OUT AND BECOME 4411 02:54:06,840 --> 02:54:09,320 CLOSE TO THE TUMOR FOR ANY OTHER 4412 02:54:09,320 --> 02:54:10,480 GENETICALLY DEFINED TYPES OF 4413 02:54:10,480 --> 02:54:12,240 CANCER, WEEZ DO A COMPLETELY 4414 02:54:12,240 --> 02:54:14,000 DIFFERENT OPERATION, FOR 4415 02:54:14,000 --> 02:54:18,280 PATIENTS FOR EXAMPLE WITH FH 4416 02:54:18,280 --> 02:54:19,520 DEFICIENCY CANCER, HLRCC, WE 4417 02:54:19,520 --> 02:54:22,200 DON'T DO ROBOTIC SURGERY, WE DO 4418 02:54:22,200 --> 02:54:24,480 OPEN SURGERY, WE DON'T DO AN 4419 02:54:24,480 --> 02:54:25,680 ENUCLEATION LIKE WE DO HERE, WE 4420 02:54:25,680 --> 02:54:29,280 DO A WIDE MARGIN SO DEPENDS ON 4421 02:54:29,280 --> 02:54:31,200 THE GENE, IT'S PRECISION 4422 02:54:31,200 --> 02:54:31,680 SURGICAL THERAPY. 4423 02:54:31,680 --> 02:54:34,760 NOW OUR PATIENTS ARE ALSO AT 4424 02:54:34,760 --> 02:54:36,040 RISK FOR PANCREAT CIANCIARULO 4425 02:54:36,040 --> 02:54:41,360 AND EBD O KRIN NIEWMORS PENT 4426 02:54:41,360 --> 02:54:42,560 WHICH ARE MALIGNANT AND CAN 4427 02:54:42,560 --> 02:54:42,800 SPHRED. 4428 02:54:42,800 --> 02:54:46,080 OUR PATIENTS ARE ALSO AT RISK 4429 02:54:46,080 --> 02:54:50,200 FOR BRAIN, AND SPINAL HEMAGIAL 4430 02:54:50,200 --> 02:54:53,880 BLASTOMAS FOR WHICH OUR PATIENTS 4431 02:54:53,880 --> 02:54:55,320 HAVE UNDERGONE OVER 1200 4432 02:54:55,320 --> 02:54:58,720 PROCEDURES AT THE CLINICAL 4433 02:54:58,720 --> 02:54:59,200 CENTER. 4434 02:54:59,200 --> 02:55:02,320 THESE ARE VHL ASSOCIATED 4435 02:55:02,320 --> 02:55:06,120 CEREBELLAR AND SPINAL 4436 02:55:06,120 --> 02:55:06,520 HEMANGIOBLASTOMAS. 4437 02:55:06,520 --> 02:55:10,880 AND FINALLY 92% OF OUR PATIENTS 4438 02:55:10,880 --> 02:55:11,800 TWEP RETINAL ANGIOMAs AND I'M 4439 02:55:11,800 --> 02:55:13,080 SAT TO SAY WE HAVE A NUMBER OF 4440 02:55:13,080 --> 02:55:14,760 PATIENT WHO IS COMPLETELY LOST 4441 02:55:14,760 --> 02:55:17,680 THEIR SIGHT. THIS IS THE FIRST 4442 02:55:17,680 --> 02:55:19,240 MANIFESTATION OF VHL, WE CAN SEE 4443 02:55:19,240 --> 02:55:20,440 THESE IN 1 YEAR-OLD. 4444 02:55:20,440 --> 02:55:21,960 SOPHISTICATEDY WE RECOMMEND 4445 02:55:21,960 --> 02:55:23,040 GERMLINE MUTATION TESTING IN 4446 02:55:23,040 --> 02:55:25,600 CHILDREN, IN BABIES TO DETERMINE 4447 02:55:25,600 --> 02:55:27,280 WHO'S AFFECTED AND WHO'S NOT 4448 02:55:27,280 --> 02:55:29,640 BECAUSE LASER PHOTO THERAPY CAN 4449 02:55:29,640 --> 02:55:33,800 HELP PRESERVE VISUAL FIELDS. 4450 02:55:33,800 --> 02:55:35,760 NOW WE HAVE NO WAY OF KNOWING 4451 02:55:35,760 --> 02:55:38,480 WHO WAS AFFECTED WHO WASN'T IN 4452 02:55:38,480 --> 02:55:40,680 THESE FAMILIES SO TO FIND THE 4453 02:55:40,680 --> 02:55:42,120 VHL GENE WE BROUGHT THESE 4454 02:55:42,120 --> 02:55:43,880 FAMILIES TO THE MERCHANDISELOUS 4455 02:55:43,880 --> 02:55:44,400 CLINICAL CENTER RESEARCH 4456 02:55:44,400 --> 02:55:46,680 HOSPITAL AND THIS IS A TRUE NIH 4457 02:55:46,680 --> 02:55:47,040 PROJECT. 4458 02:55:47,040 --> 02:55:48,560 ONE OF MY ASSISTANTS TOLD ME 4459 02:55:48,560 --> 02:55:51,320 LAST YEAR, SHE SAID, YOU KNOW, 4460 02:55:51,320 --> 02:55:54,680 OVER THE YEARS YOU'VE WORKED 4461 02:55:54,680 --> 02:55:58,600 WITH 138 INDIVIDUALS AT NIH FROM 4462 02:55:58,600 --> 02:56:01,960 29 LABS AND BRANCHES. 4463 02:56:01,960 --> 02:56:03,680 FROM 8 DIFFERENT INSTITUTES AT 4464 02:56:03,680 --> 02:56:07,720 NIH, SO THIS IS TRULY, I'M 4465 02:56:07,720 --> 02:56:10,080 GIVING THIS TALK BUT THIS IS 4466 02:56:10,080 --> 02:56:11,360 TRULY AN NIH PROJECT AND HAS 4467 02:56:11,360 --> 02:56:16,040 BEEN SINCE THE VERY BEGINNING. 4468 02:56:16,040 --> 02:56:18,400 SO TO FIND THE VHL GENE, WE 4469 02:56:18,400 --> 02:56:19,560 STUDIED THE FANLLYS HERE AT THE 4470 02:56:19,560 --> 02:56:20,680 CLINICAL CENTER ASK TRACED THE 4471 02:56:20,680 --> 02:56:22,400 GENE TO THE SHORT ARM OF 4472 02:56:22,400 --> 02:56:25,520 CHROMOSOME 3 WHERE WE HAD SEEN 4473 02:56:25,520 --> 02:56:27,120 THE ABNORMALITY IN SPORADIC 4474 02:56:27,120 --> 02:56:29,040 CLEAR CELL KIDNEY CANCER, SO WE 4475 02:56:29,040 --> 02:56:30,480 WERE VERY ENCOURAGED TO SEE 4476 02:56:30,480 --> 02:56:30,720 THAT. 4477 02:56:30,720 --> 02:56:31,880 NOW WEINARY ONED THE REGION UP 4478 02:56:31,880 --> 02:56:35,240 HERE AT THE TOP, WITH GENETIC 4479 02:56:35,240 --> 02:56:36,560 LINKAGE ANALYSIS, AND THEN DOWN 4480 02:56:36,560 --> 02:56:39,200 HERE BELOW, WE DID WHAT WAS 4481 02:56:39,200 --> 02:56:41,160 CALLED PHYSICAL MAPPING, 4482 02:56:41,160 --> 02:56:42,800 IDENTIFIED THESE ARE CDNAs 4483 02:56:42,800 --> 02:56:45,560 THEY'RE CALLED AND THE SEVENTH 4484 02:56:45,560 --> 02:56:49,160 CDNA HERE WE CALL G7 WAS THE 4485 02:56:49,160 --> 02:56:50,680 SEVENTH CDNA PIECE OF DNA THAT 4486 02:56:50,680 --> 02:56:52,880 WHEN WE LOOKED AT, AND THIS 4487 02:56:52,880 --> 02:56:56,880 TURNED OUT TO BE THE VHL GENE IN 4488 02:56:56,880 --> 02:56:58,480 THE SPRING OF 1993, NEARLY 10 4489 02:56:58,480 --> 02:57:12,800 YEARS AFTER WE STARTED THIS 4490 02:57:12,800 --> 02:57:14,200 PROJECT--MUTATIONS OF THE GENE 4491 02:57:14,200 --> 02:57:15,360 WHICH SEGREGATED WITH THE DEC IN 4492 02:57:15,360 --> 02:57:20,480 THE FAMILIES WHICH IS EXACTLY 4493 02:57:20,480 --> 02:57:20,960 WHAT WE FOUND. 