Discussing the possibilities and future of the intersection of healthcare and commercial real estate
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In part 2 of this series, Trisha’s guests are Connie Boker (Director of Operations) and Jennifer Craig-Muller (Director of All of Us Research Program), of Banner Health Alzheimer’s Institute Imaging Program. A consistent message of this podcast is how healthcare real estate is a demand-driven and mission-critical component of delivering healthcare services, and today’s guests provide the perfect example.
[2:17] Radiochemistry of PET scans
When you mention radiation, it can be a scary thing for people. What Banner Alzheimer’s Institute (BAI)’s radiation safety officer emphasizes in educational material is that the injection of this tracer for a PET scan is equivalent to about the same radiation you would get if you went and got a chest x-ray. It’s not an excessive amount, and it’s washed out of the body really quickly.
Most of the radio tracers they use are considered “investigational compounds”. They aren’t used in the market. Oncology, for example, may use PET scans frequently because they can image tumors noninvasively. BAI’s tracers are unique, in that they are targeting things like tau, inflammation, and amyloid in the brain.
Since they aren’t typically used in the clinical world, BAI has to make the tracers themselves. They have a really unique facility, including their own radiochemistry labs where they can produce some of these tracers. Most of the tracers they produce have a half-life of 90-120 minutes, but they do produce one with a 20-minute half-life.
Having a radiochemistry facility right next to their PET scanning facility is advantageous. It is a highly regulated area, as they are essentially a drug manufacturing facility. Because they ship some of the radio tracers to outside entities, they have to be trained on Department of Transportation rules regarding shipping hazardous materials.
[5:22] The focus on early detection of Alzheimer’s Disease
Connie shared BAI’s three-part mission. The first part is to end Alzheimer’s without losing another generation. Secondly, is to set a new standard of patient and family care. Last, they want to forge new models of collaboration in biomedical research. Everything they engage in, from the memory center to the family and community support, to the various types of research that they do, all support that mission.
[6:50] Philanthropic endeavors of Banner Health Alzheimer’s Institute
When it comes to grant funding, you often have to have data already in order to show them that you can get the work done. Philanthropy has been a great way for BAI investigators to look down a path that maybe they wouldn’t have funding for directly. It’s like the startup side in terms of the research, but it’s also really great for patient care as well.
They have a lot of really great programs that only exist because of donors. As a result of a donation, they now have a 24/7 support line. So if you are a patient of BAI, you can call any time of day with questions and someone will actually work through the issue with you. This speaks to part of their mission to set a new standard for patient and family care. Even though they have physicians, neurologists, psychiatrists, specialists in geriatric medicine and in dementia and Alzheimer’s Disease, they also have nurse practitioners, social workers, and support people who put together these programs and work with not just patients, but with clinical trial patients as well.
Once you have a person enrolled in a clinical trial, you want them to stay enrolled. Retention of people within a clinical trial is helped along by the family and support services they have, because Alzheimer’s Disease and dementia is not just about the patient – it can really take a toll on family members, and particularly on the caregiver. They make sure the caregivers have the support they need, because that keeps people at home or keeps them out of the hospital. In the long run, their model is trying to show that this elevated level of care is going to reduce the healthcare costs of people with these devastating diseases.
They offer music therapy, art therapy, and prior to the pandemic they were organizing events at museums and art centers in the area. BAI has a whole team of people who are thinking of events, support classes, and things that can help the patients, the caregivers, or both groups together. It makes them feel more engaged with their normal lives, but of course nobody reimburses for those kinds of things. A lot of these programs were initially funded through philanthropy, and now they have some talented people within those departments who apply for grant funding from different organizations that can continue to support the programs.
[11:05] Diversity in clinical trials
In clinical trials, you want to make sure you have diversity in gender, race, and ethnicity. You want to make sure you’re not leaving anyone behind. BAI also focuses a lot on the indigenous or Native American population in their home state of Arizona. Alzheimer’s Disease and dementia do not discriminate, so it is vital to ensure research helps everyone.
[12:38] Innovation in the field of Alzheimer’s research
Last year, BAI received a large grant to put their 20 years of research to the test. With a lot of their clinical trials, it could take five to seven years to show whether a drug is actually having an effect, and brain imaging is kind of the last piece of the puzzle. As they look to biomarkers in blood tests and things like that, their goal is to have a cohort of people and show that you can look at changes within twelve to twenty-four months. If you had a drug that you were trying to get on the market and you could know its efficacy within a year or two, that would really speed up the development of drugs in general.
They just started a project, and hope to have it completed in a couple of years, that is going to set a framework for research in the future. They want to identify blood marker changes within three months, to help determine if a drug treatment is working. This project will move them toward reaching their goal to make sure they aren’t losing another generation to Alzheimer’s Disease.
[14:15] First jobs
Connie first worked as a cashier at a department store, and Jennifer was a receptionist at a hair salon.
[14:57] What Connie and Jennifer would be doing if they were not in the healthcare industry
Jennifer loves crime shows, and she would want to be a detective as they show the job in TV and movies. If all the clues were right there and she just had to put it all together, that would be ideal. Connie would love to be a rock star, if she had the singing voice for it.
[16:02] Sources of news, information, and inspiration
Jennifer is currently working her way through the book list for the Reese Witherspoon Book Club, and she highly recommends the suggested books. Connie enjoys listening to NPR for news because she finds them to provide balanced reporting. She has also been listening to audiobooks recently. She recommends Where the Crawdads Sing, and sometimes she needs a Nora Roberts or a Nicholas Sparks book in her life.
[18:05] Healthy self-care
Jennifer has gotten really into yoga, and she also enjoys taking her dogs for walks. Connie also enjoys walking and hiking, and she gets to the gym when she can. Travel has also been part of her self-care, so she has been taking advantage of more local travel recently.
[19:28] Whether leaders are born or trained
Connie thinks that both are true. A leader isn’t just someone who is bossy, but it is also someone who isn’t afraid to make decisions. They have the confidence to not only use their own skills, but to be able to evaluate and encourage people around them to maximize their skills. You have to have certain personality traits that translate to leadership, but some of it is likely learned as well. You have to be able to listen, figure out what is going on around you, and hopefully pick up some of those clues from good leaders.
Jennifer points out that there are so many leadership styles. Whatever your personality is, there can be ways to lead and influence others. It may seem like the “born leaders” can be the people that may be more extroverted and naturally gravitate toward being the center of attention, but introverted people can also learn how to influence decisions.
Links to resources:
Banner Health Alzheimer’s Institute Imaging Program: www.banneralz.org
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