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INSIDE
2 EPIC RESPONSE
Electronic medical record system helps
patients affected by riots and looting to get
prescriptions filled.
3 MEDICAL CARE EXTENDERS
New After-Care Clinic provides host of
services for patients in need of timely
follow-up after a medical crisis.
7 LUNCH REINVENTED
Six nutritionists share their healthful
midday meal choices—and recipes—based
on their particular needs and tastes.
INSIGHT
SPINAL PRECISION
A publication for the Johns Hopkins Medicine family
Volume 66 • Number 6 • July/August 2015
Joe Rubino
Software developed at Johns Hopkins aims
to eliminate surgery at the wrong place on
the spine.
Dome
More than 30 years ago, Drew
Pardoll took the first steps
toward his goal of creating
therapies that tap the strength
of patient immune systems. His
determination is paying off.
Learn more about the strategic priority
for biomedical discovery online at
hopkinsmedicine.org/strategic_plan .
T
At the time, Drew Pardoll was
an oncology fellow, saddled with
the searing assignment of caring
for a child who would not live
to adolescence. One night, as he
flipped through the science journal Nature, an article about
the workings of the immune system caught his attention.
He thought about Nicole’s foreign immune cells, attacking
both cancer tumors and healthy organs, powerful enough
to kill her. And he contrasted her experience to that of bone
marrow transplant patients who survived graft-versus-host
disease, their cancer beaten back by the same immune
system attack.
(continued on page 4)
Published by Johns Hopkins Medicine Marketing and Communications
keith weller
Cancer’s
Persistent
Foe
he 10-year-old girl was dying.
It was 1984, and Nicole was the first patient
at The Johns Hopkins Hospital to receive a
bone marrow transplant from an unrelated
donor. She had been injected with healthy
marrow, rich in disease-fighting immune cells,
to replace material that had been decimated by cancer and
radiation. But the donated immune
cells were attacking her organs. The
condition, known as graft-versus-host
disease, occurs in about half of bone
marrow recipients and is now treated
with drugs that suppress the immune
system. These days, it is rarely severe
enough to be fatal.
Drew Pardoll, above, in
1992, and in 2015, below.
CHIEF PERSPECTIVES
integration
Helping Our City Heal
Ronald R. Peterson
President, The Johns Hopkins Hospital
and Health System
Executive Vice President,
Johns Hopkins Medicine
Learn more: See our Community Engagement Inventory at
hopkinsmedicine.org/ebcommunityaffairs/directory.html.
2
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2 0 1 5
katelynn sachs
B
altimoreans have
engaged in significant
reflection following
the tragic turmoil
that erupted in April after
the death of Freddie Gray
from injuries sustained while
in police custody. Clearly,
much remains to be done to
eliminate social inequities and
injustice in our city and elsewhere, despite the genuine
progress that has been made
in recent decades.
While pondering how
we can better address these
crucial issues, it is helpful to remember some of the remarkably
effective efforts we have already undertaken.
For example, in early spring, we took part in two distinctly
different events that celebrated the impact of Johns Hopkins
Medicine’s decadeslong commitment to improving the lives and
opportunities of those who reside in the communities surrounding The Johns Hopkins Hospital.
On June 4, my colleagues and I were touched to be recognized by Big Brothers Big Sisters of the Greater Chesapeake,
which honored Johns Hopkins Medicine’s more than two decades of work to improve the career opportunities and health
of youth in our community.
We have continuously expanded our outreach. We began in
the mid-1980s with what became our year-round health career
development and youth mentoring program, Bond-to-Bond.
Designed to support high school students in the Johns Hopkins
Hospital area by exposing them to a variety of careers in health
care through internships within our hospital, school of medicine and the broader health care system, this program is still
very much in demand.
Twenty-one years ago, we also began our Johns Hopkins
Summer Jobs Program, which since then has provided health
care work and mentoring experiences for more than 2,500
young people. We have extended our outreach through the
Dunbar High School Health Partnership and our Adopt-AClass program for fourth graders. We also have supported the
Start on Success Program for students with disabilities, as well
as the Baltimore Area Council of the Boy Scouts of America’s
Scoutreach Program, which serves the most at-risk and disadvantaged youth in underserved neighborhoods and communities. And, as much as Johns Hopkins Medicine has done to help
the youth of our community with these and other programs,
we are making plans to do even more.
Community leaders have told us that summer activities
and employment for Baltimore’s young people are the highest
priority. As a result, we are expanding our current summer
jobs program to provide employment opportunities for more
city youth. In partnership with Baltimore City’s summer jobs
program, YouthWorks, Johns Hopkins is committed to increasing our placements by 50 percent, providing 300 more young
people with paid internships across our institutions. Johns
Hopkins Medicine will work hard to meet that commitment.
On the night of May 26, a crowd packed Turner Auditorium
for our Dancing with the Hopkins Stars benefit for United
Way. By the end of the evening, more than $52,000 was raised
to support United Way’s long-term strategies to create a
region in which families have a place to call home, are financially
stable, and have access to quality and affordable health care,
and where students succeed in school.
Ten teams of top faculty, staff and students trained for
weeks to perform a variety of dances, including the tango, the
Hustle and hip-hop. It was a delight for me to emcee this event,
which was an exceptional example of how deeply Johns Hopkins Medicine cares about our community.
Like our programs dedicated to youth mentoring, Johns
Hopkins Medicine’s strong support for United Way is just one
more example of how we have demonstrated our enduring
dedication to alleviating the challenges of poverty and developing healthier communities in the neighborhoods we share.
Megan Tschudy, assistant medical director of the Harriet Lane Clinic, uses Epic to improve
population health.
Reaching Out
to Families in Need
Epic helps Harriet Lane Clinic doctors reach patients
whose pharmacies were destroyed by looting.
