Helping patients worldwide through extensive collaborations
It is a great thing to make scientific discoveries of rare value, but it is even greater to be willing to share these discoveries and to encourage other workers in the same field of scientific research.William J. Mayo, M.D. Co-founder of Mayo Clinic
What do a Star Wars-like robot that enables a Mayo Clinic neurologist to diagnose and treat a stroke patient located hours away have in common with a college student in Kentucky who is experiencing mysterious symptoms that have perplexed his local doctors? What connects them both to a man in California who just learned which antidepressants are most likely to relieve his anxiety based on his personal genetic make-up?
Mayo Clinic is the connective tissue. Or rather, it’s the way our collaboration between researchers, medical centers, biotechnology startups, care providers and others around the world is helping to derive medical insights and share resources that benefit patients wherever they are. We are known for the full-circle collaboration that occurs across Mayo Clinic, but that approach also extends beyond our walls — as we work to expand the options available to both our patients and people who never walk through our doors. We’re working in concert with physicians across the country and internationally to deliver top-quality care.
In addition, our collaborations with biotechnology companies enable us to translate our research discoveries, such as new insights on how genetics influence a person’s response to chemotherapy, into real-world applications for patients as quickly as possible. At the same time, we’re constantly sharing Mayo Clinic knowledge and resources broadly with physicians and researchers around the world to aid them in their own work in the lab and with patients.
Our founders 150 years ago cited the need to “develop medicine as a cooperative science,” and that tradition continues today at Mayo Clinic. It guides how we are training the next generation of medical leaders and identifying best practices to shape how health care is delivered in the future. As one example, Mayo Clinic School of Continuous Professional Development provides accredited continuing medical education and professional development to today’s medical professionals, who are dedicated to life-long learning.
01Expanding options for accessing Mayo Clinic care
Mayo Clinic Care Network: Mayo expertise wherever you live
Most people want to get their health care as close to home as possible. These days, Mayo Clinic is collaborating more and more with non-Mayo physicians, complementing their expertise and providing additional peace of mind for both providers and their patients.
We work together with select non-Mayo health organizations to share information and resources. Members of Mayo Clinic Care Network have access to Mayo Clinic products, services and knowledge that enhance the care they are able to provide locally. In many cases, that means avoiding unnecessary travel. If specialty care is needed, patients can be seen by local providers or referred to Mayo Clinic.
Through this collaboration, patients will benefit from tools that allow their doctors in Mexico to consult with colleagues at Mayo Clinic.Misael Uribe, M.D., executive president and chairman of the board of Médica Sur, Mexico, a Mayo Clinic Care Network member
More Than 40
Mayo Clinic Care Network sites around the United States
More Than 3,000
Number of eConsults submitted in 2015 through Mayo Clinic Care Network
Percentage of those eConsults in which patients did not need to travel, and were able to receive high-quality, cost-effective care close to home
International sites of Mayo Clinic Care Network, as far away as Singapore
Nearly 10 Million
Total number of patients who receive care through Mayo Clinic Care Network
02The many ways we connect: Mayo Clinic Care Network
Providers within the care network can connect electronically with Mayo Clinic specialists and subspecialists to ask questions about a patient’s care. The consultation is documented in the patient’s medical record, and there is no additional cost to the patient.
This point-of-care tool gives providers access to Mayo-vetted information, including disease management protocols, care guidelines, treatment recommendations and reference materials. The information is available on desktop computers or mobile devices 24/7.
eTumor board conferences
Members can observe and participate in live, interactive videoconferences where Mayo Clinic multidisciplinary teams and network members discuss management of current cancer cases.
Health care consulting
Network members can consult with Mayo Clinic experts in patient care, human resources, finance and other administrative and operational areas. Members customize their own consulting plans to support their unique strategic priorities.
Patient education library
Members have access to Mayo Clinic’s library of patient education materials, which include 2,500 pieces in English and a select number in Spanish.
Archived Mayo Clinic grand rounds
Presentations by Mayo Clinic providers and faculty address clinical care and health care delivery topics. Continuing medical education credit is available.
