Good afternoon and thank you for joining our National Jewish Health Community Health Benefits Discussion. We appreciate you taking just a little bit of time with us this afternoon.
We have several folks around the table here to really go over the work that we do with the community and so they will be introducing themselves as we go forward, but we have Dr. Michael Salem who is our President and CEO, Dr. Greg Downey who is our Executive Vice President for Academic Affairs and Provost, Dr. Kerry Horn who is our Chief Medical Officer, and Dr. Steve Frankel who's our Executive Vice President of Clinical Affairs. So with that I'm going to go ahead and turn this over to Dr. Salem.
Thank you Lauren and thank you all for joining us today.
Just a little background about National Jewish Health.
We were formed about over 125 years ago now as a free not-for-profit hospital which was mission-based that continues today is to take care of everybody in need, to find answers and cures for major illnesses, and to educate and train those within the health care space. So if you look at the pictures on your screen on the left is part of our campus today and on the right was the first hospital building that was actually built in 1892 but didn't open until 1899 because National Jewish didn't have any money. So just to get to know us a little better if I could leave you with three things to know about National Jewish Health. These are some of some of the older pictures and if you look at the picture in the upper right hand corner which is our 1925 building our motto was none may enter who can pay none can pay who enter.
So National Jewish was an entirely free hospital from 1899 and never sent a bill out to a patient until 1970. And so therefore the boards make decisions. So our board decided that we would be a free hospital. The only patients that could be admitted were homeless and that we had to take on an incurable disease, the last respiratory pandemic for which there were no cures. And so that was tuberculosis.
So if you look in the lower right hand corner, National Jewish needed to become an innovative institution, needed to be able to solve problems.
So what you see in the lower right hand corner is some surgeons taking out parts of people's lungs who had tuberculosis and they had a dairy on campus. And they knew that tuberculosis was a very serious disease. And they knew if they were ever to make any progress that National Jewish would have to be innovative. And so if you look on the lower left hand picture, we also knew that in order to invent cures or make advances in science, we needed to do research for the benefit of the community, for the benefit of everyone. And so that building that you see on the lower left hand corner is a building that was built for research in 1915. And it was the first building that was built outside of a university campus in the country. So charitable mission, innovative place, and one that was also devoted to research on behalf of the community. And a lot of great breakthroughs have been made here at National Jewish. This just lists a few. If any of you or your children have allergies, the molecule responsible or grandchildren responsible for allergic reaction?
A lot of those things have changed as we all know.
The november pandemic was discovered at National Jewish Health. We really pioneered a lot of the to decide which are friend and which are foe so they have receptors on them and that was discovered here in National Jewish Health along with others various proteins that slow the growth of cancer tumors something called the oral food challenge which is really the gold standard still was described here in 1970s for the diagnosis of food allergies by giving small amounts of allergens and seeing how people responded we are still doing a study called copg with 22 other centers around the united states the largest ever study of those patients for a very long time other vaccines and other multiple diagnostic platforms which of course were very important in the covet pandemic so our research is very important to national jewish and for the health of the community so where do we stand today we are the leading respiratory hospital in the nation a place that people come to from around the country and by many metrics not only the large number of pulmonary faculty not only rankings in u.s news but also our patients put us in in the top scores in terms of patient satisfaction in other ranking scores were in the top six percent of funded institutions by the national institutes of health but by many metrics we're very proud of it here and we're very proud of it for Colorado we are have a national impact right we're Colorado based but from our patient revenues about 29 percent of that come from patients outside of Colorado who have been to the local doc they may have been to another place they need answers for what's wrong with them and they come from out of state and 71 percent of our patient revenues are from Colorado's we are a very mission driven organization right our mission since 1899 to heal discover and educate as a preeminent health care institution and serve by providing the best integrated and innovative care for both children and adults by understanding and finding cares for the diseases we research and educating and training the next generation of health care professionals to be leaders in medicine and science our vision over the next decade and the next decade to be the global leader in the diagnosis and treatment of respiratory cardiovascular and immunologic disorders we want to be unsurpassed in coordinated specialty care powered by our discovery science and education what are the areas of specialty that we focus on this is not a full list but if you look at asthma emphysema pulmonary medicine even the rare diseases in pulmonary medicine allergy sleep related breathing disorders respiratory infections rheumatology cardiology gastroenterology oncology neurology we do a lot of critical care medicine taking care of the sickest patients in Colorado and we have the largest population of adult cystic fibrosis patients in the country on the pediatric side we focus on pulmonary allergy and immunology so allergy and asthma treatment atopic dermatitis behavioral sleep services child psychiatry consultation large food allergy programs immunodeficiency and immune system education program we have our pediatric day program for patients that come from around the country our exercise tolerance center pulmonary diagnostic center pediatric rehabilitation services severe asthma treatment clinic and psychosocial programs. So that gives you a flavor of the kind of specialties that National Jewish focuses on in children and adults. We have a lot of collaborators. We have the University of Colorado School of Medicine as our academic partner, Intermountain Health, St. Joseph Hospital, and the other Intermountain Health as our clinical partner. And we have a number of collaborative respiratory institutes around the country, one with Jefferson Health in
Philadelphia and one with the Mount Sinai School of Medicine in New York. So for us, what is community benefit? They are programs, services, and activities that are focused on addressing community health needs regardless of the source or availability of payment that provide measurable improvement in health status and increase access to health care.
