Annual Report - Cleveland Clinic

Annual Report - Cleveland Clinic

ANNUAL REPORT ACCESS 5 Dear Friends: Cleveland Clinic achieved significant milestones in 2015. We saw a record number of unique patient visits. We...

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ANNUAL REPORT

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Dear Friends: Cleveland Clinic achieved significant milestones in 2015. We saw a record number of unique patient visits. We planned, built and opened new facilities in the United States and Abu Dhabi, and welcomed the Akron General Health System into the Cleveland Clinic family. The Affordable Care Act of 2010 called for access, quality and affordability. Cleveland Clinic has responded in every domain. We have enhanced access to

Welcome

all our facilities — in person, online, by phone or tablet. We have innovated to improve patient care, increase safety and give every patient the best experience. Our caregivers have found new efficiencies and proposed hundreds of ways to reduce costs, freeing up funds for reinvestment in our communities and the future. By any measure, 2015 was one of the most successful years in our history. In a time of unprecedented change, we remain true to our Founders’ mission: to care for the sick, investigate their problems and educate those who serve. Our thanks to all of our patients, communities and supporters for making it possible for us to offer the finest in healthcare services wherever and whenever they are needed. We look forward to another year of outstanding care in 2016. Sincerely,

Delos M. Cosgrove, MD

Robert E. Rich Jr.

CEO and President | Cleveland Clinic

Director and Chairman of the Board

CLEVELAND CLINIC

ANNUAL REPORT 2015

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Cleveland Clinic introduced a new world of accessibility in 2015. Patients can now click in, walk in or call in for an appointment. And they have more locations to choose from — more than 150 patient care locations in northern Ohio, including Cleveland Clinic Akron General. We’ve opened ourselves up to the nation through high-impact alliances. We’ve expanded internationally through Cleveland Clinic Abu Dhabi and planned facilities in London. Cleveland Clinic is making healthcare better, more affordable and more accessible than ever.

1,185 NUMBER OF AORTIC SURGERIES PERFORMED AT CLEVEL AND CLINIC IN 2015

WORLD’S LARGEST AORTIC SURGERY PROGRAM The Sydell and Arnold Miller Family Heart & Vascular Institute’s volume of thoracic aorta surgeries has grown at least fourfold over the past 20 years. Today, it is the largest aortic surgery program in the world. It offers both open and leading-edge minimally invasive procedures. Diseases of the aorta — the body’s largest blood vessel — and its branch arteries can be particularly grave. Surgical correction of aortic aneurysms, dissections and diseases of the aortic root can involve some of the most technically challenging procedures in cardiovascular surgery. Yet Cleveland Clinic’s operative mortality rate is also among the lowest in the world, despite the fact that 29 percent of its surgeries are for complex, life-threatening emergencies.

›E  ric Roselli, MD (center), Director of the Aortic Disease Center in the Miller Family Heart & Vascular Institute, performs an aortic procedure in one of Cleveland Clinic’s advanced hybrid operating rooms.

AN A R T IF ICIAL HAND T HAT “ F E EL S ” Nearly 800,000 Americans have lost an upper limb. Many are young and active. Replacement prosthetics are good and getting better. But they still lack access to the neurological feedback that provides amputees with the sensations of touch and movement. Lerner Research Institute researchers are working closely with amputees to provide this feedback for artificial limbs. Restoration of these senses helps the brain perceive that the artificial limbs are part of the body, which helps these individuals feel more whole. Research is focusing on how the brain is organized and how it compensates for sensory loss, and on creating new metrics for assessing and ultimately improving these desperately needed devices.

›S  ensory feedback technology will allow a new generation of prosthetic limbs to perform everyday tasks, such as tying a shoelace, with increasing ease.

$2.5 million

FUNDING RECEIVED FROM THE DEFENSE ADVANCED RESEARCH PROJECTS AGENCY

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150

Number of Cleveland Clinic outpatient locations in northern Ohio

B RI NGI NG SI GHT T O THE BLI ND Cleveland Clinic was first in Ohio to implant an Argus II Retinal Prosthesis System that is capable of providing some new sight to adults who have completely lost their vision due to retinitis pigmentosa. The Argus II creates visual perception by electronically stimulating the part of the retina not affected by the disease. The patient wears glasses that contain a camera. Images are processed and wirelessly sent to an antenna and electronics case placed on the outside of the eye. These data are then communicated to the electrode array secured to the retina inside the eye. The Cole Eye Institute is the only site to routinely incorporate intraoperative optical coherence tomography in the process, allowing real-time surgical adjustments for better outcomes.

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PERCENTAGE OF STUDY PARTICIPANTS WHO PERFORMED SIGNIFICANTLY BETTER WHEN THE DEVICE WAS TURNED ON

›A  team led by Alex Yuan MD, PhD, and Aleksandra Rachitskaya, MD (above), performed the Cole Eye Institute’s first Argus implantation procedure with successful results.

›M  ichael Vogelbaum, MD, PhD, of the Neurological Institute, worked with Biomedical Engineering, Cleveland Clinic Innovations and engineers from Parker Hannifin to create the Cleveland Multiport Catheter.

T H E CL EV EL AN D MU LT IP ORT CATHE TE R A neurosurgeon in the Neurological Institute has developed a device that is able to bypass the blood-brain barrier and infuse therapeutic agents directly into brain tissue. The device is called the Cleveland Multiport Catheter (CMC), and it permits use of a technique known as convection-enhanced delivery.

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NUMBER OF MICROCATHETERS DEPLOYED FROM A CENTRAL CATHETER BY THE CMC

With use of this technique, therapeutic agents are introduced directly into the brain via catheters, which are connected to low-rate infusion pumps. Following successful laboratory testing, the device concept was selected by a joint development group formed by Cleveland Clinic Innovations and Parker Hannifin to commercialize new technologies from Cleveland Clinic innovators. The CMC is currently in clinical trial for patients with brain tumors.

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Cleveland Clinic Health Essentials is the No. 1 most-visited hospital blog in the nation.

2 million

NUMBER OF AMERICANS AFFECTED BY INFLAMMATORY BOWEL DISEASE

B AT T LI NG IN FL AM M ATORY B OW E L DI SE A SE Staff members of the Department of Pathobiology in the Lerner Research Institute have an unmatched commitment to inflammatory bowel disease (IBD). They pioneered cytokine therapy, now an established treatment, and were first to show how angiogenesis › Simultaneously acquired PET MR Enterography image as part of cutting-edge research being done by the Imaging Institute to distinguish between different types of Crohn’s disease

and its modulation can affect IBD. They are among the few investigating intestinal fibrosis, a major complication of Crohn’s disease, and received the first-ever NIH funding to study “sterile inflammation” as a trigger of IBD flare-ups. They were first to highlight the unique features of pediatric IBD, and now they are exploring the “IBD interactome,” a groundbreaking approach based on leading-edge systems biology bioinformatics to make personalized medicine a reality for IBD patients.

›C  leveland Clinic has joined a compact with the city of Cleveland, Cuyahoga County, the Center for Health Affairs, and other local hospital systems, foundations and organizations to reduce infant mortality.