03Collaborating to bring research discoveries to patients
Eliminating "trial and error," at Mayo Clinic and beyond
Shortly after the human genome was sequenced, John Logan Black III, M.D., a Mayo Clinic physician in the division of clinical biochemistry, worked with his colleagues and discovered that it is possible to identify how a person will respond to an antidepressant based on their unique genetic profile. Half of psychiatric patients don’t respond well to treatment using standard drug therapy, and testing different medications can take months and can be excruciating for patients.
With his colleagues, Dr. Black developed an algorithm to predict how a person’s body metabolizes different antidepressants. The result: a genetic test that categorizes available antidepressants by their level of risk for a specific patient. Now, through ongoing research and Mayo Clinic’s collaboration with industry, the test is available not just at Mayo Clinic, but throughout the United States and Canada — with additional patents led in 16 countries, including Japan, China and across Europe. “The only way to do this is to work with industry,” says Dr. Black. Mayo Clinic’s goal is to make new innovations available to as many patients as possible, and this is one of many examples of how we’re doing that.
It’s hard to know how a patient may react to psychotropic drugs, especially when they can’t tell you, which is often the case in very young or elderly patients.John Logan Black III, M.D., a Mayo doctor in the division of Clinical Biochemistry.
Thriving Research hub
Funding Mayo Clinic received from the National Institutes of Health (NIH) for biomedical research in 2015
Percent increase in NIH funding for Mayo Clinic research over 2010 levels, even as the total NIH budget has been flat (to slightly declining) over the last six years
More than 11,000
Active Institutional Review Board (IRB) human research studies at Mayo Clinic aimed at advancing human health across multiple medical specialties
Percent of physicians who actively care for patients while also having research appointments (reflecting our “physicians- engaged-in-research” model)
Read more about Mayo Clinic research
Mayo Clinic research means tangible solutions for patients
At Mayo Clinic, we believe in sharing what we learn so everyone can benefit. Some of the medical advancements most widely used throughout the world have been developed at Mayo Clinic. Nearly every MRI machine in the world contains Mayo Clinic technology, for example, and Mayo Clinic holds a patent for a way to diagnose vitamin D deficiency and monitor treatment results. Long ago our researchers were awarded a Nobel Prize for discoveries that led to the first use of cortisone.
More recently, the National Institutes of Health (NIH) awarded $142 million in funding over five years to Mayo Clinic as part of a project to advance precision medicine. For this effort, Mayo Clinic is creating a research repository of biologic samples to better understand individual differences that contribute to health and disease. By enrolling at least a million volunteers, the program will have the scale and scope to enable research for a wide range of diseases, both common and rare, as well as increase our understanding of what “being healthy” means.
Our team-based, patient-centered approach to research starts not in the lab, but in the exam room. As our doctors treat patients and see opportunities for advancing patient care, they go back to their labs, or to their colleagues, and work together with other Mayo scientists and research teams to develop new and improved diagnostic tools, medications, devices, treatment protocols and more. While we conduct a large amount of basic, clinical and epidemiological research, we aren’t satisfied until what we learn ultimately gets translated into meaningful treatments for patients.
Approximately 70 percent of all research funding at Mayo Clinic goes to support clinical and translational research, which helps advance an idea from the lab to patient care. In fact, Mayo Clinic is one of the first institutions in the nation to receive a Clinical and Translational Science Award from the NIH. This five-year, $72.5 million grant is dedicated to accelerating the translation of laboratory discoveries into improved patient care.
Mayo Clinic’s structure is specifically designed to encourage the translation of research into practice, and in some cases commercialization:
- Our Employee Entrepreneurship Program assists Mayo Clinic staff in starting medically related companies while retaining equity in the company. Additionally, Mayo Clinic grants employees entrepreneurial leave, which provides needed time away to develop companies.
- Our Mayo Clinic Business Accelerator, established in 2013, provides space and entrepreneurial support services for early-stage companies. In just two years, the accelerator has assisted more than 25 tenants.
- Mayo Clinic Ventures commercializes Mayo Clinic technologies for the benefit of patients worldwide, while generating revenue to support clinical practice, research and education at Mayo Clinic.
