The Cleveland Clinic and Case Western Reserve University will form the Cleveland Traumatic Neuromechanics Consortium, the institutions announced Friday, pairing the Clinic’s talent in medical research, imaging tools and patient care with Case’s engineering expertise, especially in the area of neurology. It will focus on collision injuries from sports, military and automobile accidents.

The Cleveland Clinic was ranked the sixth best hospital in the country for neurology and neurosurgery by U.S. News last year, and it already has a lot brewing in the area of traumatic brain injury. Researchers are developing a biomarker blood test and an iPad2 app that are aimed at identifying concussions in football players, and a mouthguard that could measure the impact of blows to the head among athletes.

The partnership could help the Clinic gain ground in this area on other institutions known for their neurology programs like Johns Hopkins, Massachusetts General Hospital and Mayo Clinic, which announced in 2010 it would work with Intel Corp. to develop computer simulations for assessing the risk of head injuries.

Northeast Ohio also has a variety of companies working on technology for neurological injuries, including high-profile company Athersys, which is developing a regenerative medicine technique called MultiStem for treatment of traumatic brain injury. Cleveland-based Life Core Technologies is also developing a medical device to cool the brain of patients who sustain brain trauma.

Public safety net hospital MetroHealth System lost $2.7 million last year, but hospitals officials are feeling optimistic about 2012 and are predicting a $10 million surplus.

Recent trends have MetroHealth leaders feeling confident as they look toward the rest of this year: rising patient volume, a reduction in staffing expenses and an increase in outpatient services, The Plain Dealer reported.

Even though Metro’s 2011 loss of $2.7 million was greater than the $1.1 million loss that had been predicted earlier, officials pronounced themselves “positively joyful” about the year’s financial results.

Metro actually made money on operations ($3.3 million), but the net loss was due to charity care and debt financing costs.

Last August, MetroHealth officials warned of an anticipated $6 million operating loss for 2011. The hospital cut about 450 jobs last year to take a bite out of the loss.

The health system is in the midst of a search for a new CEO after current chief Mark Moran last month announced his intention to step down.

Moran is widely credited with helping turn MetroHealth’s financial situation around, but his tenure has also been marked by controversy over no-bid consulting contracts and generous pay packages to departing executives.

Benjamin Spock died in 1998 and soon after that, his famous book has had one co-author: Dr. Robert Needlman.

Needlman is a pediatrician at MetroHealth Medical Center and associate professor of pediatrics at Case Western Reserve University. He’s also a graduate of Yale Medical School and worked at Boston City Hospital. He’d been part of a team working on Drspock.com and got the job as the new Dr. Spock when he interviewed with Spock’s widow.

Needlman already was among a team of medical experts developing content for www.drspock.com when he went to dinner with Morgan more than a decade ago to discuss becoming the revising author of the eighth edition of Dr. Spock’s Baby and Child Care.

During the dinner, Needlman suddenly told Morgan he needed to leave.

Morgan was perplexed — until he explained that he had a nightly tradition of reading with his daughter, Grace, then 10, even when he was out of town and had to read over the phone.

He got the job.

“I said, ‘This is the kind of person that Ben would want to carry on his work,’ ” Morgan recalled.

Needlman has been sharing top billing with Spock for years on various books and handled the eighth edition of Spock’s famous book as well. The ninth edition of Dr. Spock’s Baby and Child Care, released Tuesday, adds advice on everything from immunizations and obesity to special needs children and video games.

Needlman had a literary reputation beyond Dr. Spock. His undergraduate degree at Yale was in English literature. While in Boston he helped start Reach out and Read, a  nonprofit that promotes the value of reading out loud to children. He’s also written for Yahoo! and Parent and Child Magazine.

[Photos courtesy of Wikimedia commons and Primrose Schools]

UPDATE: Morgan writes with these addendums.

Cleveland Clinic did what all health systems do in mid-December: send out news-you-can-use, 2012 predictions about better health in the coming year. This one included top medical tests people should get in 2012.

Unfortunately, one of the leading media watchdogs on health news treated the tips like a bad infection. And now the release — which I couldn’t find on the Cleveland Clinic’s website — has become a symbol for a hot-button topic among medical professionals and media types: poor and cheesy medical information.

Gary Schwitzer of HealthNewsReview.org took aim on Dec. 19 at the Cleveland Clinic’s news tips. That critique has popped up across health sites since then and most recently on Dr. Val Jones’ GetterBetterHealth.com.

Schwitzer’s site usually targets news media outlets and is dedicated to improving the accuracy of news stories about medical information with the goal of “helping consumers evaluate the evidence for and against new ideas in healthcare.” Its criteria: accuracy, balance and completeness.

Schwitzer’s takedown of the release was merciless, particularly around the tests for men. He quoted the lists and offered his critique afterward (in red).

• “High-sensitive C-reactive protein — High levels of this inflammatory biomarker are predictive for future heart problems.” But the US Preventive Services Task Force, by comparison, states that “the evidence is insufficient to assess the balance of benefits and harms of using high-sensitivity C-reactive protein to screen asymptomatic men and women with no history of coronary heart disease.”
• “Vitamin D level — Low levels are associated with osteopenia, osteoporosis, breast cancer, colon cancer and heart disease.” But the Endocrine Society, by comparison, published a guideline recommending that doctors “screen for vitamin D deficiency in people at risk for deficiency, including obese individuals, blacks, pregnant and lactating women, and patients with malabsorption syndromes. “We do not recommend population screening for vitamin D deficiency in individuals who are not at risk,” the Society’s task force chair said.
• “PSA level — To screen for prostate cancer.” Do we really need to go through this again? The US Preventive Services Task Force doesn’t make that recommendation. The American Cancer Society doesn’t. This kind of blanket recommendation for men of all ages to be screened for prostate cancer does not reflect the growing call for fully informed, shared decision-making to take place regarding PSA testing.

Schwitzer goes on to take on the women’s side of the health tips, in particular: “Women do not have to have the PSA test, but they should have a routine breast exam and pap smear.”

But, by comparison, the USPSTF states that “the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination beyond screening mammography in women 40 years or older” and the Memorial Sloan-Kettering Cancer Center states that clinical breast exam “adds little to mammography in reducing breast cancer deaths.”

He ends the entry by saying: “We’re going to see a lot of these ‘what to do in the New Year’ health tips columns. We hope more of them are more evidence-based than this one was. And we hope that journalists don’t act on these news tips without doing their own  homework on the state of the evidence.”

Cleveland Clinic didn’t respond for a request for comment.

Health systems are going to be getting more of this scrutiny, which is typically reserved for journalists or academic journals. Cleveland Clinic’s media relations section actually takes you to a section called the Cleveland Clinic Newsroom. That’s a completely appropriate title, by the way, in an era where hospitals are even more trusted than journalistic enterprises like WebMD.

