Vivian Lee | |
---|---|
Born | September 1966 (age 58) Morristown, New Jersey, U.S. |
Education | Harvard University (BS, MD) Balliol College, Oxford (MS, PhD) New York University (MBA) |
Awards | National Academy of Medicine |
Scientific career | |
Fields | Radiology Health administration Education Author Research |
Vivian S. Lee (born September 1966) is an American radiologist and health care/health technology executive. An Executive Fellow at Harvard Business School and senior lecturer at Harvard Medical School and Massachusetts General Hospital, Lee is the author of the book, The Long Fix: Solving America's Health Care Crisis with Strategies That Work for Everyone (W.W. Norton, 2020). Lee is also a senior fellow at the Institute for Healthcare Improvement (IHI) [1] in Cambridge, Massachusetts. In 2019, she was named No. 11 in Modern Healthcare's 100 Most Influential People in Healthcare [2] and is a frequent speaker at national and international meetings on the applications of big data, AI, and technology in healthcare, leadership and managing change, health equity, and on climate change and health system resilience.
Raised in Norman, Oklahoma and trained in biomedical engineering and medicine, Lee established an NIH-funded research program in magnetic resonance imaging at NYU. She was elected Fellow of the International Society of Magnetic Resonance in Medicine (ISMRM) [3] in 2006 and served as the president in 2008–2009. For her scientific discoveries, she was elected to the American Society of Clinical Investigation [4] and the National Academy of Medicine. [5]
From 2018-2022, she was founding President of Health Platforms at Verily (Alphabet), launching and growing a number of successful health technology companies. Among her leadership roles in academic medicine, Lee served as the CEO of University of Utah Health, dean of the University of Utah School of Medicine and senior vice-president for health sciences of the University of Utah in Salt Lake City. [6] And before that as the inaugural chief scientific officer and vice dean for science at NYU Langone Medical Center. She is also a member of the scientific advisory boards of the Massachusetts General Hospital, [7] and previously served on the University of Pennsylvania's Center for Health Incentives & Behavioral Economics (CHIBE) External Advisory Board, [8] and on the Defense Health Board of the Department of Defense. She serves as Editor-at-Large for New England Journal of Medicine Catalyst. [9]
Lee has studied the management and improvement of health care, with an emphasis on data measurement and feedback to create learning health systems and her work has demonstrated the virtuous cycle of improved patient-centeredness, higher quality with better outcomes, and lower costs.
She is married to international legal scholar Benedict Kingsbury. [10] Lee also serves on the board of directors of the American Association of Rhodes Scholars and the Commonwealth Fund, and is also a director of Zions Bancorporation.
A U.S. Presidential Scholar and National Merit Scholar, Lee graduated from Norman High School, in Norman, Oklahoma in 1983.
Lee graduated from Radcliffe College of Harvard University magna cum laude in 1986 before receiving a Rhodes Scholarship to study at Balliol College, Oxford where she received a doctorate in medical engineering. [11] She then earned an M.D. with honors from Harvard Medical School and subsequently completed a residency in diagnostic radiology at Duke University [11] and a fellowship in MRI at NYU Medical Center.
In 2006, she completed a Master of Business Administration degree at NYU's Stern School of Business, graduating as valedictorian. She later delivered the commencement speech for the class of 2017. [12]
Funded initially while an MRI fellow and subsequently by the NIH, Lee's initial work developed methods to measure kidney glomerular filtration rate (GFR) and perfusion, noninvasively using ultra-low dose gadolinium-contrast enhanced MRI. [13] [14] These techniques were applied to the improved diagnosis of renovascular disease, [15] renal transplant dysfunction, [16] and renal function in cirrhosis. [17] Extensions of this work include the use of MR methods to measure tissue hypoxia [18] and tubular function. [19]
While a part of the NYU MRI research team, Lee contributed to multiple advances in clinical body MRI, including pioneering 3D (volumetric) liver imaging for routine clinical care and for improved detection of hepatocellular carcinoma, [20] improved methods for assessing vascular disease with 3D gadolinium-enhanced MR angiography [21] and venography, [22] and improved surgical planning for living related transplant donor planning in liver and kidney transplantation. [23] [24]
As the director of Cardiothoracic MR imaging at NYU, Lee developed new MR methods for fast cardiac imaging [25] and for improved detection of myocardial infarcts. [26] Subsequently, Lee's NIH funded research focused on the development of non-contrast-enhanced methods for vascular MR imaging, and functional calf muscle studies that assess exercise-induced "stress-rest" performance in patients with suspected peripheral vascular disease. [27] [28] [29]
A popular lecturer who has received multiple teaching awards, Lee authored a textbook entitled Cardiovascular MRI: Physical Principles to Practical Protocols (Lippincott 2006).