T
he images are broadcast
“We were being proactive instead of waitaround the world: thick gray
ing for patients to call us,” says Berger. “Evsmoke pouring out of a Baltimore
erybody was appreciative. I was touched by
CVS. Windows smashed. Merthe response.”
chandise stolen. A woman smells
The protests and violence in Baltimore
fire in the night air as her local drugstore
have drawn attention to the challenges faced
burns.
by many of the city’s poorest residents, a
Days later, her phone rings. It’s Jessica
population served by the Harriet Lane ClinBerger, medical resident at the Harriet Lane
ic. Of the 7,500-plus children and adolesClinic of The Johns Hopkins Hospital, ofcents seen by the clinic each year, 94 percent
fering to move her children’s prescriptions
are on public insurance, says Tschudy.
to a different pharmacy.
Founded in 1912, the
As they talk about the
clinic
serves as a com“Every family
family’s health, the
plete medical home, with
we spoke with
woman requests a refill of
services that include
albuterol, the medication
after-school tutoring and
was
extremely
her son relies on to calm
mental health treatment.
thankful.”
his asthma.
Through a program
—Megan Tschudy
Berger looks at the
called Health Leads,
child’s medical record,
staffed by Johns Hopkins
open on her computer
University undergraduscreen, and sees that the
ates, patients are conprescription was filled renected to such resources
cently. She asks if the child is having asthma
as food pantries, job training and low-cost
attacks, and the mother says he is. Berger
child care.
helps her set up an appointment for her son,
The pharmacy outreach wasn’t the first
writes a prescription for albuterol and sends
time Epic helped Harriet Lane clinicians
it electronically to the new pharmacy.
identify and help a specific category of
The woman was among those telephoned
patients. In March, with Bonetti’s help,
by Harriet Lane clinicians after the April
Tschudy created a list of 200 children and
27 riots in Baltimore. Members of the Harteens who suffer from both allergies and
riet Lane team suggested the outreach durasthma. Maria Miles, a clinic community
ing staff meetings in the days following the
health worker, contacted the families before
violence. Megan Tschudy, assistant medical
allergy season began, reminding patients to
director for the Harriet Lane Clinic, recogtake their asthma medications regularly, asknized that Epic, the electronic medical reing if refills were needed and sharing other
cord system, could be used to identify famistrategies for coping with poor air quality.
lies with prescriptions at looted pharmacies.
“This is what preventive medicine is
Project administrator Gian Bonetti tapped about,” says Tschudy.
Epic to generate a list of all 157 Harriet Lane
—Karen Nitkin
families with active prescriptions at shuttered
Learn more about the Harriet Lane
pharmacies. The task took less than half an
Clinic: bit.ly/1GMqrw3.
hour, he says, adding that it would have been
prohibitively time-consuming under the
Learn how Tina Cheng, director of
paper record-keeping system in place before
general pediatrics and adolescent
Harriet Lane switched to Epic in 2013.
medicine, fights health disparities:
Clinicians reached 102 families on the list
bit.ly/1FNJFza.
and left messages when possible for the rest.
Doctors switched pharmacies for 71 patients,
asked how residents were coping with the
unrest, referred people to city services, and
scheduled well visits and asthma treatment
appointments.
“Every family we spoke with was extremely
thankful for our outreach efforts,” says
Tschudy.
patient- and family-centered care
After-Care Clinic: A Bridge for Patients at Risk
Pilot program offers timely follow-up care and services.
Pharmacist Amanda Sowell checks Deron Bridges’ blood-thinning
level, as After-Care Clinic co-director Rosalyn Stewart, far left,
and emergency medicine physician Anneliese Cuttle look on.
B
y the time deron bridges
arrived at the Johns Hopkins
Hospital Emergency Department in late April, he was
struggling to breathe. He
also had an active cough and chest pain.
Bridges, 24, has a history of asthma and
recurring pulmonary embolisms—sudden blockages in a lung artery. The
condition places him at high risk for lifethreatening blood clots.
Bridges developed severe symptoms
after not taking his daily blood thinner
pill for an extended period. On discharge, a nurse advised him to resume
taking his medication. Then she scheduled an appointment for the following
week for Bridges to see a doctor at the
recently opened After-Care Clinic.
This new protocol, says internist Rosalyn Stewart, who co-directs the clinic
with emergency medicine physician
Arjun Chanmugam, improves the odds
that patients who struggle with managing
their health will avoid further emergency
care or readmission to the hospital.
A joint effort among the departments
of Medicine, Emergency Medicine, Care
Coordination, Ambulatory Services, Surgery and Pharmacy, the After-Care Clinic
serves as a safety net for these patients. Its
goal: to extend primary care services for
those in need of rapid follow-up—within
“Patients coming to
the hospital are sicker
than they’ve ever been.
So when we send them
home, we need to make
sure they have what
they need to manage
and to get followup.”
—Melissa Richardson, The Johns
Hopkins Hospital’s director of
clinical resource management
a week after discharge from the hospital
or evaluation in the ED.
Located on the seventh floor of the
Johns Hopkins Outpatient Center and
open Mondays, Wednesdays and Thursdays from 4:30 to 7 p.m., the clinic offers
medical evaluation, blood work, lab tests,
pharmacy access, education and social
services.
The new clinic mirrors national efforts
to keep patients released from the hospital on top of their health care needs. A
recent study by the Center for Studying
Health System Change, a Washington,
D.C.-based research group, found that
roughly one-third of adult patients discharged from the hospital don’t see a
physician within the advised 30 days.
Experts say that’s a key reason so many
are readmitted.
“Patients coming to the hospital are
sicker than they’ve ever been,” says Melissa Richardson, The Johns Hopkins
Hospital’s director of clinical resource
management. “So when we send them
home, we need to make sure they have
what they need to manage and to get
follow-up.”
