The Buffalo Niagara Medical Campus: A New Vision of Collaboration

Extending across High Street is a boxy, sand-colored skybridge that takes pedestrians from Roswell Park Cancer Institute north to Buffalo General Hospital. There is something about this bridge that is perhaps emblematic of the Buffalo medical community's long struggle to find common ground: Heading north, it goes uphill.

Indeed, in the past, it has been an uphill battle to bring together the elements of the medical community: hospital administrators, health-care providers, researchers and medical educators. But not far from this superimposed walkway, a new vision of collaboration is taking shape in the heart of the city.

In April 2001, leaders of the University at Buffalo, Roswell Park Cancer Institute, Hauptman-Woodward Medical Research Institute, Kaleida Health System and Buffalo Medical Group Foundation announced the launch of the Buffalo Niagara Medical Campus (BNMC). The venture is being undertaken in partnership with the city and county, as well as with neighborhoods surrounding the 100 acres of land that encompass the campus, which, in previous years, had been informally referred to as the High-Street Medical Corridor.

The BNMC is administered by a board of directors whose members represent its founding institutions, each of which pays dues to belong to the organization and so has a vested interest in ensuring the successful outcome of the new project. The vision of the founding institutions is to improve the overall environment of the campus and its infrastructure in order to make it an appealing place for people to seek care, provide care, conduct basic and clinical research, and teach and train health-care professionals.

While the concept of the BNMC as a cohesive, integrated entity may be new, the site itself has long been a hub for health care and biomedical education and research in Buffalo. In fact, it was at the corner of Main and Virginia-the very heart of the present-day campus-that the UB school of medicine was first built in 1849. Kaleida Health's Buffalo General Hospital, as well as Roswell Park Cancer Institute, also have been located on the present-day campus for the better part of a century. Hauptman-Woodward Medical Research Institute was established on High Street in 1956. In 1985, Herbert A. Hauptman, PhD, the current president of the institute, received the Nobel Prize in Chemistry for a mathematical technique he developed to determine the structures of biological molecules.

Also located on the present-day campus are the Buffalo Medical Group (the city's largest consortium of practitioners) and UB's Research Institute on Addictions.

Late this summer or early in the fall, construction is set to begin at the BNMC on a modernistic three-building complex. The new 400,000-square-feet complex, which is scheduled for completion in two to three years, will comprise the following interconnected buildings:

* The new home for the UB Center of Excellence in Bioinformatics, a four-story, 129,000-square-foot building to be located at the corner of Ellicott and Virginia streets (currently the center is operating in temporary headquarters nearby at 901 Washington Street)

* Roswell Park Cancer Institute's new Center for Genetics and Pharmacology

* The new headquarters for the Hauptman-Woodward Medical Research Institute

The three buildings will have more than 22,000 square feet of shared common space, including conference rooms, meeting areas, auditoriums, a courtyard, and lobby spaces. Located throughout the complex will be kitchen preparation rooms for catering; there will also be a food kiosk where people from all three institutions can dine in conjunction with seminars and classes, or meet informally for coffee or lunch.

There will be 27,000 square feet of shared laboratory space, where facilities and services will be available for scientific staff members from the three institutions. This includes five shared laboratories in Roswell Park's building, four in UB's building, and four in Hauptman-Woodward's.

But the BNMC is not just about buildings. What is being envisioned for the medical campus is a total environment, with features including green space and "pocket parks," fountains, special lighting and signs. The intent, planners say, is to create "an integrated place for living, working and learning"-a place where workers, patients and ordinary citizens will want to spend some time.

An Asset to the Region

The University at Buffalo and its School of Medicine and Biomedical Sciences are key players in the project, which university officials say will benefit medical/biomedical education as well as Buffalo's economy.

"Our sense is that we need a stronger concentration of clinical activity and clinical faculty than has been there," says UB president William R. Greiner. "We need central places where faculty can be together. We need to rebuild a faculty culture on the clinical side of the medical school." The medical campus, he says, will create opportunities for medical school professors, clinicians, students and researchers to collaborate, compare notes-even just have a cup of coffee and toss around ideas. Says Greiner: "There's nothing like face-to-face."

The university will have a strong presence on the BNMC this summer and early fall, as construction on the new home for the UB Center of Excellence in Bioinformatics begins. At this state-of-the-art facility, researchers will use the university's massive supercomputing power to conduct analytical work on genes and their protein products in hopes of developing more sophisticated diagnostic devices, as well as targeted drugs.

"UB has to be a major player in anything involved with health, medicine and science in Buffalo," says Elizabeth D. Capaldi, UB provost. She says the university anticipates making "an appreciable economic impact" on the Buffalo community as a result of work conducted at the Center of Excellence in Bioinformatics.

The life-sciences industry based on work of the center will include the development of software, diagnostic tests, medical devices, therapeutics, bioinformatics services and genomics- and proteomics-based businesses. Currently, the forecasted demand for such products is formidable: The market for information-technology products in the life-sciences sector alone is estimated to be $43 billion by 2004. The bio-pharmaceutical and bio-device industries are expected to continue to grow at approximately 6 percent annually and to have worldwide annual sales in excess of $400 billion by 2004.

This demand, according to Capaldi, has the potential to translate work at the Center of Excellence into thousands of well-paying jobs in Buffalo, ranging from computer-support and laboratory technicians, to medical informatics, to research scientists.