During her 5-year tenure as vice-chair for research in radiology, Lee helped build a research administrative infrastructure that enabled the department, previously unranked in NIH research funding, to reach the top 20. [30] During that time, NYU Langone was also the first U.S. site to install a whole body 7 Tesla MRI scanner. [31]
In 2007, Lee became the inaugural vice dean for science, chief scientific officer and senior vice-president, serving as a member of NYU's executive leadership team. Initiatives as chief scientific officer included establishing a new philanthropically-funded Neurosciences Institute [32] and a new NIH-funded Center for Translational Science Institute (CTSI), [33] upgrading core facilities, educational initiatives in grantsmanship, and establishment of a new Center for Health Informatics and Bioinformatics [34] and a new department of statistics and epidemiology. During her four-year tenure, NYU's ranking among NIH-funded schools of medicine increased from No. 36 to No. 26, and continued to rise thereafter. [30]
While at NYU, Lee held a number of leadership positions in the ISMRM, the preeminent professional organization of clinical and research MR scientists. She served on the board of trustees from 2002 to 2010, president 2008–2009, and as Scientific Program Chair for 2005 Annual ISMRM meeting. During her tenure, the ISMRM increased financial reserves, enhanced clinician membership and supported sustainability efforts through new "virtual" meetings.
From 2011 to 2017, Lee served as senior vice-president for health sciences, dean of the school of medicine, and the CEO of University of Utah Health. Lee was responsible for an academic health sciences complex that includes five major schools (School of Medicine, School of Dentistry, and Colleges of Nursing, Pharmacy and Health) and a health care system comprising four hospitals, dozens of clinical and research specialty centers, a network of 12 Salt Lake City-area health centers, a regional affiliate network of 19 partner facilities, a health plan, and over 1,400 board-certified physicians. Under her leadership, the University of Utah established a new School of Dentistry, the first new academic dental school in the nation in over 25 years, graduating its first class in 2017. [35]
Lee led University of Utah Health to recognition for its health care delivery system innovations [36] that enable higher quality at lower costs [37] [38] [39] and with higher patient satisfaction, [40] [41] [42] [43] as well as successful strategies of faculty development and mentorship. [44] [45] In 2012, the University of Utah become the first health system in the country to post patient reviews online. [46]
In 2016, University of Utah was ranked first among university hospitals in quality and safety, [47] with NYU Langone and Mayo Clinic rounding out the top three. That year marked the 7th consecutive year that the University of Utah was ranked in the top 10 in quality in the nation. The university's health insurance plan acquired a commercial license, grew five-fold, and was successful in the individual exchange. Improved financial performance of the clinical enterprise enabled increased support and growth of education, research, and community service initiatives.
As dean, Lee led the significant expansion of the school of medicine class size from 82 to 125 students per year with increased ongoing state funding. [48] A number of significant philanthropic commitments were made during her tenure, including the establishment of a new Rehabilitation Hospital, [49] funding for a number of research initiatives including the Utah Genome Project, [50] the Center for Medical Innovation, [51] and Driving Out Diabetes: A Larry H. Miller Family Foundation Wellness Initiative, [52] as well as both private and state funding for a new School of Medicine building. [53] During her tenure, the University of Utah's health sciences budget grew 50 percent to over $3.5 billion.