4494 02:57:20,960 --> 02:57:22,400 WE THEN WENT ON TO DEVELOP A 4495 02:57:22,400 --> 02:57:24,480 BLOOD TEST WHICH IS USED WORLD 4496 02:57:24,480 --> 02:57:26,440 WIDE FOR ALL OF OUR GENES WE 4497 02:57:26,440 --> 02:57:28,080 DEVELOPED AND WAS POSITIVE IN 4498 02:57:28,080 --> 02:57:31,480 100% OF OUR FAMILIES. 4499 02:57:31,480 --> 02:57:33,200 NEXT WE WANTED TO SEE IF THERE 4500 02:57:33,200 --> 02:57:35,480 THIS WAS THE GENE THAT WE LOOKED 4501 02:57:35,480 --> 02:57:37,960 FOR FOR SO LONG? 4502 02:57:37,960 --> 02:57:46,080 WAS THIS THE GENE FOR TUMORS? 4503 02:57:46,080 --> 02:57:49,520 WE TESTED TUMORS FROM PATIENTS 4504 02:57:49,520 --> 02:57:51,080 WITH SPORADIC NONFAMILIAL KIDNEY 4505 02:57:51,080 --> 02:57:53,320 CANCER AND SURE ENOUGH WE FOUND 4506 02:57:53,320 --> 02:57:54,480 MUTATION OR METHYLATION CHRKS IS 4507 02:57:54,480 --> 02:57:56,880 THE SILENCING THE GENE IN 91% OF 4508 02:57:56,880 --> 02:57:58,400 THE TUMORS. 4509 02:57:58,400 --> 02:58:01,880 NOW WE DID NOT FIND THE VHL GENE 4510 02:58:01,880 --> 02:58:03,080 MUTATION IN OTHER HISTOLOGIC 4511 02:58:03,080 --> 02:58:04,400 TYPES OF KIDNEY CANCER THAT I 4512 02:58:04,400 --> 02:58:06,240 SHOWED YOU A MINUTE AGO, 4513 02:58:06,240 --> 02:58:08,120 PROVIDING THE FOUNDATION FOR THE 4514 02:58:08,120 --> 02:58:10,320 DEVELOPMENT OF PRECISION 4515 02:58:10,320 --> 02:58:12,160 CLINICAL MANAGEMENT, PRECISION 4516 02:58:12,160 --> 02:58:13,960 THERAPY, AND PRECISION SURGERY 4517 02:58:13,960 --> 02:58:17,200 BASED ON THE GENO TYPE OF THE 4518 02:58:17,200 --> 02:58:17,520 CANCER. 4519 02:58:17,520 --> 02:58:20,840 NOW THIS WAS A COMPLETELY 4520 02:58:20,840 --> 02:58:22,040 [INDISCERNIBLE] GENE WE HAD NO 4521 02:58:22,040 --> 02:58:23,800 IDEA WHEN WE FOUND IT HOW IT 4522 02:58:23,800 --> 02:58:24,040 WORKED. 4523 02:58:24,040 --> 02:58:26,400 AND WE WANTED TO KNOW HOW THE 4524 02:58:26,400 --> 02:58:29,720 VHL GENE WORKED SO TO DO THIS, 4525 02:58:29,720 --> 02:58:33,880 WE FIRST IDENTIFIED 2 PROTEINS, 4526 02:58:33,880 --> 02:58:36,680 A LONG C AND ELONGIN B HERE 4527 02:58:36,680 --> 02:58:38,800 WHICH FORMED A COMPLEX WITH VHL 4528 02:58:38,800 --> 02:58:40,520 AND I WILL PUBLISH THIS IN 4529 02:58:40,520 --> 02:58:42,080 SCIENCE AND JOINT WEB CONNECTED 4530 02:58:42,080 --> 02:58:44,880 WITH A YOUNG SCIENTIST BILL 4531 02:58:44,880 --> 02:58:46,520 KAELIN WHO WILL HEAR MORE ABOUT 4532 02:58:46,520 --> 02:58:48,800 IN A MINUTE, HOWEVER WE STILL 4533 02:58:48,800 --> 02:58:50,800 DIDN'T REALLY KNOW OR HAVE A 4534 02:58:50,800 --> 02:58:54,480 CLUE ON HIGHWAY HOW THIS WORKED. 4535 02:58:54,480 --> 02:58:58,480 NOW, THE NEXT YEAR, WE AND AGAIN 4536 02:58:58,480 --> 02:59:01,600 WITH BACK-TO-BACK WITH BILL 4537 02:59:01,600 --> 02:59:03,800 KAELIN'S GROUP, SHOWED THE VHL 4538 02:59:03,800 --> 02:59:06,280 GENES THAT ARE OXYGEN SENSITIVE. 4539 02:59:06,280 --> 02:59:07,840 WELL, HOW'S THAT HAPPEN. 4540 02:59:07,840 --> 02:59:11,240 WELL, THE FOLLOWING YEAR WITH 4541 02:59:11,240 --> 02:59:13,240 RICK CLASSENER, WE SHOWED THAT 4542 02:59:13,240 --> 02:59:16,240 THE VHL COMPLEX INCLUDES A 4543 02:59:16,240 --> 02:59:18,200 PROTEIN CALLED COL2, A RECENTLY 4544 02:59:18,200 --> 02:59:19,520 DISCOVERED GENE THE YEAR BEFORE. 4545 02:59:19,520 --> 02:59:23,120 WE LOOKEDDA THE HOMOLOGOUS YEAST 4546 02:59:23,120 --> 02:59:23,920 PROTEINS OVER HERE ON THE RIGHT 4547 02:59:23,920 --> 02:59:26,160 AND YOU CAN SEE THEIR COMPLEX, 4548 02:59:26,160 --> 02:59:28,480 HOW THEY WORK AND THE REASON VHL 4549 02:59:28,480 --> 02:59:32,480 HAD TO BE BE BE A DEGRADATION 4550 02:59:32,480 --> 02:59:33,440 COMPLEX THAT TARGETS 4551 02:59:33,440 --> 02:59:36,880 TRANSCRIPTION FACTORS THAT 4552 02:59:36,880 --> 02:59:40,080 REGULATE THE STABILITY OF 4553 02:59:40,080 --> 02:59:42,040 HYPOXIA INDUCIBLE RNAs, IN 4554 02:59:42,040 --> 02:59:47,280 OTHER WORDS THAT ARE OXYGEN 4555 02:59:47,280 --> 02:59:49,680 SENSITIVE, AND WE REASON IT HAD 4556 02:59:49,680 --> 02:59:51,960 TO BE HYPOXIA INDUCIBLE AND 4557 02:59:51,960 --> 02:59:54,360 SHORTLY THEREAFTER OUR COLLEAGUE 4558 02:59:54,360 --> 02:59:55,840 PETER RADCLIFF PROVED THAT, 4559 02:59:55,840 --> 02:59:58,280 SHOWED THAT, THAT VHL DOES 4560 02:59:58,280 --> 03:00:01,000 INDEED TARGET HYPOXIA INDUCIBLE 4561 03:00:01,000 --> 03:00:04,480 FACTOR FOR DEGRADATION, THAT VHL 4562 03:00:04,480 --> 03:00:08,080 TARGETS HIF FOR DEGRADATION AND 4563 03:00:08,080 --> 03:00:11,240 THIS IS OXYGEN SENSITIVE. 4564 03:00:11,240 --> 03:00:14,120 BUT NO 1 KNEW HOW THAT WORKED 4565 03:00:14,120 --> 03:00:16,640 UNTIL SHORTLY THEREAFTER IN 4566 03:00:16,640 --> 03:00:17,360 2001. 4567 03:00:17,360 --> 03:00:19,920 PETER RADCLIFF AND BILL KAELIN 4568 03:00:19,920 --> 03:00:23,640 SHOWED THE MECHANISM FOR VHL HIV 4569 03:00:23,640 --> 03:00:24,680 OXYGEN SENSING. 4570 03:00:24,680 --> 03:00:29,000 IN RETROSPECT VERY SIMPLE. 4571 03:00:29,000 --> 03:00:32,080 IT'S PROLEGAL HYDROX ACE, WHICH 4572 03:00:32,080 --> 03:00:33,280 PUTS HYDROXYL GROUPS WHEN 4573 03:00:33,280 --> 03:00:34,880 THERE'S OXYGEN IN THE CELL AND 4574 03:00:34,880 --> 03:00:36,880 NORM OXIA AND THERE ARE 4575 03:00:36,880 --> 03:00:38,960 COMPLEXES, VHL CAN TARGET AND 4576 03:00:38,960 --> 03:00:41,960 DEGRADE, HOWEVER IF YOU ARE LOW 4577 03:00:41,960 --> 03:00:43,600 IN OXYGEN, YOU'RE IN HYPOXIA, 4578 03:00:43,600 --> 03:00:45,280 YOU CAN'T THROW THOSE ON HERE, 4579 03:00:45,280 --> 03:00:48,040 THE COMPLEX CAN'T TARGET HIT THE 4580 03:00:48,040 --> 03:00:49,840 GRADE AND CAN'T ACCUMULATE. 