The Health Sciences Center became the first division on Grounds to surpass the $100 million mark in the Capital Campaign. This is an especially significant milestone in this age of managed care, as the University develops a new model to support medical education that relies less heavily on hospital revenues. The Health Sciences campaign, at $125 million, is the largest of any University-wide initiative.

Health Sciences has raised more than $10 million to endow faculty chairs, $4 million for medical scholarships, $1.8 million for nursing scholarships, and $6 million for biomedical research. Private funds have also helped establish research and patient-care programs across the Health Sciences Center for prostate cancer research, health care worker safety, and transplant surgery.

Increases in productivity and higher-than-expected earnings at the University of Virginia Medical Center bode well for the hospital's future. By the first half of the 1996-97 fiscal year, the Health Sciences Center had a surplus of $20.8 million. These moneys are being reinvested in equipment and operations and funding gain-sharing bonuses for hospital workers, who were instrumental in slowing the growth of expenses. Expanding the center's network of ambulatory care services and reducing the average length of stay in the hospital have been crucial to this accomplishment. In 1996-97, out-patient visits totaled 485,000, up almost 200,000 since 1991. At the same time, the average stay dropped from 7.8 to 6.2 days.

As part of a multifaceted strategy to improve the competitive position of the University Medical Center and to compensate for the anticipated declines in Medicare reimbursements, the University this year:

§ Joined forces with two Shenandoah Valley hospitals to form VaLiance, a buyer's group targeting lower prices on common services like laboratory work;

§ Received approval from the Virginia Department of Health to build a new $1.8 million cardiac catherization laboratory with Martha Jefferson Hospital;

§ Entered into a joint venture with Culpeper Memorial Hospital to purchase twelve primary care practices in Culpeper.

The Health Sciences Center is also expanding its facilities in Charlottesville. The University began construction on a state-of-the art fifty-bed rehabilitation hospital at Fontaine Research Park in partnership with HealthSouth, which operates more than one thousand inpatient and outpatient facilities in fifty states. The facility will treat adult patients with brain injury, spinal cord injuries, multiple trauma, and polyarthritis. It will offer a ventilator-weaning program and rehabilitative care for patients recovering from strokes, burns, and orthopedic injuries.

The University's newly created Office of Telemedicine has helped the Health Sciences Center extend its reach to under-served areas of the state. Using voice, video, and data transmission to link the Medical Center with clinics and hospitals in outlying areas, University doctors conduct in-depth physical examinations in conjunction with local physicians and nurses. Eugene Sullivan, director of the office, and Dr. Karen Rheuban, professor of pediatrics and the office's medical director, hope to expand the Central Virginia Telemedicine Network to include ten regional hospitals throughout Virginia.

Telecommunications have helped the Medical Center disseminate its expertise more widely throughout the state. Grand rounds have been transmitted to the Augusta Medical Center and to the Southwest Virginia Mental Health Institute in Marion. The University has also provided educational and clinical telemedicine consultations in dermatology, neurosurgery, pediatrics, rheumatology, and thoracic and cardiovascular surgery.

The University is sharing its expertise with nations in the developing world. Representatives of the World Health Organization from Ghana, Namibia, South Africa, Ethiopia, and Kenya came to Charlottesville to explore partnerships with University physicians to improve health care in African countries. The University has also entered into preliminary discussions with representatives of several African nations to build collaborative relationships and possibly to help establish medical schools in Namibia and Ghana.

The University is pioneering many of the advances in medical knowledge and clinical practice that save lives and reduce suffering. In a score of fields, researchers have made breakthroughs with the potential to cure some diseases and revolutionize the treatment of others:

Contraception: The University has emerged as one of the nation's leading centers for a new contraceptive vaccine being developed by John Herr and others at the University's Contraceptive Vaccine Center. The center received an endorsement from the NIH, which renewed the center's grant and made a $10 million commitment over the next five years.

Alzheimer's Disease: Dr. W. Davis Parker, professor of neurology, and researchers at MitoKor, a biotechnology company, demonstrated that the most common form of Alzheimer's disease is associated with defects in mitochondrial DNA, which is passed down exclusively from the mother. MitoKor hopes to use the research to develop a simple, fast diagnostic test and eventually a treatment for the disease.

Parkinson's Disease: Two studies suggested that there may be a genetic basis for Parkinson's disease, a development scientists hope may lead to a preventive treatment. University professor of neurology Dr. W. Davis Parker, neurologist Dr. Russell Swerdlow, and researchers at MitoKor identified a genetic defect in mitochondrial DNA that causes Parkinson's disease. Another University study provided additional clinical evidence. Dr. Frederick Wooten, chair of the Department of Neurology, and colleagues found a preponderance of maternal inheritance in families where a Parkinson's patient had both an affected parent and sibling.

Prostate Cancer: Physicians unveiled an improved method to fight prostate cancer in a demonstration that brought doctors from throughout the state to the University. The procedure, pioneered in the United States by Dr. Haakon Ragde, a U.Va. medical school graduate, involves implanting radioactive seeds into the prostate gland to destroy cancer cells.

Medical Imaging: Magnetic Resonance Imaging machines are excellent for examining muscles and water-filled organs like the brain. James R. Brookeman, professor of radiology and biomedical engineering, and his colleagues are working on a process using xenon and helium gases that will allow MRIs to create images for the first time of such relatively dry, air-filled organs as the lungs.

Flu Vaccine: Dr. Frederick G. Hayden led the University's participation in a nationwide trial of a nasalspray flu vaccine, expected to be available by fall 1999, that proved to be 93 percent effective as well as easier and less painful to administer than injections.

Transplantation: Robb W. McGory, a transplant pharmacist, and his colleagues at the University's Charles O. Strickler Transplant Center have devised a procedure that improves the success rates of liver transplants in patients with hepatitis B. Nabi, a biopharmaceutical company, has demonstrated its commitment to this research by contributing to a chair in transplant pharmacology.

Heart Disease: Dr. Sanjiv Kaul, professor of medicine, has developed a noninvasive, affordable screening technique for detecting the early stages of coronary artery disease. The new test, which should be available in two years, could save millions of dollars in emergency medicine.

HIV Research: HIV infection, long considered an urban health problem, is occurring with growing frequency in rural areas, according to an eleven-year study conducted by Dr. Barry M. Farr, University Hospital epidemiologist and professor of medicine, and colleagues at the Health Sciences Center. The increase was particularly dramatic among minority and female heterosexual patients.

Osteoporosis: Dr. Lee Jensen, associate professor of radiology, and Dr. Jacques E. Dion, professor of radiology and neurosurgery, were the first in the United States to use a new method to strengthen the backs of osteo-porosis sufferers, injecting a special cement directly into the crushed vertebrae. Patients who typically arrive at the hospital bedridden, undergo vertebroplasty, and walk out the next day virtually pain free.