The Utah Center for Clinical and Translational Science: transformation through collaboration.

The Intermountain West encompasses a 400,000 square mile area that includes the states of Utah, Idaho, Wyoming, and Montana. Within the region the University of Utah Health Sciences Center (UUHSC) is the only academic health center and Intermountain Healthcare (Intermountain), a not-for profit corporation, is the largest healthcare provider. The UUHSC and Intermountain are competitors for clinical market share in most service lines. Both UUHSC and Intermountain have significant research enterprises and each has different strengths. The University of Utah developed the first Biomedical Informatics Department in the nation, is internationally recognized for research in human genetics, and has robust programs in molecular medicine and other laboratory-based sciences. Intermountain is internationally recognized for health services research and programs in quality improvement. The impetus for collaboration in the research enterprise was however, limited before the national initiative to establish a consortium of academic health centers supported through the National Institutes of Health (NIH) clinical and translational science awards (CTSA). Here we describe the transformation of the clinical research environment in the Intermountain West as a result of the collaborative relationships developed between UUHSC and Intermountain following the establishment of the Utah Center for Clinical and Translational Science (CCTS) through the CTSA consortium. Founded in 1905, the University of Utah School of Medicine, located in Salt Lake City, houses 16 clinical and 6 basic science departments. In collaboration with UUHSC, the faculty and staff of the University of Utah educate and train healthcare professionals, conduct research, and provide medical care for adults and children in Utah and the surrounding Intermountain states. Intermountain Healthcare (Intermountain), founded in 1975, is a not-for-profit, integrated healthcare delivery system based in Salt Lake City, UT. Intermountain is the largest healthcare provider in the Intermountain West, providing healthcare services in southeastern Idaho plus the entire state of Utah and operating 23 inpatient facilities including one tertiary children’s hospital, Primary Children’s Medical Center [PCMC] in Salt Lake City, UT. Over 500 multi-specialty physicians are employed through the Intermountain Medical Group and hundreds of other affiliated providers practice in Intermountain hospitals and clinics. Within the region, competition related to clinical market share decreased the ability of institutions to collaborate. Exceptions included 1) the delivery of inpatient pediatric care at PCMC which is owned and operated by Intermountain and staffed by both UUHSC and Intermountain physicians and 2) the training of physicians to serve several western states in both urban and rural locations which resulted in a well-developed Affiliation Agreement defining teaching programs operated in several Intermountain hospitals for UUHSC trainees. Intermountain and UUHSC operate integrated residency and fellowship programs in medicine, obstetrics and gynecology, pediatrics, radiation therapy, and surgery. In contrast, the collaboration in the research enterprise for the past three decades had been limited to the efforts of individual investigators and there were no institutional policies or infrastructure to systematically support the research efforts across institutions or to share resources. The national competition to join the CTSA consortium provided an opportunity to re-evaluate the research relationship and to and develop and support research collaboration between both institutions. UUHSC and Intermountain joined forces in order to apply for a CTSA and to represent the Intermountain West in the consortium. The Utah Center for Clinical and Translational Science (CCTS) became part of the national CTSA consortium in 2008. Linkages created through the CCTS across both organizations have served to create productive and trusting work relationships, allowing us to provide a shared research infrastructure that takes advantage of our innovative systems and shared intellectual capital of personnel. These linkages have increased collaboration and resulted in significant benefits for both instituions.