4581 03:00:49,840 --> 03:00:59,120 AND THAT'S HOW IT WORKS. 4582 03:00:59,120 --> 03:01:04,920 AND IN 2019, THE NOBEL ASSEMBLY 4583 03:01:04,920 --> 03:01:09,360 AWARDED BILL KAELYN AND PETER 4584 03:01:09,360 --> 03:01:12,440 RATCLIFFE, AND GREG SEMENZA THE 4585 03:01:12,440 --> 03:01:17,480 NOBEL PRIZE OF HOW CELLS SENSE 4586 03:01:17,480 --> 03:01:19,080 AND ADAPT TO OXYGEN 4587 03:01:19,080 --> 03:01:21,320 AVAILABILITY, AND THEY WERE VERY 4588 03:01:21,320 --> 03:01:22,920 GRACIOUS TO CITE OUR WORK AS 4589 03:01:22,920 --> 03:01:24,480 BEING CRITICAL TO THIS DORPHY. 4590 03:01:24,480 --> 03:01:29,320 NOW OF COURSE OUR GOAL, OUR 4591 03:01:29,320 --> 03:01:31,040 EFFORT, OUR TARGET HAD BEEN TO 4592 03:01:31,040 --> 03:01:32,400 DEVELOP THERAPIES. 4593 03:01:32,400 --> 03:01:34,360 SO UNDERSTANDING THE VHL PATHWAY 4594 03:01:34,360 --> 03:01:39,240 HAS PROVIDED THE FOUNDATION FOR 4595 03:01:39,240 --> 03:01:45,880 THE DEVELOPMENT AND FDA APRAWFAL 4596 03:01:45,880 --> 03:01:47,080 NONPRECISION THERAPEUTIC AGENTS. 4597 03:01:47,080 --> 03:01:48,800 TARGETING THE DOWN STREAM GENES 4598 03:01:48,800 --> 03:01:57,040 REGULATED BY THE VHL HIFF WAGHT 4599 03:01:57,040 --> 03:01:57,200 WAY. 4600 03:01:57,200 --> 03:01:59,240 NOW, YOU KNOW HAVE HIGH 4601 03:01:59,240 --> 03:02:01,440 RESPONSE, WE WERE TARGETING THE 4602 03:02:01,440 --> 03:02:03,880 DOWN STREAM GENES WUWE WANTED TO 4603 03:02:03,880 --> 03:02:04,680 DO BETTER. 4604 03:02:04,680 --> 03:02:08,320 WE WANTED TO TARGET HIF ITSELF, 4605 03:02:08,320 --> 03:02:21,440 INSTEAD OF JUST THE QUOTE DOWN 4606 03:02:21,440 --> 03:02:23,480 STREAM GENES. 4607 03:02:23,480 --> 03:02:25,520 TUMORIGENESIS, AND THIS WORK LED 4608 03:02:25,520 --> 03:02:27,680 TO THE DEVELOPMENT BY RICK BROOK 4609 03:02:27,680 --> 03:02:35,360 AND HIS COLLEAGUES OF AN AGENT 4610 03:02:35,360 --> 03:02:38,640 BELZUTIFAN THAT TARGETS HIF TO 4611 03:02:38,640 --> 03:02:39,200 ITSELF. 4612 03:02:39,200 --> 03:02:41,880 SO THEY CONTACTED US AND ASKED 4613 03:02:41,880 --> 03:02:45,480 IF WE WOULD DO A TRIAL, WE SAID 4614 03:02:45,480 --> 03:02:46,080 OF COURSE. 4615 03:02:46,080 --> 03:02:50,320 WE THEN CONDUCTED A MULTICENTER 4616 03:02:50,320 --> 03:02:53,520 TRIAL LED BY RON KD--SALLY HA IN 4617 03:02:53,520 --> 03:02:57,680 OUR GROUP EVALUATING THIS AGENT 4618 03:02:57,680 --> 03:03:02,400 BELZUTIFAN IN VHL PATIENTS. 4619 03:03:02,400 --> 03:03:05,080 IN THIS TRIAL, WE HAVE SEEN A 4620 03:03:05,080 --> 03:03:07,400 98% PARTIAL RESPONSE OR STABLE 4621 03:03:07,400 --> 03:03:11,000 DISEASE IN RENAL TUMORS IN WHICH 4622 03:03:11,000 --> 03:03:21,280 92% OF OUR TARGET LESIONS GET 4623 03:03:21,280 --> 03:03:21,840 SMALLER. 4624 03:03:21,840 --> 03:03:24,520 AND CNS AND ANGIO BLASTOMAS WE 4625 03:03:24,520 --> 03:03:28,240 SEE A 60% RESPONSE WITHA 86% 4626 03:03:28,240 --> 03:03:29,040 PARTIAL RESPONSE FROM THESE 4627 03:03:29,040 --> 03:03:30,200 BRAVE PATIENTS WE HAVE WORKED 4628 03:03:30,200 --> 03:03:33,160 WITH AND BEEN OUR PARTNERS ALL 4629 03:03:33,160 --> 03:03:34,520 THESE YEARS. 4630 03:03:34,520 --> 03:03:35,480 AND AGGRESSIVE PANCREATIC INDO 4631 03:03:35,480 --> 03:03:44,920 KRIN CANCERS WE HAVE A 91% 4632 03:03:44,920 --> 03:03:47,280 OBJECTIVE--91% OBJECTIVE 4633 03:03:47,280 --> 03:03:50,120 RESPONSE RATE WITH A 14% 4634 03:03:50,120 --> 03:03:53,280 COMPLETE RESPONSE RATE IN 4635 03:03:53,280 --> 03:03:54,840 ENDOCRINE TUMORS. 4636 03:03:54,840 --> 03:03:57,880 IN 12 VHL PATIENTS WITH 16 4637 03:03:57,880 --> 03:03:59,880 RETINAL HEME ANG I DON'T MEANAS, 4638 03:03:59,880 --> 03:04:01,640 TREATED WITH THIS AGENT, WHICH 4639 03:04:01,640 --> 03:04:05,720 HAS REALLY VERY MODEST SIDE 4640 03:04:05,720 --> 03:04:06,680 EFFECTS WE'VE SEEN IMPROVEMENT 4641 03:04:06,680 --> 03:04:13,000 IN A HUNDRED% OF OUR LESIONS. 4642 03:04:13,000 --> 03:04:16,080 AND MY COLLEAGUE, IN 4643 03:04:16,080 --> 03:04:17,480 OPHTHALMOLOGY EMILY CHU HAS BEEN 4644 03:04:17,480 --> 03:04:25,480 BY OUR SIDE FOR NEARLY 3 DECADES 4645 03:04:25,480 --> 03:04:26,680 WITH THESE PATIENTS. 4646 03:04:26,680 --> 03:04:29,200 SHE HAS DONE 6 CLINICAL TRIALS 4647 03:04:29,200 --> 03:04:30,520 WITH AGENTS TARGETING THIS 4648 03:04:30,520 --> 03:04:35,120 PATHWAY AND NOT SEEN A WHOLE LOT 4649 03:04:35,120 --> 03:04:35,560 UNTIL THIS. 4650 03:04:35,560 --> 03:04:37,800 NOW OR GOAL HAS BEEN OBVIOUSLY 4651 03:04:37,800 --> 03:04:40,080 TO DEVELOP A THERAPY SO THESE 4652 03:04:40,080 --> 03:04:41,800 BRAVE PATIENTS WON'T HAVE TO 4653 03:04:41,800 --> 03:04:43,720 HAVE SURGERY, AFTER SURGERY 4654 03:04:43,720 --> 03:04:45,080 AFTER SURGERY FOR THEIR TUMORS 4655 03:04:45,080 --> 03:04:47,200 WHICH WE'VE LIVE WIDE FOR 4656 03:04:47,200 --> 03:04:48,880 NEITHER 40 YEARS, THE PATIENTS 4657 03:04:48,880 --> 03:04:49,920 ON THIS TRIAL, CAN YOU LOOK AT 4658 03:04:49,920 --> 03:04:51,240 THIS SLIDE HERE, THE PATIENTS ON 4659 03:04:51,240 --> 03:04:57,280 THIS TRIAL, IF YOU LOOK AT THE 2 4660 03:04:57,280 --> 03:04:59,320 AND HALF YEARS BEFORE THEY 4661 03:04:59,320 --> 03:05:00,880 STARTED THERAPY AT 53 SURGICAL 4662 03:05:00,880 --> 03:05:02,480 PROCEDURES IN THE 2 AND HALF 4663 03:05:02,480 --> 03:05:06,160 YEARS AFTER WE STARTED DRUG, 4664 03:05:06,160 --> 03:05:08,160 ONLY 3 SURGICAL PROCEDURES IN 4665 03:05:08,160 --> 03:05:13,360 THIS PATIENT POP VIEWLINGS. 