New University of Iowa medical leader optimistic in face of unknown

IOWA CITY - Dominating the vista from walls of windows in a Kinnick Stadium press box, an illuminated University of Iowa Stead Family Children's Hospital - opened only months earlier - set a symbolic backdrop for the event at hand.

'Simply put, this is ushering in the next era of the UIHC system,” UI President Bruce Harreld said Wednesday in his introduction of Brooks Jackson, who a week earlier took over as vice president for medical affairs of UI Health Care and as dean of the Carver College of Medicine. He'll earn $825,000 annually leading the $1.4 billion-a-year health care engine.

Jackson succeeds Jean Robillard - who had led one of the two enterprises, and most recently both, since 2003.

The transition coincides with seismic shifts in the health care industry and in the UIHC system, which began treating patients at its $360 million Children's Hospital earlier this year and has continued to launch new research and clinical initiatives and institutions even as marketplace changes and challenges threaten financial models.

Both Harreld and Jackson made it clear during the reception - attended by lawmakers, community dignitaries and members of the Board of Regents among others - that Iowa intends to lead the way in navigating the unpredictable and uncharted health care waters.

'This is a major, major role here,” Harreld said of Jackson's hire. 'Not only for us, but for the state, maybe for the nation in many ways.”

The position the 64-year-old former University of Minnesota vice president and medical school dean is assuming has him overseeing UI Health Care's three primary missions - research, academics and clinical care.

'Those three are very, very different, but yet they're all integrated,” Harreld said. 'Tightly integrated here. I know one of the reasons he's here is because of that degree of tightness and integration.”

Jackson, when he stepped to the lectern, stressed broad excellence and expertise across the university will be imperative for success of its health care enterprise. And success, he said, is not measured only in financial reports but in research breakthroughs, medical innovation and academic achievements.

'While there are real challenges here, it's also a very exciting time in medicine,” he said. 'There are incredible advances.”

With practitioners on the cusp of cures for some cancers and new treatment and prevention methods in sight for things like HIV, Jackson said, the university's hospitals and clinics are 'in a great position to be world leaders.”

'We will be able to provide new treatments and therapies and social changes so that we can all live longer, healthier, more fulfilling lives,” he said.

Solving grand challenges has motivated much of Jackson's career. He served as principal investigator of the multimillion-dollar International Maternal Pediatric Adolescent AIDS Clinical Trials, which worked to prevent mother-to-child HIV transmission and to treat pediatric HIV infection and complications. The project prevented hundreds of thousands of infections and improved treatment for more.

Among today's health care challenges is industry unrest, something Jackson acknowledged in making his first report last week to the regents.

'Many of the challenges UI Health Care faces - from rising costs to the transition from volume-based care to value-based care to state and federal funding cuts - are similar to those experienced by health care organizations elsewhere,” he said. 'What I am certain of, however, is that UI Health Care's integrated health system is uniquely positioned to weather the challenging headwinds that lie ahead.”

UIHC Chief Executive Officer Ken Kates last week updated regents on financial woes the system had experienced of late - including 'substantial under performance and negative margins” at the start of the new budget year.

The health care enterprise in September reported operating income for the 2017 budget year was 50 percent below its budget and more than 72 percent below the previous year. The new fiscal year began with an operating income deficit of nearly $7.2 million.

Since that time, Kates said, things have turned around - with positive cash flow margins in recent months.

'Driven by September and October results, the year-to-date operating margin is now positive,” he told regents. 'We're optimistic that November also will show a positive operating performance.”

In the system's focus to hit its target operating margin, Kates said, administrators have identified $86 million in revenue enhancements and cost reductions - including cutting its use of traveling nurses, which are provided by agencies for hospitals struggling with the national nurse shortage and often paid a premium.

Kates reported UIHC has trimmed its use of agency nurses by 159, bringing the total to 70. The hospital system also has deferred some construction projects and acquisitions, and it's continuing to streamline administrative services - gaining some wage savings, Kates said.

And yet the hospital system remains slammed - with daily census numbers topping 700 on 22 days in the first three months of the new budget year, Kates said.

'Our demand remains very strong,” he said. 'When we compare that to the other hospitals within the state, we are experiencing much greater volume increases.”

l Comments: (319) 339-3158; vanessa.miller@thegazette.com