Lee became embroiled in a public controversy when University leadership fired Huntsman Cancer Institute CEO, Mary Beckerle, on April 17, 2017. Lee and university leadership were publicly criticized for the move by HCI's founder and prime benefactor, billionaire philanthropist Jon Huntsman, Sr. [54] The decision prompted public protests by University of Utah faculty and staff, [55] including an online petition calling for University leadership to reverse the decision and reinstate Beckerle. [56] Jon Huntsman, Sr., publicly called for Lee and University President David W. Pershing to be fired from their leadership positions on April 21, 2017, [57] [58] questioning their ethics and predicting that the governor and state legislature would become involved to ensure their removal. [59] On April 22, 2017, the Editorial Board of the Salt Lake Tribune (a newspaper owned by a member of the Huntsman family) called for Lee's removal as the "only remedy in this case." [60] The University Board of Trustees met with Pershing and Lee on April 25, 2017. [61] Within hours after the meeting, Pershing released a written statement announcing that Beckerle was immediately resuming her service as CEO and Director of Huntsman Cancer Institute and would report directly to the President of the University. [62] [63] [64] Pershing's announcement signaled that Lee would no longer oversee the Huntsman Cancer Institute, raising questions about the future direction of the University Health system. [65]
Huntsman stated that a planned donation of $250M dollars would have been withheld unless the university's decision was reversed and Beckerle reinstated. On 28 April, Lee announced via email that, effective the same day, she was stepping down as the university's senior vice president for health sciences, dean of the medical school, and CEO of the healthcare system. [66] [67]
After her resignation, local reporters at the Deseret News discovered more details about the dispute over finances with Huntsman Cancer Institute, including demands for substantial increases in financial transfers from the University to the Huntsman Cancer Institute. [68]
From 2018 to 2022, Lee served as President of Health Platforms at Verily, an Alphabet company. As the founding leader of health platforms, she helped to launch and grow several new successful businesses in areas of digital health, precision risk insurance, healthcare analytics, mental and behavioral health, and pandemic management, with substantial year-over-year growth during her tenure. She announced her departure at the end of 2022 to move to Harvard University to focus on the intersection of tech, climate change and health care, with the aim of building more resilient systems for the future.
In her academic career Lee was awarded a Rhodes Scholarship to study at Balliol College, Oxford, and was recognized as one of Crain's "40 Under 40." In 2009, she received the Chang-Lin Tien Leadership award. [69] She was elected to the American Society of Clinical Investigation in 2015 and to the National Academy of Medicine in October 2015. [70] In 2019 she received the gold medal, the highest award from the International Society for Magnetic Resonance in Medicine. Modern Healthcare listed her among the 100 Most Influential People in Healthcare, ranking her at No. 11.
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves to generate images of the organs in the body. MRI does not involve X-rays or the use of ionizing radiation, which distinguishes it from computed tomography (CT) and positron emission tomography (PET) scans. MRI is a medical application of nuclear magnetic resonance (NMR) which can also be used for imaging in other NMR applications, such as NMR spectroscopy.
Endorectal coil magnetic resonance imaging or endorectal coil MRI is a type of medical imaging in which MRI is used in conjunction with a coil placed into the rectum in order to obtain high quality images of the area surrounding the rectum. The technique has demonstrated higher accuracy than other modalities in assessing seminal vesicle invasion and extra-capsular extension (ECE) of prostate cancer. Endorectal coil MRI is useful for determining the extent of spread and local invasion of cancers of the prostate, rectum, and anus. The coil consists of a probe with an inflatable balloon which helps maintain appropriate positioning. Similar coils may be used vaginally for evaluating cervical cancer.
One alternative to mammography, breast MRI or contrast-enhanced magnetic resonance imaging (MRI), has shown substantial progress in the detection of breast cancer.
Magnetic resonance elastography (MRE) is a form of elastography that specifically leverages MRI to quantify and subsequently map the mechanical properties of soft tissue. First developed and described at Mayo Clinic by Muthupillai et al. in 1995, MRE has emerged as a powerful, non-invasive diagnostic tool, namely as an alternative to biopsy and serum tests for staging liver fibrosis.