One of the toughest jobs in healthcare — CEO for a public/charity hospital — opened up in Cleveland on Friday. Mark Moran, the leader of MetroHealth Medical Center in Cleveland, told staff  members he wouldn’t renew his contract when it expires in March.

His email to the staff is as follows:

MetroHealth is on the right path.  The System is providing more care for the uninsured at a lower subsidy.  The ACCESS Campaign is proven.  The patient centered medical home is working.  The Medicaid waiver holds the promise of insuring more County residents.  The Middleburg Heights ambulatory center will soon break ground.  The campus master plan will define a sustainable future for the System.  The faculty ranks have grown and their commitment to MetroHealth is secure.  The management team is talented and accountable.  The 2012 budget is realistic.

However there is a lot more to do.  Most importantly, healthcare reform will bring changes that we see only dimly now.  MetroHealth needs a CEO that will lead the System to and through 2014.  As you know, when I joined MetroHealth in 2008, my intention was to stay only two years and I have already stayed four.

Therefore I have notified the Board that I am not going to enter into a new contract as President and Chief Executive Officer.  I will work through the end of my current contract and assist in the leadership transition.

I have been privileged to have worked with all of you and am honored to have shared in the valuable work done at MetroHealth.

How hard is it to be the CEO of a public health system in the era of looming healthcare reform? Moran himself called public hospital an endangered species, facing the specter of decreased federal payments, narrower to disappearing margins around charity care and likely fewer paying patients.

Rumors poured out of MetroHealth earlier this year that the health system was all but planning its inevitable acquisition by another health system in the region. Moran directly refuted these assertions, however, saying: “MetroHealth’s elimination is not inevitable!” He added: “The future is uncertain, but we have shown the determination to take our destiny in our own hands and build for it.”

Metro, meanwhile, had been pummeled by the local press for a series of goof ups and missteps, and faced increasing scrutiny from government officials who provide a small subsidy to the hospital. And it continued to trim jobs related to the challenges of uncompensated care.

Who will be the person to take on this job?

“We will look for a person whose view of health care is significantly patient-centric, who understands public health care and who has sound knowledge of the health care business,”  said board Chairman Ronald Fountain. “The new CEO will understand and believe in our mission and understand the impact of this organization on the community and the community’s impact on the organization.”

Metro says a time line hasn’t been set yet, but the board will form a search committee to identify Moran’s successor.

A former consultant who helped Metro develop a new strategic plan before becoming interim CEO and president in 2008, Moran was named permanently to the position in 2009. Under his leadership, Metro turned around several years of operating losses with three consecutive years of surplus, although a spike in charity care and reduced reimbursements has led to expectations that Metro will just break even this year.

Fountain noted that Metro has also expanded its care, providing 220,000 unreimbursed visits this year and fully integrated an electronic medical records system under Moran.

“With a solid foundation and a secure direction now in place, and health reform on the horizon, Mark is confident that it is time for new leadership to carry MetroHealth forward,” Fountain said.

Chris Seper contributed to this report.

This post is sponsored by Cervilenz Inc.

12.9 million babies are born too soon every year around the world, and 1 million of those babies die. The United States has the second-highest rate of prematurity in the world.  Here, 1 of 8 babies is born prematurely, and these early deliveries are the leading cause of infant death and many long-term disability and health complications. It’s time to do more.

For more than a decade, researchers have been talking about cervical length as the best predictor of preterm birth risk. The shorter the cervix, the higher the risk. A big problem without a solution. Until now.

This year, researchers are talking about an evidence-based intervention for prematurely short cervix. There is now conclusive data that vaginal progesterone treatment for women diagnosed with a short cervix mid-pregnancy reduces the rate of prematurity by 45% and improves infant outcomes. Diagnose a short cervix, and now we can treat it.

Today, leading Maternal-Fetal Medicine experts are calling for a fundamental shift in obstetrics practice to start measuring cervical length for all pregnant women to find high-risk patients for treatment.

Cervilenz Inc. – a small, venture capital-backed company – is poised to play a vital role. The company’s new CerviLenz® device gives doctors an immediate cervical length measurement during any prenatal visit.
While Americans are prone to look for high-tech solutions, sometimes the best answer is something simple. That’s what CerviLenz is  – a simple, low-cost device that identifies pregnant women with a prematurely short cervix.
Prematurity is a $26.2 billion problem in the U.S. annually. When more moms have healthier babies, we save millions of dollars. Improving care while reducing cost. Today is a new day in the world of prematurity.
Learn more at www.measure2besure.com.

Melanie Sweeney

This post is sponsored by Cervilenz Inc.

November is a time for thanks.  Every day, I am thankful for my husband, Jim, and our three healthy children – Emmett, Riley, and Allie. But, this time of year is a mixed blessing for me.

November is Prematurity Awareness Month.   Every minute of every day, a baby is born prematurely.   That’s 1 of 8 babies, and it’s the leading cause of infant death.   On October 29th, 1993, my twin daughters were born three months too soon.  Annabelle died at birth.  Isabelle lived for only 10 months. I’m grateful for all the time and effort of so many people to bring attention to this huge problem of prematurity.

I’ve dedicated endless hours to spreading hope, supporting other families like ours, and helping raise money for research.  This year is different because there’s a new message  — and it’s great news.  Researchers have found a way to prevent prematurity for some pregnant women.   A study sponsored by the NIH showed that daily vaginal progesterone started mid-pregnancy for women diagnosed with a short cervix reduced their rate of prematurity by 45%.

For such a complex, multi-factorial disease, this research offers a simple solution.  Measure cervical length to identify high-risk patients.  Treat those high-risk patients with vaginal progesterone.  The result:  fewer premature births and healthier babies.

When I met Dean Koch in 2008, just after he founded Cervilenz Inc., he told me this day would come as he showed me the CerviLenz® device.   This low-tech yet sophisticated device makes it easy to measure cervical length during any prenatal visit.  CerviLenz is going to be part of the solution to the worldwide epidemic of prematurity.   That’s why I’m proud to help bring this novel device to market.

The stakes are too high to rely on someone’s finger to estimate cervical length.  There’s plenty of evidence that abdominal ultrasound isn’t reliable either.  Transvaginal ultrasound can provide an accurate cervical length measurement, but this high-tech exam is not available for all pregnant women in the United States, much less abroad.  CerviLenz is cost-effective innovation.

The annual economic toll of prematurity in the U.S. is $26.2 billion.  Preventive medicine saves money.   One cost analysis showed a savings of $19.5 million for every 100,000 pregnant women evaluated for short cervix with transvaginal ultrasound and treated with vaginal progesterone as appropriate.  CerviLenz can help save even more.

This November, I’m thankful for Dr. Rosalyn Baxter-Jones who invented CerviLenz, my colleagues at Cervilenz Inc. who all share my passion for fighting prematurity, and the company’s investors (Arboretum Ventures, Chrysalis Ventures, JumpStart Ventures, and North Coast Angel Fund) who give hope to moms like me.