4666 03:05:13,360 --> 03:05:15,400 SO WHAT I'VE SHOWN YOU IS THAT 4667 03:05:15,400 --> 03:05:16,480 KIDNEY CANCER IS NOT KIDNEY 4668 03:05:16,480 --> 03:05:18,440 CANCER IT'S A NUMBER OF 4669 03:05:18,440 --> 03:05:19,640 DIFFERENT CANCERS, DIFFERENT 4670 03:05:19,640 --> 03:05:21,640 MEDICAL COURSES, RESPONDING 4671 03:05:21,640 --> 03:05:23,000 DIFFERENTLY TO THERAPY, CAUSED 4672 03:05:23,000 --> 03:05:24,040 BY DIFFERENT GENES WITH 4673 03:05:24,040 --> 03:05:24,760 DIFFERENT PATHWAYS AND IT'S OUR 4674 03:05:24,760 --> 03:05:31,480 HOPE THAT OUR CONTINUED STUDY OF 4675 03:05:31,480 --> 03:05:33,120 KIDNEY CANCER FAMILIAL AND 4676 03:05:33,120 --> 03:05:34,560 SPORADIC AT THE CLINICAL CENTER, 4677 03:05:34,560 --> 03:05:35,600 INSTEAD OF STUDYING THESE 4678 03:05:35,600 --> 03:05:39,280 PATHWAY AND GENES WILL DEVELOP 4679 03:05:39,280 --> 03:05:41,120 EFFECTIVE FORMS OF THERAPY FOR 4680 03:05:41,120 --> 03:05:41,960 EVERY PATIENT AFFECTED WITH THIS 4681 03:05:41,960 --> 03:05:43,280 DISEASE AND I WANT TO 4682 03:05:43,280 --> 03:05:44,600 ACKNOWLEDGE OUR COLLEAGUES AS I 4683 03:05:44,600 --> 03:05:49,720 MENTIONED, THIS IS A REAL NIH 4684 03:05:49,720 --> 03:05:49,920 TRIAL. 4685 03:05:49,920 --> 03:05:53,800 I'M INDEBTED TO THE COLLEAGUES 4686 03:05:53,800 --> 03:05:55,880 IN OUR GROUP OUR THERAPEUTICS 4687 03:05:55,880 --> 03:05:58,480 AND CLINICAL TIME LED BY RON, 4688 03:05:58,480 --> 03:06:00,200 AND MATT, AND NIH IT WOULD TAKE 4689 03:06:00,200 --> 03:06:01,880 MY 5 SLIDES TO SHOW EVERYBODY 4690 03:06:01,880 --> 03:06:04,960 FROM NIH ACROSS THE WHOLE FIELD. 4691 03:06:04,960 --> 03:06:10,480 OUR COLLEAGUES IN RADIOLOGY 4692 03:06:10,480 --> 03:06:12,720 ASKING SURGICAL AND NEUROLOGY, 4693 03:06:12,720 --> 03:06:16,480 AND BEFORE THAT FERS IT ED, I 4694 03:06:16,480 --> 03:06:18,680 STARTED WORKING WITH ED IN 84 ON 4695 03:06:18,680 --> 03:06:19,360 THIS. 4696 03:06:19,360 --> 03:06:22,000 THE MARVIN MUSCAN EVERYBODIOUS 4697 03:06:22,000 --> 03:06:23,880 EMILY CHU, ENDOCRINE ONCOLOGY, 4698 03:06:23,880 --> 03:06:27,320 IT GOES BACK TO JEFF NORTON, 4699 03:06:27,320 --> 03:06:28,880 DOUG, STEVE, I CAN'T TELL YOU 4700 03:06:28,880 --> 03:06:29,840 HOW MANY SURGICAL COLLEAGUES 4701 03:06:29,840 --> 03:06:33,320 WE'VE WORKED WITH, THE WONDERFUL 4702 03:06:33,320 --> 03:06:35,280 MA RIAMOLECULAR MEDICINE, TRACE 4703 03:06:35,280 --> 03:06:37,320 WHO HELPED US DEVELOP NOVEL 4704 03:06:37,320 --> 03:06:41,560 APPROACHES TARGETING THE VHL HIF 4705 03:06:41,560 --> 03:06:43,880 PATHWAY, ENDOCRINOLOGY, WERE 4706 03:06:43,880 --> 03:06:44,680 ALSO INCREDIBLY APPRECIATIVE OF 4707 03:06:44,680 --> 03:06:47,200 THE CLINICAL CENTER AND NIH FOR 4708 03:06:47,200 --> 03:06:55,280 SUPPORTING 2 U01 PROJECTS BASED 4709 03:06:55,280 --> 03:06:58,560 ON CHL WITH THE INSTITUTE AND 4710 03:06:58,560 --> 03:07:03,520 OUR WORK WITH BILL KAELIN AND 4711 03:07:03,520 --> 03:07:06,000 DAVID Mc DORMOT FOR THE VHL 4712 03:07:06,000 --> 03:07:07,840 CANCERS SO THANK YOU VERY MUCH 4713 03:07:07,840 --> 03:07:12,080 IT'S BEEN A HONOR TO HAVE AN 4714 03:07:12,080 --> 03:07:13,400 OPPORTUNITY TO COMMUNICATE WITH 4715 03:07:13,400 --> 03:07:15,840 YOU, THE WONDERFUL WORK OF THE 4716 03:07:15,840 --> 03:07:18,080 SMALL PIECE THAT IS ONGOING AT 4717 03:07:18,080 --> 03:07:19,440 THIS WONDERFUL CLINICAL CENTER. 4718 03:07:19,440 --> 03:07:31,920 THANK YOU VERY MUCH. 4719 03:07:31,920 --> 03:07:34,160 >> I SEE A COUPLE HANDS THERE, 4720 03:07:34,160 --> 03:07:34,360 OKAY. 4721 03:07:34,360 --> 03:07:35,720 ELEN LET ME GO TO YOU FIRST AND 4722 03:07:35,720 --> 03:07:40,040 THEN GO TO RICK AND JOHN. 4723 03:07:40,040 --> 03:07:40,480 >> OKAY. 4724 03:07:40,480 --> 03:07:41,520 CONGRATULATIONS ON THIS 4725 03:07:41,520 --> 03:07:42,160 WONDERFUL RESEARCH. 4726 03:07:42,160 --> 03:07:43,680 THAT'S WHY WE LOVE NIH. 4727 03:07:43,680 --> 03:07:46,240 BUT I ALSO WANT TO THANK YOU FOR 4728 03:07:46,240 --> 03:07:47,280 MAKING IT SIMPLE ENOUGH FOR 4729 03:07:47,280 --> 03:07:50,360 PEOPLE LIKE ME TO UNDERSTAND. 4730 03:07:50,360 --> 03:07:55,240 SO THANK YOU. 4731 03:07:55,240 --> 03:07:56,440 >> THANK YOU. 4732 03:07:56,440 --> 03:07:59,720 >> ELLEN, YOU ARE PRETTY 4733 03:07:59,720 --> 03:08:03,720 SOPHISTICATED BUT I WILL ALSO 4734 03:08:03,720 --> 03:08:07,040 GIVE DR. LINEHAN CREDIT FOR 4735 03:08:07,040 --> 03:08:08,080 MAKING VERY UNDERSTANDABLE AND 4736 03:08:08,080 --> 03:08:09,760 QUITE AN ACTION PACKED STORY IN 4737 03:08:09,760 --> 03:08:10,320 TERMS OF DEVELOPMENT. 