Dr. Mark Roberts, a pediatric hematologist/oncologist and St. Luke’s Health System medical director for research, is putting finishing touches on our first-ever symposium to bring together leaders in research across industries for information-sharing and brainstorming.
We’re making plans to sponsor a daylong symposium Feb. 1, and we think the mix of physicians, scientists, academics, and industry executives will raise the profile of research efforts at St. Luke’s and throughout our region.
St. Luke’s is doing exciting work in research, and Dr. Roberts is heading up the effort to build a solid base of knowledge around many of our accountable care initiatives.
His background, a two-decade blend of medical practice and scientific research, makes him a perfect fit for the large task of corralling our research efforts and filling the gaps.
“My practice of medicine as a children’s cancer doctor always involved research,” he said. “After caring for patients, I went to the lab to do basic science research to try to impact kids’ treatment.”
Cancer research underpins St. Luke’s history with research as well. Founders of Mountain States Tumor Institute “saw that research was integral to cancer cure,” Dr. Roberts said.
And research into pediatric oncology, nationwide and at St. Luke’s, has been a particularly active area. As it stands, about 85 percent of children under St. Luke’s care take part in clinical trials with parental permission and children’s assent, which speaks to the long-established practice of discovery and the abiding interest in finding solutions on the part of researchers, physicians, and the families of children with cancer.
Research into pediatric oncology goes back to the 1950s, when a handful of pioneering institutions including the National Institutes of Health, St. Jude Children’s Research Hospital, and Memorial Sloan-Kettering Cancer Center launched efforts to help children dying of leukemia and other cancers.
Challenges in early research, for St. Luke’s and other institutions, had to do with the numbers of people with the cancers and other conditions to be studied. St. Luke’s rural nature means some of these challenges remain today, even in the case of diseases that are relatively common. The solution is teamwork, pooling information, and collaborating with other health entities to examine results across broader populations. That’s how pioneering researchers started making gains against childhood cancers, and it continues to be a model for research today being conducted across dozens of fields.
The results of this approach when it comes to pediatric oncology have been stunning.
“We’ve gone from a near-zero cure rate in the ‘50s to roughly a 25 percent cure rate in the 1970s to about 85 percent now,” Dr. Roberts said. “This remarkable progress is a tribute to a steadfast commitment to learning from every patient.”
Increasing the number of adults in cancer clinical trials is one of St. Luke’s goals. While about one in three adults will get cancer in their lifetime, only a fraction, 2 percent or 3 percent, are enrolled in St. Luke’s Mountain States Tumor Institute clinical trials. If St. Luke’s were able to triple the participation rate, Dr. Roberts believes, improvement in outcomes would accelerate and the testing of promising new treatments targeted to changes discovered in cancer cells could go forward.
The rural nature of the region and its scattered and sparse population also have posed challenges when it comes to optimal diagnosis and treatment options for those with serious diseases such as cancer. To meet some of these challenges, St. Luke’s MSTI has gone out into the communities, de-centralizing to help ensure appropriate care and robust inquiry into cancers affecting the region’s residents.
St. Luke’s is taking a similar approach in addressing other health problems to offset the historically fragmented nature of medical practice. We are working to clinically integrate, improve transitions of care, and take other needed measures to improve the health care experience for patients, and Dr. Roberts would like to expand St. Luke’s efforts to improve outcomes in other areas as well.
St. Luke’s is actively participating in clinical trials in pediatric ophthalmology and other pediatric specialties, rheumatology, nursing, and other areas. We are making a name for ourselves with work in cystic fibrosis, with Dr. Henry Thompson and Dr. Perry Brown leading research being watched nationwide.
Dr. Kevin Shea, a St. Luke’s orthopedic surgeon, also is gaining national notice, for his work with colleagues on osteochondritis dissecans, a joint disorder in which cartilage breaks down, and other disorders affecting bones and joints. Dr. David Hinchman and St. Luke’s Clinic – Idaho Cardiology Associates also have been very active, with several research projects under way to improve treatment of common conditions affecting the heart for patients admitted to the hospital and being treated at the clinic.
“The work in all of our areas of research is really very impressive,” Dr. Roberts said. “We’ve largely focused on participating in clinical trials led by others, but we’ve got talented doctors, nurses, and other clinicians, and they’ve got their own brilliant ideas for helping the people we serve in our region.”
Dr. Roberts and his team have been working to facilitate the process of research participation, applying lean methodology, used at St. Luke’s as TEAMwork, for improved efficiency. Dr. Roberts’ team has trimmed the time to approval from as long as a year in some cases to less than three months.
Next up for him are opportunities to build research into some of St. Luke’s accountable care initiatives and processes. St. Luke’s Center for Spine Wellness, knee and hip joint replacement program, and new electronic intensive care unit program all are potential candidates for research efforts that could focus on optimal intervention and shared decision-making, research that would support all of St. Luke’s sites.
“The future of health care depends on figuring out how best to conduct accountable care,” Dr. Roberts said. “It reverses the mindset, where before you might have not started with a research approach.”
Our February research symposium is being created in this same spirit of open-mindedness, Dr. Roberts points out. Several hundred people have been invited, and speakers and guests will come from regional leaders in all fields of research, including J.R. Simplot, Hewlett-Packard, and Idaho National Laboratory. The Veterans Administration, Boise State University, Idaho State University, and the University of Idaho also will be active participants in the event.
“I don’t want it to be a display of one facet of research or another,” he said. “I want our business leaders to help us think through how we might adapt our accountable care approach to include research in novel ways. The symposium is designed to get feedback, rather than just for us to do all the talking.
“It’s not a traditional symposium in that way,” Dr. Roberts said. “We’re expecting to listen and have new partnerships that come out of this. I want doctors meeting scientists and business experts, so that they can start working together. I hope that new and cool things will come from that.”
David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.