Over time, adds Stewart, “we want
to make the After-Care Clinic an entry
point for patients into a ‘medical home’
that connects them with Johns Hopkins
primary care—the place where they can
receive comprehensive services and patient education continuously under one
roof.”
The After-Care Clinic is not an urgent
care center, nor is it a primary care office, explains Stewart. Rather, it provides
a setting where patients can be assessed,
treated and transitioned to a community
provider.
There’s also a financial reason for the
clinic. Under new Medicare laws, hospitals are responsible for patients 30 days
postdischarge and can incur substantial
penalties for patients who are readmitted
unnecessarily.
Six days after his ED visit, Bridges arrives for his clinic appointment. He tells
Stewart and nurse practitioner Nancy
Feeley that he’s doing OK.
“Good news,” says Feeley. “Your CT
scan shows no pneumonia.” She listens
to his chest and hears a murmur. “That
could be because of clots in your lungs.”
Stewart dons a stethoscope, listens and
agrees. Then, after taking a drop of blood
and using specialized equipment, pharmacist Amanda Sowell discovers that his
blood-thinning index is 1.
“Getting to 2 is your goal,” says Sowell.
She and Stewart tell Bridges to continue
on the second blood thinner prescribed
the previous week. Before he leaves,
Feeley reminds him to schedule a followup appointment with a primary care
provider to chart his progress.
Despite the clinic’s best efforts, however, patients can fall through the cracks.
Many, says Stewart, fail to provide their
phone number. And about 50 percent
of scheduled patients don’t show up for
appointments.
For Bridges, who lives just blocks from
The Johns Hopkins Hospital, the AfterCare Clinic feels natural. “When I was
growing up, Hopkins was a second home
for my family, like when I got hurt playing football,” he says. “My aunts, uncles
and grandparents all came here too.”
If Stewart has her way, The Johns Hopkins Hospital will become his—as well
as other clinic patients’—medical home.
Meanwhile, she hopes to expand the
clinic model it at other Johns Hopkins
hospitals.
—Judy F. Minkove
Learn more about the After-Care
Clinic: bit.ly/JHHaftercareclinic.
patient- and family-centered care
Conversations About Safety
New website for patients deciphers Johns Hopkins’ patient safety and quality performance efforts.
W
hen colleen caroll’s husband
became a patient at Johns Hopkins
Bayview Medical Center in 2012,
she knew he was in good hands. The
hospital had a reputation for excellent care. But there were still several scary unknowns.
Would staff members wash their hands before caring for
her husband? Would the doctor clearly explain how to
take any new medications? Would someone tell her how
to care for her husband once they got home?
Now Johns Hopkins Medicine provides a resource
for answering such questions. The Patient Safety and
Quality website, introduced in May, gives consumers
important information about the health system’s quality of care and the patient experience, allowing them to
understand the institution’s quality of care performance
scores and helping them draw their own conclusions
about each hospital’s performance.
The site shares how Johns Hopkins Medicine is working to continuously improve its performance on five
initial safety issues: the patient experience, infection
rates, hand hygiene, hospital readmissions and standard
processes of care known as core measures. Information
about the institution’s five adult inpatient hospitals and
home health care service focuses on how well each entity
provides evidence-based care.
“This site is about our patients and the communities
we serve. Our goal is to build relationships and trust,
rather than just share data,” says Matt Austin, the project’s leader and a faculty member with the Armstrong
Institute for Patient Safety and Quality.
One innovative feature offers a portrait of trends over
time. Consumers can view three years’ worth of performance data to track each hospital’s progress and learn
how it compares to national and state averages.
“What struck me is how staff members narrowed in
on an area like hygiene and hand-washing, and how the
data showed that they actually improved their compliance,” says Caroll, now a member of the Johns Hopkins
Bayview Patient and Family Advisory Council.
The project took more than two years and enlisted
quality experts, graphic designers, Web strategists, communicators and data analysts from the health system’s
five adult inpatient hospitals and home health care
group. More than 40 former patients and family members, including Caroll, advised the team and reviewed
the site for ease of use and functionality. The final product allows patients and families to review data and learn
about the ways frontline clinical staff members support
safety and quality.
Although the site just launched, the Armstrong Institute is already hard at work keeping the data
relevant. Current plans include
adding other
measures, such
as pediatric
quality data,
information
about community physicians’
performance and
the amount of
common surgical
procedures performed annually
at each hospital.
—Lisa Broadhead
Learn more at
hopkinsmedicine.
org/patient_safety.
D OM E
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2015
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3
biomedical DIscovery
Cancer’s Persistent Foe
(continued from page 1)
Drew Pardoll arrived at Johns Hopkins at age 15 and never left. Top left,
receiving his undergraduate degree in 1977, with parents Helen and Joe,
and Wen Shen, now a Johns Hopkins gynecologist. Bottom left, Pardoll
poses with fellow residents in 1983 as he pursues his M.D./Ph.D. Above,
Pardoll today heads the Cancer Immunology Program.
“I decided two things,” says Pardoll, 58, leaning
forward in a leather chair in his fourth-floor corner
office of the Bunting Family and Jacob and Hilda
Blaustein Family Cancer Research Building. “One
was that the immune system was the most powerful anticancer weapon that we had, more powerful than any drug. The other was that we had to
understand how to regulate it so we could focus it
more on the cancer.”
With that “aha” moment, Pardoll began decades
of research, at first in obscurity and now as a leader
in immuno-oncology, a field that is transforming cancer treatments by tapping the power of the
immune system to shrink and eliminate tumors.
Today, FDA-approved treatments and clinical trials
based in part on Pardoll’s discoveries are extending
the lives of people with melanoma, lung cancer and
other forms of cancer.
“Drew and his team are leading research that
not only tremendously advances the field, but also
generates new optimism about cancer treatments,”
says Landon King, executive vice dean of the Johns
Hopkins University School of Medicine.