4738 03:08:10,320 --> 03:08:14,640 RICK AND THEN JOHN. 4739 03:08:14,640 --> 03:08:15,280 >> DR. LINEHAN THANK YOU VERY 4740 03:08:15,280 --> 03:08:21,480 MUCH IT WAS JUST TERRIFIC AND I 4741 03:08:21,480 --> 03:08:22,480 THINK THAT EARLIER IN THE COURSE 4742 03:08:22,480 --> 03:08:26,200 OF OUR CONVERSATION THIS MORNING 4743 03:08:26,200 --> 03:08:28,080 AND TALKING ABOUT EFFORTS AT THE 4744 03:08:28,080 --> 03:08:36,480 CLINICAL CENTER TO THINK ABOUT 4745 03:08:36,480 --> 03:08:39,400 ADDRESSING AND I KNOW THAT 4746 03:08:39,400 --> 03:08:40,440 HISTORICALLY RENAL CELL CANCER, 4747 03:08:40,440 --> 03:08:41,840 I UNDERSTAND HOW ARE NOT 1 4748 03:08:41,840 --> 03:08:43,240 DISEASE BUT IN GENERAL ARE 4749 03:08:43,240 --> 03:08:46,320 THOUGHT TO HAVE A HIGHER 4750 03:08:46,320 --> 03:08:47,120 INCIDENCE AMONG AFRICAN-AMERICAN 4751 03:08:47,120 --> 03:08:48,880 MEN SO I WONDER WHETHER AS PART 4752 03:08:48,880 --> 03:08:50,400 OF THE CENTER'S EFFORTS TO 4753 03:08:50,400 --> 03:08:53,400 REALLY FOCUS ON EQUITY WE CAN 4754 03:08:53,400 --> 03:08:57,760 BEGIN TO REALLY TEASE OUT FOR 4755 03:08:57,760 --> 03:09:00,880 EXAMPLE, RESPONSE RATES BY RACE, 4756 03:09:00,880 --> 03:09:02,000 GIVEN AGAIN WITH A DISEASE THAT 4757 03:09:02,000 --> 03:09:02,880 IS HISTORIC LOAMACYY AND I'M 4758 03:09:02,880 --> 03:09:04,840 SURE YOU KNOW MORE THAN THIS 4759 03:09:04,840 --> 03:09:06,600 ABOUT THIS THAN ME BUT 4760 03:09:06,600 --> 03:09:08,840 HISTORICALLY HAD A HIGH INITANCE 4761 03:09:08,840 --> 03:09:09,760 AMONG AFRICAN AMERICANS, JUST 4762 03:09:09,760 --> 03:09:10,400 ANOTHER CONTRIBUTION THE CENTER 4763 03:09:10,400 --> 03:09:15,320 COULD MAKE TO A NATIONAL 4764 03:09:15,320 --> 03:09:17,680 CONVERSATION AROUND EQUITY WHERE 4765 03:09:17,680 --> 03:09:19,200 CLINICAL DISPARITIES ARE 4766 03:09:19,200 --> 03:09:24,160 ADDRESSED WITH THIS KIND OF 4767 03:09:24,160 --> 03:09:24,400 SCIENCE. 4768 03:09:24,400 --> 03:09:24,760 >> ABSOLUTELY. 4769 03:09:24,760 --> 03:09:25,880 THANK YOU FOR BRINGING THAT UP 4770 03:09:25,880 --> 03:09:26,960 AND ABSOLUTELY OF COURSE. 4771 03:09:26,960 --> 03:09:28,520 FOR MANY, MANY REASONS, 1 IS 4772 03:09:28,520 --> 03:09:30,240 IT'S THE RIGHT THING TO DO BUT 4773 03:09:30,240 --> 03:09:31,920 ANOTHER OF COURSE, BUT ANOTHER 4774 03:09:31,920 --> 03:09:33,920 THING IS SCIENTIFICALLY, IT'S 4775 03:09:33,920 --> 03:09:34,280 VERY IMPORTANT. 4776 03:09:34,280 --> 03:09:36,080 WHAT IS GOING ON HERE, WHAT 4777 03:09:36,080 --> 03:09:38,520 IS--HOW DOES THAT WORK, I AGREE, 4778 03:09:38,520 --> 03:09:40,680 IT'S HIGHER INCIDENCE IN BOTH 4779 03:09:40,680 --> 03:09:44,080 MALES AND FEMALES, SO PEOPLE WHO 4780 03:09:44,080 --> 03:09:45,480 ARE OF AFRICAN AMERICAN DESCENT, 4781 03:09:45,480 --> 03:09:47,120 ANOTHER THING IS THAT ACTUALLY 4782 03:09:47,120 --> 03:09:49,000 THEY GET A LITTLE DIFFERENT TYPE 4783 03:09:49,000 --> 03:09:49,800 OF KIDNEY CANCER. 4784 03:09:49,800 --> 03:09:52,200 THEY GET MORE APPLIEDULARAR SKPE 4785 03:09:52,200 --> 03:09:53,880 BAKUGAN LESS CLEAR CELL AND 4786 03:09:53,880 --> 03:09:55,120 THAT'S A VERY--IT'S A VERY 4787 03:09:55,120 --> 03:09:55,880 IMPORTANT POINT AND WE'RE 4788 03:09:55,880 --> 03:09:57,520 WORKING VERY HARD TO EXPAND OUR 4789 03:09:57,520 --> 03:10:00,760 EFFORTS IN THOSE AREAS AND OF 4790 03:10:00,760 --> 03:10:02,680 COURSE, I'M A NEUROLOGIC SURGEON 4791 03:10:02,680 --> 03:10:05,680 AND OF COURSE, WE MANAGE 4792 03:10:05,680 --> 03:10:07,880 PATIENTS WITH PROSTATE CANCER, 4793 03:10:07,880 --> 03:10:09,600 KIDNEY CANCER, PROSTATE CANCER, 4794 03:10:09,600 --> 03:10:10,880 BLADDER CANCER AND IN PROSTATE 4795 03:10:10,880 --> 03:10:13,320 CANCER WE HAVE SIMILAR ISSUES 4796 03:10:13,320 --> 03:10:14,400 THERE, EARLIER ONSET, WORST 4797 03:10:14,400 --> 03:10:17,000 DISEASE AND WE'RE MAKING A BIG 4798 03:10:17,000 --> 03:10:18,280 EFFORT TO EXPAPPED OUR YORK IN 4799 03:10:18,280 --> 03:10:20,000 THAT AREA AND REACHING OUT TO 4800 03:10:20,000 --> 03:10:23,360 OUR COLLEAGUES WITH DR. GALLAN'S 4801 03:10:23,360 --> 03:10:24,480 HELP AT HOWARD'S, MATTER OF FACT 4802 03:10:24,480 --> 03:10:27,560 1 OF OUR FORMER FELLOWS IS 4803 03:10:27,560 --> 03:10:29,200 FORMING ATTENDINGS ARE DOWN 4804 03:10:29,200 --> 03:10:30,040 THERE AT NEUROLOGIC SURGERY 4805 03:10:30,040 --> 03:10:31,440 WE'RE WORKING WITH THAT GROUP 4806 03:10:31,440 --> 03:10:33,760 AND ALSO WORKING WITH OTHER 4807 03:10:33,760 --> 03:10:35,720 GROUPS THAT HAVE NETWORKS ACROSS 4808 03:10:35,720 --> 03:10:37,840 THE COUNTRY, IN THIS CASE, 4809 03:10:37,840 --> 03:10:38,800 AFRICAN AMERICAN PHYSICIAN WHO 4810 03:10:38,800 --> 03:10:42,280 IS HAVE HIGH PERCENTAGE OF 4811 03:10:42,280 --> 03:10:43,640 PATIENTS WITH AFRICAN AMERICAN 4812 03:10:43,640 --> 03:10:46,880 DESCENT AND I AGREE THESE ARE 4813 03:10:46,880 --> 03:10:47,760 INCREDIBLY IMPORTANT AND 4814 03:10:47,760 --> 03:10:49,840 IMPORTANT FOR MANY REASONS TO DO 4815 03:10:49,840 --> 03:10:52,880 IT BUT ALSO SCIENTIFICALLY IT'S 4816 03:10:52,880 --> 03:11:00,680 SOMETHING THAT'S VERY IMPORTANT 4817 03:11:00,680 --> 03:11:02,200 TO UNDERSTAND. 4818 03:11:02,200 --> 03:11:02,560 >> THANK YOU. 4819 03:11:02,560 --> 03:11:03,240 >> THANK YOU. 4820 03:11:03,240 --> 03:11:05,360 JOHN AND THEN ANTOINETTE? 