Medical professionals, learn more at cervilenz.com.

Moms-to-be, learn more at measure2besure.com.

The Novant-Cleveland Clinic affiliation is not the first such collaboration for a Charlotte-area hospital. In 2010, CaroMont Health, which operates Gaston Memorial Hospital, announced a partnership with Columbia HeartSource, part of New York Presbyterian Hospital/Columbia University Medical Center. CaroMont doctors visit the N.Y. hospital, and N.Y. doctors have scrubbed in on surgeries at Gaston Memorial. Doctors confer about patient cases weekly, and CaroMont offers procedures that weren’t available before.

“This is really a new paradigm in medicine,” said Dr. Paul Kurlansky, a cardiac surgeon with Columbia HeartSource. It’s a way for top-tier academic medical programs to share what they know with community hospitals and begin to reduce disparities in medical care across the U.S., Kurlansky said. “You will start seeing this increasingly throughout the country.”

This is all about the race to tertiary care access which is increasingly being restricted. The hospital system that offers continued access to advanced therapies will hold a competetive (not to mention) financial advantage.

Neurowave's NeuroSense brain monitor

Cleveland neurotechnology device company NeuroWave Systems is ramping up its global marketing efforts by releasing the next-generation version of its flagship anesthesia-monitoring device in Canada and Europe.

The new model of the NeuroSENSE Monitor, which uses an algorithm to help doctors tailor the amount of anesthesia patients need by displaying and interpreting electroencephalogram (EEG) signals from both sides of the front of the brain, is smaller and lighter than its predecessor, according to a press release from the company.

Its 10.4″ compact version also includes more advanced software capabilities for users to access recorded data, and uses an advanced algorithm to better detect signals in noisy recordings.

The device received the CE Mark in June of 2010 and received a license to be marketed in Canada last August. NeuroWave signed a deal with CareFusion (NYSE: CFN) to distribute the device in December.

“With this new generation of NeuroSENSE product, we plan to implement an aggressive market expansion together with our distribution partners,” said Tatjana Zikov, president and CEO of NeuroWave, in a press release.

The company is raising up to $5 million to fund new hires to support the distribution of NeuroSENSE and to work on gaining FDA approval of the device, Zikov said in July. Chairman Bob Schmidt said the company has also brought manufacturing of the device to Cleveland from overseas.

“We’ve made significant progress there, reducing the price of the device,” he said.

The company already has FDA clearance on its basic device, the NeuroFAST Monitoring System. He said the challenge now is getting U.S. clearance for the NeuroSENSE and other algorithms the company has developed to detect seizures and control delivery of anesthesia and analgesia drugs using brainwaves.

The company was created in 2003 and spun out of its parent company, CleveMed, in 2008. Initially it relied on federal and state grants and contracts to develop NeuroSense and its other brain monitoring technologies.

A review of life science current events reported by MedCity News this week:

Cleveland’s most in-demand biotech and medical jobs. Even as Ohio bled jobs over the last decade, employment in its bioscience industry grew 20 percent. Now, with a new analysis showing the state ranked an impressive fourth in the nation in job creation over the last year, hiring for biotechnology and medical jobs seems likely to pick up even more.

Nanotechnology in North Carolina: How N.C. became a nanobiotech hub. Silicon Valley, Boston and Houston are the nation’s top three nanotechnology hubs. Silicon Valley and Boston have nanotech companies in various industries, including medicine. Houston excels in energy applications. Raleigh, North Carolina broke into PEN’s top ranks in 2009 and is still climbing.

Cardinal Health sees opportunity (but faces challenges) in specialty drugs. Sales of specialty drugs are expected to explode in coming years — and therein lies the opportunity for Dublin, Ohio-based Cardinal and competitors AmerisourceBergen (NYSE:ABC) and McKesson (NYSE:MCK).

OXBT fires CEO Chris Stern ‘for cause’ after audit investigation. Stern, who was also chairman of Oxygen Biotherapeutics’s board of directors, will not receive any severance, according to terms of an employment agreement signed on May 13. Stepping in as interim CEO is CFO and treasurer Michael Jebsen, who has worked for Oxygen Biotherapeutics since 2009.

Blood analysis medical device gets FDA clearance for Tem Systems. Tem Systems has received U.S. Food and Drug Administration 510(k) clearance on new tests for its hemostasis analyzer and now the company aims to offer the technology to a wider group of users in the United States.

A. Malachi Mixon, the longtime CEO of Invacare Corp., was honored as The Cities’ Medical Mayor — its person of the year award. Explorys, which has a cutting-edge approach to medical data that has won it millions in investment and top-flight customers within two years, was named Startup of the Year.

Others honored included Cleveland Clinic Innovations for its achievements in commercialization; MIM Software for bringing the first FDA-approved app to Apple’s App Store; and ChanTest for its role in supporting the goals of healthcare.

The Cities are national awards that honor innovation, entrepreneurship and achievement from America’s elite medical cities. The first round of awards were given in Cleveland. Additional Cities Awards will be handed out in the Twin Cities in Minnesota, Research Triangle Park in North Carolina, as well as other select markets.

A representative from The Ewing Marion Kauffman Foundation presented the awards.

It’s exciting to honor invaluable members of Cleveland’s medical community. These companies and individuals were chosen among nominations submitted by readers of Medcitynews.com and our staff as the stand-outs among a community of impressive candidates. We are thrilled to partner with The Kauffman Foundation to present these trophies and to recognize their contributions.

The Cities awards were conceived because life sciences and healthcare have so many innovation hubs: places like Research Triangle Park, Boston, Philadelphia, Minneapolis-St. Paul, Cleveland and beyond. It’s easy for some of healthcare’s greatest contributors to go unnoticed. So The Cities, along with MedCityNews.com, will recognize these local superstars to our nationwide audience of healthcare stakeholders.

A. Malachi Mixon of Invacare received Medical Mayor — the “person of the year” award recognizing the recipient’s insight, vision and contribution to healthcare. Mixon, recently retired CEO of Invacare Corp., was the driving force behind Invacare’s dramatic growth from wheelchair maker to the world’s largest home health products manufacturer.

Explorys, named The Cities Startup of the Year, was founded in 2009 and provides health data management, namely in the form of electronic medical records, an industry that is sure to see tremendous growth in the coming years. Explorys’ database not only manages the individual records, but is capable of scraping the files for trends and patterns that can be applied to improving patient safety and clinical effectiveness.

MIM Software was honored as The Disruptor — a company that has made a major breakthrough in the last 12 months. MIM Software is the developer of the first-ever mobile radiology application. MIM’s endless FDA-approval saga has helped pave the way for similar applications to be accepted by the agency. In uniting the traditionally conservative and slow-changing healthcare industry and the fast-paced and constantly-morphing technology world, MIM Software has provided critical innovation and a way forward.