Turning immune system insights into lifesaving drugs, however, is a long and expensive
process, requiring substantial investment and
no promise of success. “The big cost jumps are
when you go into clinical trials,” says Pardoll,
director of the Cancer Immunology Program.
“The funding system in academic centers can’t
support that.”
To move his ideas forward, he teamed with
investors to start an immuno-oncology company, Amplimmune, in 2006. When it was
acquired by MedImmune for $500 million in
2013, investors took notice. Last year, Pardoll
joined other immuno-oncology entrepreneurs
to create Potenza Therapeutics in Cambridge,
Massachusetts.
These business deals are lucrative for the researcher and Johns Hopkins, and they provide
funding and business support critical to shepherding his discoveries forward. Says Pardoll:
“The only things that matter for me is FDA
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approval and having the therapies available around
the world.”
Immuno-Oncology
The human immune system is astonishingly complex and nimble, one day fighting the flu and the
next making sure a paper cut stays infection-free.
“It has to be ready for any invader,” says Pardoll.
“Chemotherapy is one drug at a time. The immune
system is trillions of different drugs.”
The idea of tapping this powerful internal weapon is not new. More than 120 years ago, William
Coley, a bone surgeon at New York’s Memorial
Hospital (now the Memorial Sloan Kettering Cancer Center), noticed that patients with cancer who
got infections often saw their tumors shrink or disappear. In 1891, Coley began testing the phenomenon by injecting his patients with bacteria to spark
an immune system response against the cancer.
Despite some success—and many excruciating
failures—the procedure fell out of favor, particularly after radiation became the standard cancer
treatment at the turn of the 20th century.
Coley’s theory was not in dispute. Scientists just
had to figure out why immune systems are so good
at vanquishing so many invaders yet so bad at stopping the spread of cancer. And they had to figure
out how to tell immune system cells to attack cancer but spare healthy parts of the body.
Pardoll began tackling those questions when
he was 27. Under the guidance of Johns Hopkins
professors Donald Coffey and Bert Vogelstein, his
Ph.D. advisers, he studied the immune system at
the National Institute of Allergy and Infectious
Diseases, a place devoted to research of immune
response disorders.
“Don, Drew and I had weekly meetings about
the best way to eventually conquer cancer, and
[studying the immune system] was one of the approaches we discussed often,” says Vogelstein,
whose own pioneering work has focused on the
genetic mutations that cause cancer.
Preparing to Attack
Pardoll was used to taking the lead. He
had skipped three grades while growing
up in Elizabeth, New Jersey, becoming a
Johns Hopkins undergraduate at age 15.
He enrolled in the school of medicine just
three years later. But this quest could not
be rushed. When Pardoll joined the Johns
Hopkins faculty in 1988, he was still far from
his goal of developing immune-based cancer
vaccines.
“You have to take 10 shots on goal to score
that one goal,” he says. “Cancer has beaten us
How Immuno-Oncology Works: The top
panel shows how the immune system’s T cells
attack infected cells. Healthy cells give off signals
called checkpoints, which tell the T cells they are
not a threat. However, cancer cells can send out
the same checkpoint signals, causing the T cells
to back down. The bottom panel shows how new
drugs called checkpoint inhibitors create a path
that allows the T cells to override the checkpoint
and attack.
Animagraffs, Jacob O’Neal
The Next Frontier
More than 1,500 cancer researchers
crowded into the auditorium, taking
every available seat and standing in rows
against the walls. It was June 2012, the
annual meeting of the American Society
of Clinical Oncology. Anticipation was
high as Suzanne Topalian, director of
the Melanoma Program at Johns Hopkins, walked to the podium.
Topalian and other Johns Hopkins
investigators, including Julie Brahmer,
The faculty, staff, fellows and students of the Cancer Immunology Program. Front row,
left to right, Leisha Emens, Suzanne Topalian, Elizabeth Jaffee, William Nelson, Drew
director of the Thoracic Oncology
Program, and Topalian’s husband, Drew Pardoll, Charles Drake, Jonathan Powell, Michael Lim and Young Kim.
Pardoll, had teamed with Bristol-Myers
“Oncologists, a grounded-in-reality bunch, say a corner has been
Squibb to develop and test a cancer drug called nivolumab. Known as
turned and we won’t be going back,” it said.
a checkpoint inhibitor, nivolumab works by dissolving a shield called
Investment followed. “Big pharmaceutical companies are getting in
PD-1 that protects tumor cells from immune system attack.
the game,” says Elizabeth Jaffee, deputy director of the Johns Hopkins
The drug had been given to 296 patients with advanced cancers,
Kimmel Cancer Center. She is developing immuno-oncology vaccines
including lung, renal cell, prostate, colorectal and melanoma. Their
disease had survived multiple treatments. But with nivolumab, tumors for pancreatic cancer with the support of drug companies that are
funding multisite clinical trials.
shrank in about 25 percent of subjects across cancer types.
As a result, treatments are moving into the marketplace. In 2014,
As she explained the study’s results to the packed room, Topalian
the FDA approved two melanoma treatments based on the anti-PD-1
delivered the best evidence to date that checkpoint inhibitors can triumph over cancer. In a follow-up at the same convention the following discoveries pioneered at Johns Hopkins: Merck & Co.’s Keytruda and
Bristol-Myers Squibb’s nivolumab, marketed as Opdivo. Early this
year, she reported even better news—the benefits in most patients
year, Opdivo also won FDA approval for treatment of advanced lung
lasted 12 months or longer. Immuno-oncology is “the next frontier”
cancer.
in cancer treatments, Topalian said in an interview at the time.
In December 2013, Science magazine endorsed that view, declaring immune-based cancer treatments the breakthrough of the year.
—Karen Nitkin
on a lot more occasions than we’ve beaten cancer.”
