Health Sciences Restructuring

A Message from President Kaler

June 22, 2018

Dear Colleagues,

Last winter I asked for feedback from several stakeholders, including members of my cabinet, the deans of the health science colleges/schools, center directors, and faculty governance leadership, about the current structures and functions of the Academic Health Center. I requested recommendations for the most effective organization of the University's health sciences colleges/schools and associated programs. I received many suggestions, and I'm grateful for your thoughtful input. I consulted with AHC deans and other academic and faculty leaders, and studied the structure and organization of aspirational peers.

The University of Minnesota has one of the most comprehensive academic health centers in the nation. Because of our unique depth and breadth, the future success of the health sciences depends upon integration and alignment of our clinical work, our discoveries, and interprofessional education. At the same time, seamless collaborations between units currently in the AHC and those outside it are essential for realizing the full potential of a world-class university like ours to advance health and health care. The diversity of our clinical mission includes all of the AHC schools/colleges and is one of our greatest strengths. We serve the full spectrum of health--not only clinical work, but also population health.

With this in mind, I am moving forward with significant changes to the Academic Health Center, anchored in my belief that the AHC is not simply an administrative structure of support services, but, rather, the manifestation of the collaborative work that happens across all of our health science disciplines. Let me be clear: The AHC is not "closing." Rather, based on extensive input and our shared commitment to best support innovation in the health sciences, I have decided that AHC leadership and administrative structure must and will change, and that the future of our many centers and institutes must be evaluated.

My goals are to strengthen collaboration in the research and teaching missions of our work in the health sciences and to create greater operational integration and alignment. My vision is that we be unparalleled in our clinical excellence, scientific discoveries, and interprofessional education in the health sciences. That was an important component of the original vision that created the AHC in 1970.

As you know, on Monday June 18, 2018, the University's Board of Regents approved a nonbinding letter of intent that moves us closer to re-imagining our M Health clinical partnerships. As we enter a new phase in our relationship with Fairview Health Services, our chief clinical partner, an enhanced focus on our clinical enterprise is of utmost importance to the University and to me. I believe that the responsibilities of the dean of the Medical School must be streamlined, but we must also have absolute clarity in the leadership of our clinical enterprise when working with our clinical partners. Therefore, a central element of the restructuring will be a new, more focused role for the dean of the Medical School that also encompasses collaborative leadership of our clinical enterprise.

With these goals in mind, I will:

Appoint our chief medical officer, Jakub Tolar, as the vice president for clinical affairs (VPCA) and dean of the Medical School, pending approval of the Board of Regents at its July 11, 2018, meeting. The purpose of this combined role recognizes the essential leadership role of the Medical School--its role in coordination of clinical affairs, including clinical research and clinical training, across all of our disciplines--and will provide greater attention to clinical work at the University.

  • The VPCA will report to the president, but the Medical School dean's academic role will be accountable to the executive vice president and provost for promotion and tenure and academic programming, similar to other college deans.
  • This structure will help to enhance coordination of clinical affairs across all disciplines.
  • The VPCA will have membership on the Fairview board and will serve as chair of the University of Minnesota Physicians (UMP) board.
  • The VPCA will likely deploy one associate vice president to oversee clinical strategy, research, and academics. This associate vice president will work closely with the vice provost for academic health sciences (see below) on interprofessional education and will coordinate the work of all collegiate clinical health science programming.
  • Each college that has clinical work and responsibilities should charge an associate dean to work closely with the VPCA. The VPCA, through the associate vice president, will convene these associate deans regularly, similar to how associate deans of faculty affairs or research are regularly convened.

Create the vice provost for academic health sciences (VPAHS) position to report to Executive Vice President and Provost Karen Hanson. The purpose of the VPAHS is to establish a University-level academic leadership position for the health sciences, to centralize academic work in the health sciences, to introduce greater connections to and integration across other non-AHC colleges, and to provide increased support for interprofessional education.

Responsibilities for this new vice provost will include:

  • Convening the Academic Health Center Deans Council, consisting of the deans of the School of Dentistry, Medical School, School of Nursing, College of Pharmacy, School of Public Health, and College of Veterinary Medicine. The AHC Deans Council will also regularly meet jointly with the associate vice presidents for clinical affairs and research in order to best leverage the synergy of all AHC mission areas.
  • Leading and enhancing interprofessional education across the University. Recognizing that interprofessional education will often have a clinical component, interprofessional work in this new vice provost office will have a dotted line relationship to the associate vice president in the Office of the Vice President for Clinical Affairs.
  • Overseeing the Center for Allied Health Programs (CAHP).

We have great capacity for improvement in interprofessional education. With that in mind, the provost and I will charge a work group--led by the new vice provost, with participation from the AHC deans and faculty across the health sciences--to develop recommendations for how to better align and synergize all interprofessional activities.

The deans of the School of Dentistry, School of Nursing, College of Pharmacy, School of Public Health, and College of Veterinary Medicine will continue to report to the executive vice president and provost. The dean of the Medical School will be accountable to the executive vice President and provost for promotion and tenure and academic programming.

I recognize that the success of the restructuring of leadership and work in health sciences will depend upon the associate vice president in the Office for Clinical Affairs, the vice provost for academic health sciences, and an associate vice president in OVPR devoted to the health sciences having a close and successful working relationship. They should meet regularly, be in close contact, and most importantly, together develop, promote, and sustain synergies in the health sciences and across the University.