Impact on Medical Education

The benefits to medical education may be just as dramatic, says Margaret Paroski, MD, interim dean of the UB School of Medicine and Biomedical Sciences and interim vice president for health affairs: "One of the main problems that we have is that, unlike a lot of other medical schools that own a university hospital, our students are trained in nine different hospitals. Once you start fragmenting and dispersing people, you don't have the corridor conversations and the type of collegiality that you have when people are all in one place. There's an inherent inefficiency to it." The BNMC, she says, mitigates such problems by creating opportunities for that collegiality.

Many variables remain as the project begins to develop, Paroski says. What shape UB's medical education will take in the future "is going to depend on what the campus really evolves into," she observes. "We have 280 people doing a clinical rotation at any one time. They need exposure to a whole range of fields: obstetrics, pediatrics, psychiatry. [The medical campus] becomes a focus for a subgroup of services. It offers great potential for research, for specialty services and as an academic think tank."

One possibility the medical school is considering, she explains, is an ambulatory care center on the medical campus. Such a facility, she says, would serve inner-city residents who don't have cars to drive to the suburbs for medical care, as well as other city residents who simply prefer to seek treatment closer to home.

And as the details of the medical campus evolve, she says, UB will continue to play the role of the visionary motivated by interests other than profit. "The university always has the advantage of serving as the noncompetitive umbrella, as the coordinator of services with a higher goal than money," she adds. "We don't pretend to be the people calling all the shots. We can step back and look at all the parties and try to help coordinate their interests.

"For example, UB is providing a lot of the faculty who are driving the academic research piece of the project. UB is a huge information source, and I think we bring a quality to the table in terms of an entity that has its foot in every camp and so is in a good position to appreciate where everyone is coming from."

As for the medical campus's economic aspects-its hoped-for role as a catalyst for the economic resurgence of Buffalo-Paroski is pragmatic. "The better shape the city is in, the easier it is for us to attract quality students and quality faculty," she says. "UB is a major player in the Western New York area, so we're obviously interested in the health of the city.

"But I think UB looks at this project from an educational and regional health-care perspective rather than from strictly a business perspective. The idea of being able to pull together the infrastructure to let groups work together is tremendously helpful."

Thomas R. Beecher Jr., a Buffalo attorney and investment advisor, serves as volunteer chair of the nonprofit organization that is overseeing the BNMC. He says that identifying new ways of working together has been key to the planning process.

Beecher points, for example, to the proximity of Roswell Park Cancer Institute to Buffalo General Hospital, institutions that require much specialized equipment and so could save money by sharing some of it. Likewise, he points out, patients with cancer often have other general medical problems, so it makes sense to make the transition across the street to Buffalo General Hospital as seamless as possible.

Beecher and others have seen how this kind of integration can work at such facilities as Longwood Medical Center in Boston. For one thing, he says, "the interplay between the scientists and the clinicians is very powerful. Even something as simple as a common meeting space, where people can share ideas, is very important."

As for UB's participation in the project, Beecher says, "My hope is that, long-term, the medical school would have even more of a presence there. We'll have lots of space to grow-far more space available than we'll need for 10 to 15 years."

Member of the "Fruit Belt" Neighborhood

Beecher also has been working to ensure good relations with the medical campus's neighbors in Buffalo's "Fruit Belt" section, holding public information sessions and making such goodwill gestures as sponsoring a spring cleanup in the neighborhood. Representatives from the Fruit Belt and Allentown neighborhoods are included on the planning committee for the medical campus. "For the project to be successful, it really shouldn't have borders at all," Beecher emphasizes. "Among other things, we want the Buffalo Niagara Medical Campus to provide jobs and health care for people in the neighborhood."

Indeed, one key to the medical campus's success will be the degree to which it encourages the people who visit and work there to explore the surrounding city. Toward that end, Beecher says, planners hope to have the Niagara Frontier Transportation Authority reconfigure the Allen-Hospital station of the Metro Rail so that Allen Street-which now dead-ends at Main Street, in front of the station-can continue east toward the medical campus. (A step in that direction was recently taken when the authority agreed to change the name of the station to "Allen-Medical Campus.")

At the very least, the reconfiguration of the station should encourage people to make the short walk across Main Street and patronize the businesses on Allen, in the city's artsy Allentown district.

"There has been inspiration and leadership for the project from the university and the medical school," Beecher says. "Bill Greiner has been very interested in collaborating across institutions, and now Dr. Paroski, as well. They already had a very significant investment in people there. They could see the benefit, from the university's perspective, of having a presence."

Amy M. Schmit, the medical campus's project manager, notes the "tremendous philanthropic support" for the project, in addition to investment by the component institutions and the city, county and state. That charitable support, she says, has included a $4.5 million grant from the Margaret L. Wendt Foundation and $10.5 million from the John R. Oishei Foundation.

"There's public and private support that's really going to have a tremendous effect on the economy of the region," Schmit says. "These institutions, through their operations at the BNMC, generate over $600 million in annual expenditures. What we're seeing here is the confluence of a lot of good things."

Another good thing Schmit has encountered while working to educate people about the BNMC is how the project is resonating in a very positive way with alumni of UB's school of medicine.

"We had a display booth for the BNMC at Spring Clinical Day in April," she recounts. "It was amazing to me the number of alumni who came up to our table and stopped to look at the maps and to tell me such things as 'fifty years ago when I was a student this is where I lived, this is where my classes were,' or 'I'd go down this street to the hospital.'

"I was touched to see how many people in the Spring Clinical Day audience had very distinctive memories of this geography and were really enjoying the notion of it being brought back to life again."