Health care resources. So improve access, enhance public health, increase general knowledge on health topics, and relieve or reduce the health burden in order to improve the health of the community. So how are these programs funded? Okay. First of all, our mission prioritizes a focus on serving all people, first come, first serve, regardless of their ability to pay, type of insurance, Medicaid or Medicare.
To accomplish this, we rely on a variety of funding sources dedicated to charity care and community benefit programs, including grants and directed funds that are applied or awarded and dedicated to the purpose for which they're given. Philanthropy and charitable contributions, very important, specified for community benefit. And a federal program known as 340B that helps us fill a large gap between reimbursement and the cost of care. So we have a variety of funding sources dedicated to care for organizations that provide high levels of charity care, National Jewish Health does. This program was created to help hospitals offset to ensure that those patients with the fewest resources can have access to the highest quality care.
So just by some numbers, our total patient visits on this campus are about 117,000, most of them outpatient visits.
We have 1700 employees, we practice at 18 locations throughout Colorado, and we have about 187 physicians on staff.
So what are the numbers for community benefit?
We provide significant benefits to our communities in the Denver across the state and the country.
In 2023, 11.1% of our unrestricted annual revenue was reinvested in our community.
Thank you.
And I hope that happens.
The next There are several key measures that we look at to help people receive the support and the opportunity to get in to our local communities.
What are some examples?
So charity care and program shortfalls, 11.3 million. Health professional education, 3.1 million. Community outreach, benefit programs which include a variety of others, recycling, food bank programs, asthma management programs, lack on clinics, and others.
That's about a million dollars.
Subsidized health services, about $3 million.
And our research investment is about $17.9 million.
That's for fiscal year 2023.
And now for our research mission,
I'll turn it over to Dr. Greg Downey.
Hi, good afternoon.
My name is Greg Downey. I'm the Executive Vice President for Academic Affairs
and the Provost, and I'm in charge of the research part of the enterprise.
One emphasized it, in addition to the clinical and the educational missions,
research is one of the three pillars of our institution, and they are intimately involved. And I'll try and point out some of those overlaps.
So currently we have approximately 300 people in the institution who are dedicated primarily to research.
Some of those are part-time in the clinic and part-time in research. And we think that's important because people who are part-time in the clinical part of the enterprise need to give feedback to the basic researchers and the research done in our institution needs to be fed back to patient care.
And that integration is a key part.
We focus on several core areas.
In the pulmonary area, in the clinical
and translational part of our enterprise, we have specialties in airways disease, such as asthma and chronic obstructive pulmonary diseases, allergy and immunologic diseases, surgical diseases, critical care, and people who have lung injury from critical care called ARDS, fibrotic lung diseases, such as pulmonary fibrosis, occupational lung disease, and cancer.
And the more basic translational side of the institution, we look at the very basic mechanisms, allergy, immunology, lung injury repair, and fibrosis or scarring.
We have a group interested in how lung cells work and communicate with each other.
And then we have a group looking at how the lining cells of our lung or our gut help fend off infection.
We call that mucosal immunity and inflammation.
In addition, we have core resources.
We have a genomics core, data sciences, precision medicine, stem cells and regenerative medicine, as well as epidemiology and outcomes core parts of the institution.
We want to emphasize that we look at things
from both the very basic science through clinical trials, through epidemiology.
So we try and look at the entire spectrum of the diseases that we do research in.
Just before I leave this slide, I want to point out that we have some very specialized centers,
the Center for Gene Environment and Health, which is our genetic center, the Center for Environment, Climate, and Health.
And then we have a clinical trials unit called Clinical Research Services, run many clinical trials, both FDA and investigator-initiated trials. Our research has changed lives throughout our history, and that continues today and into the future. We focus on developing new treatments, taking information learned in the very basic part of the institution and translating that into clinical research that affects patients. Some examples of that, a study published this year in April found genetic links between asthma, respiratory inhalers, and air pollution. Research that was published in November of last year identified a protein that is involved in asthma airway obstruction and the mucus plugging that we see in severe asthmatics.