RED UC I NG IN FANT M ORTA LI TY Cleveland Clinic has joined Cleveland Mayor Frank Jackson and 11 other Northeast Ohio foundations, healthcare providers and government entities to form “First Year Cleveland,” a compact to reduce infant mortality across Cuyahoga County. Internally at Cleveland Clinic, an Infant Mortality Task Force has been formed by the Office of Government & Community Relations to unify current programs addressing infant safety, identify best practices and seek additional funding. The task force will focus on education, prevention strategies, healthy pregnancies and well-baby programs in the community. The goal is to leverage Cleveland Clinic’s organizational and clinical expertise to address this complex issue of regional concern, and ensure that every baby born in Greater Cleveland gets a chance at a healthy life.

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SIGNATORIES OF A “COMMUNITY COVENANT TO SIGNIFICANTLY AND SUSTAINABLY REDUCE THE RATE OF INFANT MORTALITY”

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1.2 million

Number of same-day appointments in 2015

CLINICA L TRANS F O R MAT I ON Cleveland Clinic continues the transition from volume to value and is responding to strategic imperatives and market forces to transform the way that care is delivered. Fundamental to this transformation is ensuring that our focus remains on providing our patients with exceptional quality, safety, experience, affordability and access. Optimizing our integrated care model, we are able to standardize our care processes through care paths and episodes; formalize our management of rising-risk and high-risk patients through care coordination and our patient-centered medical homes; and improve the way that we deliver care through advances in wellness programming, technology and the use of data. We continue to create a value-driven community-based care system.

60,000

› Jame Abraham, MD, of the Taussig Cancer Institute, is among the 3,432 staff physicians and scientists at Cleveland Clinic — all of whom are helping implement clinical transformation.

NUMBER OF LIVES ASSIGNED TO CLEVELAND CLINIC’S MEDICARE ACCOUNTABLE CARE ORGANIZATION

5,500

NUMBER OF PHYSICIANS FROM AROUND THE WORLD WHO APPLIED FOR 175 POSITIONS AT CLEVELAND CLINIC ABU DHABI

CLEVE L A ND C L I N I C ABU DHA BI O P E N S In the presence of His Majesty King Mohammed VI of Morocco, His Highness Sheikh Mohamed bin Zayed Al Nahyan, Crown Prince of Abu Dhabi and Deputy Supreme Commander of the UAE Armed Forces, officially inaugurated Cleveland Clinic Abu Dhabi, a multispecialty hospital on Al Maryah Island in Abu Dhabi, on Dec. 3, 2015. Cleveland Clinic Abu Dhabi began seeing patients in March 2015 and completed more than 54,000 appointments and 3,000 interventional procedures and surgeries the same year. In 2015, the new hospital employed 3,200 caregivers from more than 70 countries. A partnership with Mubadala Development Company, Cleveland Clinic Abu Dhabi is an extension of Cleveland Clinic’s model of care, specifically designed to address a range of complex and critical care requirements unique to the Abu Dhabi population.

›C  leveland Clinic Abu Dhabi provides patients in its region direct access to the world’s best healthcare providers and Cleveland Clinic’s unique model of care, reducing their need to travel abroad for treatment.

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6.6 million

Number of outpatient visits in 2015

1,900

NUMBER OF FORMER NFL PLAYERS IN THE TRUST

IMP ROVI NG B RAIN HE A LTH W IT H THE NFLPA The long-term effects of sport-related collisions and brain trauma are a growing concern, particularly for retired pro football players. The Trust, powered by the National Football League Players Association, established a relationship with Cleveland Clinic in 2014 as a medical partner for the Brain and Body program. Former players are hosted at main campus, Cleveland Clinic Florida and the Lou Ruvo Center for Brain Health in Las Vegas. Caregivers provide a comprehensive neurological and body system evaluation, and develop care plans to address potential functional changes. More than 400 former players from 32 states have been evaluated.

›T  he NFL reported that concussions were up 58 percent in regular-season games in 2015. The number of helmet-to-helmet hits also rose significantly.

4,200

NUMBER OF VIRTUAL VISITS COMPLETED IN 2014-2015

›C  leveland Clinic Express Care clinics such as those at the Beachwood Family Health Center provide convenient, walk-in care for adults, families and children.

FACE TO FA C E WIT H EXPR E SS C A RE Patients don’t need an appointment at Express Care clinics located throughout Cleveland Clinic’s health system. Express Care clinics offer walk-in treatment for common acute health problems, and reassurance or referral as needed. Board-certified nurse practitioners and physician assistants are available to diagnose and treat common medical conditions, backed by the full resources of Cleveland Clinic. In 2015, Express Care centers expanded to cover all primary care conditions and extended hours from 6 a.m. to 9 p.m. Walk-in mammography is also now available at many Cleveland Clinic locations, and Express Care Online offers faceto-face visits with caregivers 24/7 — from home or anywhere via smartphone, tablet or computer.

AKRON G E NE R A L H EALT H SYSTE M JOI NS CL EV EL AND C LI NI C Akron General Health System became fully part of Cleveland Clinic in November 2015. Cleveland Clinic has already begun developing and expanding services in the system, which includes Akron General Medical Center, Lodi Community Hospital, the Edwin Shaw Rehabilitation Institute, three health and wellness centers, the Justin T. Rogers Hospice Care Center, Partners Physician Group, and Visiting Nurse Service and Affiliates. Construction is underway on a new emergency department and outpatient facilities in Kent and Lodi, Ohio. Akron General is becoming part of Cleveland Clinic’s integrated electronic medical records system. Work teams are collaborating on clinical improvements, cost savings and the sharing of best practices.

1914

YEAR AKRON GENERAL HEALTH SYSTEM WAS FOUNDED › A bridge at Cleveland Clinic Akron General Medical Center proclaims a new day for regional healthcare.

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We are One Cleveland Clinic. Across all locations. Changing lives. Putting patients first.

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Cleveland Clinic Innovations Cleveland Clinic Innovations (CCI) is the commercialization arm of Cleveland Clinic. CCI helps care-

2015, Cleveland Clinic spin-off company NaviGate

givers assess, strategize, protect, build and market

Cardiac Structures — which develops valved stents

their solutions for advancing patient care on a glob-

for replacement of incompetent mitral heart valves

al scale. Since its inception in 2000, CCI has acted

— announced that a first-in-human implant of its

on approximately 3,400 new inventions, resulting in

catheter-guided, mitral-valved stent into a beating

over 800 issued patents, over 450 licenses and

heart was performed successfully. Invented by José

40 active spin-off companies.

Navia, MD, a surgeon in the Department of Thorac-

Here is a quick look at just a few of these innovations: ›C  leveland Clinic CEO and President Toby Cosgrove, MD (far right), and (left to right) CNBC’s Bertha Combs, Humana Inc. CEO Bruce Broussard and Novartis US Country Head Christi Shaw, at the 2015 Medical Innovation Summit

• Multiple sclerosis app – In January 2015, CCI facilitated an exclusive license with a multinational biopharma company and market-leading provider of therapies for multiple sclerosis (MS) to complete development, clinical validation and deployment of the MS Performance Test (MSPT) tablet app. The app was invented by a team of experts from Cleveland Clinic’s Mellen Center for Multiple Sclerosis under the direction of Jay Alberts, PhD. • Explorys – In April 2015, Explorys, a company

› Centerline Biomedical navigation system

a minimally invasive treatment option for patients suffering from mitral valve disease who are considered too high-risk to undergo open heart surgery. INNOVATION ACROSS INDUSTRIES

In addition to CCI’s commercialization of Cleveland Clinic inventions, CCI’s Global Healthcare Innovations Alliance delivers its capabilities to a collaborative network of innovative healthcare and industry partners across the commercialization continuum. Three new members joined the Alliance in 2015: Cox Communications, The Lubrizol Corporation and NASA’s Glenn Research Center. In May 2015,

was acquired by IBM. Explorys is a healthcare

Cleveland Clinic expanded its network internationally

intelligence cloud company that has built one of

by becoming a member of eHealth Ventures LLC, an

the largest clinical data sets in the world. Explorys’

investment and development entity that will provide

HIPAA-enabled cloud-computing platform is used

incubation services to promising early-stage health-

by 26 healthcare systems and clinically integrated

care technology companies in Israel.

treatments and outcomes. • Centerline Biomedical – This Cleveland Clinic spin-off company raised seed capital in August 2015 to continue the development and testing of a surgical navigation system. This system uses catheters and guide wires with sensors to give surgeons a 3-D image of the organs and blood vessels on which they are operating. This system may be an alternative to the X-ray images currently used to guide surgeons’ instruments.