ChanTest was named  Healthcare Ally — honoring a service provider that has demonstrated extraordinary service to healthcare. ChanTest recently signed an agreement with the FDA that will facilitate collaboration on predicting the risk of cardiac arrest associated with various drugs and substances, which represents just a small part of ChanTest’s contribution to patient safety and pharmaceutical development.

Cleveland Clinic Innovations received The Paragon award for an organization, company or institution that demonstrates national or global excellence. Cleveland Clinic Innovations includes, among its vast projects, developing methods of medical device marketing in Europe, backing start-ups ImageIQ and SironRx and hosting an innovations summit for the most recent and important inventions in the industry.

The Cleveland-based company knows data, or as its executives like to say, “Big Data.” Explorys has started a Google-like service that helps researchers analyze in real-time information culled from troves of electronic medical records (EMRs). The idea is that medical researchers can mine the vast amounts of data to learn how variations in treatment can affect outcomes, uncovering best practices to enhance patient care and lower costs. The company’s technology was developed by a physician formerly at the Cleveland Clinic, which is an Explorys investor.

As part of the so-called Big Data movement — a term that refers to the analysis of large data sets — Explorys has positioned itself in a high-growth industry that federal officials say has the potential to revolutionize healthcare in America.

“I think we’re a next-generation company like Google and Facebook with a really important mission,” CEO Steve McHale said.

Launched just two years ago, Explorys has already made impressive progress  — raising $15 million in investment funding and growing to 25 employees. But what makes Explorys so promising is that it’s only just begun. The company plans to employ 100 by the end of next year. McHale dreams of an initial public offering, which would represent a huge milestone for the company — though that’s at least several years away — as well as a day when the company employs as many as 1,000 people.

“We have attracted the best people and they truly live our mission of ‘improving healthcare through the use of Big Data,’” McHale said.

For Explorys, bigger certainly is better.  As more medical records are loaded into its database, the stronger the conclusions researchers are able to draw from that data. In a short time, the company has inked deals with six U.S. health systems ranging from the East Coast to the Midwest to the West Coast. Earlier this summer, Explorys scored a big win when it added California-based St. Joseph Health System to its network.

McHale listed attracting prominent health system clients like St. Joseph and MedStar Health in Maryland as Explorys’ top recent accomplishments.

McHale and Explorys cofounder Charlie Lougheed have tasted success before. The partners sold their previous company, Everstream, for $15 million. That proven track record no doubt gives investors confidence that Explorys will be another lucrative success story.

“We believe Cleveland is a great place to build a disruptive company like Explorys,” McHale said.

A. Malachi Mixon III

A. Malachi Mixon III – known to most as Mal — is one of the Cleveland healthcare industry’s entrepreneurial successes. But that’s just one of the reasons why he is MedCity Media’s first recipient of “The Cities” Medical Mayor award, which recognizes his insight, vision and contributions to healthcare. “The Cities” awards honor the best, brightest and most innovative in Cleveland’s healthcare scene.

Mixon’s  story, told modestly, goes something like this: A small-town Oklahoma boy becomes the first from his school to attend an Ivy League college, and after a four-year stint in the U.S. Marine Corps and a return to Harvard for a business degree, he recruits some investors and uses his own savings to purchase a wheelchair company. He then  spends the next 30 years developing that company into the world’s largest home healthcare device maker and distributor.

Mixon purchased Invacare from Johnson & Johnson’s Technicare unit in 1979, when the company had about $19 million in annual sales. He took it public in 1984 for $11 a share. When he gave up his post as CEO this past November, Invacare was trading for around $27 a share and made $1.7 billion in annual sales in 80 countries.

Throughout his tenure, Mixon diversified the company by completing  roughly 57 acquisitions, growing it from three factories with 300 employees to more than two dozen factories with 3,600 employees. Invacare has churned out innovative wheelchairs, devices and equipment for the comfort and care of seniors and people with disabilities.

“I added 6,000 jobs in the world — I’m pretty proud of that,” he said reflecting on his accomplishments with the company. “We were an obscure wheelchair company in the early years and have grown to be the biggest company in our market.”

But his contributions to the healthcare community don’t stop there. He’s also helped launch several companies in Cleveland — most notably another big medical player, Steris Corp.

In his “off time,” Mixon has devoted himself to  many community organizations; for starters, he was part of the group that founded BioEnterprise, the economic development organization that has helped put and keep Cleveland on the radar as a hotspot for healthcare innovation.

He also served as chairman of the board of trustees at the Cleveland Clinic for 13 years and is now chairman emeritus of the board of directors and board of trustees.

A trained piano player and self-proclaimed classical music lover, Mixon also sits as chairman of the board of trustees for the Cleveland Institute of Music.

Although Mixon stepped down as CEO of Invacare in November, he remains chairman of the board of trustees and is still involved in the big-picture happenings of the company. “I’m spending a lot of my time on Washington matters, because reimbursement is the key to our future,” he said.

In 2009, Invacare led the way in lobbying spending among Ohio healthcare organizations, a testament to the company’s efforts in Washington, D.C. Over the past decade, Mixon has become an outspoken advocate for home healthcare, lobbying on issues from Medicare reimbursement to the medical device tax. He says his biggest concern now is the uncertainty of where healthcare is headed policy-wise and the lack of a clear vision in Washington.

Uncertainty aside, Mixon looks forward to expanding research and development efforts at Invacare over the next several years and watching his company continue to grow.

In early 2008, MIM’s developers began hammering out the initial lines of code to what three years later became the first-ever medical imaging mobile app to be cleared for sale by the U.S. Food and Drug Administration.

“It wasn’t part of our business plan. It just happened,” said Chief Technology Officer Mark Cain. “Two of our employees began writing the code just to see if they could do it.”

It’s that visionary work and first-mover status that makes Beachwood, Ohio-based MIM Software the first winner of MedCity  Media’s “The Cities” Disruptor Award, given to a company that has made a major breakthrough in the last 12 months. “The Cities” awards honor the best, brightest and most innovative in Cleveland’s healthcare scene.

“I am proud that we haven’t lost sight of the goal to improve the healthcare of patients through our software, even as we have grown from four people in a one-room office nine years ago to over 60 employees today,” Cain said.

The company navigated through a lengthy, two-year minefield of regulatory uncertainty to obtain FDA clearance of its Mobile MIM app, which shrinks the size of radiology images like CT and PET scans and transfers them securely while still allowing physicians to measure image intensity values.

MIM has created versions of the app for the iPhone and iPad. The company hopes the app makes reading medical images more convenient and spurs more collaboration among physicians.

In May, the company released another app, the VueMe, that allows patients to view medical images sent to them by doctors.

In addition to the mobile radiology app, MIM sells several other software imaging packages used in oncology, neurology and cardiology. The company recently released the second-generation version of its web-based MIM Cloud software, which allows for the transfer and sharing of radiology images.