4821 03:11:05,360 --> 03:11:07,280 SO I JUST WANT TO EMPHASIZE A 4822 03:11:07,280 --> 03:11:10,200 FEW THINGS AND THANK MARSTON WHO 4823 03:11:10,200 --> 03:11:12,080 I THINK KNOWS I'M 1 OF HIS BIG 4824 03:11:12,080 --> 03:11:14,080 FANS, HE'S A DOCTOR, I MEANEE 4825 03:11:14,080 --> 03:11:20,000 TAKES CARE OF PEOPLE, THAT'S 4826 03:11:20,000 --> 03:11:21,960 WHAT HE DOES 12 HOURS, 14 HOURS, 4827 03:11:21,960 --> 03:11:23,520 24 HOURS A DAY AND THIS ALL 4828 03:11:23,520 --> 03:11:24,480 HAPPENED IN THIS SETTING AND 4829 03:11:24,480 --> 03:11:27,880 WHAT I REALLY WANT TO EMPHASIZE 4830 03:11:27,880 --> 03:11:30,680 IS WHAT MARSTON ALLUDED TO AND 4831 03:11:30,680 --> 03:11:32,520 THAT IS THE PARTNERSHIPS HE 4832 03:11:32,520 --> 03:11:34,400 CREATED BETWEEN THE BASIC 4833 03:11:34,400 --> 03:11:37,280 SCIENTISTS COMMUNITY AND THE 4834 03:11:37,280 --> 03:11:38,560 CLINICIAN SCIENTIST COMMUNITY 4835 03:11:38,560 --> 03:11:42,560 BOTH ACROSS THE NIH AND ACROSS 4836 03:11:42,560 --> 03:11:43,000 THE COUNTRY. 4837 03:11:43,000 --> 03:11:44,720 I MEAN THAT'S WHY THE MAGIC 4838 03:11:44,720 --> 03:11:46,680 HAPPENS AND THIS IS MAGIC. 4839 03:11:46,680 --> 03:11:48,680 I MEAN THIS A MONUMENTAL 4840 03:11:48,680 --> 03:11:50,320 ACCOMPLISHMENT THAT YOU HEARD 4841 03:11:50,320 --> 03:11:51,880 TODAY, INCLUDING A NOBEL PRIZE. 4842 03:11:51,880 --> 03:11:53,400 I MEAN, IT DOESN'T GET BETTER 4843 03:11:53,400 --> 03:11:55,080 THAN THAT. 4844 03:11:55,080 --> 03:11:58,440 SO, WHEN YOU ASK, WHY DO WE NEED 4845 03:11:58,440 --> 03:11:58,920 THE NIH? 4846 03:11:58,920 --> 03:12:00,760 WHAT DOES IT HAVE? 4847 03:12:00,760 --> 03:12:02,480 IT'S THAT ENVIRONMENT THAT 4848 03:12:02,480 --> 03:12:04,640 ENABLES THREEZ SORTS OF 4849 03:12:04,640 --> 03:12:05,600 THINGS--THESE SORTS OF THINGS TO 4850 03:12:05,600 --> 03:12:08,880 HAPPEN TO ME THAT IS SO SPECIAL. 4851 03:12:08,880 --> 03:12:10,640 SO MARSTON, THANK YOU FOR 4852 03:12:10,640 --> 03:12:11,760 PRESENTING THIS AND PRESENTING 4853 03:12:11,760 --> 03:12:14,520 IT IN A WAY THAT I THINK 4854 03:12:14,520 --> 03:12:16,520 EVERYBODY CAN CAPTURE THAT 4855 03:12:16,520 --> 03:12:16,720 MAGIC. 4856 03:12:16,720 --> 03:12:17,240 >> THANK YOU VERY MUCH. 4857 03:12:17,240 --> 03:12:19,120 I MEAN I COULDN'T HAVE PUT IT 4858 03:12:19,120 --> 03:12:19,360 BETTER. 4859 03:12:19,360 --> 03:12:23,000 I MEAN WE SAY, DR. GALLAN, WE 4860 03:12:23,000 --> 03:12:24,000 STUDY THE HUMAN MODEL TO ANSWER 4861 03:12:24,000 --> 03:12:25,520 ARE AND YOU KNOW WE COULDN'T DO 4862 03:12:25,520 --> 03:12:27,600 IT, I MEAN I COULDN'T HAVE DONE 4863 03:12:27,600 --> 03:12:29,680 THIS, ANYWHERE ELSE AND AS YOU 4864 03:12:29,680 --> 03:12:44,000 SAID, ALL THESE OTHER 4865 03:12:44,000 --> 03:12:45,040 COLLEAGUES--BE SURPRISED THE 4866 03:12:45,040 --> 03:12:46,880 PROGRESS PEOPLE CAN MAKE WORKING 4867 03:12:46,880 --> 03:12:48,440 TOGETHER IF YOU'RE NOT SO QUITE 4868 03:12:48,440 --> 03:12:49,480 CONCERNED WITH WHO GETS CREDIT 4869 03:12:49,480 --> 03:12:50,680 FOR THE WORK AND YOU CAN LOOK AT 4870 03:12:50,680 --> 03:12:52,480 THAT AND LOOK AT THE AUTHORSHIP 4871 03:12:52,480 --> 03:12:55,160 IN THOSE PAPERS, THAT'S THE WAY 4872 03:12:55,160 --> 03:12:55,920 WE BELIEVE. 4873 03:12:55,920 --> 03:12:57,800 AND YOU KNOW IT'S THESE 4874 03:12:57,800 --> 03:12:59,080 MARVELOUS AND OF COURSE WE ALL 4875 03:12:59,080 --> 03:13:01,680 KNOW IT BUT THESE MARVELOUS 4876 03:13:01,680 --> 03:13:02,880 BRAVE PATIENTS THAT ARE OUR 4877 03:13:02,880 --> 03:13:03,960 PARTNERS IN ALL THIS WORK AND 4878 03:13:03,960 --> 03:13:05,480 WITHOUT THEM, I TELL THEM EVERY 4879 03:13:05,480 --> 03:13:06,880 WEEK, WITHOUT THEM, WE WOULDN'T 4880 03:13:06,880 --> 03:13:08,280 HAVE BEEN ABLE TO MAKE ANY 4881 03:13:08,280 --> 03:13:09,040 PROGRESS BUT HAVING THE 4882 03:13:09,040 --> 03:13:10,800 OPPORTUNITY TO BRING THOSE 4883 03:13:10,800 --> 03:13:13,680 PEOPLE HERE, TO WORK IN THIS 4884 03:13:13,680 --> 03:13:16,160 WOBDERFUL HOSPITAL, WONDERFUL 4885 03:13:16,160 --> 03:13:17,920 CLINICAL CENTER, I CAN'T IMAGINE 4886 03:13:17,920 --> 03:13:19,200 ANYTHING BETTER AND FOR SOMEONE 4887 03:13:19,200 --> 03:13:21,680 LIKE ME, IT'S BEEN THE DREAM OF 4888 03:13:21,680 --> 03:13:24,080 A LIFETIME AND WE'RE VERY 4889 03:13:24,080 --> 03:13:25,000 ENCOURAGED BY THE PROGRESS 4890 03:13:25,000 --> 03:13:26,840 THAT'S BEEN MADE BUT WE HAVE A 4891 03:13:26,840 --> 03:13:33,680 LONG WAY TO GO BUT WE WILL GET 4892 03:13:33,680 --> 03:13:35,720 THERE. 4893 03:13:35,720 --> 03:13:37,560 >> ANTOINETTE. 4894 03:13:37,560 --> 03:13:38,920 >> THANKS, DR. LINEHAN FOR WHAT 4895 03:13:38,920 --> 03:13:40,520 YOU'VE BEEN DOING ON THE STUDY 4896 03:13:40,520 --> 03:13:42,880 OF KIDNEY CANCER AND ISSUES. 4897 03:13:42,880 --> 03:13:45,160 ALTHOUGH I KNOW I'VE BEEN 4898 03:13:45,160 --> 03:13:46,320 DIAGNOSED WITH KIDNEY CANCER, I 4899 03:13:46,320 --> 03:13:48,280 DID HAVE AN ISSUE WITH MY 4900 03:13:48,280 --> 03:13:51,040 KIDNEYS A LITTLE BIT OVER 10 4901 03:13:51,040 --> 03:13:52,360 YEARS AGO AND I KEPT GOING TO 4902 03:13:52,360 --> 03:13:53,880 THE DOCTOR AND DOCTOR AND 4903 03:13:53,880 --> 03:13:55,280 DOCTOR, THEY HAD NOT A CLUE WHAT 4904 03:13:55,280 --> 03:13:57,240 WAS HAPPENING TO ME BECAUSE MY 4905 03:13:57,240 --> 03:14:00,560 BLOOD WORK WAS SAYING EVERYTHING 4906 03:14:00,560 --> 03:14:06,240 IS OKAY BUT DUE TO MY SIZE, IT 4907 03:14:06,240 --> 03:14:07,840 REALLY WASN'T SO MY DR. AT 4908 03:14:07,840 --> 03:14:14,080 GEORGE TOWN BY THE WAY HER LAST 4909 03:14:14,080 --> 03:14:15,120 NAME IS MELLIBLE, NEVERROLOGYIST 4910 03:14:15,120 --> 03:14:16,680 THERE, SHE GOT ME BACK ON TRACK, 4911 03:14:16,680 --> 03:14:20,760 SHE DID A SPECIAL TEST BECAUSE 4912 03:14:20,760 --> 03:14:22,320 SINCE I'M [INDISCERNIBLE], I HAD 4913 03:14:22,320 --> 03:14:23,120 [INDISCERNIBLE] AND THAT'S WHY 4914 03:14:23,120 --> 03:14:26,040 THE BLOOD WORK WAS REALLY OFF 4915 03:14:26,040 --> 03:14:27,520 AND TELLING ALL THE DOCTORS 4916 03:14:27,520 --> 03:14:28,480 EVERYTHING'S OKAY, I KEPT GOING, 4917 03:14:28,480 --> 03:14:29,680 I DIDN'T KNOW WHAT WAS GOING ON 4918 03:14:29,680 --> 03:14:31,040 WITH ME TO THE POINT THAT BY THE 4919 03:14:31,040 --> 03:14:37,280 TIME I WAS ABLE TO GET IN TO SEE 4920 03:14:37,280 --> 03:14:38,520 DR. NEELABLE, MY KIDNEY 4921 03:14:38,520 --> 03:14:42,480 FUNCTIONS WERE AT 34% AND THEY 4922 03:14:42,480 --> 03:14:46,760 DIAGNOSED ME WITH STAGE 3 4923 03:14:46,760 --> 03:14:47,280 CHRONIC KIDNEY DISEASE. 