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ic and Cardiovascular Surgery, the novel stents offer

that was spun off from Cleveland Clinic in 2009,

networks to identify patterns in diseases,

› NaviGate catheter-guided, mitral-valved stent

• NaviGate Cardiac Structures Inc. – In November

A SUCCESSFUL 13TH INNOVATION SUMMIT

Cleveland Clinic Innovations hosted the 13th Annual Medical Innovation Summit in October 2015 at the Global Center for Health Innovation in downtown Cleveland. The focus of the Summit was new products and treatments for the brain and nervous system. The Summit drew more than 1,700 industry leaders, investors and entrepreneurs looking to network with fellow innovators, advance the latest technologies to market and strategize for the future of healthcare. ■

›Professor Andrew W. Lo, of the MIT Sloan School of Management

CLEVELAND CLINIC

ANNUAL REPORT 2015

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World-Class Nursing The Stanley Shalom Zielony Institute for Nursing

paths to reduce unnecessary readmissions and

Excellence now oversees the practice and education

emergency department visits. They implemented

of more than 14,000 nurses across all Cleveland

bundled protocols that have reduced in-hospital falls

Clinic locations. In 2015, Cleveland Clinic nurses

by 41 percent. Obstetrics nurses have become part

innovated for better care, published substantial

of a statewide effort to reduce infant mortality in the

research, and addressed a wide range of quality,

community through education and outreach. Nurses

safety and community health issues.

are leading continuous improvement initiatives that

AN EXPANDING FORCE

The number of Cleveland Clinic nurses grew substantially this year. A talent acquisition push called

are improving processes, eliminating waste and standardizing operating procedures with “lean” tactics learned from industry.

Nurses Right Now recruited 700 registered nurses

REINVENTING OUR FUTURE

to Cleveland Clinic in eight weeks. With the opening

Lifelong learning is a hallmark of Cleveland Clinic

of Cleveland Clinic Abu Dhabi, 600 nurses from 37

nursing. Four Cleveland Clinic nurses recently earned

countries were added (out of more than 6,000 nurses

their doctorate in nursing practice, including Executive

interviewed). Nurses from Akron General Health

Chief Nurse Kelly Hancock, DNP, RN, NE-BC.

System have also joined Cleveland Clinic’s family. IMPROVING CARE

Cleveland Clinic nurses are leading clinical transformation from administrative offices to the patient bedside. In 2015, they helped develop comprehen-

“As nursing organizations move forward in 2016,” says Dr. Hancock, “the nurse-led model of care will continue to drive further refinement of the nurse’s role as well as the nurse’s influence on care delivery, general health policy and more.” ■

sive care plans based on evidence-based care

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CLEVELAND CLINIC

ANNUAL REPORT 2015

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One HR for One Cleveland Clinic Cleveland Clinic is the largest employer in Northeast

through Human Resources’ Hero Experience program

Ohio and the second-largest in the state. Human

since 2012, and nearly 3,000 students took part in

Resources at Cleveland Clinic supports a diverse

Student Experience and other internship programs.

workforce and patient care at all locations.

More than 4,500 new caregivers were onboarded

THE POWER OF EVERY ONE

In 2015, Human Resources improved engagement and enhanced inclusion through a campaign called

caregivers for the opening of Cleveland Clinic Abu Dhabi.

the Power of Every One, generating a 9 percent

TRAINING LEADERS FOR TODAY AND TOMORROW

increase in engagement scores with voluntary feed-

A Global Leadership & Learning Institute was

back from 38,000 caregivers. Seventeen thousand

launched to train and inspire a new generation of

nurses and allied health professionals received pay

leaders for Cleveland Clinic and the region, nation

adjustments, and minimum hourly pay was raised

and world.

to $12. Accessibility was enhanced through a shared services model called One HR. OUR NEWEST CAREGIVERS

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across the system in 2015, including over 3,800

ENCOURAGING DIVERSITY AND ENGAGEMENT

Employee Resource Groups and Diversity Councils continued to promote inclusion and engagement.

Responding to an anticipated shortage of nurses,

A Cleveland Clinic Center for Excellence — LGBT

Human Resources quickly organized a new talent

Healthcare website was launched, and gap analyses

acquisition program, which hired 700 registered

of health disparities data were performed. A dash-

nurses in only eight weeks. More than 900 military

board was developed to collect data for key health

veterans and reservists have joined Cleveland Clinic

equity indicators systemwide. ■

CLEVELAND CLINIC

ANNUAL REPORT 2015

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Clinical and Research Achievements Cleveland Clinic physicians and scientists made 2015

• Post-stroke rehabilitation – A preclinical study

another brilliant year of clinical and research break-

performed by Dr. Machado is the first to demon-

throughs. Here are a few examples of the hundreds

strate DBS’s potential for selective nerve growth

of accomplishments that made the year special.

after focal injury. This study, showing that DBS may

NEW APPLICATIONS FOR DEEP BRAIN STIMULATION

Deep brain stimulation (DBS) is the implantation of tiny electrodes into highly targeted brain tissue

promote the formation of new neural connections during stroke recovery, was among the five winning abstracts in the International Neuromodulation Society’s inaugural best abstract competition.

to affect neurological function by means of mild elec-

USING DBS IN CONJUNCTION WITH fMRI

trical stimulation. Andre Machado, MD, PhD, of the

A collaborative group including Stephen Jones, MD,

Neurological Institute, is at the forefront of using DBS

PhD, of the Imaging Institute; Howard Goldman, MD,

to treat pain and severe movement disorders. He is

of the Glickman Urological & Kidney Institute; and

continually investigating new ways to apply DBS

Jorge Gonzalez-Martinez, MD, PhD, of the Neurologi-

to a range of neurological conditions, including:

cal Institute, has developed a technique to image the

• Thalamic pain syndrome – Dr. Machado and his colleagues conducted the first-ever prospective, randomized, double-blind, controlled clinical trial of DBS for the management of chronic pain. He demonstrated for the first time that it is safe to surgically intervene with DBS in the emotional networks of the brain in patients with chronic pain.

patterns of brain function associated with an electrode while stimulating the electrode as the patient undergoes functional MRI (fMRI) scanning. This novel technique is an improvement over standard DBS,

DBS more accurate and effective than ever, and

a likely cause of preeclampsia, or pregnancy-related

opens it up to a new range of potential applications.

hypertension. Now Dr. Wu has found that genetic

It also allows the use of DBS in pediatric patients

variants of corin are also related to salt-sensitive

— an effort being led by Dr. Machado — because

hypertension, and that an enzyme called proprotein

it reduces the need for conscious stimulation.

convertase subtilisin/kexin-6 (PCSK6) is responsible

which targets only the structural anatomy associated

NEW CELLULAR TARGET MAY INHIBIT

with neurological disorders. DBS enhanced by fMRI

DEADLY BRAIN TUMOR

allows operators to visualize the effect of stimulation on whole neural networks. This innovation makes

Shideng Bao, PhD, of the Lerner Research Institute, led a study investigating the role of tumor-associated macrophages (TAMs) in a type of lethal cancer known

cause of salt-sensitive hypertension, and a genetic mutation of the enzyme may increase risk of the disease.