Over time, Pardoll and other researchers began to
understand how cancer cells protect themselves from the
immune system and its T cells. Think of T cells as the
troops in a hardworking, multitasking army, working
to keep the body healthy by recognizing and attacking
invaders. When the battle is victorious and good health
has been restored, a protein receptor on the T cell,
known as a checkpoint, tells the troops to stop fighting,
like an army sergeant delivering a “stand down” command. But cancer cells also emit signals telling T cells
not to attack. As a result, the army backs down, allowing tumors to grow and spread.
Immuno-oncology research at leading academic medical centers around the world focuses on creating “checkpoint inhibitors” that block these “don’t attack” messages, freeing the T cells to vanquish cancer. Much of
that work centers on an immune system brake expressed
by T cells called PD-1. PD stands for programmed
death, because T cells emit it when their work is done,
as a way of calling off their immune system attack. PD-1
merges with molecules expressed by tumor cells to create
a checkpoint brick wall that prevents the T cell troops
from reaching the enemy cancer.
Today, Pardoll leads the Cancer Immunology Program at Johns Hopkins, where about 30 scientists are
seeing dramatic progress in their pursuit of immunooncology treatments. “We expect the program to grow
significantly with the many opportunities ahead,” says
William Nelson, director of the Johns Hopkins Kimmel
Cancer Center.
Starting a Company
These are klieg-light days for immuno-oncology. But
back in 2006, the spotlight on researchers like Pardoll
was considerably dimmer.
That’s when Arnold Oronsky came to Johns Hopkins
in search of investment ideas. Oronsky, with a Ph.D.
in immunology from Columbia University’s College of
Physicians and Surgeons, is a partner of InterWest, a
Menlo Park, California, firm that invests in early-stage
health care and information technology.
Pardoll and his team told Oronsky they had discovered several molecules expressed by cancer cells that
interacted with PD-1 to block cancer cells from immune
attack. Oronsky liked what he heard. “Because he had
a background in asthma and allergy, he believed in the
immune system,” says Pardoll. “We were not specifically
thinking about creating a company until he proposed it.”
Pardoll came up with the name Amplimmune,
because the company would develop therapies that
amplify the potency of the immune system. Oronsky
secured $10 million each from InterWest and from the
Wellcome Trust, a U.K.-based foundation. In early
2007, the company hired its CEO: Michael Richman, a
businessman-biologist who had run other cancer therapy
companies.
“Amplimmune had exciting technology and prominent
scientists, but they had a hole with respect to the business,”
recalls Richman. “It looked like a great opportunity.”
“Chemotherapy is one
drug at a time. The
immune system is trillions
of different drugs.”
—Drew pardoll
The company launched in 1,500 square feet of laboratory and office space in the David H. Koch Cancer
Research Building and moved to Rockville six months
later. It now occupies a 20,000-square-foot facility in
Gaithersburg, with on-site biologics manufacturing.
In August 2013, seven years after that initial $20 million investment, Amplimmune was purchased by its
neighbor MedImmune, an arm of the global biopharmaceutical firm AstraZeneca, for $225 million, plus $275
million as agreed-upon milestones are reached.
“It made a lot of sense to bring Amplimmune into the
MedImmune family,” explains Richman. “MedImmune
had its own pipeline of immune therapy.” With Pardoll
serving on MedImmune’s science advisory board, the
company continues to develop therapies that “target
the critical areas of the immune system that cancer
can hijack to escape destruction,” says Ronald Herbst,
MedImmune’s vice president for oncology research and
development.
Soon after the acquisition, MedImmune and Johns
Hopkins forged a five-year, $6.5 million research partnership, with both sides contributing funding and
expertise to move forward several research projects,
including immuno-oncology.
The sale of Amplimmune to MedImmune showcased Pardoll’s business acumen as well as his research.
“It made a big splash, with big numbers and high visibility,” says King. In the spring of 2014, MPM Capital
asked Pardoll to be a founder of Potenza Therapeutics, an
immuno-oncology startup.
Commercial Appeal
With Pardoll leading the way as co-chair of the Committee on the Innovation Ecosystem, launched in 2013,
Johns Hopkins is helping researchers bring their ideas
to the marketplace, either by licensing discoveries to
companies or by forming enterprises of their own.
In 2015, the Technology Transfer Office was renamed
Johns Hopkins Technology Ventures, and Christy
Wyskiel, with a background as an institutional investor in medical technology and life sciences companies,
was hired to helm it. A fast-track licensing program was
rolled out, and a business incubation space, FastForward
East, opened on Wolfe Street on the East Baltimore
medical campus, a companion to FastForward Homewood, which opened in the Stieff Silver Building in June
2013. Another innovation hub, at 1812 Ashland Ave., is
scheduled to open in August 2016 with 25,000 square
feet of space for startups.
Johns Hopkins researchers launch about 10 companies
per year, says Wyskiel. “Yet few researchers are able to
attract large institutional funding, as Pardoll did, and
have a successful liquidity outcome.”
When commercialization pays off, as it did with
Amplimmune, the inventors and their lab get half, and
the rest is split between the school, department and
university. In 2014, Johns Hopkins collected $16.5
million in licensing revenue, and leaders believe the
potential for additional revenue is enormous.
Still, financial rewards are only part of the story. “Amplimmune is a success mainly because it brings cancer
treatments that much closer to patients,” Wyskiel says.
“I’ve always been impressed with Drew’s approach to
science,” says Vogelstein. “He tries to get at the basic scientific aspects first, understanding the biological aspects
of the process. But he has always had therapy in mind,
and as soon as he sees an opportunity for taking his
benchwork to the bedside, he immediately implements
it. This has meant more rapid translation of his ideas to
the clinic than virtually any other researcher I know.”
As his therapies move forward in the private sector,
Pardoll keeps learning more about the interactions between immune systems and cancer. He is investigating
new checkpoint molecules and teaming again with Vogelstein, this time to study how cancers with different
genetic compositions react to immune therapies. “This
work brings together two fields of cancer research that
normally do not interact,” he says.