MIM Software got its start after founder and CEO Dennis Nelson saw that the technical limitations associated with viewing medical images like CT and PET scans were harming doctors’ ability to provide the best patient care. He worked nights and weekends to come up with a software package to better align the two types of images, and that software eventually became the company’s MIMfusion product.

So what’s next for MIM Software? Cain points to one of the company’s most recent products, MIM Symphony, a software package that helps doctors perform a procedure called low-d0se rate (LDR) brachytherapy. The procedure can be used to treat breast and prostate cancer, and involves implanting radioactive seeds into the body. The procedure can offer fewer side effects and less discomfort than traditional radiation therapy.

Cain said the new software package fits with the company’s mission of providing physicians with the tools they need to improve patient care. If MIM Software sticks with that ethos, it’ll likely help Cain achieve his own goals for the company.

“My goal is to keep MIM Software a place I’ll want to work at 20 years from now, because of the joy in what we’ve accomplished and the quality of life and satisfaction we’ve made possible for our entire staff,” he said.

Cleveland Clinic Innovations, led by Executive Director Chris Coburn, leverages the ideas and technologies coming out of the Clinic by transforming promising therapies, devices and diagnostics into products through spinoff companies and licenses to existing companies. In its second decade of existence, CCI spins out more than 200 new inventions per year.

Last April, CCI opened the doors to its state-of-the-art, 50,000-square-foot Global Cardiovascular Innovation Center on Cedar Avenue, which now hosts 27 up-and-coming biomedical companies. Made possible through a $60 million grant from Ohio’s Third Frontier Program, GCIC focuses on the formation, attraction, expansion and retention of cardiovascular companies to create jobs and facilitate economic development in the region.

It’s doing that with startup companies that are already making a splash, like Explorys Medical Inc., the winner of MedCity Media’s Startup of the Year award. Another GCIC company, SironRX, just closed a $3.4 million round to fund clinical trials of its wound therapy technology and the hiring of senior management and clinical staff. CCI spinoff Cleveland HeartLab just rejected an acquisition offer to continue growing the company, which has 70 employees after its first two years.

But one CCI company did accept an acquisition offer this year: 2011 started off with a bang when neuromodulation technology company IntElect Medical was acquired by Boston Scientific for $78 million in January.

A week later, CCI signed a deal with Maryland-based MedStar Health to do just what it does in Cleveland — help develop and commercialize medical inventions from the system’s clinicians.

In addition to spinning off companies and licensing products, CCI also runs the Atrial Fibrillation Innovation Center, established in 2005, and the Clinical Tissue Engineering Center.

Next up for Cleveland Clinic Innovations is bringing together hundreds of the world’s top innovators for its annual Medical Innovations Summit in October, a testament to the global impact that makes CCI a true medical paragon in Cleveland.

Add another: The Cleveland-area company has been chosen as the first recipient of MedCity Media’s ”The Cities” Healthcare Ally award, given to a service provider that has demonstrated extraordinary service to healthcare. “The Cities” awards honor the best, brightest and most innovative in Cleveland’s healthcare scene.

ChanTest helps its clients by making the drug development process faster and cheaper. The company works with the world’s largest drug companies, such as Eli Lilly, Pfizer and GlaxoSmithKline, to screen drug candidates to find the ones most likely to become safe and effective pharmaceuticals.

“We’re developing drugs that are going to improve the quality of life and safety for a whole bunch of diseases,” Founder and Chief Science Officer Arthur “Buzz” Brown said. “Nobody else in the world can do what we can do with this particular set of drug targets.”

To understand what ChanTest does — Brown calls the 70-employee company a “niche clinical research organization” — it’s necessary to gain a little insight into what ion channels are. Think of them as valves in cell membranes that open and close to let certain ions (such as potassium or sodium, for example) in and out.

Ion channels make up about 10 percent of all drug targets, according to Brown, and are linked to a long list of diseases, including cystic fibrosis, diabetes, cardiac arrhythmias, neurologic and psychiatric diseases, gastrointestinal disorders, and hypertension. ChanTest has developed the world’s largest library of ion channel drug targets, Brown said.

He likens the company’s research process to a giant funnel. At the top are hundreds of thousands of drug candidate compounds that are tested for their effects on ChanTest’s library of drug targets. Those hundreds of thousands of compounds likely yield two or three promising drug candidates that go on to be tested in animals.

“We toss everything but the kitchen sink at a bunch of targets and see what sticks,” Brown said.

The company’s strong reputation in the industry helped it earn a research contract with the U.S. Food and Drug Administration earlier this summer. The deal calls for ChanTest to develop a large database of side effects associated with cardiac drugs, as well as a model to predict whether in-development drugs are likely to pose a risk to cardiac health.

As for the company’s future, Brown says it’s in “growth mode.” He points to a 2009 acquisition of Maryland-based Applied Cell Sciences as an example of ChanTest’s endeavors to broaden its expertise.

“We plan to expand our offerings,” he said. “We have a fair bit of cash and we’re looking for an acquisition.”

Last year it all came crumbling down around the healthcare architecture firm Perspectus. One point away from victory in the 2010 MedCityNews.com Medical Cornhole Tournament, they lost to eventual champions Medical Mutual.

But there are no Buffalo Bills in healthcare cornhole. Perspectus returned to the finals again and this time won the 2011 version of the MedCityNews.com Medical Cornhole Tournament, edging a team representing the city’s Health Tech Cooridor.

Victory is always sweet. But it’s often best served up by your peers. Perspectus was one of 60 cornhole teams culled from the medical industry, while more than 200 people attended Thursday’s event in Gateway Plaza in downtown Cleveland. Everyone from Cleveland’s University Hospitals and EMH Healthcare; startup companies including NDI Medical, Explorys, CleveMed and Cervilenz; trade organizations such as Ohio Hospital Association and BioEnterprise; and businesses such as Perspectus, Carleton McKenna financial services and Squire, Sanders & Dempsey participated this year.

This year’s cornhole tournament included victory through competition but also through recognition. MedCity Media unveiled its first The Cities awards, national awards that honor innovation, entrepreneurship and achievement from America’s elite medical cities. The first round of awards were given in Cleveland. Addition Cities awards will be handed out in the Twin Cities in Minnesota, Research Triangle Park in North Carolina, as well as other select markets.

Sincere thanks to the event sponsors that made this year’s gathering – already the best networking event in the life sciences – an even more amazing, dynamic and fun event. The Ewing Marion Kauffman Foundation, STERIS, Downtown Cleveland Alliance, Benesch, Sequentia, The Ohio State Medical Association, The Krill Company, Case Western Reserve University School of Medicine, TWIST Creative, Perspectus, RGI, Studiothink and Thunder::Tech truly delivered for the community.

One example was RGI providing “Angry Birds Cornhole,” while STERIS’ enthusiasm before and during the event made it even better. And we’re honored to have Kauffman Foundation inject even more entrepreneurship into an event meant for the innovators across the life science and medical sectors.