4924 03:14:47,280 --> 03:14:49,200 WELL SHE GOT ME, IT 1 OF THE 4925 03:14:49,200 --> 03:14:51,840 MEDICATIONS I WAS ON, WAS REALLY 4926 03:14:51,840 --> 03:14:53,120 DAMAGING MY KIDNEYS SO I WAS 4927 03:14:53,120 --> 03:14:54,880 TAKEN OFF THE MEDICATION AND 4928 03:14:54,880 --> 03:14:55,880 SHE'S BEEN MONITORING ME EVERY 4929 03:14:55,880 --> 03:14:57,480 YEAR SINCE THEN AND EVERY TIME I 4930 03:14:57,480 --> 03:15:01,880 SEE HER, I SAY THANK GOD FOR 4931 03:15:01,880 --> 03:15:02,880 DR. NEELABLE, BECAUSE SHE SAVED 4932 03:15:02,880 --> 03:15:05,040 ME FROM BEING ON KIDNEY DIALYSIS 4933 03:15:05,040 --> 03:15:06,600 AND SHE SAVED MY KIDNEYS, RIGHT 4934 03:15:06,600 --> 03:15:10,880 NOW I MOVE FROM WASHINGTON D. C. 4935 03:15:10,880 --> 03:15:15,960 AND I'M NOW LIVING IN 4936 03:15:15,960 --> 03:15:17,240 ALLEGEHENYAND WHEN I WAS IN DID 4937 03:15:17,240 --> 03:15:20,440 D. C. NIGH KIDNEY FUNCTION WAS 4938 03:15:20,440 --> 03:15:23,200 TO LET STAGE 3 AND THEY WERE 4939 03:15:23,200 --> 03:15:25,920 BASICALLY LEVELED OFF DUE TO THE 4940 03:15:25,920 --> 03:15:27,840 TREATMENT THAT DR. NEELABLE HAD 4941 03:15:27,840 --> 03:15:28,720 GIIVE ME. 4942 03:15:28,720 --> 03:15:33,240 RIGHT NOW, SINCE I'M LIVING IN 4943 03:15:33,240 --> 03:15:34,640 THE APPALACHIA MY WATER SUPPLY 4944 03:15:34,640 --> 03:15:38,600 IS WELL WATER AND MY KIDNEY 4945 03:15:38,600 --> 03:15:40,080 FUNCTIONS HAVE IMPROVED TO I'M 4946 03:15:40,080 --> 03:15:43,240 STAGE 2 CHRONIC KIDNEY DISEASE 4947 03:15:43,240 --> 03:15:44,160 AND EVERYTHING'S REALLY LEVELING 4948 03:15:44,160 --> 03:15:47,440 OFF AND I DEFINITELY FEEL A 4949 03:15:47,440 --> 03:15:49,720 WHOLE LOT BETTER AND I'M NOT 4950 03:15:49,720 --> 03:15:51,800 SURE IF THE DOCTOR IS ON YOUR 4951 03:15:51,800 --> 03:15:54,680 TEAM IS THE HUSBAND OF THE 4952 03:15:54,680 --> 03:15:56,400 DOCTOR AT GEORGE TOWN, BUT 4953 03:15:56,400 --> 03:16:03,600 THAT'S A POWER COUPLE THERE. 4954 03:16:03,600 --> 03:16:03,880 THANK YOU. 4955 03:16:03,880 --> 03:16:05,160 >> IT'S FUNNY,IME SO GLAD YOU'RE 4956 03:16:05,160 --> 03:16:11,080 DOING BETTER AND EVERYTHING, YOU 4957 03:16:11,080 --> 03:16:12,480 KNOW IT'S 1 OF THE WONDERFUL 4958 03:16:12,480 --> 03:16:13,880 THINGS ABOUT THE NIH AND THE 4959 03:16:13,880 --> 03:16:15,640 CLINICAL CENTER IS WE HAVE THE 4960 03:16:15,640 --> 03:16:17,040 OPPORTUNITY TO SEE SO MANY 4961 03:16:17,040 --> 03:16:18,040 PATIENTS WITH DIFFERENT DISEASES 4962 03:16:18,040 --> 03:16:19,240 AND TO HELP THEM AND THE NICE 4963 03:16:19,240 --> 03:16:21,160 THING WE DON'T HAVE TO CHARGE 4964 03:16:21,160 --> 03:16:22,400 THEM FOR INSURANCE OR ANY OF 4965 03:16:22,400 --> 03:16:23,520 THAT SORT OF STUFF, IT MAKES 4966 03:16:23,520 --> 03:16:26,280 SUCH A DIFFERENCE THAT WE MIGHT, 4967 03:16:26,280 --> 03:16:28,240 IF WE DO SURGERY WE MIGHT 4968 03:16:28,240 --> 03:16:30,080 INFLICT PAIN BUT WE DON'T 4969 03:16:30,080 --> 03:16:31,080 INFLICT FINANCIAL PAIN SO IN 4970 03:16:31,080 --> 03:16:33,720 OTHER WORDS WE CAN TREAT ALL 4971 03:16:33,720 --> 03:16:35,080 PATIENTS AND THAT'S A WONDERFUL 4972 03:16:35,080 --> 03:16:36,680 THING ABOUT WORKING HERE. 4973 03:16:36,680 --> 03:16:37,800 YOU JUST NEVER HAVE TO WORRY 4974 03:16:37,800 --> 03:16:38,080 ABOUT THAT. 4975 03:16:38,080 --> 03:16:40,040 IT'S NEVER AN ISSUE WITH WHO YOU 4976 03:16:40,040 --> 03:16:41,320 WILL BRING SOMEBODY IN OR NOT. 4977 03:16:41,320 --> 03:16:42,880 SO WE'RE THRILLED ABOUT THAT AND 4978 03:16:42,880 --> 03:16:45,240 ALSO, SO GLAD TO HEAR YOU'RE 4979 03:16:45,240 --> 03:16:45,880 DOING BETTER. 4980 03:16:45,880 --> 03:16:47,200 THAT IS GREAT. 4981 03:16:47,200 --> 03:16:51,880 >> YES, ALSO WHAT RICK WAS 4982 03:16:51,880 --> 03:16:54,080 SAYING REGARDING THE KIDNEYS 4983 03:16:54,080 --> 03:16:57,120 ISSUES WITH AFRICAN AMERICANS 4984 03:16:57,120 --> 03:16:58,000 VERSUS OTHER RACES, I ALSO 4985 03:16:58,000 --> 03:17:01,640 NOTICED WHEN I WAS IN D. C., 4986 03:17:01,640 --> 03:17:06,080 IT'S LIKE THEY'RE PUTTING THE 4987 03:17:06,080 --> 03:17:08,760 DIALYSIS CENTERS IN STRIP MALLS, 4988 03:17:08,760 --> 03:17:09,640 THEY'RE EVERYWHERE NOT IN 4989 03:17:09,640 --> 03:17:10,920 HOSPITALS LIKE THEY WERE YEARS 4990 03:17:10,920 --> 03:17:14,200 AGO, NOW THEY'RE JUST LIKE 4991 03:17:14,200 --> 03:17:14,480 EVERYWHERE. 