There will be successes and failures, but Pardoll remains focused. “We don’t think there’s a single cancer
that can ultimately beat the patient’s own immune system,” he says. n
—Karen Nitkin
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patient- and family-centered care
Every day, Johns Hopkins
Bayview Medical Center
patients, their family
members and staff stroll
through the labyrinth.
Below, Hopkins Bayview
financial manager Nicole
Utech walks a path with her
husband after exchanging
wedding vows at the site.
Circle of Healing
The labyrinth at Johns Hopkins Bayview Medical Center offers a path for quiet
contemplation.
O
n a cool day, a woman
with short, cropped white
hair walks slowly, following the lines of a large
concentric circle. Behind
her looms Johns Hopkins Bayview Medical Center. Although cars speed by just
yards away, a shoulder-high hedge blocks
any noise, preserving a sense of tranquility.
The circular path is one that thousands
have trod over the past 15 years. Since
the labyrinth opened on June 7, 2000, it
has served as a haven for those who have
come—in sun and in drizzle, on warm
summer days and frigid winter evenings—
to seek a spot for quiet contemplation.
Some look for inspiration, like the
surgeon who routinely walks the circular
path before a complex operation. Others seek comfort, like the grief-stricken
nurse who must care for others while she
mourns the loss of her own child. The
concentric stone path has also seen its share
of happy moments: local moms pushing
strollers, neighborhood teens—even a
summer wedding.
“The idea is to walk in with whatever
burden is on your heart, and then to
walk around the labyrinth really being
‘present,’” says Hopkins Bayview chaplain Marian Boyer. “Once you get to the
center, you can release the concern and,
ideally, walk out of the labyrinth having
achieved some sense of clarity about it.”
Some visitors, like the white-haired
woman, conclude their walk by sitting
quietly for a time on one of several
benches that line the circle’s periphery.
Others share their musings in a journal
that’s kept in a protective cover beneath
one of the benches:
I have found that the path to my destination is not always straight. If I am
feeling lost, well, I might still be headed in
the right direction …
I come to walk for my mom who could
not, and she always wanted to walk this
circle. She was a patient here. She is gone
to be with the Lord. I walk and talk and
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2 0 1 5
think of my mother.
I found a sense of mindlessness, but a good
kind. Not like when you get lost in TV or
electronics or books, but in yourself.
I would like to say: Don’t give up. No
matter what. Never give up …
An Artful Vision
Anita langford, formerly vice president
for care management services at Hopkins
Bayview, has been involved with the labyrinth since its inception. She was brought
onto the project after learning that local
modern dancer Nancy Romita wanted to
establish a labyrinth in Baltimore as a way
to promote healing through movement
arts. Romita partnered with Hopkins
Bayview to secure funding, which came
in large part from the TKF Foundation
of Annapolis. Then, she and Langford
collaborated to find a suitable location—
between the John R. Burton Pavilion and
the Francis Scott Key Pavilion buildings.
Dave Tolzmann was the project’s designer. “It became clear to me that designing a labyrinth was moving people
through space—that I was designing
choreography,” he told The Baltimore Sun
soon after the labyrinth’s opening.
The circular space he created, constructed of cobble pavers in gray and
salmon, is 60 feet in diameter, with paths
wide enough for wheelchairs. The center
“The idea is to walk
in with whatever
burden is on your
heart, and then to
walk around the
labyrinth really
being ‘present.’”
—Marian Boyer,
johns Hopkins Bayview
medical center chaplaiN
is always visible and accessible. There are
no false turns.
“We thought it would be a great healing
place, a peaceful spot for patients and families to come, as well as for employees and
community neighbors,” recalls Langford.
Paula Teague, senior director of spiritual
care and chaplaincy at Hopkins Bayview,
often walks the labyrinth when she has a
particularly thorny issue to puzzle through.
“There’s something about being able to
get outside—to clear the cobwebs and get
out of your normal space,” she says.
The Ideal Venue
Hopkins Bayview’s Nicole Utech has
been a regular visitor for years, often taking a lunch hour break from her work as
a financial manager. “I like the idea that
if you’re following these lines, you get to
lose yourself,” she says, “no matter what’s
distracting you. Just focus on the pattern.”
When it came time for her wedding,
Utech and her fiance, Michael, lit upon
the labyrinth as the ideal location. “For
the past 10 years, I’ve been practicing
more of a Buddhist lifestyle,” she says. “I
wanted our wedding space to reflect that
mindset—peaceful and meditative.”
On July 26, 2014, a light rain threatened to put a damper on things. But as
the bride stepped out of the limousine,
“the sun came out—it was gorgeous.”
She walked through an archway into the
space and down “the aisle,” with guests
standing gathered on either side in two
half-circles. Nicole and Michael said their
vows in front of the labyrinth’s small gurgling water feature.
“For months afterward, I would walk
by the labyrinth on my way into work—it
just made me smile every time,” Utech
says. This month marks a year since her
wedding. These days, when she walks the
circle, her thoughts are focused on the
next big milestone in her life: the couple’s
baby, due to arrive in August.
—Sue De Pasquale
A Favorite Path
Fifteen years after it was established,
the labyrinth remains a welcome
sanctuary for healing and meditation on
the campus of Johns Hopkins Bayview
Medical Center. Once a month, from
April through November, staff members turn out for a 4 p.m. labyrinth
walk. After chaplain Marian Boyer
distributes a brief meditation, those
who have gathered set out alone and in
pairs to think as they stroll.
Each month’s walk has a theme. For
instance, April’s community-centered
walk, Donate Life, focuses on organ donation. May’s walk serves as a memorial
service. In early December, Light the
Labyrinth, a multicultural celebration
that kicks off the Season of Light, typically involves music and dancing, with
participants laying candles along the
labyrinth’s paths.
people
What’s for Lunch?