A study published late in 2024 clarified the role of macrophages and fibrosis, and this study set a stage for disease intervention research, which is ongoing right now and being developed in our preclinical laboratories.
Research results published in December of last year found a new medication treatment for children with atopic dermatitis. And finally, new biomarkers were identified to guide asthma treatment.
AsthmaNet is a nationwide clinical trials group set to address asthma in vulnerable populations, and we are the key center.
We are the key center in that network. COPD gene, which is one of the largest ongoing national studies ever to investigate the underlying genetic mechanisms leading to chronic obstructive lung disease, is housed both here and at the Brigham and Women's Hospital in Boston. And this study is led by physicians here, at least the clinical part of the study, and this continues, will continue into the next decade. We have a group of both physicians and basic scientists looking at lung disease, and we have a group of physicians and basic scientists looking at lung disease, that we see in war fighters. This group seeks to understand how illnesses suffered by soldiers returning home from Southwest Asia are generated. So we're looking at the mechanisms, how the lung injury occurs, and how we can help those soldiers and other war fighters recover from their injuries that they suffered. We have a group looking at air pollution, particularly in vulnerable populations, and there are many populations in the Denver community that are quite vulnerable.
And we're looking to understand the risks of that and also options for care. And finally, a study that has recently been completed is a multicenter national study looking at the treatment of a drug called saracatinib and how that can prevent pulmonary fibrosis that was recently completed.
And we were the institution, the lead institution on that study. Thank you.
Hello, I'm Carrie Horn. I'm the chief medical officer for National Jewish Health, and I serve to support our clinical teams.
So I'm just going to briefly talk about one of the ways in which we provide clinical support to the community. We participate in the Hospital Transformation Program, which is one of the state's programs related to the Medicaid population in our community. On the slide, you can see the seven measures or eight measures that we have chosen to participate with this program. We are currently in the improvement phase. So we have done all of the background and planning and work to build these processes and are continuing to fine tune those so that our patients can have easy access to care and get improved outcomes.
Last year, we talked about some of the specific work this year, as we continue to improve those processes, we're going to focus on how we're working with the community around improving the care for our Medicaid population, which is one of the ethics measures that we provide atz December are a national health care center in our particular research. population, which is one of our HTP program aims. So we have partnered with the Metro Denver
Public Health Collaborative, and we are partnering with other Metro Denver community hospitals related to their HTP programs. All of this work is centering around the social determinants of health and how we can improve healthcare equity for our community. And next up, we have Dr. Frankel for some of our specific programs. Thank you, Carrie, and thank you for everyone joining us this afternoon. So I'm pleased to touch on just a number of our clinical community outreach programs that perhaps people may not be as aware of as some of a lot of our other programs.
So we operate the Clinical and Translational Research Center, which provides infrastructure for community-based research, really allowing us to offer the community access to investigational trials and the latest cutting-edge advances in healthcare. So we have a number of programs in medicine, really opportunity to participate in those. We provide the Lung Line, which is a free information service specifically focused on lung health and lung diseases, and that's available for healthcare consumers and staffed by our registered nurses. We operate the Miners Clinic of Colorado, and this is particularly important for many of our partners in other parts of the state on the Western Slope and high country and so forth. And this provides medical screening, diagnosis, treatment, pulmonary rehab, and education, free screening programs. And this program has taken out into key communities where the people in those communities are likely to be more affected. We operate the Radiation Exposure, Screening and Education Programs Clinic, and this is a program for uranium miners, again, providing disease screening, referrals for diagnostic and treatment procedures, and assistance with documenting claims under the Radiation Exposure Compensation Act.
As Dr. Downey mentioned, we have the Center for Climate, Environment, and Health, where researchers and clinicians generate novel projects and collaborations and ways of really working to prevent and treat the impacts of climate-induced disease. This past year, we held Immune Deficiency Day here at National Jewish and hosted a free patient event to provide an opportunity for patients with immune deficiency and immune disorders in the community to connect with doctors and support and resources that might be available, as well as provide additional education about their conditions. Our history started with tuberculosis, but at present, non-tuberculous mycobacterial pulmonary infections are much more prevalent. And we host an annual non-tuberculous mycobacterial patient conference for patients currently diagnosed and or being treated for non-tuberculous mycobacterial infections. And of course, we host a variety of other patient education events and patient-focused programs throughout the year.
While the pandemic may have begun, folks are still affected by long COVID and other impacts and health complications from their COVID. And we continue to provide Long COVID services, care, and research to help people suffering from Long COVID.