MRI contrast agents are contrast agents used to improve the visibility of internal body structures in magnetic resonance imaging (MRI). The most commonly used compounds for contrast enhancement are gadolinium-based contrast agents (GBCAs). Such MRI contrast agents shorten the relaxation times of nuclei within body tissues following oral or intravenous administration.
Gadoteridol (INN) is a gadolinium-based MRI contrast agent, used particularly in the imaging of the central nervous system. It is sold under the brand name ProHance. Gadoteridol was first approved for use in the United States in 1992.
The University of Utah School of Medicine is located on the upper campus of the University of Utah in Salt Lake City, Utah. It was founded in 1905 and is currently the only MD-granting medical school in the state of Utah.
An imaging biomarker is a biologic feature, or biomarker detectable in an image. In medicine, an imaging biomarker is a feature of an image relevant to a patient's diagnosis. For example, a number of biomarkers are frequently used to determine risk of lung cancer. First, a simple lesion in the lung detected by X-ray, CT, or MRI can lead to the suspicion of a neoplasm. The lesion itself serves as a biomarker, but the minute details of the lesion serve as biomarkers as well, and can collectively be used to assess the risk of neoplasm. Some of the imaging biomarkers used in lung nodule assessment include size, spiculation, calcification, cavitation, location within the lung, rate of growth, and rate of metabolism. Each piece of information from the image represents a probability. Spiculation increases the probability of the lesion being cancer. A slow rate of growth indicates benignity. These variables can be added to the patient's history, physical exam, laboratory tests, and pathology to reach a proposed diagnosis. Imaging biomarkers can be measured using several techniques, such as CT, PET, SPECT, ultrasound, electroencephalography, magnetoencephalography, and MRI.
Thomas M. Kolb is an American radiologist specializing in the detection and diagnosis of breast cancer in young, predominantly high-risk premenopausal women. He has served as an assistant clinical professor of Radiology at Columbia University College of Physicians and Surgeons from 1994–2010. Kolb is double board certified, having received his training in pediatrics at the Albert Einstein College of Medicine in Bronx, New York, and in diagnostic radiology at the Columbia-Presbyterian Medical Center in New York.
Mary C. Beckerle is an American cell biologist who studies cancer at the Huntsman Cancer Institute at the University of Utah School of Medicine. At Huntsman Cancer Institute, she serves as the CEO and also as Associate Vice President for Cancer Affairs at the University of Utah. Beckerle's research helped to define a novel molecular pathway for cell motility, and more recently, she has begun research into Ewing’s sarcoma, a pediatric bone cancer. Beckerle's lab made a ground breaking discovery in regards to Ewing's Sarcoma in relation to the EWS/FLI protein. Her lab discovered EWS/FLI to disrupt the internal cellular skeleton, which decreases the ability of cells to adhere to their proper environment. This can help explain the metastasis of tumors in patients with Ewing's sarcoma.
In medicine, breast imaging is a sub-speciality of diagnostic radiology that involves imaging of the breasts for screening or diagnostic purposes. There are various methods of breast imaging using a variety of technologies as described in detail below. Traditional screening and diagnostic mammography uses x-ray technology and has been the mainstay of breast imaging for many decades. Breast tomosynthesis is a relatively new digital x-ray mammography technique that produces multiple image slices of the breast similar to, but distinct from, computed tomography (CT). Xeromammography and galactography are somewhat outdated technologies that also use x-ray technology and are now used infrequently in the detection of breast cancer. Breast ultrasound is another technology employed in diagnosis and screening that can help differentiate between fluid filled and solid lesions, an important factor to determine if a lesion may be cancerous. Breast MRI is a technology typically reserved for high-risk patients and patients recently diagnosed with breast cancer. Lastly, scintimammography is used in a subgroup of patients who have abnormal mammograms or whose screening is not reliable on the basis of using traditional mammography or ultrasound.
