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UCare and U of M Partner to Address Health Equity  

UCare and the University of Minnesota have recently announced a new collaboration that strengthens their shared commitment and service to underserved Minnesotans.

The two parties view this moment as an opportunity to redesign their long-standing strategic relationship and underscore the university’s mission to serve the health care needs of all Minnesotans. It will also allow UCare to better compete in a challenging health care marketplace while continuing to serve its members. UCare has committed to four, $25-million payments to the university over the next three years that the university will invest to reduce disparities in underserved communities through the following U of M initiatives:

• Priorities around health equity and access, such as expansion of services at Broadway Family Medicine Clinic in North Minneapolis, Community University Health Center in South Minneapolis and the mobile health initiative
• Rural health and outreach, such as telehealth training, community education and developing new clinics in underserved areas
• Mental health and aging, such as expanding training and services to improve access to mental health services and developing new clinics for the aging
• Programs in family medicine, such as increasing access to primary care services and meeting needs of family medicine trainees

“This next chapter of our work with the University of Minnesota to advance excellent patient care in marginalized communities—as well as primary care education and training—is extremely meaningful,” said Hilary Marden-Resnik, UCare President and CEO. “UCare’s three-year community investment propels the University of Minnesota Medical School’s mission to increase access to high-quality health care and improve wellness in underserved communities throughout urban and rural Minnesota.”  

“Our long history with UCare, which started as a pilot program in our Department of Family Medicine and Community Health, has allowed us to reach Minnesota’s underserved communities in important ways. It is one of many vital benefits of the university’s academic health mission—combining health sciences education and training, research and discovery and service to improve the health and vitality of our state,” said Dr. Jakub Tolar, Dean of the University of Minnesota Medical School. 

MDH Expands Newborn Screening List

The Minnesota Department of Health (MDH) is boosting health protections for newborn infants by adding three new conditions to its Newborn Screening Program. Newborn screening is a public-health practice designed to help parents and health care providers catch and treat conditions early in life so they can be addressed effectively and limit negative impacts for the child and family. The MDH Public Health Laboratory routinely screens all babies born in Minnesota for more than 60 conditions, and Minnesota Commissioner of Health Dr. Brooke Cunningham recently approved an advisory committee’s recommendation to add the following conditions to the screening panels:

• Guanidinoacetate Methyltransferase Deficiency (GAMT) is a disorder that can lead to neurological problems, such as intellectual disability, seizures, behavior problems and limited speech development. Treatment may include amino acid supplements as well as dietary guidance from specialists.
• MucopolysaccharidosisType II (MPS II), also known as Hunter Syndrome, occurs almost exclusively in males. It affects many body systems, including the muscles, skin, eyes and nerves. Treatment may include enzyme replacement therapy, physical therapy and surgeries.
• Krabbe disease 

Krabbe disease can cause muscle stiffness, blindness and deafness and can be fatal if treatment is not administered in time. Treatment involves a stem cell transplant by four to six weeks of age, which is not a cure but greatly improves quality and length of life for most affected children. Newborn screening for Krabbe allows families to consider a stem cell transplant before their child develops symptoms and it is too late to treat.

Although rare, the three new conditions can be serious if not detected and treated early. “Minnesota has one of the most comprehensive newborn screening programs in the country and regularly considers additions to the program,” Commissioner Cunningham said. “I want to thank the members of the Newborn Screening Advisory Committee for their dedication to this important public health service.” A start date for the new screening conditions has yet to be determined. Last year the lab screened more than 62,600 newborns and recommended treatment for conditions detected in about 400 of them. More information can be found on the MDH website: Newborn Screening Program.

Mayo Launches Data Disparities Project

To address the lack in quantity and quality of diverse genomic data in public research databases used by the global scientific community, the Mayo Clinic has recently undertaken a new initiative. With a goal of improving scientific understanding of diseases in all populations, the Data Disparities Project will study genomic links to diseases and how they can contribute to de-escalating health care inequities. Yan Asmann, PhD, and Aaron Mansfield, MD, lead the project of tailoring the diagnosis and treatment of certain cancers to a person’s genomic makeup. Racial and ethnic minorities often experience cancer disparities in the U.S., with higher disease prevalence, shorter survival times and higher death rates with many cancer types, according to the National Institutes of Health. “This Data Disparities Project addresses a significant need to study the disparities in cancer research. Our results could potentially lead to an immediate pathway to changing practice with how germline (normal cells) and tumor genomes are sequenced and analyzed in racial minorities to improve treatment selections,” says Dr. Mansfield, co-director of Mayo Clinic Precision Cancer Therapeutics in the Center for Individualized Medicine and Chair of Data Safety and Monitoring in the Mayo Clinic Comprehensive Cancer Center.

These data disparities are believed to arise from an interconnection of non-biological (socioeconomic, environmental and behavioral) and biological factors (genetic and genomic features). Studies conducted by Dr. Asmann and Dr. Mansfield found the existing database quantity of African ancestry patients’ tumor mutations is overestimated, which could lead to inaccurate treatment strategies. Another study found lower sequencing-data quality for ancestrally African patients in the Cancer Genome Atlas, which is one of the largest and most widely used cancer sequencing projects. “We’re working to clear a path to a future where every patient fully benefits from individualized medicine,” Dr. Asmann says. “But first we must understand the genomic links to diseases across all populations.” Dr. Asmann and Dr. Mansfield are creating a detailed genomic map that reveals precise locations where genetic differences between patients with African and European ancestries are difficult to determine. The team is developing analytic solutions to mitigate these data disparities. As discoveries driven by genomic data continue to advance individualized medicine, the researchers emphasize that addressing data disparities has taken on an urgent importance. 