Published in Nature Medicine.

DRUG METABOLITE MORE POTENT

as glioblastoma multiforme (GBM) — a common,

VS. PROSTATE CANCER

fast-growing, malignant brain tumor. TAMs are found

Abiraterone is an effective drug that kills prostate

in many types of tumors. They may either promote or

cancer cells. But Cleveland Clinic researchers have

inhibit tumor growth. The density of TAMs in GBMs

learned something new about abiraterone. When

correlated with the seriousness of the tumor, suggesting

you give abiraterone to patients with prostate can-

that TAMs may promote tumor progression in GBM.

cer, the body converts the drug into an even more

Dr. Bao and his team identified a factor, periostin,

potent cancer fighter called D4A. A team led by

which is secreted by glioma stem cells (GSCs) in GBMs

Nima Sharifi, MD, an associate staff member of the

to recruit the monocyte-derived TAMs. They discovered

departments of Hematology and Medical Oncolo-

that silencing periostin in GSCs reduced TAM density

gy, Cancer Biology, and Urology, has shown that

and markedly inhibited tumor growth in mice. They

abiraterone (a steroid inhibitor) is metabolized into

conclude that GBM treatment in humans could be

D4A, which is more effective than abiraterone at

improved by targeting periostin-mediated TAM recruit-

killing aggressive prostate cancer cells. Abiraterone

ment. Published in Nature Cell Biology.

works by blocking the production of androgens, or

IDENTIFICATION OF ENZYME ESSENTIAL FOR NORMAL BLOOD PRESSURE

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for activating corin. Lack of PCSK6 appears to be a

male hormones, which are required for the prostate tumor to grow. Dr. Sharifi’s team found that D4A also inhibits androgen synthesis, but does so by

Corin is an enzyme in the heart. Qingyu Wu, MD,

blocking several different pathways. These findings

PhD, of the Lerner Research Institute, discovered

suggest that D4A might be a more effective alterna-

corin almost 15 years ago. He has identified it as

tive to its metabolic parent.

CLEVELAND CLINIC

Published in Nature.



ANNUAL REPORT 2015

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Here are additional highlights: • Led by the Center for International Medical Education, Cleveland Clinic welcomed more than 350 international guests — the most to date — from 15 countries to the Patient Experience Summit. We also welcomed more than 850 international observers, whose goal is to be exposed to the latest clinical/surgical and technological advancements at Cleveland Clinic. › Case Western Reserve University School of Medicine graduation ceremony

• Since both leadership development executives programs launched in 2011, the Samson Global Leadership Academy has attracted 114 executives from

Education Institute Highlights The Education Institute oversees Cleveland Clinic’s

CLEVELAND CLINIC LERNER COLLEGE OF

educational mission, with a focus on addressing the

MEDICINE OF CASE WESTERN RESERVE UNIVERSITY

ever-increasing educational needs of healthcare professionals around the globe. GRADUATE MEDICAL EDUCATION

Cleveland Clinic maintains one of the largest graduate medical education programs in the country. In 2015, more than 1,500 clinical trainees (residents and fellows) trained at Cleveland Clinic, Fairview and South Pointe hospitals, Akron General Medical Center, and Cleveland Clinic Florida. Research trainees, including those at the Lerner Research Institute and Cleveland Clinic Florida, numbered 373. Cleveland Clinic offers 108 training programs approved by the Accreditation Council for Graduate Medical Education (ACGME), along with 92 fellowship programs outside of ACGME oversight. Nearly 16,000 alumni from our GME program have taken their knowledge home, practicing medicine in some 71 countries around the world. CONTINUING MEDICAL EDUCATION

Physicians and other medical personnel around the world are required to keep their knowledge and skills up to date through participation in continuing medical education (CME) programs. Cleveland Clinic is a leading provider of CME courses in virtually all media and enjoys the highest Accreditation Council for Continuing Medical Education ranking: “Accreditation with Commendation.” In 2015, the center offered 1,770 CME programs to 309,000 participants from around the world.

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Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CCLCM) continues to attract exceptional students with MCAT scores well above the national average. In 2015, the college

23 countries, and the Executive Visitors’ Program has attracted 392 executives from 63 countries. • The Lerner College of Medicine is collaborating

› Samson Global Leadership Academy

with Microsoft to develop a prototype for medical student anatomy education using HoloLens, a device that shows 3-D hologram images of internal organs and systems. • The Simulation and Advanced Skills Center

drew 1,900-plus applicants for 32 positions.

attained accreditation by the Society for

Graduates continue to experience enviable match

Simulation in Healthcare.

results, with 52 percent going to their first-choice program and 77 percent going to one of their top

• More than 191 anatomical donations have been

three choices. In all, 65 percent matched to a top

gratefully received by the Body Donation Program,

10 U.S. News & World Report hospital. Six students

a new record.

are training at Cleveland Clinic. Ground was broken for the new Health Education Campus, which is expected to open in 2019 and will house CCLCM and the medical, nursing and dental schools of Case Western Reserve University. STRATEGIC EDUCATIONAL COLLABORATIONS

In collaboration with Case Western Reserve University, the Education Institute offers the Cleveland Clinic-Weatherhead School of Management executive MBA in healthcare, designed to give high-potential healthcare professionals the opportunity to advance their leadership and management skills. To give health professions educators the opportunity to further refine their teaching skills and strengths, the Education Institute offers a Master of Education degree in Health Professions Education in collaboration with Cleveland State University.

• More than 2 million healthcare professionals and consumers, nearly half of whom are international, are annually exposed to Cleveland Clinic Journal of Medicine in its print and digital formats. • The Alumni Library was renamed the Floyd D. Loop Alumni Library in honor of the late Dr. Loop. • The Center for Consumer Health Information is translating patient education materials into Arabic for use at Cleveland Clinic Abu Dhabi and throughout our health system. •T  he Education Institute continued “Leading in Healthcare” as an integrated leadership development program with a current cohort of 70 professionals. To date, 537 caregivers have participated (nurses, administrators and staff). ■

CLEVELAND CLINIC

Floyd D. Loop, MD 1936-2015 Dr. Loop was Chairman and CEO of Cleveland Clinic from 1989 to 2004. In 2015, the Alumni Library in the Education Institute was renamed the Floyd D. Loop Alumni Library in his honor.