The event maintained its tradition of fun that united different segments of the medical industry — service providers, hospitals, startups, investors and others — for a few hours of camaraderie, competition and community. Last year’s champions, Medical Mutual, showed up in royal robes and crowns (only to be bounced in the third round). And players traveled from everyone from Columbus to Kansas City to Pittsburgh to take part.

We’ll post additional photos and video of the event as the day goes on. Thanks to everyone for making it a tremendous event.

First, MetroHealth’s Board and management team have demonstrated an ability to manage the organization to deliver the mission at break-even or better financial results. MetroHealth has run in the black since 2008 after a decade with seven years of losses. More importantly, MetroHealth delivered 200,000 uncompensated visits in 2010, up 25 percent since 2008, demonstrating our commitment to mission. We use margin to do mission!

Second, MetroHealth’s mission will never make an attractive acquisition target. As a public safety net hospital almost 20 percent of our care is uncompensated. The coverage expansion in health reform may give half of those patients insurance, but Medicaid rates will probably decline, as you report. So medical care for lower income patients will continue to be a money losing proposition. The County subsidy only pays for one third of the cost of our uncompensated care, so that cannot be the rationale for acquisition. Therefore MetroHealth can only be an attractive target if the acquirer can jettison the mission. We who are committed to provide access to all will fight that prospect zealously.

Third, your view that no one with alternatives will come to a safety net hospital is belied by the data. In Massachusetts ambulatory care visits to safety net providers grew at over twice the rate as visits to non-safety net providers once uninsured patients were covered. (Arch Intern Med/Vol 17/Aug 8/22 2011: Safety Net Providers After Health Care Reform). Assuming that MetroHealth is not attractive to patients with choice is a leap too far. We are planning to serve the influx of newly insured patients with the same convenient, high quality medical services we provide today.

MetroHealth’s elimination is not inevitable! Our Boards, physicians, staff and management come to work every day with a commitment to deliver outstanding care to all. The future is uncertain but we have shown the determination to take our destiny in our own hands and build for it.

It appears that pharma stocks fared better than medical device and biotech stocks. GlaxoSmithKline (NYSE:GSK) was down a mere 28 cents to close at $39.44 on Monday. Pfizer (NYSE:PFE)  was down 45 cents to $16.66. Abbott Laboratories (NYSE:ABT), however, fared a little bit worse with its share price falling by $1.24 to close at $48.06.

In the world of medical devices, Boston Scientific (NYSE:BSX) came home least battered with its share price falling only 29 cents to close at $6. However, its single-digit stock price doesn’t really afford much comfort. Medtronic (NYSE:MDT) and St. Jude Medical (NYSE:STJ) both had reductions of more than $2 each to their share prices, which fell to $31.07 and $41.12 respectively. Stryker (NYSE:SYK) closed at $47.43 after a drop of $1.51, while Zimmer (NYSE:ZMH) was at $53.90, down $1.76.

Biotechnology stocks like Amgen (NASDAQ:AMGN)  was cut to $49.88, a decline of $1.78 . Gilead Sciences (NASDAQ:GILD) slid only 22 cents to close at $36.82, while Biogen Idec (NASDAQ:BIIB) took a bigger hit dropping $3.29 to finish at $88.

These are just a sampling of some stocks in each sector and how they survived Manic Monday. Feel free to add how other stocks weathered the maelstrom in the comments section.

The future of public hospitals throughout the United States is imperiled, and for a preview on the impact of U.S. healthcare reform on hospitals, look no further than Cleveland’s public safety-net hospital, MetroHealth System.

Faced with a raft of financial pressures and unfavorable trends, MetroHealth will likely have no choice but to essentially be swallowed up by a larger competitor in the coming years. Given MetroHealth’s moves to strengthen its balance sheet, diversify its revenue base and, in turn, make itself a more attractive acquisition target, the hospital has in a sense already begun the process.

While local health systems say otherwise, recent meetings involving Metro’s executives, administrators and top doctors have led staff to conclude the earliest parts of this endgame are already underway.

In short: MetroHealth a decade from now will bear little resemblance to the MetroHealth of today. At a national level, the takeaway here is the impact of healthcare reform on hospitals will mean the idea of the public hospital will almost certainly be redefined — if not eliminated entirely.

So why is MetroHealth’s future looking so shaky?

It’s no coincidence that CEO Mark Moran used surprisingly stark language recently when describing the future of MetroHealth and other publicly subsidized hospitals like it. Public hospitals are an “endangered species,” he told the Cuyahoga County Council – the county government that provides the hospital its public subsidy. And looking ahead, Moran called federal healthcare reform a “freight train heading toward us.”

A look at MetroHealth’s long odds suggest Moran wasn’t merely employing a rhetorical flourish. Public hospitals could easily lose patients in a post-healthcare-reform, nearly-everyone-is-insured world. Let’s be realistic: If most Clevelanders had the choice — and health insurance — would they go to Cleveland Clinic or MetroHealth? That perception might be unfair, but it’s probably fair to say it’s pretty widespread.

But even then, of the additional 32 million Americans who will be insured, half of them will receive coverage through Medicaid. And Medicaid pays hospitals at such a lower rate than private insurers that some claim Medicaid pays less than hospitals and doctors spend to provide care. (Cue one of Moran’s favorite healthcare sayings: “If there is no margin, there is no mission.”)

Fewer patients? Probably. Lower-margin patients? Almost certainly. Now add the elimination of the Medicare and Medicaid Disproportionate Share Hospital (DSH) payments that pays hospitals like MetroHealth for its low-income patients. Health reform calls for $21 billion in cuts to Medicare DSH payments over 10 years, and $14 billion in Medicaid DSH cuts between 2014 and 2020.

And who would want to be a public hospital, anyway? MetroHealth’s subsidy from Cuyahoga County accounts for about 5 percent of its patient revenues and exposes Metro to so much public scrutiny that Moran and his cohorts have to be wondering whether it’s worth the headache. Thirty years ago public dollars covered all of the charity care the hospital provided. This year the subsidy covers only about one-third of the charity care, a MetroHealth spokeswoman said.

Mark Moran

Add a few more factors: an industry-wide shift from inpatient to outpatient care, further stress on state and local budgets, competition from local rivals like University Hospitals and Cleveland Clinic for insured patients, deteriorating facilities, and rising technology and personnel costs that take a toll on its margins (not to mention its mission).

So what will Metro’s future look like?

Entering pure speculation mode, MetroHealth’s future will almost certainly involve an acquisition, strategic partnership or some sort of change in control that would allow the hospital to come under the umbrella of a larger, richer counterpart.

At least one MetroHealth staffer has come out of meetings believing leadership is already moving in this direction. A scenario that came out of one meeting – rebuffed by MetroHealth – would have seen University Hospitals take over MetroHealth in some fashion, the staff member said. UH would get priority over all patients except trauma and geriatrics, which would remain primarily with Metro. But UH would also have right of first refusal of any patient, which it could then send to MetroHealth.