Shortening the lung transplant list
Mayo Clinic may be the largest provider of organ transplants in the country, but with more than a thousand people in the U.S. waiting for a lung transplant at a given time, we wanted to do more. One reason for the high demand is the limited number of lungs available that are considered viable for transplant. However, researchers at Mayo Clinic discovered that many damaged lungs can actually be restored. A lung restoration center scheduled to open in 2019 on Mayo Clinic’s Florida campus is slated to do just that, ultimately increasing the number of viable lungs available on the national waiting list.
Mayo Clinic and the biotechnology company we worked with to establish this center also may collaborate to develop additional lung-restoration centers at Mayo Clinic’s campuses in Arizona and Minnesota.
The restored lungs will be made available not just to patients at Mayo Clinic, but also to other transplant centers throughout the United States.
Translating Research Into Solutions
Total number of technologies Mayo Clinic has available for licensing
2 a day
Approximate number of new inventions brought to Mayo Clinic Ventures, which develops business opportunities based on the clinic’s intellectual resources
Technologies licensed or optioned in 2015
Patent applications led in 2015
Patents issued in 2015
Total number of start-up companies formed over time around Mayo Clinic inventions
Total amount Mayo Clinic Ventures has invested in venture deals with ties to Mayo Clinic innovations
Answers derived at Mayo Clinic are benefitting patients elsewhere
Can a breast cancer diagnosis be made any less stressful?
Situation: People diagnosed with breast cancer who have a lumpectomy traditionally must wait weeks for the results of a pathology report to determine whether the tumor was removed completely. In up to half of cases, it wasn’t, so they need to go back for a second surgery. The waiting period can be stressful, and ultimately a second surgery adds more burden on the patient and increases costs for the health care system as a whole.
Mayo Clinic’s answer: By using a technique Mayo Clinic and other researchers pioneered, called intraoperative frozen section analysis during a lumpectomy, we eliminate the need for a second surgery in more than 95 percent of patients — substantially reducing the psychological side effects of a breast cancer diagnosis. Mayo Clinic is one of very few institutions in the nation that performs this technique. If every medical facility did this, we’d be able to save about $90.9 million for payers and $1.8 million for providers, nationwide. And that doesn’t even include the costs of lost income and productivity for patients and their communities.
Do complicated aortic aneurysms nearly always have to mean immediate death?
Situation: Aortic aneurysms are nearly always deadly. In fact, 175,000 people around the world die each year — many within a matter of minutes — from a sudden bursting of the aorta, the largest blood vessel in the body. Traditionally, aneurysms were treated with open-heart surgery, if they were detected in time. In the 1990s, a less-invasive technique was developed to repair aneurysms using a stent, or wire mesh tube and fabric. But this type of stent can only be used to repair simple aneurysms, not complex ones that involve many different arteries to the kidney, intestine and liver.
Mayo Clinic’s answer: Vascular surgeon Gustavo Oderich, M.D., and his team developed a new kind of stent — using dimensions based on actual data gathered from the anatomy of more than 500 Mayo Clinic patients — that can be used in patients whose aneurysms are too complex for the traditional type of stent. The team created the new stent using a 3-D printed model, which enabled surgeons to practice their exact techniques for inserting the stent before operating on a patient. Though the new stent is in the early stages of development, the team was able to test it out in 2015 when a Minnesota man, Ronnie Hall, became the first person in the U.S. to be treated with this kind of stent. The hope is that many more patients will eventually benefit from this technology.
Can we better identify and treat colorectal cancer by making screening tests more accessible?
Situation: Colorectal cancer remains one of the most common cancers in the United States, yet the number of people who are screened for it remains low. Factors including the required time away from work, the necessary dietary and medication changes, and a lack of easy access to screening facilities — especially in remote areas such as Alaska — make getting a colonoscopy prohibitively difficult for many people.
Mayo Clinic’s answer: David Ahlquist, M.D., a gastroenterologist who had studied Alaska Native populations early in his career as a resident and fellow at Mayo Clinic, worked with a team of colleagues — and ultimately a commercial enterprise — to research and develop a noninvasive screening option. Alaska Natives, as well as other ethnic groups such as African Americans, have a disproportionately high rate of colorectal cancer.