ANNUAL REPORT 2015

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NAMED CHAIRS

The VeloSano Bike to Cure event raised $3 million

Philanthropy also created named chairs that help

in 2015 alone, and nearly $5 million since it was

Cleveland Clinic’s most accomplished clinicians expand the scope of their research and train fellows, interns, residents and medical students. Through the years, generous benefactors have created a total of 120 named chairs. SPECIAL EVENTS

Each year, well-attended events further Cleveland Clinic’s mission in Ohio, Florida and Nevada. In 2015, the biennial 1921 Society Dinner recognized

launched in 2014. Every dollar raised directly benefits cancer research at Cleveland Clinic. Signature fundraisers in 2015 included the Cleveland Clinic Florida Ball; An Evening with Scott Hamilton & Friends, advancing programs at the Taussig Cancer Institute; Cleveland Clinic Children’s Gala; and the Power of Love Gala, presented by Keep Memory Alive on behalf of Cleveland Clinic’s Lou Ruvo Center for Brain Health in Las Vegas. ■

40 new inductees, bringing the total number of 1921 Society members, who have made commitments of › Toby Cosgrove, MD, CEO and President of Cleveland Clinic, left, along with Campaign Co-Chair Larry Pollock (far right) and Campaign Co-Chair Stewart Kohl, thanks Norma Lerner for her leadership as Chair of the 1921 Society and Distinguished Chair of the Power of Every One Centennial Campaign.

$1 million or more, to more than 440.

Philanthropy Institute – Brilliant Generosity The Power of Every One Centennial Campaign

•T  he Health Education campus, a joint project with

33 Grosvenor Place

finished 2015 with $175.8 million in total commit-

Case Western Reserve University, received major

ments for the year. Launched in 2014, the historic

gifts from the Mandel Foundation ($8 million),

$2 billion philanthropic campaign will continue until

the Marc A. and Rhonda L. Stefanski Foundation

Cleveland Clinic has signed a long-term lease on

Cleveland Clinic’s 100th anniversary in 2021.

($5 million) and the Timken Foundation of Canton

a 198,000-square-foot office building in London,

($5 million), and an anonymous gift of $4 million.

England, and is converting it to a private medical

Every gift that supports the campaign is helping to make the highest-quality healthcare accessible to

hospital and clinic. The building, which is being • Eugene Shvidler made a $2 million gift to the

completely renovated, will have more than 200

the greatest number of people through projects and

Glickman Urological & Kidney Institute supporting

single-bed occupancy patient rooms. Organizationally,

programs that put patients first, including the new

nephrology and hypertension.

it will be integrated with Cleveland Clinic’s clinical,

Cleveland Clinic Cancer Center to open in 2017.

• The Ralph C. Wilson, Jr. Foundation made a

Excellence in medical care is achieved through the

$4 million gift establishing the Ralph C. Wilson, Jr.

best medical education, as well as philanthropic

Fellow Leadership Education Endowment and the

supporters who, understanding the pressing need

Dr. Mehdi Razavi Education Endowed Chair.

for highly trained medical professionals, make gifts toward the new Health Education Campus.

• Rick and Lori Buoncore made a $2 million gift supporting an endowed chair in the area of lung

Following are just a few of the many generous gifts

transplantation. The first chair holder is the surgeon

made in 2015 toward the campaign’s priorities of

who performed Mrs. Buoncore’s successful

promoting health, advancing discovery, transforming

double-lung transplant, Atul Mehta, MD.

care and training caregivers: • The Richard J. Fasenmyer Foundation made an $18.5 million gift to Cleveland Clinic and Case Western Reserve University supporting an immunology research and clinical care partnership.

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• An anonymous donor made a $10 million gift supporting the Miller Family Heart & Vascular Institute. • An anonymous donor made a $10 million

research and education programs, as well as Cleveland Clinic Innovations. ■

Medical School at South Pointe The Ohio University Heritage College of Osteopathic

The campus emphasizes teamwork and is digitally

Medicine opened a new campus in affiliation with

linked to Heritage College’s other two campuses.

Cleveland Clinic on the campus of South Pointe Hos-

Group workstations, or “learning pods,” do away with

pital in Warrensville Heights to address the pressing

old auditorium-style lecture halls and allow students

need for more primary care physicians in Northeast

and instructors at all three Heritage College campuses

Ohio and the rest of the country. The first class of 51

to interact in real time. ■

medical students arrived for classes on July 8, 2015.

gift supporting regional priorities.

CLEVELAND CLINIC

ANNUAL REPORT 2015

52

2015 U.S. News & World Report Rankings

Selected 2015 Awards & Honors

In the “HONOR ROLL” Top 5

FOR CLEVELAND CLINIC OVERALL

Cleveland Clinic

5th | 17 years in a row

World’s Most Ethical Companies® From Ethisphere® Institute

Ranked No. 1 Cardiology & Heart Surgery

100 Great Hospitals in America 1st | 21 years in a row

From Becker’s Hospital Review No. 1 in the World for Scientific Activity —

In America’s Top 3 Gastroenterology & GI Surgery

Ranking Web of Hospitals 2nd | 19 years in a row

From Cybermetrics Lab

Nephrology 2nd | 6 years in a row 150 Great Places to Work in Healthcare From Becker’s Hospital Review Rheumatology 2nd | 8 years in a row Urology 2nd | 17 years in a row NorthCoast 99 — Northeast Ohio’s Best Diabetes & Endocrinology

3rd | 4 years in a row

Places to Work (10-Year Legacy Award)

From the HR services organization ERC Gynecology 3rd | 4 years in a row

53

DiversityInc Top 5 Hospitals and Health Systems From DiversityInc Top 25 U.S. Employee Resource Groups and Diversity Councils From the Association of ERGs & Councils Best Overall Recognition Program From Recognition Professionals International, a workforce recognition association CareerSTAT Frontline Health Care Worker Champion From the National Fund for Workforce Solutions Corporation of the Year (Class II) From the Ohio Minority Supplier Development Council Corporate Sponsor Award From the National Black MBA Association

Orthopaedics 3rd | 4 years in a row Pulmonology 3rd | 6 years in a row

In America’s Top 20 Ophthalmology 6th | 16 years in a row Ear, Nose & Throat

7th | 23 years in a row

Neurology & Neurosurgery

8th | 26 years in a row

Geriatrics 10th | 22 years in a row Cancer 12th | 11 years in a row Pediatric Pulmonology

14th | 2 years in a row

Pediatric Neurology & Neurosurgery

17th | 8 years in a row

Pediatric Cancer

20th | 2 years in a row

Pediatric Gastroenterology & GI Surgery

20th | 5 years in a row

Pediatric Orthopaedics

20th | 2 years in a row

In America’s Top 50 Pediatric Urology

22nd | 7 years in a row

Pediatric Cardiology & Heart Surgery

24th | 7 years in a row

Neonatology 33rd | 2 years in a row Pediatric Diabetes & Endocrinology

40th | 7 years in a row

Pediatric Nephrology

44th | 2 years in a row

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CLEVELAND CLINIC

ANNUAL REPORT 2015

54

FOR SPECIFIC CLEVELAND CLINIC FACILITIES Top Performer on Key Quality Measures®

• Hillcrest Hospital

From The Joint Commission

• Lutheran Hospital

• Euclid Hospital • Fairview Hospital • Lutheran Hospital Guardian of Excellence Award (Patient Experience) From Press Ganey • Richard E. Jacobs Family Health Center Emergency Department • Twinsburg Family Health and Surgery Center Emergency Department Magnet Recognition ®

From the American Nurses Credentialing Center • Cleveland Clinic main campus • Cleveland Clinic Akron General • Fairview Hospital • Hillcrest Hospital