We also operate the Immediate Care Clinic. So this is a walk-in urgent care clinic that we operate a week to meet the needs of not only established patients at national judge but new patients from our community here local and across Denver who have acute symptoms that need more urgent attention and they have the ability to walk in and this is a again it's a walk-in urgent care clinic really for for any kind of acute symptom that folks need just to be clear it's not an emergency department we obviously are partnered with saint joseph for those services but for more minor acute symptoms certainly this is available and then we are the largest provider of vaping and tobacco cessation services so tobacco use is still the leading cause of preventable disease and death in the united states and contributes to 8.5 million dollars of tobacco use and 6.5 million dollars of tobacco use in the united states and thousand deaths every year in the United States. Our team has published eight studies related to tobacco use and vaping cessation over the past year. We operate the Quitline, which has helped more than two and a half million Americans with their quit attempt. And we have focused programs specifically for vulnerable populations and populations at risk and serve 26 states, including Colorado. Importantly, we also developed My Life, My Quit, which is a vaping cessation program. And vaping use is now seen about 10% among teens, particularly high among high school students and other young adults. And this program specifically targeted to help people quit vaping has shown significant reductions and has proven to be a particularly and especially effective program. And vaping does disproportionately affect our vulnerable populations and underserved communities. And we're really pleased to be able to offer this.
Thank you, Dr. Frankel. So what are some of the community additional community program highlights? This is a picture of our community garden that we have. A portion of our campus is set aside for community garden. And as you can see, it is really active. We also do something unique that you won't find anywhere else. We have a community garden that we have a community garden that is not defined on any other hospital campus in the nation. And that is our mortgage academy. It's kindergarten through eighth grade free day school for children's children with chronic illnesses, serves up to 90 children. They are chronically ill, and they miss a lot of school.
So what we do is we take various illnesses from asthma to severe allergies to HIV, to cystic fibrosis to transplant. And we have a community garden that is set aside for community health and care for individuals that have chronic healthcare needs and are struggling with childhood illnesses and we assess their medical needs. We have three nurses there, and we help them with their social issues, and then catch them up in school.
Oftentimes they've missed so much school that they're two grades behind. So the Colorado Department of Education is the curriculum, and the students and families are educated on how to manage their illnesses in future school and at home. And we provide breakfast and lunch for all the students.
It's right on campus and we've made many facility improvements over the last couple of years to enhance learning, improve energy efficiency. Our school curriculum focuses on experimental learning and problem solving and they have a school project garden with food that we donate to the local food pantries. Really miracles go on in that school. What other areas of focus do we have going forward? So we want to expand access to specialty care, to bring that specialty care and personalized education to underserved populations for respiratory illnesses, heart disease, immune-related diseases. In pediatric respiratory and health care we want to develop and expand programs focuses on the research, diagnosis, and treatment and education to address the increasing needs in pediatric asthma, allergy, immune system and other diseases for all populations and in education developing and providing access to targeted programming online patient education and professional education courses providing education and care for students and their families through the mortgage academy and with that we thank you for your time we thank you for your support of National Jewish Health we've been in this community over 125 years and have always been proud of what we've been able to achieve on behalf of our community and with that Adam will be happy to take any questions that might have been submitted
First how do we bring kids into the school mortgage academy do they need to apply do they need doctors what's that process it's a good question. It's a very easy application process they just need to have a chronic illness oftentimes they're referred by their pediatrician oftentimes we get out and do community events in order to gain new students and word of mouth is also a great way to get new students so we are happy to serve and really just the issue of chronic illness is the entry point to the school
Do you anticipate opening any clinics in the western part of Colorado or in other communities?
So we operate the miners clinic and and certainly do our outreach to our communities in western Colorado we don't have any freestanding standalone full-service clinics out that way but we do have a strong partnership with intermountain health and obviously Saint Mary's is a cornerstone of more tertiary at secondary acute health care.
Those are the questions we've received thank you thank you folks for being with us today you will receive a survey on monday that will include a way for you to ask more questions. And again, you will receive that email on Monday. And we will also be posting this session in case people that wanted to get here couldn't come at this time, we'll have it out there for you. So thank you very much. We appreciate your time.
National Jewish Health sees patients from around the nation and the world. Many patients come from Denver and the surrounding counties. For the purposes of this assessment, we have defined our community as Denver County and four contiguous counties — Adams, Arapahoe, Jefferson and Douglas counties — in which a majority of our local patients live. As a tertiary care hospital focused on respiratory health, we have further defined our community as those who will benefit from diagnosis, treatment and prevention of respiratory disease.