Realign AHC research centers into colleges or central units and evaluate their futures. Currently, the AHC is the administrative home to several centers and institutes. As outlined below, these centers will be transitioned to reporting to either collegiate deans or vice presidential units. As with the realignment plan as a whole, we will work with academic and administrative leadership and faculty governance to assess the effectiveness of these changes and adjust, if necessary.

  • The Clinical and Translational Science Institute (CTSI) and Masonic Cancer Center will report directly to the VPCA. The Institute for Health Informatics (IHI), Simulation Center, Community-University Health Care Center (CUHCC), and Institute for Molecular Virology (IMV) will report to the associate vice president under the VPCA. The Center for Global Health and Social Responsibility (CGHSR) will move to the vice provost for academic health sciences.
    • All of the aforementioned centers and institutes have clinical, academic, and research elements. I will be charging the six AHC deans to further assess the appropriateness of these designated homes. For example, the IHI is intricately connected to the CTSI, and it is also the home of academic degree programs, so its reporting structure is complicated. The assessment from the deans will include a recommendation for a long-term home for the IHI with an eye for its interdisciplinary academic strengths and its role in the clinical enterprise.
    • Similarly, the CGHSR is a hub for interdisciplinary research across several colleges and also fosters clinical trials around the world, and therefore, will clearly be tied to both the leadership of the vice provost for academic health sciences and the vice president for clinical affairs.
    • Research centers will continue to be strongly connected to the Office of the Vice President for Research and deliver on their mission to provide important clinical and translational research support across the University.
  • The Center for Excellence in Critical Care will move to the Medical School.
  • The Bakken Center for Spirituality and Healing will move to the School of Nursing.
  • The Center for Drug Design will move to the College of Pharmacy.
  • The Food Protection and Defense Institute will move to the Office of the Vice President for Research (OVPR) and continue to be linked to MnDRIVE Global Food Ventures work, and connected closely to the College of Food, Agricultural and Natural Resource Sciences, the School of Public Health, and the College of Veterinary Medicine.
  • The Center for Infectious Disease Research and Policy (CIDRAP) will move to OVPR.
  • The Center for Bioethics is currently under review, and we will wait for final recommendations in order to make a decision on the best location for this center.
  • The following AHC research services will move to OVPR: Research Animal Resources (RAR), Biomedical Genomics, and Biosafety Level 3 Labs (BSL-3).

All centers moving into colleges and central units should be reviewed for effectiveness and impact.

Realign AHC service units into the vice provost for academic health sciences or the vice president for clinical affairs.

  • The National Center for Interprofessional Practice and Education, Center for Health Interprofessional Programs (CHIP) and CLARION, Pre-Health Student Resource Center, and 1Health coordination will move to the vice provost for academic health sciences.
  • The AHC Simulation Center/Interprofessional Education Resource Center is important for both the academic mission and clinical affairs, so this is another unit, like the IHI, which I am charging the AHC deans to assess and forward recommendations to me. The AHC Simulation Center/IERC will continue to work closely with other simulation centers that currently exist in AHC colleges and schools.

Preserve the current governance model in the AHC: the AHC Faculty Consultative Committee and the Student Consultative Committee.

  • These governance committees are important to represent our faculty and students in the AHC and to address specific goals and concerns in the health sciences.
  • The executive vice president and provost, the vice president for clinical affairs, and the vice president for research will all be expected to meet with these governance
  • committees.

Restructure AHC operations (finance, human resources, information technology, facilities, emergency preparedness).

  • While realignment of several of the AHC operations has been effective, ongoing assessment to achieve greater seamlessness and efficiency is needed.
  • Where appropriate these operational units will be integrated into the Office of the Senior Vice President for Finance and Operations units and, as applicable, into the Office of the Vice President for Research and Office of the Executive Vice President and Provost.
  • The restructuring effort will determine the appropriate level of integration, including specific central reporting lines, the operational expertise needed for health sciences work, appropriate workforce levels, and the physical location of units.

Please see this draft organization chart (PDF) for visual representation of the AHC realignment.

I know that changes of this magnitude are often difficult. I also acknowledge that as we have consulted with you on this new structure, concerns have been raised. I look forward to working with leadership in the health sciences and faculty governance to develop evaluative measures that will be used to assess the effectiveness of this new structure. This will be an evolutionary process.

A new vision is necessary to lift our academic health sciences to the national and international prominence we all want, to improve our clinical services, and to elevate our health sciences research enterprise. Simply put, these changes are necessary to keep the University of Minnesota on our bold upward trajectory.

Our objective is to implement the above work plan with as little disruption to faculty and students as possible. The executive steering committee that will oversee the transition plan will be Executive Vice President and Provost Karen Hanson, Senior Vice President Brian Burnett, Vice President Jakub Tolar, Vice President Allen Levine, and one AHC dean. I will also charge a staff implementation workgroup that will immediately begin the process of reaching out to leadership and staff in the transitioning units to determine what changes can be made in the immediate future and where we will need more extensive planning. Please rest assured that the expertise and experience of individuals in the current AHC structure will be heavily utilized as we make these changes. I anticipate additional communications about the workgroup and time frame for changes in the near future. Teaching, research, and service activities should continue with little, if any, disruptions during these transitions.

Thank you for all you do for the Academic Health Center and the University of Minnesota.


Eric W. Kaler