• South Pointe Hospital 3-Star Rating in All 3 STS Categories

• Cleveland Clinic main campus • Fairview Hospital

• Medina Hospital Beacon Award for Excellence From the American Association of Critical-Care Nurses • Cleveland Clinic main campus — Coronary ICU and Heart Failure ICU (Gold) • Cleveland Clinic Florida — ICU (Bronze) • Hillcrest Hospital — Coronary Care Unit (Silver) No. 2 in U.S. for Safety and Patient Experience From Consumer Reports • Lutheran Hospital Most Connected Hospitals From U.S. News & World Report • Cleveland Clinic main campus • Cleveland Clinic Florida • Euclid Hospital

From the International Board of Lactation

From the Ohio Department of Health

Consultant Examiners and International

and the Ohio Hospital Association

Lactation Consultant Association • Hillcrest Hospital

From Becker’s Hospital Review

Get With The Guidelines Awards From the American Heart Association and American Stroke Association Stroke Gold Plus Achievement Award • Cleveland Clinic Florida

Practice Greenhealth Awards From Practice Greenhealth • Top 25 Environmental Excellence Award • System for Change Award

• Euclid Hospital

•C  ircles of Excellence Award: Chemicals Circle

• Fairview Hospital

• Circles of Excellence Award: Greening the

• Hillcrest Hospital

OR Circle

• Hillcrest Hospital

• Circles of Excellence Award: Climate Circle • Circles of Excellence Award: Green Building Circle • Emerald Award (Euclid and Marymount hospitals) • Partner for Change Award (9 hospitals and 9 family health centers) • Partner Recognition Award (Independence and Wooster family health centers)

• Lakewood Hospital

Stroke Gold Achievement Award • Medina Hospital Heart Failure Gold Plus Achievement Award • Cleveland Clinic main campus

HOSPITAL DESIGN AWARDS Best Hospital Design

Peoples’ Choice Award

From Building Healthcare Middle East

From Building Healthcare Middle East

Best Sustainable Hospital Project From Building Healthcare Middle East

ACTION Registry® Gold Achievement Award • Fairview Hospital • Hillcrest Hospital Resuscitation Silver Achievement Award • Cleveland Clinic main campus • South Pointe Hospital Target: StrokeSM Honor Roll Recognition • Cleveland Clinic Florida (Elite Plus) • Hillcrest Hospital • South Pointe Hospital Fit-Friendly Worksites Gold Award From the American Heart Association • Cleveland Clinic Florida

COMMUNICATIONS AWARDS Best Corporate Blog (for “Health Essentials” blog) From the Content Marketing Institute eHealthcare Leadership Awards From Strategic Health Care Communications clevelandclinic.org •P  latinum Award for Best Healthcare Content (healthcare system category) • Platinum Award for Best Doctor Directory (healthcare system) •P  latinum Award for Best Social Networking (healthcare system)

• Fairview Hospital

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• Fairview Hospital

ENVIRONMENTAL AWARDS

®

• South Pointe Hospital

• Marymount Hospital

for Healthy Babies

50 Greenest Hospitals in America

• Hillcrest Hospital

• Marymount Hospital

• Lutheran Hospital

Consultant Care Award

55

From the Society of Thoracic Surgeons (STS)

From the American Nurses Credentialing Center • Euclid Hospital

5-Star Rating — Ohio First Steps

of Adult Cardiac Surgery

Pathway to Excellence® Designation • Cleveland Clinic Florida

International Board-Certified Lactation

CLEVELAND CLINIC

•G  old Award for Best Overall Internet Site (healthcare system) • Gold Award for Best Annual or Special Report (healthcare system) clevelandclinicmeded.com • Gold Award for Best Overall Internet Site (physician/clinician-focused category) • Gold Award for Best Healthcare Content (physician/clinician-focused category) SCOPY Award — Best Infographic from an Institution From the American College of Gastroenterology

ANNUAL REPORT 2015

56

Financial and Statistical Highlights CLEVELAND CLINIC MAIN CAMPUS

Outpatient Visits

PATIENT CARE

2014

2015

Outpatient visits

5,421,528

5,633,024

Emergency visits

112,048

126,991

53,707

53,765

Admissions Acute

89,978

Outpatient

64,253 66,261

EDUCATION

2014

2015

Residents and fellows in training

1,757

1,888

Continuing medical education Activities

1,938 1,705

Participants

370,220 284,730

Accredited residency training programs

70

74

1,832

2,061

65

65

Programs for allied health specialists

Grant and contract revenue Federal revenue

58.1

164.7 144.5

145.2

49.7

140.6

38.1

43.4

91,731

25,725 25,470

RESEARCH

6.6

375 371

Inpatient

Allied health student rotations

5.6

5.1

5.9

Outpatient Observations

Acute Admissions

53,332 53,394

Nonacute Surgical cases

57

CLEVELAND CLINIC HEALTH SYSTEM (CCHS)

2012

2013

2014

2015

2012

2013

2014

2015

2012

2013

2014

2015

IN MILLIONS

IN THOUSANDS

IN THOUSANDS

Surgical Cases Inpatient and Outpatient

Emergency Department Visits

Education — Residents and Fellows in Training

208.8 186.0

188.7

1,785

1,793

1,757

2012

2013

2014

640.2

186.2 458.3

475.8

497.6

2012

2013

2014

1,888

2014 2015 $168M

$166M

$98M

$104M

178

176

Laboratory principal investigators

2012

2013

2014

2015

2015

IN THOUSANDS

IN THOUSANDS

Research Funding

Caregivers (Employees)

2015

CLEVELAND CLINIC HEALTH SYSTEM (CCHS) PATIENT CARE

2014

2015

Outpatient visits

5,852,700

6,620,152

Emergency visits

497,631

640,215

Admissions

152,504

178,528

Acute Nonacute Surgical cases

140,596 164,704 11,908

13,824

186,221

208,807

Inpatient

55,515 61,750

Outpatient

130,706 147,057

FINANCIAL HIGHLIGHTS

2014

2015

$6.7B

$7.2B

Operating income

$468M

$480M

Assets

$12.3B $13.6B

Community Benefit

$682M

Operating revenues

NOTE: 2015 statistics include Cleveland Clinic Akron General (full year); 2014 statistics exclude Akron General. Some figures for 2014 have been updated following revision of the 2014 annual report after its release.

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Professional Staff (Physicians)

49.2 255

2012

248

255

251

2013

2014

2015

$ IN MILLIONS

43.9

43.4

42.5

2012

2013

2014

2015

3,034

2012

3,225

3,150

2013

2014

3,432

2015

IN THOUSANDS

PENDING NOTE: 2015 statistics include Cleveland Clinic Akron General (full year); years 2014 and prior exclude Akron General. Some figures for 2014 have been updated following revision of the 2014 annual report after its release.