Six nutritionists share their midday meal strategies.
Diane Vizthum
Susan Oh
Melissa Moser
Bobbie Henry
Hong Brereton
Meghan Ames
Taco Salad
Steak salad; low-carb
high-fiber brownie
Red and white quinoa
with cucumber, tomato
and kidney beans
Shredded chicken and
cabbage topped with
dressed fish sauce;
cranberry and flaxseed
brownies
For recipes, visit
hopkinsmedicine.org/dome.
Lasagna and salad
Can you match the nutritionist with her lunch?
The Low-Carb Eater: Bobbie Henry,
31, began eating a low-carbohydrate diet
about five years ago to combat reactive
hypoglycemia, a condition that impairs
her ability to regulate blood sugar. As
a result, her dramatic energy spikes
and troughs have disappeared, she says.
Henry treats patients in the Adult Epilepsy Diet Center, where research is showing
that diets that are high in fat and low in
carbohydrates can lower seizure rates. Her
indulgences: super-dark chocolate (85–90
percent cocoa), pizza.
The Local and Sustainable Advocate:
Diane Vizthum, 29, gravitates toward
food that is locally grown. Recently, she
and her husband purchased a quarter cow
(more than 100 pounds of meat) from
a Harford County farm. The grass-fed
beef is portioned, packaged and in their
freezer, ready for quick meals made with
“a lot of vegetables, healthy fat, whole
grains and protein,” says Vizthum. Her
indulgences: dark chocolate, cookies,
brownies.
The Athlete: Melissa Moser, 25, runs
about 70 miles per week and needs a diet
that fuels all those footsteps. She tries to
get about 60 percent of her calories from
carbohydrates, 20 percent from protein
and 20 percent from fat. Her research
showing the dangers of food additives for
people with kidney disease inspires Moser
to “eat real food.” Her indulgences: apples
with peanut butter, trail mix, dry cereal,
ice cream, chocolate.
The Antioxidant and Estrogen Proponent: Hong Brereton, 66, likes to
cook, modifying recipes from her native
Vietnam to meet her nutrition goals.
She adds broccoli sprouts and other
members of the cabbage family to prevent cell damage and fight disease, and
chooses flaxseed and other foods with
plant chemicals called phytoestrogens to
combat the symptoms of menopause. Her
indulgences: fruitcake, mango, dates and
a banana eaten with a wedge of Laughing
Cow cheese.
The Busy Food-Lover: Meghan Ames,
27, captains a bicycling team, rockclimbs, hikes and takes yoga classes.
When she can grab a few minutes in the
kitchen, she’ll make a big pot of something easy, like soup or a grain-based
salad, and bring the leftovers with a green
salad for lunch. Ames, a school of nursing nutrition instructor and state obesity program coordinator, offers simple
weight-loss advice: Move more, eat lots of
produce. Her indulgence: mint chocolate
chip ice cream.
The Working Mom: Susan Oh, 43,
sneaks as much produce as she can into
the diets of her three children, ages 8 to
12. She often makes entrees with tomato
sauce, which contains the antioxidant
lycopene, and adds pureed vegetables,
including butternut squash, mushrooms,
carrots, bell pepper, onions and garlic.
She cooks on the weekends so she can
heat up dinners during hectic weeknights;
her family brings leftovers for lunch. Her
indulgence: chocolate cake.
—Karen Nitkin
(Key: Bobbie, steak; Diane, taco; Melissa, quinoa; Hong, shredded
chicken and cabbage; Meghan, chili; Susan, lasagna.)
B
ringing lunch to
work instead of eating out can save
money and improve
health. But choosing
nutritious, tasty and easy-tomake meals day after day can be
challenging.
Six registered dietitians with
the Johns Hopkins Institute
for Clinical and Translational
Research provide lunchtime inspiration. Each woman takes a
different approach, influenced by
her research, clinical work and
particular nutrition needs. One
is a distance runner who energizes with carbohydrates, while
another chooses foods that combat menopause symptoms. All
load up on fruits and vegetables,
avoid foods made with artificial
ingredients, and drink lots of
water. They also eat healthy fats,
enjoy occasional indulgences,
and don’t obsess about calories.
Chili; gluten-free
goat cheese
cornbread
D OM E
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2015
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who / what
Picture THIS
Ronald R. Peterson,
president of The
Johns Hopkins Hospital and Health System and executive
vice president of
Johns Hopkins Medicine, has received the 2015 Lifetime Achievement Award from
Big Brothers Big Sisters of the
Greater Chesapeake in recognition of his personal and organizational commitment to multiple
youth mentoring programs in
Maryland. Peterson spent 14
years on the board of directors of
the Maryland Mentoring Partnership, which merged with Big
Brothers Big Sisters, and serves on
the board of another Baltimorebased mentoring nonprofit, the
Living Classrooms Foundation.
He also has been closely involved
with Johns Hopkins Medicine’s
participation in the Bond-toBond youth mentoring and career
development program, the AdoptA-Class program, the Johns Hopkins Summer Jobs Program and
the Dunbar High School Health
Partnership.
New Senior VP and CFO
Ronald Werthman
has become senior
vice president and
chief financial officer
for Johns Hopkins
Medicine and the
Johns Hopkins University School of Medicine. A 22year veteran of finance and strategic planning for Johns Hopkins
Medicine, Werthman succeeds
Richard Grossi, who retired after
37 years with Johns Hopkins.
Previously, Werthman was senior
vice president of finance and the
treasurer and chief financial officer for The Johns Hopkins Hospital and Health System. As coleader of Johns Hopkins Medicine finance and of the Strategic
Plan’s performance priority,
Werthman spearheads efforts to
reduce system costs while improving patient care.
Administrative
Appointments
Ralph Hruban,
M.D., has been
named the Baxley
Professor in Pathology, director of the
Department of Pathology, director of
pathology for Johns Hopkins
Medicine and pathologist-in-chief
for The Johns Hopkins Hospital.