MetroHealth, essentially, would have a future as UH’s triage unit.

The denials couldn’t be stronger from the hospitals on that particular scenario.

“Over the course of time we have had many conversations with many organizations about affiliations and partnerships,” Moran stated in an e-mail. “We pride ourselves on being able to work collaboratively in clinical, teaching and research endeavors with all organizations in our region. The arrangement that you describe is not something we have been presented with or considered in any way and does not sound like it would benefit MetroHealth. We are not in any conversation with any other organization about a change of control of MetroHealth.”

UH spokeswoman Janice Guhl said: “UH did not make an offer to buy Metro. We do talk to them about collaborative opportunities and our door is very open to those.”

“Collaborative opportunities” may be a key phrase here. It’s possible that UH or another hospital could enter a “collaborative” arrangement with Metro, in which the collaborator takes over all of Metro’s specialty services, while leaving primary care and emergency care within Metro’s purview. In such an arrangement, the “collaborating” hospital would essentially be subsidizing Metro’s money-losing operations in exchange for gaining access to all of its more lucrative specialty patients.

But these kinds of scenarios are likely the only future for MetroHealth and other hospital systems like it nationwide. For MetroHealth in particular, UH may be the only option. Other candidates like Kaiser Permanente may take too long to act, and nearby Summa Health System is perceived as cash poor and unable to do a deal. Cleveland Clinic is thought to have no interest.

But all the better to do a deal now before the health reform train smashes into MetroHealth’s balance sheet and the hospital loses bargaining leverage.

If you think about how Moran has been managing Metro in the last several years, it’s comparable to the way a private CEO would streamline a company before acquisition. He’s cut jobs; planned expansion outside of the City of Cleveland to attract a wealthier, suburban customer base; pushed patients away from expensive ER treatments and – as a result – greatly improved the health system’s balance sheet. MetroHealth held $148 million in current, or liquid, assets, at the end of 2010, according to its financial statements. That’s an impressive increase of 49 percent compared to the prior year.

That improved balance sheet is what gives Metro a little leverage now. But it’s easy to imagine that those liquid assets will dwindle as Metro is rundown by the freight train of health reform. The hospital could easily burn through its money a few years after reform goes into effect. Then it will have no margin, no mission and no leverage against cut-throat takeovers.

Will this be the future of all public hospitals nationwide?

Malaria, 2012 will make you an endangered species.

Word has it that Cleveland Clinic is gathering nominees from its staff for the best healthcare innovations of 2012: the  Top 10 list that’s the cornerstone of the health system’s annual innovations summit.

This year’s summit, which starts Oct. 3, will focus on cardiovascular technologies. But the list never focuses on one single technology. And since they’re asking, MedCity News will get in on the act. Here are my suggestions for a notable healthcare innovations for the future.

Who knows? Maybe one or two of these innovations in healthcare might even end up on the Clinic’s list?

Feel free to post your own in the comments section, too.

New malaria drugs. Though health providers and government officials have been looking to bring malaria under control for decades, the disease remains endemic in many parts of the world – in Africa, particularly. The disease can bring on kidney failure, seizures, permanent neurological damage, coma, and death. But there are several promising new malaria drugs under development that could help fight the disease, including one that could treat the disease with a single oral dose.

New laparoscopic system. A flexible laparoscopic instrument from North Carolina-based TransEnterix opens like an umbrella inside a patient’s body after being inserted via a single incision in the navel. The system provides surgeons with two flexible channels for right- and left-hand instruments with 360-degree range of motion, and two rigid channels for small cameras and other instruments.

Robotic heart catheter. A robotic catheter system from California-based Hansen Medical allows surgeons to remotely guide a heart catheter with hand movements at a work station while seeing a 3-D view of the operation. The device could allow for more precise catheter movements inside the heart.

Gastric plication. A surgery called gastric plication that involves folding a patient’s stomach in on itself and stitching it up looks to hold promise in treating weight loss. The procedure can reduce the stomach’s volume by as much as 80 percent. With a smaller stomach, patients feel full sooner and don’t eat as much.

“I’m thinking this is going to really take off in a big way because it does offer some significant advantage over existing procedures,” said Philip Schauer, director of the Cleveland Clinic’s Bariatric and Metabolic Institute.

Color-changing, heat-sensing bandages. An Australian researcher has created a bandage that changes color (at left) in response to changes in temperature as small as a half-degree Celsius. Increases in heat at a wound site are associated with inflammation and infection, so the color-changing bandage could be a quicker, cheaper means of diagnosing infection.

Stem cell therapy for heart failure: A stem cell product from Florida-based BioHeart called MyoCell could improve cardiac function in chronic heart failure patients by growing new muscle in the heart. The therapy is in phase 3 trials, but BioHeart’s experience illustrates the inherent riskiness — from a business perspective, at least — associated with stem cells. The company began clinical trials in 2001, has spent more than $100 million, and has no products on the market.

Diagnosing cataracts by smartphone: Diagnosing cataracts typically requires a $5,000 piece of equipment and a physician to interpret the test results, and each of those aren’t easy to come by in rural areas and less-developed countries. Now, a team of MIT researchers has developed a simple device that can clip onto an ordinary smartphone and provide a diagnosis of cataracts within a few minutes.

“I like to think of this as a radar for the human eye,” said one researcher.

The clinical trial, which is expected to follow 50 diabetic PAD patients for 11 weeks, could lead to big things for Cleveland-based TheraVasc. CEO Tony Giordano hopes a successful trial will position the company for a development partnership with a big drugmaker or a venture round of between $10 million and $20 million.

“We’re really excited that it’s finally getting rolling,” Giordano said. “Now we just have to get these patients in as quickly as possible, and see if the drug does what we expect it to do.”

The company is reformulating a drug — sodium nitrite — for the treatment of PAD, a condition in which narrowed arteries reduce blood flow to the limbs. The condition often afflicts diabetics and can result in the amputation of patients’ feet.

Sodium nitrite is available in injectable form, but TheraVasc is working to commercialize the drug in pill form. A capsule or tablet would not only be more user friendly, it would allow for a sustained release that would help patients maintain adequate levels of the drug over time.

In addition to measuring the drug’s safety and tolerability, the phase 2a clinical trial’s design calls for assessments of patients’ vascular integrity, walking ability and quality of life improvements at the end of the trial period, Giordano said.

Cleveland Clinic likely will be the first of eight clinical sites that will go live, with patient enrollment and dosing expected to begin this month. The University of Pennsylvania is another of the trial sites. Others will start up throughout the coming months.

TheraVasc closed a $2.1 million series A round of investment last year. Investors included JumpStart. Portal Capital, North Coast Angel Fund, Ohio TechAngels and Dayton-based Physician Investment Group. The company also last year received a $500,000 grant last year from the Global Cardiovascular Innovation Center on Cleveland Clinic’s campus, Giordano said.