CLEVELAND CLINIC

ANNUAL REPORT 2015

58

Cleveland Clinic Leadership Board of Directors Robert E. Rich Jr. Chair, Board of Directors Cleveland Clinic Chairman, Rich Products Corp. Joseph M. Scaminace Vice Chair, Board of Directors Cleveland Clinic Former Chairman and CEO, OM Group Inc. A. Malachi Mixon III Chair Emeritus, Board of Directors Cleveland Clinic Chairman (Retired), Invacare Corp. Delos M. Cosgrove, MD CEO and President Chair, Board of Governors Cleveland Clinic Brian J. Donley, MD Chief of Staff Vice Chair, Board of Governors Cleveland Clinic Patrick V. Auletta President Emeritus, KeyBank, N.A. Serpil Cemile Erzurum, MD Department Chair and Co-Director, Pathobiology Staff, Pulmonary Medicine, Taussig Cancer Institute, Pediatric Institute and Critical Care Medicine Cleveland Clinic Umberto P. Fedeli President and CEO, The Fedeli Group Carole Hoover President and CEO, Hoover Milstein Norma Lerner Chair and President, The Lerner Foundation William E. MacDonald III Vice Chair (Retired), National City Corp. Daniel F. Martin, MD Institute Chair, Ophthalmology Cole Eye Institute Cleveland Clinic

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Pamela Miller Chair, Medina Hospital Board of Trustees

Waleed Al Mokarrab Al Mahari Chief Operating Officer, Mubadala Development Co.

Samuel H. Miller Co-Chairman Emeritus of the Board, Forest City Enterprises Inc.

Lord Michael Ashcroft, KCMG PC

Beth E. Mooney Chairman and CEO, KeyCorp Mario Morino Chairman, Venture Philanthropy Partners Chairman, Morino Institute Frederick R. Nance, Esq. Regional Managing Partner, Squire Patton Boggs LLP Larry Pollock Managing Partner, Lucky Stars Partners LLC Ronald J. Ross, MD, FACR Chair, Hillcrest Hospital Board of Trustees Director Emeritus, Department of Radiology, Hillcrest Hospital Ronald E. Weinberg Director and Principal, Weinberg Capital Group Morry Weiss Chairman, American Greetings Corp.

Board of Trustees *Emeritus Trustee Robert E. Rich Jr. Chair, Board of Trustees Cleveland Clinic Chairman, Rich Products Corp. Joseph M. Scaminace Vice Chair, Board of Trustees Cleveland Clinic Former Chairman and CEO, OM Group Inc. A. Malachi Mixon III Chair Emeritus, Board of Trustees Cleveland Clinic Chairman (Retired), Invacare Corp.

Gregory M. Avis Co-Founder and Senior Advisor, Summit Partners William W. Baker President, Winfield Associates Inc. James M. Biggar* Chairman and CEO, Glencairn Corp. Edward B. Brandon* Chair and CEO (Retired), National City Corp. Stephen Brogan, Esq. Managing Partner, Jones Day Jeanette Grasselli Brown, DSc* Past Chair, Ohio Board of Regents Director of Corporate of Research (Retired), BP America Jeffrey A. Cole* Chairman and CEO (Retired), Cole National Corp. Thomas A. Commes President and Chief Operating Officer (Retired), The Sherwin-Williams Co. William E. Conway* Chairman Emeritus, Fairmount Santrol Sam Covelli Owner/Operator, Covelli Enterprises Inc. Deborah A. Crawford Paul J. Dolan Chairman/CEO, Cleveland Indians Julian M. Earls, PhD Director (Retired), NASA’s Glenn Research Center Executive in Residence, Nance College of Business Administration, Cleveland State University

Terrance C.Z. Egger Publisher and Chief Executive Officer, Philadelphia Media Network LLC Serpil C. Erzurum, MD Department Chair and Co-Director, Pathobiology Staff, Pulmonary Medicine, Taussig Cancer Institute, Pediatric Institute and Critical Care Medicine Cleveland Clinic Jose C. Feliciano Partner, BakerHostetler Law Nancy F. Fisher, Esq. Former Prosecutor, City of Cleveland Jeffrey I. Friedman Chairman, President and CEO, JIF Investment Co. Inc. Thomas J. Gable Chair, Lakewood Hospital Association Board of Trustees Owner/President, Four Gable Management Co. Inc. Daniel Gilbert Chair and Founder, Quicken Loans Majority Owner, Cleveland Cavaliers Thomas Glocer Founding Partner, Angelic Ventures Private Investor

Michael J. Horvitz, Esq. Partner (Retired), Jones Day

Sydell L. Miller Chair and CEO (Retired), Matrix Essentials Inc.

W. Nicholas Howley Chairman and CEO, TransDigm Group Inc.

Lakshmi Mittal Chairman and CEO, ArcelorMittal

E. Bradley Jones* Chairman and CEO (Retired), Republic Steel Corp.

Charles Modlin, MD Staff, Urology and Transplantation Center Cleveland Clinic

John W. Kemper Sr. CEO/Treasurer (Retired), Avalon Precision Casting Co. Kenneth J. Kies Managing Director, Federal Policy Group LLC Stewart Kohl Co-CEO, Riverside Co. Jonathan Korngold Managing Director, General Atlantic Mark S. Lerner President, Chief Operating Officer and Director, GOJO Industries Inc. Chair, Akron General Health System Board of Directors Robert L. Lintz Plant Manager (Retired), General Motors Corp. Parma Metal Fabricating Division James Magisano, MD Community West Foundation Michael E. Maroone President, Chief Operating Officer and Director (Retired), AutoNation

Larry P. Goldberg CEO, Goldberg Companies Inc.

Daniel F. Martin, MD Institute Chair, Ophthalmology Cole Eye Institute Cleveland Clinic

William R. Gorton* President, Gorton & Co.

Patrick F. McCartan, Esq.* Senior Partner, Jones Day

Harley Gross Partner, Gross Builders

Atul Mehta, MD Staff, Pulmonary, Allergy and Critical Care Medicine Cleveland Clinic

Stephen R. Hardis* Chair and CEO (Retired), Eaton Corp. David J. Hessler, Esq. Senior Partner, Wegman, Hessler & Vanderburg

Loretta Mester, PhD President and CEO, Federal Reserve Bank of Cleveland

CLEVELAND CLINIC

Dan T. Moore III President, Dan T. Moore Co. Inc. David T. Morgenthaler* Founding Partner, Morgenthaler Ventures Morgenthaler Partners Bert W. Moyar President, MEI Hotels Inc. LifeHealth Science LLC William C. Mulligan Managing Director, Primus Capital Funds John R. Nottingham Co-President, Nottingham Spirk Timothy O’Brien Chair, Board of Trustees Cleveland Clinic Children’s Hospital for Rehabilitation Vice President, Strategic Intellectual Property, Moen Inc. Clarence Otis Jr. Chairman and CEO (Retired), Darden Restaurants Raymond P. Park* Chairman, Park Corp. Roseann Park Anthony A. Petrarca Owner/President, Cedarwood Development Inc. Michael B. Petras Jr. CEO, Cardinal Health at Home Michael Phillips, MD Staff, Neurosciences Vice Chair for Research & Academics, Diagnostic Radiology Staff, Mellen Center Director, Center of Business Development Cleveland Clinic

Ronald Ratner Director and Executive Vice President, Forest City Enterprises Inc. Harry T. Rein Private Investor Melinda Rich Vice Chairman, Rich Products Corp. President, Rich Entertainment Group Larry Ruvo Founder, Keep Memory Alive Senior Managing Director, Southern Wine & Spirits of Nevada Bill R. Sanford Chairman, Symark LLC Lee Scott CEO (Retired), Wal-Mart Stores Inc. John Sherwin Jr. President (Retired), Mid-Continent Ventures Inc. John W. Spirk Co-President, Nottingham Spirk Thomas C. Sullivan Sr. Chairman Emeritus, RPM International Inc. Brian J. Taussig Ambassador William R. Timken Jr. Chair (Retired), The Timken Co. Chairman, Strategic Public Partners Group Robert J. Tomsich Chairman, NESCO Inc. Thomas V.H. Vail* Publisher and Editor (Retired), The Plain Dealer Tom Wamberg Chairman and Co-Founder, Uniphy Health LLC Robert Warren Jr., Esq. Of Counsel, Brouse McDowell LPA Robert C. Weber Senior Advisor, IBM Corp.