“The test is highly accurate and doesn’t require bowel preparation,” says Dr. Ahlquist. “It can be done at home, no matter where home is.” In a significant number of patients, in fact, the test has reached people who had never previously been screened — potentially allowing their treatment to begin before the cancer has advanced to a more complex stage.
The American Cancer Society and U.S. Preventive Services Task Force now include the test as part of their guidelines. “We have the opportunity to do with colon cancer what Pap smears did for cervical cancer,” Dr. Ahlquist says. “If you have a tool that’s going to benefit humankind, you have the responsibility to advance it.”
Advancing medical practice rapidly — thanks to Mayo Clinic’s scale
Whenever a new medical technology or approach to care emerges, whether arising from research conducted at Mayo Clinic or elsewhere, it can take time to reach its full potential. Care providers need to be trained on how to apply it. Researchers need to identify best practices such as which patients might benefit most and how to efficiently incorporate a new technology or approach into existing practice. And medical students need to learn up-to-date guidance on the way tomorrow’s care will be delivered. All that happens simultaneously at Mayo Clinic.
We translate the latest research and technology effectively into practice, at rapid speed. We’re able to act fast in applying new techniques such as robotic surgery and individualized, genome-based medicine because of the breadth and depth of resources we have available — experts from all medical specialties, and one of the largest surgical practices in the world, which translates into hundreds of thousands of learning opportunities.
04Sharing what we learn with the global medical community
Putting our resources to good use, for you
Thanks in part to our sheer size, Mayo Clinic has a wealth of information at our fingertips. Medical professionals around the world tap into our data, insights and resources to better understand the diseases and conditions that affect patients everywhere.
Our Department of Laboratory Medicine and Pathology (DLMP), one of the largest clinical laboratories in the world, serves as a reference laboratory for other clinics and hospitals both nationally and internationally through Mayo Medical Laboratories (MML). Health care systems, hospitals, specialty clinics and other clinical laboratories can access our laboratory services 24 hours a day.
I come from Uganda, and in Uganda we have certain diseases — tropical diseases. So if I need information about anything ... I find Mayo one of the most reliable resources online.Martha, a nurse who treats and educates people in small African villages, frequently referring to MayoClinic.org for information on symptoms and treatments to guide the care she provides
Different tests and pathology service offerings available through Mayo Clinic’s DLMP
Up to 150
New tests launched each year
Patients DLMP serves annually
Countries around the globe that consult DLMP for testing services
Research and review articles Mayo Clinic researchers published in peer-reviewed journals in 2015, helping to advance understanding of diseases, conditions and therapeutic approaches
Annual participants in Mayo Medical Laboratories’ educational programming
25% of all visitors
To MayoClinic.org are international visitors who refer to Mayo Clinic’s online educational resources
Average number of test samples Mayo Clinic receives each day for diagnostic and therapeutic evaluations (enough to require a specific facility at the Rochester, Minnesota, airport to handle specimen logistics)
Monthly visitors to Mayo Clinic’s website, which offers the general public significant resources on diseases and conditions, tests and procedures, and healthy lifestyle topics
Expansive Insights from Rochester Epidemiology Project
Years the REP has been supported by the NIH
Publications from REP data, in every field of medicine
Number of medical diagnoses, surgeries, prescriptions, lab tests, dental procedures and immunizations included in the REP — invaluable to understanding diseases and finding ways to improve health
Improving health globally by studying health locally — for half a century
Will anesthesia hurt your child’s brain? Why do your bones break when you fall? Should women have their ovaries removed to prevent cancer? Could a head injury from a bike accident when you’re young increase your risk of dementia decades later? For 50 years, the REP has been collecting and analyzing in-depth information from medical records in Minnesota and Wisconsin — including data from almost everyone who lives in Olmsted County, Minnesota — to answer questions like these, and more. This rich resource links long-term health and medical records to enable researchers to look for patterns over time. The REP is helping scientists at Mayo Clinic and around the world understand what causes certain diseases, how people respond to medical and surgical therapies, and how a person’s overall health is likely to evolve over time.