Meredith Bond

Cleveland State University has hired a former Cleveland Clinic and University of Maryland cardiovascular researcher as the new dean of its College of Sciences and Health Professions.

Meredith Bond, who most recently chaired the department of physiology at the University of Maryland’s School of Medicine, is scheduled to begin her tenure at CSU on July 18, according to a statement from the university.

In her new role, Bond’s charge is to increase the amount of research funding CSU takes in and to develop a new urban primary care medical program that CSU is launching with Northeast Ohio Medical University (NEOMED).

Bond spent 16 years as a heart researcher at Cleveland Clinic where her work focused on “the molecular basis of the regulation of contractility in the heart,” according to the statement.

At the University of Maryland, Bond is credited with boosting the department of physiology’s grant funding, something CSU leaders hope she can replicate in her new job.

Bond’s new salary will be $235,000, Crain’s Cleveland Business reported.

The CSU-NEOMED urban primary care medical education initiative is scheduled to begin this fall.

But JumpStart and the lead investor in the fund, which would be called Euclid Ventures, haven’t given up on the fund and are exploring options to create it, JumpStart CEO Ray Leach said. Initial plans called for a $4 million fund, with half the amount coming from the state and the other half from private investor Keith Brown of Universal Equities.

The future of for-profit Euclid Ventures — if it has one — could involve private or public funding, or both, according to Leach.

“We’re trying to find ways to raise as much capital as we can for companies in the region,” he said.

The idea behind the fund was to co-invest with other venture firms in series A rounds for startups that are too mature for the JumpStart model and had already received seed funding. (Disclosure: JumpStart is an investor in MedCity News’ parent company, MedCity Media.)

Currently, JumpStart receives most of the funding for its existing nonprofit investment fund, which focuses on earlier-stage companies than Euclid Ventures would have, from the state and private sources. JumpStart was founded in 2004 and has received $27.5 million in state funding over its lifetime. That figure accounts for about 45 percent of JumpStart’s overall funding.

Roughly speaking, Euclid Ventures would’ve made about 10 investments at around $400,000 each. Money likely would’ve gone to some JumpStart portfolio companies, though investments wouldn’t be limited to those startups.

It’s that last part — Euclid Ventures’ investment in JumpStart portfolio companies — that raised questions by Third Frontier administrators — or, more precisely, a Columbus-area consulting firm called Invantage Group that was hired by the state to evaluate proposals for the program.

“The reviewers were troubled by the proposal’s frequent focus on specifically aiding JumpStart and the applicant’s lack of accepting market valuations,” said a (pdf) report evaluating Third Frontier proposals.

“The potential for conflict of interest, by an overt focus on investing in existing portfolio companies, raises concern,” the report stated.

Leach chalks up the conflict-of-interest concerns to a misunderstanding with Third Frontier reviewers, and the explanation seems reasonable. The key thing to keep in mind is that Euclid Ventures would’ve invested alongside other venture firms, which would have no incentive to allow JumpStart to hijack the process.

So, for example, if JumpStart intended to use Euclid Ventures as a means of propping up struggling companies and saving face on previous investment decisions, no rational venture firm would want any part of such a deal. Further, if the concern is that JumpStart would use Euclid Ventures to artificially jack up valuations of its portfolio companies in subsequent investment rounds, again, no partnering venture firm that cared about making money would want to touch such an overinflated deal.

The Third Frontier reviewers did praise Euclid Ventures for one aspect of the proposal: JumpStart’s ability to oversee the fund with existing employees, which would make management of the fund much cheaper than it would’ve otherwise been.

“The absence of direct expenses for due diligence and enhanced management services is a benefit,” according to the report.

Dr. James Levine

A little over six months ago Dr. James Levine was University Hospitals Case Medical Center’s prestigious new recruit – a rockstar doctor from Mayo Clinic who helped pioneer the treadmill desk and won international acclaim as a groundbreaking obesity researcher.

Now, Levine has gone back to Mayo, leaving in his wake lots of unanswered questions about why his stay with Cleveland’s University Hospitals (UH) was so brief.

“You’ll have to ask him,” UH spokeswoman Janice Guhl said. “He got here and was very excited and then felt this wasn’t the right structure for him. It was totally his decision.”

The mysterious loss of its most high-profile recruit in years has to be seen as a blow to UH, which has recently racked up several notable victories, including the opening of a new $300 million suburban medical center and its largest-ever donation. The health system had tapped Levine to lead its endocrinology division.

News of a hire of Levin’s stature was greeted late last year with much fanfare by UH and the local press. Dr. Richard Walsh, UH’s chairman of medicine, crowed that Levine was “one of the most innovative thinkers” in weight-loss research and pronounced himself “thrilled” that Levine was joining the health system.

When I interviewed the voluble and engaging Levine in November, his enthusiasm for an ambitious public health initiative called “The Cleveland Project” was infectious.”On one hand, I’m probably crazy to be doing this, but on the other, it’s such an honor to try to help people get healthy, so at least I want to try,” he said at the time.

So what could’ve caused things to go wrong and send Levine scurrying back to the friendly confines of Rochester, Minnesota, and Mayo? Levine isn’t saying.

In a brief email forwarded to me through a Mayo spokesman, Levine ducks the “why” question. Here’s what he said: “I had a superb six-month sabbatical at Case…the Cleveland Project grant is under review at CDC…..we hear news in the first week of July.  That will be a world-changing healthcare delivery system in the underserved.”

That’s it. When I told the Mayo spokesman, who noted that Levine was “swamped at the moment,” that the response didn’t exactly answer all my questions, he said, “I don’t have that information; you’ll have to get it from him when he’s available.”

So we’re left to wonder whether Levine will be “available” any time soon. (Dr. Levine, if you’re reading this, you know where to find me.)

Credit UH – which obviously isn’t in as good a position as Levine to answer why he departed – for shedding slightly (I stress “slightly”) more light on the situation.

Guhl said she wasn’t sure of the timing around Levine’s tenure with UH. When his hiring was first announced, he was to begin at UH on Nov. 1. He apparently had returned to Mayo at least as far back as mid-April, when he was interviewed by the New York Times for an article on his research into what the newspaper called “inactivity studies,” which roughly focuses on how people burn calories during periods of non-exercise. (The article is well worth a read for more background into Levine’s research and begins with the tantalizing four words, “Dr. Levine’s magic underwear…”)

Still, the question remains, why would Levine so quickly quit a job he initially seemed so enthused about? Homesickness for Rochester? A dispute with his superiors? Did he discover he’d have less input and control into “The Cleveland Project” than he was initially led to believe? His silence only invites speculation.

Only Levine can answer, and when and if he does, let’s hope it’s something a little more genuine than the cliched “I just wanted to pursue other opportunities” or “It was time for me to move on.”