2007

Health sciences unit A

We will become the architects of health care delivery programs that bring to every citizen of the state the finest health care that society has seen.

img0056.jpgWith these words, Malcolm Moos, the tenth president of the University of Minnesota, celebrated the groundbreaking for Health Sciences Unit A in 1971. Unit A was the first in a series of interconnected facilities designed to integrate interprofessional education and optimize health care delivery. Based on commissioned studies and committee recommendations during the 1960s, health science education was brought together under the newly created administrative body of the Academic Health Center as well as physically in a complex of buildings, tunnels, and skyways.

Also during the groundbreaking ceremony, the Board of Regents charged the newly formed health sciences administration and faculty to remember

It is the Health Sciences facilities which we are here talking about today [that] will be implemented physically by a moral and intellectual commitment to see that all people of our state, those in the inner city and those in the out edges of the state, without regard to the particular circumstance in which they find themselves economically, will have available to them the degree and the facilities of health care which are adequate and appropriate to the dignity which each man has as a human being.

The building was completed in 1973 for a total cost of $45 million and was home to the School of Dentistry, teaching laboratories for basic sciences, and departments from the School of Public Health and the Medical School upon its opening.

In 1983 the University officially changed the name of Health Sciences Unit A to the Malcolm Moos Health Sciences Tower to commemorate President Moos’ commitment to the expansion of the health sciences on campus.

Read the full remarks made at the groundbreaking ceremony on April 1, 1971.

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CENSHARE records

censhare-logo.gifThe Center to Study Human Animal Relationships and Environments (CENSHARE) recently transfer approximately 6 cubic feet of records to the archives. The transfer was prompted by the Center’s relocation to its new facilities at 717 Delaware.

The Center, an early promoter of companion animal therapies and studies, is situated within the School of Public Health and has historical ties with the College of Veterinary Medicine. CENSHARE’s director, Dr. R. K. Anderson, and long-time supporter, Ruth Foster, are well known for their design of the Gentle Leader.

The records include early correspondence on establishing the Center, information bulletins regarding human-animal relationships, conference planning, material related to pet therapies and animal assistance studies and projects, administrative records, newsletters, and photographs. The material documents the Center’s beginnings in the early 1980s through the 1990s. More recent and active records are still maintained by the Center.

Read an early bulletin published by the Center describing pet therapy:

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U of M health sciences in Asia

A delegation of leaders from the AHC recently returned from a trip to India to meet with their counterparts and establish connections between their respective programs in the health sciences.

img0054.jpgHowever, collaborations between the University of Minnesota’s health science programs and universities in Asia have a long history. In 1954 the U of M began such a partnership with Seoul National University to provide technical and advisory support for educational programs and administrative organization in medicine, nursing, public health, and veterinary medicine. The project with Seoul National University ran for seven years until 1961. The benefits of the project are still evident today through the AHC’s continued outreach and partnership with other international institutions.

To learn more about the project with Seoul National University, see “Korea – A New Venture in International Medical Education” by Dr. N. L. Gault, Jr. (then Assistant Dean, College of Medical Sciences) from the November 1961 edition of the Medical Bulletin.


Team approach to comprehensive health care

In 1967, Dean Robert Howard of the College of Medical Sciences along with Dr. Erwin Schaffer, dean of the School of Dentistry, Lawrence Weaver, dean of the College of Pharmacy, and John Westerman, director of University Hospitals issued their program for the advancement of the health sciences at the University of Minnesota.

In order to meet the needs of health care delivery over the next twenty years, the program calls to double the enrollment in health science fields from 3,124 in 1966 to 6,900 by 1986.

The press release closely associates the growth of the health sciences with the University. The model proposed focused on tying together all of the health science and health care delivery programs in order to better educate and prepare the next generation of health professionals by stating:

Closer integration of all health science programs, in recognition of the “team approach” to comprehensive health care, was a major point. This has significant implications for the training of physicians, dentists, nurses, pharmacists, and members of the growing number of associated health professions. Closer interaction among research workers in all areas of the health sciences also is a part of the plan.

These same ideas continue today. The education model of interprofessional education continues to be a core function of the Academic Health Center.

Read the full press release dated April 14, 1967 below.