The REP is a collaborative project that grew out of a Mayo Clinic effort started back in the late 1800s and early 1900s, when Mayo Clinic physicians recorded case histories in leather-bound ledgers. In 1966, a Mayo Clinic researcher created the REP by collaborating with other health care providers in the area beyond Mayo Clinic to build what would ultimately become a network of clinics, hospitals and other medical and dental organizations across 27 counties in Minnesota and Wisconsin.
Mayo Clinic’s REP is unlike any other resource available in the United States because:
- It covers a well-defined geographic area and includes a particularly large sample size of people within the region, enabling researchers to study just about all of a population in depth (identifying, for example, causes of rare diseases).
- It contains robust, searchable details on a number of variables, including diagnostic and surgical procedures, prescriptions, immunizations and lifestyle habits, as well as demographic data.
- Its comprehensive findings have even informed U.S. Congressional decision-making, as Congress debated compensation of military personnel who have experienced head trauma.
Evolving medical practice
Thanks to research from the REP, doctors now know to avoid surgeries in children under age 2 when delaying a procedure is an option. One REP study showed that children who receive general anesthesia before that age have a greater risk of developing attention-deficit hyperactivity disorder (ADHD) later in life. This study led to new surgical guidelines that are now adopted by surgeons everywhere.
Today, the REP continues to advance understanding on topics such as osteoporosis, dementia, aging, cardiovascular disease, women’s health and various cancers.
05Training medical professionals for tomorrow
Opening doors globally
During his fifth year of residency at Mayo Clinic, William Copeland III, M.D., former neurosurgical resident, had the opportunity to visit Kenya and experience first-hand Tenwek Hospital’s significant needs. The facility had no neurosurgeon and lacked many resources. That educational experience inspired him to embark on a two-year post-residency program there, to deliver clinical care and educate local physicians. “My desire for that time was to provide care to people who otherwise would not have access to a neurosurgeon and to teach general surgeons in training how to perform basic neurosurgery.”
Education, intertwined with research and clinical care
“No matter what your role is, a fundamental component of being at Mayo Clinic is being an educator.” This is as true for Frederic Meyer, M.D., executive dean for education at Mayo Clinic, as it is for the thousands of physicians, nurses and allied health professionals who call Mayo Clinic home.
Mayo Clinic residents make up one of the largest post- graduate medical schools in the country. Residents are heavily involved not only in treating patients and educating fellow residents, but also in conducting research. In fact, Mayo Clinic has secured the most winners nationally in the American College of Physicians Resident Research Competition since its inception. Mayo Clinic offers a clinician-investigator track in many of its specialties, designed to train physicians for careers incorporating both research and clinical practice.
Nurses also play an important role as educators. Our nurses participate in joint appointments with several local universities, in which they both practice and teach – addressing faculty shortages while building their own skill set. Some use the opportunity to prepare for a future role in nursing education.
Several people have asked me why I have made this choice, forfeiting potential earnings and the comforts of life here [to go to Africa]. I am so thankful for those who have selflessly trained me, and I recognize there are certainly opportunities to do good in the U.S., but at present I cannot turn my eye to the needs I’ve seen overseas; this compels me more than a paycheck.William Copeland III, M.D., former neurosurgical resident at Mayo Clinic in Rochester, Minnesota
Through five schools of education, Mayo Clinic College of Medicine and Science trains physician leaders and researchers:
- Mayo Clinic School of Medicine is fully accredited and has historically enrolled a class of 50 students annually. In July 2017, Mayo Clinic School of Medicine will open its Arizona campus, enrolling 50 additional students and nearly doubling the size of classes thereafter. Planning is also underway for expansion on the school’s Florida campus.
- Mayo Clinic School of Graduate Medical Education offers residencies and fellowships across almost every medical and surgical field through its three campuses.
- Mayo Clinic School of Health Sciences provides more than 100 training programs for allied health professionals. Programs range from certificate through doctoral level training for over 1,100 students.
- Mayo Clinic Graduate School of Biomedical Sciences provides advanced scientific training toward Ph.D., M.D.-Ph.D., and master’s degrees in biomedical research, with training opportunities in Arizona, Florida and Minnesota.