4992 03:17:14,480 --> 03:17:16,880 AND I ALSO NOTICED THAT THE 4993 03:17:16,880 --> 03:17:22,440 KIDS, THE FOLKS ARE GETTING MUCH 4994 03:17:22,440 --> 03:17:26,080 YOUNGER WHO ARE BEING SUBJECT TO 4995 03:17:26,080 --> 03:17:30,480 DIALYSIS BECAUSE I USED TO RIDE 4996 03:17:30,480 --> 03:17:32,240 METROACCESS IN D. C. AND I WOULD 4997 03:17:32,240 --> 03:17:33,280 LEAVE OUT EARLY IN THE MORNING 4998 03:17:33,280 --> 03:17:36,560 AND WE WERE DROPPING PEOPLE OFF 4999 03:17:36,560 --> 03:17:38,080 AT KIDNEY DIALYSIS CENTERS AND 5000 03:17:38,080 --> 03:17:51,600 STRIP MALLS AND SORE SOME OF 5001 03:17:51,600 --> 03:17:53,160 THESE BUILDINGS, LIKE--IT WAS 5002 03:17:53,160 --> 03:17:55,080 LIKE AT LEAST IN THE 70S BY THE 5003 03:17:55,080 --> 03:17:59,040 TIME THEY NEED THAD TYPE OF 5004 03:17:59,040 --> 03:18:00,040 INTERVENTION, IF THEY EVER 5005 03:18:00,040 --> 03:18:02,520 NEEDED IT SO IS THERE SOMETHING 5006 03:18:02,520 --> 03:18:04,600 GOING ON IN THE INNER CITY OR 5007 03:18:04,600 --> 03:18:06,040 WITHIN THE BLACK COMMUNITY THAT 5008 03:18:06,040 --> 03:18:09,640 YOU THINK THAT MAY BE INCREASING 5009 03:18:09,640 --> 03:18:14,880 THIS DAMAGE TO OUR KIDNEYS? 5010 03:18:14,880 --> 03:18:16,720 >> WELL I'M A UROLOGIC SURGEON, 5011 03:18:16,720 --> 03:18:18,840 THE PEOPLE WHO STUDY THAT ARE 5012 03:18:18,840 --> 03:18:20,920 OTHER KIDNEY DOCTORS AND 5013 03:18:20,920 --> 03:18:22,680 NEFFROLOGYIST HOWEVER I KNOW 5014 03:18:22,680 --> 03:18:23,640 THIS IS AN IMPORTANT AREA THAT 5015 03:18:23,640 --> 03:18:24,560 PEOPLE ARE LOOKING AT. 5016 03:18:24,560 --> 03:18:26,400 YES THIS, THIS IS AN YSH, NO 5017 03:18:26,400 --> 03:18:27,360 QUESTION ABOUT IT AND A LOT OF 5018 03:18:27,360 --> 03:18:29,960 PEOPLE ARE WORKING ON THAT, BIG 5019 03:18:29,960 --> 03:18:30,880 EFFORT ON THAT. 5020 03:18:30,880 --> 03:18:33,440 BIG EFFORT TO GOING ON TO HELP 5021 03:18:33,440 --> 03:18:34,760 PEOPLE WITH THEIR KIDNEY 5022 03:18:34,760 --> 03:18:39,000 FUNCTION, ABSOLUTELY, VERY 5023 03:18:39,000 --> 03:18:40,080 IMPORTANT QUESTION. 5024 03:18:40,080 --> 03:18:45,800 >> OKAY, GREAT. 5025 03:18:45,800 --> 03:18:46,080 ALL RIGHT. 5026 03:18:46,080 --> 03:18:47,240 JUST TERRIFIC, WHAT A GREAT WAY 5027 03:18:47,240 --> 03:18:50,880 FOR US TO CONCLUDE THIS MEETING 5028 03:18:50,880 --> 03:18:52,400 MARSTON, THANK YOU SO MUCH, THIS 5029 03:18:52,400 --> 03:18:54,120 REALLY DOES BRING THIS TO LIFE, 5030 03:18:54,120 --> 03:18:57,640 I WANT TO SAY A SPECIAL THANK 5031 03:18:57,640 --> 03:19:01,640 YOU TO ELLEN, FOR ALL THE GREAT 5032 03:19:01,640 --> 03:19:02,320 PARTICIPATION. 5033 03:19:02,320 --> 03:19:04,680 YOU HEARD WITH ELLEN AND OUR 5034 03:19:04,680 --> 03:19:05,880 DEPARTED BEE, BY THE WAY THAT WE 5035 03:19:05,880 --> 03:19:08,240 WERE TALKING ABOUT BEFORE, AND 5036 03:19:08,240 --> 03:19:09,000 NOW, WITH--YOU SEE HOW IMPORTANT 5037 03:19:09,000 --> 03:19:13,680 IT IS TO HAVE THE WORDS OF 5038 03:19:13,680 --> 03:19:14,880 PATIENT, FANTASTIC ELLEN, GLAD 5039 03:19:14,880 --> 03:19:16,480 YOU ARE NOT LEAVING THE PATIENT 5040 03:19:16,480 --> 03:19:16,680 GROUP. 5041 03:19:16,680 --> 03:19:17,800 THAT WILL BE IMPORTANT. 5042 03:19:17,800 --> 03:19:21,760 THANKS TO OUR NEW MEMBERS 5043 03:19:21,760 --> 03:19:22,760 ANTOINETTE, DAVID AND CRAIG, I 5044 03:19:22,760 --> 03:19:25,080 THINK QUIEWR IN FOR A REAL 5045 03:19:25,080 --> 03:19:26,560 TREAT. 5046 03:19:26,560 --> 03:19:28,760 JIM, DID WE CONFIRM FRIDAY 5047 03:19:28,760 --> 03:19:33,080 JULY 15 AS OUR MEETING? 5048 03:19:33,080 --> 03:19:35,880 >> I BELIEVE WE HAVE AND I 5049 03:19:35,880 --> 03:19:36,680 BELIEVE THE MOST RECENT 5050 03:19:36,680 --> 03:19:37,760 DESCRIPTION I HEARD OF THAT 5051 03:19:37,760 --> 03:19:39,880 MEETING IS, IT WILL BE A HYBRID 5052 03:19:39,880 --> 03:19:44,200 MEETING WHICH MEANS WE WILL HAVE 5053 03:19:44,200 --> 03:19:47,480 PEOPLE PRESENT WE ALSO HAVE THE 5054 03:19:47,480 --> 03:19:50,400 OPTION OF ATTENDING VIRTUALLY 5055 03:19:50,400 --> 03:19:53,840 AND STILL PARTICIPATING IN THE 5056 03:19:53,840 --> 03:19:54,120 MEETING. 5057 03:19:54,120 --> 03:19:58,920 HYBRID MEETINGS WE'RE DOING SOME 5058 03:19:58,920 --> 03:20:00,240 EXPERIMENTING WITH--IT'S A 5059 03:20:00,240 --> 03:20:01,240 LITTLE DIFFERENT BUT--I HOPE 5060 03:20:01,240 --> 03:20:04,680 THAT SOME OF THE NEW MEMBERS CAN 5061 03:20:04,680 --> 03:20:06,240 COME TO THE CLINICAL CENTER, WE 5062 03:20:06,240 --> 03:20:10,160 WOULD LOVE TO BE ABLE TO SHOW 5063 03:20:10,160 --> 03:20:11,960 YOU THE FACILITIES, THERE'S SOME 5064 03:20:11,960 --> 03:20:13,680 OPPORTUNITIES WE HAVE WHEN 5065 03:20:13,680 --> 03:20:16,680 YOU'RE HERE THAT WE DON'T HAVE 5066 03:20:16,680 --> 03:20:19,280 WHEN WE'RE ALL ON THE COMPUTER, 5067 03:20:19,280 --> 03:20:21,400 SO, I'M HOPEFUL THAT WE CAN SEE 5068 03:20:21,400 --> 03:20:25,760 SOME OF YOU IN PERSON. 5069 03:20:25,760 --> 03:20:26,440 >> TERRIFIC. 5070 03:20:26,440 --> 03:20:27,480 GOOD. 5071 03:20:27,480 --> 03:20:28,960 WELL, ONCE AGAIN, THANKS ALL, 5072 03:20:28,960 --> 03:20:32,400 THIS IS A GREAT MEETING. 5073 03:20:32,400 --> 03:20:34,480 WITH THE SPIRIT OF OPTIMISM 5074 03:20:34,480 --> 03:20:37,080 ABOUT EVERYTHING THAT'S MOVING 5075 03:20:37,080 --> 03:20:38,480 FORWARD SO, THANKS TO THE TEAM, 5076 03:20:38,480 --> 03:20:40,880 THANKS TO OUR ONGOING BOARD 5077 03:20:40,880 --> 03:20:41,000 MEMBERS VA GREAT REST OF THE 5078 03:20:41,000 --> 00:00:00,000 DAY, EVERYONE.