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The night the lights went out

On October 31, 1957, a rolling blackout struck the upper Midwest. A causality of the event included the electronically powered pacemakers in the pediatric unit of the University of Minnesota Hospital. The Halloween blackout inspired the development of the portable, battery powered pacemaker. To learn more, see the Minnesota Public Radio report by Lorna Benson.


Dr. Verby and the Rural Physician Associate Program

img0051.jpgOn October 23, 2007, Dr. John Verby, the founder of the Rural Physician Associate Program, passed away.

Dr. Verby was a member of the Department of Family Medicine and Community Health from his appointment in 1969 until his retirement in 1993.

Dr. Verby, a graduate of Carlton College and the University of Minnesota’s Medical School, served as a lieutenant in the Army Medical Corps in Korea and had a private practice from 1949 to 1969 before coming to the University.

Dr. Verby was acting head for the Department of Family Medicine and Community Health from 1970-1971 and then became the first director for the Rural Physician Associate Program after developing and implementing the idea.

The document below is a press release from 1975 that highlights the program then entering its fifth year and quotes Dr. Verby in regards to the program’s successes.

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Structure and governance

img0050.jpgThe Regents of the University of Minnesota are strongly committed to building improvements in both the quality and availability of health care. In pursuing these goals, the University commissioned several studies that prompted a Regents’ decision to expand the scale and scope of the University’s programs in the Health Sciences.

To accomplish the objectives of this comprehensive program most effectively it became clear that major administrative reorganization of the Health Sciences was necessary.

So began President Malcolm Moos’ introduction of the July 10, 1970 resolution by the Board of Regents to reorganize health science education and care delivery at the University of Minnesota into the Academic Health Center.

The Health Sciences Mission Statement and Proposed Structure and Governance documents the Regents’ decision. The Mission Statement was prepared and adopted by the Regents and delivered at the July meeting by the Honorable Fred J. Hughes. In part, the Mission Statement reads

For ninety years the University of Minnesota Health Sciences have been providing leadership in professional education and research. Statewide, nationally and world-wide, Minnesota has won acclaim for outstanding achievements in health science education, and for outstanding quality in the delivery of health care. In undertaking major administrative reorganization of the Health Science units, the Regents proceed with confidence that Minnesota can continue to be a pacesetter for the nation as we strengthen our commitment to better serve the health needs of our Minnesota citizens. We are justly proud of our accomplishments in the health sciences in the State, but the question is not how far we have come but how far we have to go.

Click the above image to download and read the full report.


Information ecologies

img0049.jpgArchives are often described as organic in nature and the material within the collections as containing organic-like relationships that archivists strive to preserve and to promote.

The organic metaphor fits nicely with the life-cycle model for records and records management: organic/inorganic; active/inactive; living/dead.

Management of electronic records and digital surrogates is casting a new light on an old problem with the organic/life-cycle metaphor: When does an active document become a record? Furthermore, does our own desire/ability to provide stewardship for a record determine whether or not it will become a part of the archival process? Are records outside of our traditional management process of less importance?

The organic/life-cycle model works best when there are clear beginnings and endings. It seeks to establish the birth, life, and death of a record at which point it becomes archival.

Many Australian archivists and some of their counterparts in Canada are promoting a continuum model to replace the life-cycle approach to records management. The records continuum model changes the organic metaphor from birth/death to ecological in its application. The information’s survival is not dependent upon our stewardship; instead, its use relies on the archivist’s ability to contextualize the information and manage it as a time/space object. The archivist’s job becomes less of a mission to preserve the information landscape and more of an undertaking to make ecological connections for our users and constituents.

To understand its practical application, a recent post by Lorcan Dempsey highlights the problem with life-cycle stewardship. Research, data, learning objects, and institutional records are less stewarded than other traditional material like books, serials, newspapers, and manuscripts. By creating better points of contact to these former materials that are intricately bound to the latter, Dempsey sees the potential for new unique resources previously out of reach for both the researcher and information professional. It emphasizes the continuing use of information, not its product.

Dempsey uses the University of Minnesota Digital Conservancy, an institutional repository, as an example of tool designed to provide context and access to information that does not fall neatly into a life-cycle model. This will also become more of a method to document and provide access to material that is part of the AHC History Project.