Children’s Minnesota Opens New Concussion Clinic

Children’s Minnesota recently announced the opening of the Children’s Minnesota Concussion Clinic in Woodbury, Minnesota. The Kid Experts® from the pediatric health care system’s concussion program will now use the facility to provide comprehensive medical evaluations and treatment for children and young adults with concussions, the most common type of traumatic brain injury. “The new expansion improves access and will serve as a vital resource for countless families across the eastern Twin Cities metro and throughout the upper Midwest,” said Katie Slifko, CPNP-PC, APRN, lead provider at the Woodbury Concussion Clinic. “As the kid experts, we know that just like children, not all concussions are exactly alike—that’s why giving families a new option to receive this specialized care is a vital part of our vision of being every family’s essential partner in raising healthier children.” A dedicated concussion care clinic will provide patient families with the opportunity to receive treatment for both their brain injury and any needed physical rehabilitation at the same location. Children’s Minnesota will continue to provide outpatient concussion care at the organization’s St. Paul hospital campus. The experts at both facilities are part of the Children’s Minnesota neuroscience program that includes specialists in neurosurgery, neurology, neuropsychology, rehabilitation and other departments that care for brain and spine issues. A concussion is usually caused by a blow to the head or body, often through sports, accidents or falls, that results in a disruption or loss of normal brain function and potentially a loss of consciousness. A concussion is diagnosed based on symptoms that can occur immediately after the injury or are recognized hours, possibly days, later. These symptoms can include headache, dizziness, drowsiness, blurred vision, coordination problems and others. Concussions may take time to heal, as much as several months, and following the recommendations provided by a medical professional will ensure that children or teens are on the right path to healing. The Centers for Disease Control and Prevention estimates that as many as 40% of young athletes who sustain a concussion return to play sooner than they should. Whether mild or severe, all concussions should be evaluated by a medical professional within two to three days.

Cuyuna Regional Medical Center Crosby Receives Level III Trauma Center Designation

The Minnesota Department of Health has recently designated the Cuyuna Regional Medical Center (CMRC) in Crosby as a Level III facility. Level III trauma centers have a team of physicians and nurses available to assess the patient upon arrival. Patients that require more comprehensive care are managed and stabilized before being transferred to a Level I or Level II trauma center. One of 33 hospitals in Minnesota with Level III Trauma Certification, CRMC treats about 250 trauma patients a year with more than 10,400 annual emergency department visits. This designation represents the dedicated work by multiple teams to improve best practices leading to better patient outcomes in providing this level of critical care. CRMC staff voluntarily participated in the intense designation process, which included an outside review of the hospital’s resources and capabilities to care for trauma patients. The hospital also participates in a continuous performance improvement process and provides educational opportunities in trauma care for the community. “Level III Trauma designation will help us support our patients with higher levels of care so we can continue to serve our growing communities,” stated the CRMC CEO Amy Hart. “We congratulate our trauma team for this significant achievement. Trauma III status recognizes that CRMC provides the expertise, teamwork and facilities necessary to treat a higher level of injuries than ever before.” For a severely injured person, the time between sustaining an injury and receiving definitive care is the most important predictor of survival—the “golden hour.”  

“Injury is a leading cause of premature death in Minnesota,” said Minnesota Commissioner of Health Dr. Brooke Cunningham. “The goal of the trauma system is to decrease injured patients’ time to care by making sure their medical needs are appropriately matched with hospital resources. With the designation of CRMC as a Level III trauma hospital, we are getting closer to our goal of ensuring that seriously injured Minnesotans have access to an organized system of trauma care wherever they are in the state.” On average, trauma claims the lives of 4,300 Minnesotans annually.

Avera Receives $58M Federal Grant for Community Research Project

 The Avera Research Institute recently received $58 million in federal grant funding over the next seven years to expand its community research programs that benefit mothers and children. “This is the largest grant that Avera has ever received,” said Amy Elliott, PhD, chief clinical research officer at Avera Research Institute, a department of Avera McKennan Hospital & University Health Center in Sioux Falls. “Our goal is simple: improving health for mothers and their children. The complex part is reaching all of our different populations, as we never want anyone’s ZIP code to determine their maternal or pediatric health.” Research conducted by Elliott’s team is not the typical laboratory-based research or clinical trials that people often picture. “We take research to the people, with interventions to improve lives as we go along,” Elliott said. “Our mantra is bringing cutting-edge research to the prairie.” Elliott’s team has enrolled some 3,500 children, who are now 5 to 14 years old and are followed throughout childhood. The team looks at five outcomes including neurodevelopment with a particular focus on autism; airways and asthma; childhood obesity; positive health (healthy habits like getting enough sleep); and delivery outcomes. “We gather lots of data that will impact children of the future. But we also engage with these families to encourage a healthier future for them,” Elliott said. Since late 2017, when Elliott’s team joined Avera, it has grown from 16 full-time equivalent (FTE) employees to 80. That growth is all supported by grant awards. “We’re quite large in terms of a research institute for these types of awards. It’s uncommon for a health system to receive these large federal grant awards; it’s much more common for a university or research center,” Elliott said. “But we’re set up for this type of research and conduct it successfully, providing insight on the diverse populations of South Dakota including American Indians. Receiving this funding is a moment to celebrate for our team. But what’s important is what we actually do with it, turning it into real action and real change. The real moment to celebrate is when the positive outcomes and results start to roll in.”