59

Loyal W. Wilson Managing Director, Primus Capital Lisa Yerian, MD Staff, Anatomic Pathology Staff, Transplantation Center Medical Director, Continuous Improvement Cleveland Clinic Nizar Zein, MD Chair, Global Patient Services Staff, Gastroenterology and Hepatology Staff, Transplantation Center Cleveland Clinic

Administration Delos M. Cosgrove, MD CEO and President Chair, Board of Governors/ Medical Executive Committee Wael Barsoum, MD CEO, Cleveland Clinic Florida Michael Benninger, MD Chair, Head & Neck Institute Adrienne Boissy, MD Chief Experience Officer Brian J. Bolwell, MD Chair, Taussig Cancer Institute Professor of Medicine, CCLCM Bradford Borden, MD Associate Chief of Staff Chair, Emergency Services Institute Gregory Borkowski, MD Chair, Imaging Institute Raymond Borkowski, MD Director, Clinical Compliance Armando L. Chardiet Chair, Philanthropy Institute John Costin, MD Medical Director — LESH Community Medical Group Conor Delaney, MD, PhD Chair, Digestive Disease & Surgery Institute Cynthia Deyling, MD Chief Quality Officer Brian G. Donley, MD Chief of Staff Vice Chair, Board of Governors/ Medical Executive Committee

ANNUAL REPORT 2015

60 Raed Dweik, MD Executive Director, Innovation Management & Conflict of Interest Program Tommaso Falcone, MD Chair, Ob/Gyn & Women’s Health Institute Ben Frank System Executive Director of Clinical Enterprise Steven C. Glass Chief Financial Officer and Treasurer Jorge A. Guzman, MD VP, Regional Hospital Medical Operations Thomas Hamilton Interim Chair, Lerner Research Institute K. Kelly Hancock, DNP, RN, NE-BC Executive Chief Nursing Officer Chief Nursing Officer, Main Campus

Eric Klein, MD Chair, Glickman Urological & Kidney Institute Kandice Kottke-Marchant, MD, PhD Chair, Robert J. Tomsich Pathology & Laboratory Medicine Institute Calum Laurie Chief Financial Officer, Cleveland Clinic Abu Dhabi Andre Machado, MD, PhD Chair, Neurological Institute Daniel F. Martin, MD Chair, Cole Eye Institute Paul G. Matsen Chief Marketing and Communications Officer Linda McHugh Acting Chief Human Resources Officer Atul Mehta, MD President, Medical Staff

Michael P. Harrington Controller and Chief Accounting Officer

Mike Michetti Executive Director, Professional Staff Affairs

C. Martin Harris, MD Chief Information Officer Chair, Information Technology Division

Tomislav Mihaljevic, MD CEO, Cleveland Clinic Abu Dhabi

A. Marc Harrison, MD Chief of International Business Development

Joshua Miller, DO VP, Regional Family Health Center Operations

Ann Huston Chief Strategy Officer

Michael T. Modic, MD Chief Clinical Transformation Officer

Joseph Iannotti, MD, PhD Chair, Orthopaedic & Rheumatologic Institute

Kristen Morris Chief Government and Community Relations Officer

J. Harry Isaacson, MD Executive Director, Professional Staff Leadership Development

Peter O’Neill Executive Director, Cleveland Clinic Innovations

J. Stephen Jones, MD President, Regional Hospitals and Family Health Centers Catherine Keating, MD Associate Chief of Staff, Clinical Integration Operations Chair, Quality Alliance/Community Physician Partnership Michael Kessel CEO, Cleveland Clinic Canada

Francis Papay, MD Chair, Dermatology & Plastic Surgery Institute William M. Peacock III Chief of Operations Shannon Phillips, MD, MPH Quality Officer, Main Campus Giovanni Piedimonte, MD Chair, Pediatric Institute & Cleveland Clinic Children’s Michael Reagin Chief Information Officer, Cleveland Clinic Abu Dhabi

Susan J. Rehm, MD Vice Chair, Department of Infectious Disease Executive Director, Physician Health Michael F. Roizen, MD Chair, Wellness Institute J. Gregory Rosencrance, MD Chair, Medicine Institute David W. Rowan, Esq. Chief Legal Officer Chief Governance Officer and Secretary Donald A. Sinko, CPA Chief Integrity Officer

61 Kathleen Franco, MD James Gutierrez, MD J. Harry Isaacson, MD Paul Krakovitz, MD Daniel F. Martin, MD* Margaret McKenzie, MD Atul Mehta, MD Michael Phillips, MD Timothy Spiro, MD Lisa Yerian, MD Nizar Zein, MD

Appointed Members Brad Borden, MD Ben Frank

James K. Stoller, MD, MS Chair, Education Institute Lars G. Svensson, MD, PhD Chair, Heart & Vascular Institute Christopher Troianos, MD Chair, Anesthesiology Institute Herbert Wiedemann, MD Chair, Respiratory Institute

Steven C. Glass Thomas Hamilton, MD (Interim) K. Kelly Hancock, DNP, RN, NE-BC Mike Michetti Charles Modlin, MD (President-elect /MSO) William M. Peacock III David W. Rowan, Esq.

Robert Wyllie, MD Chief Medical Operations Officer James Young, MD Chair, Endocrinology & Metabolism Institute Executive Dean, Cleveland Clinic Lerner College of Medicine Nizar Zein, MD Chair, Global Patient Services Andrea Zwischenberger Administrative Director, Executive Administration

Board of Governors *Senior Board of Governors members for 2016 Delos M. Cosgrove, MD Chair Brian Donley, MD Vice Chair

Elected/Voting Members Wael Barsoum, MD Sri Chalikonda, MD Serpil Erzurum, MD* Nancy Foldvary-Schaefer, MD

Edmund Sabanegh Jr., MD James K. Stoller, MD, MS

Regional Hospital Presidents *Affiliate hospital Michael Habowski Ashtabula County Medical Center* Brian Harte, MD Hillcrest Hospital Robert Juhasz, DO South Pointe Hospital Donald Malone, MD Lutheran Hospital Daniel Napierkowski, MD Euclid Hospital Richard Parker, MD Marymount Hospital Neil Smith, DO Fairview Hospital Rebecca Starck, MD Avon Hospital Tim Stover, MD Akron General Hospital Thomas Tulisiak, MD Medina Hospital

© 2016 Cleveland Clinic This annual report was produced in-house. Cleveland Clinic Content Marketing Amanda Todorovich | Director Steve Szilagyi | Writer Michael Viars | Senior Graphic Designer Ann Bakuniene-Milanowski | Managing Editor Leslie Radigan | Marketing Manager Marty Goan | Print Production Manager Gillian Smith | Marketing Associate Photography Matt Kohlmann, Russell Lee, Yu Kwan Lee, Tom Merce, Annie O’Neil, Steve Travarca, Paul Warchol

To view an online version of this annual report, visit clevelandclinic.org/annualreport.

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ANNUAL REPORT 2015

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