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Eustis hospital

img0047.jpgWilliam Henry Eustis, born in 1845 in New York State, was a prominent philanthropist, entrepreneur, and politician in Minnesota. After graduating from Columbia University’s law school, Eustis practiced in New York City and in Minneapolis, moving to Minnesota in 1881. Eustis served a single term as mayor of Minneapolis from 1893-1895. In addition to his law practice, Eustis built a fortune in real estate acquisition and development in partnership with his brother Gardner T. Eustis, also of Minneapolis. Eustis never married. He died on Thanksgiving Day 1928 at the age of 83.

Modeling himself after Andrew Carnegie, Eustis believed his wealth should be passed along to those in need. After suffering a debilitating accident at the age of fifteen, Eustis focused his gift giving to institutions that provided benefits to disabled children. During his life, Eustis gave large portions of his estate to the Dowling School in Minneapolis and provided the funds to establish the Minnesota Hospital and Home for Crippled Children. Construction began at the University in 1928 and the hospital included an outpatient department, two floors for hospitalized children with a space for an on site school, and an amphitheater for teaching purposes. In total, Eustis gave over $1 million dollars to the University, primarily for health care services. Eustis agreed to the University’s request to name the hospital and facilities after him in recognition of his generosity only after first refusing their overture.

Eustis saw the city of Minneapolis as a secularized manifestation of the proverbial City on the Hill, albeit with a river running through it. In a 1926 letter to the Board of Regents accompanying his gift of his final interest in the Flour and Corn Exchange Building, Eustis predicted,

The time is ripe under your guidance to establish here one of the great medical centers of the World. The helpful generosity of the Rockefeller Foundation, the genius of the University, and the old time spirit of Minneapolis united and working in the closest accord, bearing aloft the banner of Excelsior would establish here a beacon light of medical science and research that shall for all ages redound to the glory of man’s genius and the highest welfare of his being.

Only yesterday the barbers were our surgeons and the pharmacists our physicians. The time is short and the distance long between the barber’s pole and the Mayo clinic…The tide is at its flood. The golden opportunity is here, and I cannot believe that the heroic, civic spirit that once dominated Minneapolis will now be weighed in the balance and found wanting.

By the early 1930s, the Eustis Children’s Hospital and the Elliot Memorial Hospital with its newly expanded Christian and Todd wings provided inpatient care with outpatient and rehabilitation services at the University of Minnesota.

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Elliot Hospital (center) and Eustis Hospital under construction (right), circa 1929.

In 1954 the Mayo Memorial Building opened as a consolidated health care delivery and education facility. The construction process of Mayo incorporated the Elliot and Eustis Hospitals as wings of the new health sciences center. Some services and operations that previously took place in Eustis Hospital were moved to other locations within Mayo. However, the Eustis Wing of Mayo still had an active hospital station (Station #35), audiology and dental clinics, and medical educational rooms including the Eustis Amphitheater.


Medical records and their keepers

In the course of collecting materials, it seems inevitable that those charged with maintaining records become part of the historical documentation.

img0044.jpgI recently stumbled across two items that document the changes in managing medical records and the role their keepers play in the larger health care delivery system. The first document is a typed page summarizing key points regarding the use of medical records in court. The text is taken from the 1941 Manual for Medical Records Librarians by Edna K. Huffman. It notes that “the position of the medical records librarian is one of especial trust” and “it is her duty to ascertain that the record is properly completed.” The responsibility of the medical record librarian is to protect the “chief value of a medical record… an unbiased statement inasmuch as the doctors, interns, nurses, and others concerned in making the record at the time of the patient’s hospitalization have no interest in any subsequent litigation.”

img0046.jpgAlmost forty years later, the medical records librarian has been replaced by the medical records manager. In a 1980 article from the UMHC Monitor (a former publication of the University of Minnesota Hospital and Clinics) the activities of the medical records department are highlighted to introduce others to their important function within the health delivery system. The director at the time, John Dennis, explained “Management of information is the business we’re in. We deal with the whole life-cycle of recorded information, from the creation of the information to distribution and maintenance.” Accredited record technicians (ARTs) and Registered Record Administrators (RRAs) “ensure that all record components are accounted for” including the coding and abstracting of records for electronic storage. The message of the article concludes with stating “record and information management goes beyond the basic ‘record’ and deals with their generation and use. It is a powerful institutional tool contributing to quality patient care and increased revenue.” Indeed.