In the field of medicine, radiomics is a method that extracts a large number of features from medical images using data-characterisation algorithms. These features, termed radiomic features, have the potential to uncover tumoral patterns and characteristics that fail to be appreciated by the naked eye. The hypothesis of radiomics is that the distinctive imaging features between disease forms may be useful for predicting prognosis and therapeutic response for various cancer types, thus providing valuable information for personalized therapy. Radiomics emerged from the medical fields of radiology and oncology and is the most advanced in applications within these fields. However, the technique can be applied to any medical study where a pathological process can be imaged.
The Liver Imaging Reporting and Data System is a quality assurance tool created and trademarked by the American College of Radiology in 2011 to standardize the reporting and data collection of CT and MR imaging patients at risk for hepatocellular carcinoma (HCC), or primary cancer of the liver cells. It provides a standardized framework for classification of liver lesions by a radiologist, and only applies in patients with chronic liver disease, the main risk factor for liver cancer. The hierarchical classification, from LR1 to LR5, is based on specific imaging features of the lesion in question, and corresponds to the degree of suspicion for malignancy. For example, a lesion with features corresponding to the highest category, LR5, is "definitely" HCC. Importantly, the increasing acceptance of the LI-RADS system of reporting by referring clinicians has reduced the need for tissue biopsy confirmation of cancer in patients with chronic liver disease.
Fiona Jane Gilbert is a Scottish radiologist and academic.
Christiane K. Kuhl is a German scientist at RWTH Aachen University. She is Head of the Department of Radiology.
Nola M. Hylton is an American oncologist who is Professor of Radiology and Director of the Breast Imaging Research Group at the University of California, San Francisco. She pioneered the usage of magnetic resonance imaging for the detection, diagnosis, and staging of breast cancer by using MRIs to locate tumors and characterize the surrounding tissue.
Luis Marti-Bonmati is a Spanish professor and researcher. He is the director of the Clinical Area of Medical Imaging Department at La Fe Polytechnic and University Hospital, and Head of Radiology Department at QuironSalud Hospital, Valencia, Spain. Marti-Bonmati is the founder of QUIBIM S.L., and is the Director of its Scientific Advisory Board. He is a member of the Spanish National Royal Academy of Medicine. He is also the director of the Biomedical Imaging Research Group (GIBI230) at La Fe Health Research Institute. The group is now included in the Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, Spain.
Denis Le Bihan is a medical doctor, physicist, member of the Institut de France, member of the French Academy of Technologies and director since 2007 of NeuroSpin, an institution of the Atomic Energy and Alternative Energy Commission (CEA) in Saclay, dedicated to the study of the brain by magnetic resonance imaging (MRI) with a very high magnetic field. Denis Le Bihan has received international recognition for his outstanding work, introducing new imaging methods, particularly for the study of the human brain, as evidenced by the many international awards he has received, such as the Gold Medal of the International Society of Magnetic Resonance in Medicine (2001), the coveted Lounsbery Prize, the Louis D. Prize from the Institut de France, the prestigious Honda Prize (2012), the Louis-Jeantet Prize (2014), the Rhein Foundation Award (2021). His work has focused on the introduction, development and application of highly innovative methods, notably diffusion MRI.
Daniel Kevin Sodickson is an American physicist and an expert in the field of biomedical imaging. A past president and gold medalist of the International Society for Magnetic Resonance in Medicine, he is credited with foundational work in parallel magnetic resonance imaging (MRI), in which distributed arrays of detectors are used to gather magnetic resonance images at previously inaccessible speeds. Sodickson is an elected Fellow of the US National Academy of Inventors. He currently serves as Vice-Chair for Research in the Department of Radiology at New York University (NYU) Grossman School of Medicine, as Director of the department's Bernard and Irene Schwartz Center for Biomedical Imaging, as Principal Investigator of the Center for Advanced Imaging Innovation and Research, and as Co-Director of NYU's Tech4Health Institute.
Rachel F. Brem is an American diagnostic radiologist, professor of radiology at the George Washington University School of Medicine & Health Sciences, and director of the Breast Imaging and Interventional Center at George Washington University’s Cancer Center. She previously served as director of Breast Imaging at Johns Hopkins. Brem develops novel technologies to better support early diagnosis and treatment of breast cancer. She is a fellow of the American College of Radiology and the Society of Breast Imaging.
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