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One Year Later: Lessons Learned from Ebola in the U.S. and Academic Medicine’s Role in Preparing for the Next Threat

Bryce Gartland, MD, FHMCEO, Emory University Hospital

Bruce Ribner, MD, M.P.H.Director, Emory SCDU

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DEFINING ACADEMIC MEDICINE

Clinical Care

EducationResearch

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DEFINING ACADEMIC MEDICINE

Clinical Care

EducationResearch

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U.S. Story of Ebola

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WOODRUFF HEALTH SCIENCE CENTER

Clinical Care• Emory University Hospital• 733 bed quaternary care facility• ~ 30,000 admissions per year• High acuity with Case Mix Index of 2.3• ~ 15% of patients arrive via acute-to-acute transfer• Transplant, Neurosciences, Cardiovascular, Oncology,

Complex Surgical Care, Critical Care• Location of Serious Communicable Disease Unit

(SCDU)

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WOODRUFF HEALTH SCIENCE CENTER

Research• $572 million funding• Highlights:– Ebola/Vaccine– CDC/ASPR– Lasker Award

(DeLong)– TAVR

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WOODRUFF HEALTH SCIENCE CENTER

Education• School of Medicine

– 560 medical students– > 1,200 residents/fellows– 98 accredited programs

• School of Nursing– 525 RN students

• Rollins School of Public Health– > 1,100 masters degree students

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Course of the Current Ebola Outbreak

• December 2013: 2 year-old boy in Meliandou, Guinea, developed an illness characterized by fever, black stools, and vomiting- he died two days later

• August 2014: first two American healthcare workers admitted to the Emory Serious Communicable Diseases Unit (established 2001)

• Ultimately 11 patients with Ebola virus disease would be cared for in U.S. facilities, and several more would be managed for high risk exposures

• Current outbreak totals: 28,421 infected 11,297 fatalities

What Have We LearnedClinical

observations made in academic medical centerspatients with serious communicable diseases can safely

be cared for in U.S. facilitiesback bone of care for EVD is aggressive resuscitationpatients can survive even after multiorgan failure

Therapeuticsinsufficient data to reach any conclusions

Vaccinessome promising vaccines but may not be sufficient data

Preparedness is Critical

• There will be another infectious diseases outbreak SARS, avian influenza, MERS, Ebola

• By failing to prepare, you are preparing to fail ― Benjamin Franklin

What Do We Need Going Forward

Need a continued robust infrastructure to allay anxiety and deliver effective patient care

-National Ebola Training and Education Center -Hospital Preparedness Program

Need to be able to react quickly to evaluate new therapeutics and vaccines

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LESSONS LEARNED

1. Health system preparedness is not a one time event – it requires ongoing investment.

2. Academic Medical Centers are uniquely capable and competent to successfully meet the demands for responses to Ebola and similar situations.

3. Must foster and, where feasible, structure improved collaboration between health systems and governmental agencies.

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LESSONS LEARNED

Health system preparedness is not a one time event – it requires ongoing investment.

Must maintain federal funding• Clinical• Research• Education

“Preparedness” is not enough, more is required to be successful

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LESSONS LEARNED

Academic Medical Centers are uniquely capable and competent to successfully meet the demands for responses to Ebola and similar situations.

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Clinical Team

Success = Necessary Resources

Research/ Education

Culture

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LESSONS LEARNED

Must foster and, where feasible, structure improved collaboration between health systems and governmental agencies.

Use Ebola as a learning opportunityRemove barriers to inter-system/inter-agency

collaboration and decision makingExpedite system responsiveness

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SUCCESS IN PARTNERSHIP

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Questions?