A 1985 graduate of the Johns
Hopkins University School of
Medicine and a faculty member
for 25 years, Hruban has served
as interim director of the department since February 2014.
Hruban also directs the Sol Goldman Pancreatic Cancer Research
Center and the Division of Gastrointestinal/Liver Pathology.
Thierry Huisman,
M.D., professor of ra-
diology and radiological science, pediatrics, neurosurgery
and neurology, has
been appointed director of the Department of Imaging
at Johns Hopkins Bayview Medical Center. Formerly chairman
and radiologist-in-chief of the Department of Diagnostic Imaging at
the University Children’s Hospital
in Zurich, Switzerland, he was recruited in 2007 to join the faculty
at Johns Hopkins, where he is also
medical director of the Division of
Pediatric Radiology.
8
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brady anderson
Lifetime Achievement
Award
SPIRITUAL CARE TRIUMPH: After a rigorous credentialing
process, three members of Johns Hopkins’ Clinical Pastoral
Education Program recently earned certification as associate
supervisors from the Association for Clinical Pastoral Education.
Pictured from left, Emmanuel Saidi, Tahara Akmal and Tommy
Rogers spent four years training at Johns Hopkins. Saidi, a
Catholic priest from Malawi, says he’s benefited from the Johns
Hopkins mission to help others within a diverse environment.
Akmal, a Muslim raised in California, who grew up with interfaith
parents observing both Christian and Muslim holidays, says
she appreciates that every spiritual journey is unique and
Kim Sherbrooke,
M.H.A., has become
vice president and
chief operating officer of the Office of
Johns Hopkins Physicians. She will
oversee the ambulatory care operations at sites where Johns Hopkins-employed physicians practice. Her responsibilities also include overseeing the training, education and engagement for community physicians aligned with or
employed by Johns Hopkins. She
will collaborate with the Office of
Managed Care Contracting and
will be the primary lead for assessing and implementing telemedicine in ambulatory care and
for Access Services. Previously,
she was chief operating officer for
Indiana University Health Physicians.
Leslie Tung, Ph.D.,
professor and director of the undergraduate program in biomedical engineering,
has been named interim director of the
department, succeeding Elliot
McVeigh, Ph.D., who resigned as
department director after serving
eight years at its helm. Tung, a
graduate of the Massachusetts Institute of Technology and a 19year veteran of The Johns Hopkins University’s Department of
Biomedical Engineering, oversees
the largest undergraduate major
at The Johns Hopkins University.
Becker’s Best
The Johns Hopkins Health System has been named to Becker’s
Hospital Review 2015 list of 50
Great Health Systems to Know.
It also named Richard Grossi,
recently retired senior vice president and chief financial officer
of Johns Hopkins Medicine, as
among the 150 Hospital and
Health System CFOs to Know.
Ebola Response Kudos
The Johns Hopkins Hospital
has received the Maryland Hospital Association’s Distinguished
Service Award for the creation
2 0 1 5
of the Johns Hopkins Hospital
Ebola Response Team. In recognizing the hospital’s initiative,
the association cited the team’s
bravery, dedication, compassion
and readiness to provide care at a
moment’s notice for potential patients with Ebola virus disease.
Greenhealth Recognition
The Johns Hopkins Hospital
has received the Greenhealth Emerald Award and the Circle of Excellence Greening the OR Award
from Practice Greenhealth, a
nonprofit organization promoting sustainability in health care.
Johns Hopkins was one of only
10 institutions in the country
to receive the Greening the OR
Award.
Johns Hopkins Bayview
Medical Center has received the
organization’s Partner Recognition Award in acknowledgment of
the medical center’s implementation of early-phase, effective programs to promote environmental
sustainability.
E a s t Ba ltimo r e
Xinzhong Dong,
Ph.D., professor of
neuroscience and
neurosurgery, has
been named a Howard Hughes Medical
Institute investigator.
He is one of 26 newly tapped investigators and will receive a renewable five-year appointment
that provides salary and benefits
to foster the work of his research
team, which studies the mechanisms behind sensation, including
pain, itch and touch.
Jonathan Lewin,
M.D., senior vice
president of integrated health care delivery, co-chair for
Johns Hopkins Medicine strategic planning, professor and director of the
Department of Radiology and
Radiological Science, and radiologist-in-chief for The Johns Hopkins Hospital, has been elected
president of the American
Roentgen Ray Society.
requires constant self-reflection. Rogers, an Episcopal priest
and Oklahoma City native, says he’s found that a patient’s
spiritual experience is as important as his or her religious
tradition. Rogers has accepted a position as executive director
of Bishop Anderson House in Chicago, while Akmal and Saidi
remain undecided about their next career moves. “It’s rare for
a clinical pastoral education center to send three students to
be certified at one time, and even rarer that they all passed,”
notes Ty Crowe, assistant director of the program. Learn more
about the Department of Spiritual Care and Chaplaincy at
bit.ly/JHMspiritualcare.
Paul Nagy, Ph.D.,
associate professor of
radiology and radiological science and
director of the Johns
Hopkins Medicine
Technology Innovation Center, has been named one
of eight Health Care Innovator
honorees chosen by the Baltimore
Business Journal out of more than
60 nominees. Nagy received recognition for health care education. He is program director for
multidisciplinary clinical leadership programs in patient safety
and quality, clinical analytics,
and commercial ventures creation.
J oh n s H opk i n s
Bay vie w medi c a l
center
Maria Rowena Benitez, R.N.,
has been named by the Department of Nursing as its Nurse
of the Year for 2015. A 10-year
veteran of the medical center,
Benitez is a nurse on the Wenz
Orthopaedic Unit. Among other
things, Benitez was credited for
implementing hourly rounding
on the unit to improve patient
satisfaction and safety.
Dome
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