- Mayo Clinic School of Continuous Professional Development provides accredited continuing medical education and professional development to today’s life-long learning professionals and is fully accredited by the Accreditation Council for Continuing Medical Education.
Defining the future of medical education
Throughout Mayo Clinic’s history, the words of one of our founders, William J. Mayo, M.D., have guided our continued evolution: “The glory of medicine is that it is constantly moving forward, that there is always more to learn.”
That is especially true in today’s resource- and cost-strapped health care environment, where delivering effective patient care is complex. Reflecting this reality, the 2015 incoming class of Mayo Clinic School of Medicine included some of the first medical students in the country to participate in a specialized Science of Health Care Delivery curriculum.
The program applies business principles and best practices from other disciplines, including engineering, economics, systems management and information technology, to answer questions about the most comprehensive, seamless ways to deliver care.
This is one example of Mayo Clinic’s forward-looking planning to build the infrastructure to meet tomorrow’s health care needs.
Training Tomorrow's Leaders
Miles from the hospital to the medical school (education is fully integrated with research and clinical care)
More than 135,000
Learners educated in one of Mayo Clinic College of Medicine’s five schools in 2015
Residency and fellowship programs available through Mayo Clinic, in virtually all medical specialties
Mayo Clinic School of Medicine enrollees in 2015
Mayo Graduate School of Biomedical Sciences enrollees in 2015
Mayo School of Graduate Medical Education enrollees in 2015
Mayo Clinic School of Health Sciences enrollees in 2015, in 125 programs representing 55 health science careers
Annual participants in the Mayo School of Continuous Professional Development
Percentage of participants in the Continuous Professional Development program who are physicians
Percentage of participants in the Continuous Professional Development program who are non-Mayo attendees
06Exploring best practices for today's health care systems
Engineering smooth experiences
Eric Boie, M.D., an emergency medicine physician at Mayo Clinic Hospital — Rochester, Saint Marys Campus, led a project to redesign the physical space in the Emergency Department, so researchers could study how care is delivered in real time. Our Emergency Department Clinical Engineering Learning Laboratory is helping emergency room physicians do their jobs more efficiently. And that, of course, means less waiting time for patients and better quality care. It’s all part of how Mayo Clinic is transforming the practice of medicine, and the delivery of health care.
Health care reform, the Mayo way
As government continues to grapple with how to structure and implement effective health care policies, Mayo Clinic is reforming how care is delivered within our own medical practice. We constantly strive to perfect our own processes and procedures because we believe that health care providers have a responsibility to lead this effort, not just for Mayo Clinic but also for other medical practices around the world.
Mayo Clinic’s Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery enables us to do so by tapping insights using large-scale data analysis, engineering principles and external research to ultimately define which approaches best improve patient care, outcomes and cost. In other words, we’re defining the standard of care, building on the more than a century of health care delivery research at Mayo Clinic.
We’ve investigated questions that patients and physicians need to know, including:
- Is going “fully under” anesthesia during a hip replacement always a good idea? Many people may think being completely “knocked out” is the most effective route to go, but Mayo Clinic researchers have identified that for certain groups, spinal anesthesia with light sedation may result in a quicker recovery time and less pain after 30 days. Mayo Clinic’s insights on which types of patients benefit most from both approaches are supplying concrete evidence to benefit patients and providers within and beyond Mayo Clinic.
- How can we improve care within a busy emergency department, where every minute matters? The Center for the Science of Health Care Delivery has studied ways to embed radio frequency identification technology directly into the walls of an emergency department. This can enable health care workers to spend more time caring for patients rather than having to interrupt care to locate items such as IV poles. It also supports public health efforts by enabling health professionals to track everyone who came into contact with a patient who has a communicable disease.
The Center publishes findings across a range of topics, including continuity of care, medical decision-making techniques and accessibility of care.
I can’t help but think what this Monday would have looked like before. Clearly ... [there would be] patients waiting and many leaving without being seen.Eric Boie, M.D., Emergency Medicine, Mayo Clinic Hospital — Rochester, Saint Marys Campus