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2 Winter 2025 Contents Providence Research Proles ………………………………………………..………………….……….….. 3 Dr. John Cairns ………………………………………………………………………………..………...…...... 4 Dr. Julio Montaner……………………………………….…………………...…………………………….… 7 Dr. Nadia Khan……………………………………….………………………………………..……….…..... 10 Dr. Pascal Bernatchez.…………………………………………………………………………………….. 13 Dr. Scott Tebbutt………..…………………………………………….……………….…………………..... 15 Research Highlights………..……………………………………………………………………………………..… 17 Supporting heart transplant patients beyond the clinic……………………………… 18 PHIR+E: Advancing Innovation with Providence Research ……………………....... 21 Cultivating innovation and entrepreneurship at Providence Research…….. 24 Interdisciplinary teams hack chronic disease at fourth annual Skunkworks.……………………………………………………………………….. 27 Gene-editing treatment approved by Health Canada for sickle cell disease and thalassemia was tested in St. Paul’s Hospital clinical trial………………..…. 32 The Clinical Support and Research Centre—2024: A year in review for research……………………………………………………………………………………………………………..34 Special Feature: “A unique resource in the world” - how Providence Research biobanks enable groundbreaking research …………………………………………………..….…. 38 Connect with Us ……………………………………………………………………..…………………………...…. 50 PRESIDENT: Dr. Darryl Knight MANAGING EDITOR: Susan Ogilvie EDITOR: Grace Jenkins Research Review Magazine is published by Providence Research, 1190 Hornby Street, Vancouver, BC V6Z 2K5, 604-806-9090, fax 604-806-8568, providenceresearch.ca
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4 Winter 2025 Providence Research Proles: Dr. John Cairns Researcher, CCI-CIC Dr. John Cairns is Dean Emeritus of the UBC Faculty of Medicine and a researcher with the Centre for Cardiovascular Innovation (CCI-CIC). He was appointed to the Order of Canada, one of the country’s highest honours, for his major international contributions to cardiology and his role in the expansion of UBC’s Medical School. Dr. John Cairns shaped the eld of cardiology, heart attack treatment Dr. John Cairns has made international contributions to medicine, leading research that has established new clinical practice guidelines and shaped the eld of cardiology, but when he was beginning his education, he was torn between pursuing medicine or engineering. Ultimately, he realized he found medicine more fullling, particularly the ability to inuence health outcomes. “I knew from the rst day in medicine that I was in the right place,” says Dr. Cairns. He went on to practice cardiology for many years, becoming interested in medical research while working at McMaster University. “It was great to be an expert in management of cardiac problems, but it was even more satisfying to develop areas of new knowledge,” says Dr. Cairns. It was motivating to make breakthroughs that would help not only his current patient, but all patients with that condition. He was initially interested in discovering ways to measure and reduce the size of myocardial infarctions – heart attacks. He later led a multi-centre study looking at the impact of using aspirin to treat unstable angina, a condition where blood supply to the heart is reduced and complete blockage is threatened. The results were dramatic. The risk of developing a heart attack was reduced by fty per cent and death rates by seventy per cent. Aspirin became a fundamental part of treatment for this condition the world over. Dr. John Cairns
5 Winter 2025 As part of the Oxford-led ISIS-2 clinical trial, Dr. Cairns and his colleagues at McMaster brought together eighty hospitals across Canada to show that aspirin combined with the thrombolytic drug streptokinase dramatically reduced death rates in heart attack patients. Another study conducted by Dr. Cairns and McMaster colleagues and involving patients from both St. Paul’s and Vancouver General Hospitals, found that the medication amiodarone reduced mortality rate of patients who survived a heart attack but had an abnormal heart rhythm. Amiodarone became the primary treatment for this condition, until it was largely overtaken by the advent internal cardiac debrillators. Today, it is still used when those are not an option. Growing medical schools at UBC, McMaster University Dr. Cairns spent twenty-one years at McMaster, eight of which he served as the Chair of the Department of Medicine. He helped to build a substantial cardiovascular program and grow the Department of Medicine. In 1996, he became Dean of the UBC Faculty of Medicine. When he took the role, the medical school had half as many students for the population size as the Canadian average. In his role as Dean, he led eorts to expand it province-wide, with campuses in Prince George, Victoria and “It was great to be an expert in management of cardiac problems, but it was even more satisfying to develop areas of new knowledge.” - Dr. John Cairns Aspirin has become a fundamental part of treatment for unstable angina.
6 Winter 2025 Kelowna. He credits his successors, Deans Gavin Stuart and Dermot Kelleher, with full implementation of the expansion and further development of the medical school. The enrollment of medical students and residents is now almost three times what it was in 1996. Today, UBC is one of the top medical schools in Canada. Honoured to be appointed to the Order of Canada While retired from his role as Dean, Dr. Cairns is still involved with research through the CCI-CIC, of which he has been a member since it was established by Dr. David Wood in 2021. A recent study he conducted, in collaboration with Dr. Wood and Dr. Shamir Mehta, was published in the New England Medical Journal. It investigated whether putting additional stents into coronary arteries that are narrowed, but not fully blocked, while treating a patient for a heart attack would improve outcomes. They found that this led to a marked reduction of recurrent heart attacks and death, and this approach is now standard therapy. Dr. Cairns was hounoured to be appointed to the Order of Canada and is grateful to those who nominated him for the honour. “It's nice to be recognized amongst your medical colleagues. It’s even nicer to be recognized amongst other Canadians not directly involved in the practice of medicine,” says Dr. Cairns. Order of Canada badge “It's nice to be recognized amongst your medical colleagues. It’s even nicer to be recognized amongst other Canadians not directly involved in the practice of medicine.” - Dr. John Cairns
7 Winter 2025 Providence Research Proles: Dr. Julio Montaner Executive Director, BC-CfE Dr. Julio Montaner is the is the Executive Director and Physician-in-Chief of the BC Centre for Excellence in HIV/AIDS (BC-CfE). He was awarded the King Charles III Coronation Medal, which recognizes Canadians who have made signicant contributions to the country, a province, territory, region, or community, for his internationally recognized research ghting against HIV/AIDS. Dr. Julio Montaner changed the course of HIV/AIDS treatment Dr. Montaner’s research in developing antiretroviral therapies and the Treatment as Prevention (TasP) strategy has shaped HIV/AIDS treatment in British Columbia and around the world. Originally from Buenos Aires, Argentina, Dr. Montaner went into medicine like his father, who was a prominent respiratory physician. After meeting at a conference in Uruguay he was invited by Dr. James Hogg, co-founder of the Centre for Heart Lung Innovation, to come to Vancouver to conduct research. Dr. Julio Montaner
8 Winter 2025 Addressing the primary killer of HIV patients As a part of his Canadian medical training, Dr. Montaner was working as a fellow in the St. Paul’s Hospital respiratory division at the beginning of the HIV/AIDS pandemic. He would often treat HIV patients who had Pneumocystis pneumonia, which was the primary cause of death for people with HIV at the time. Dr. Montaner realized that these deaths were driven by immune dysregulation, not just deciency, and helped to create an eective anti-inammatory treatment. “By the time we were done with [Pneumocystis pneumonia], we could diagnose, treat and prevent it, one hundred per cent. It was no longer a problem. But I was frustrated, because my patients were going on to die from other AIDS-related complications,” says Dr. Montaner. Leading research to develop a treatment for HIV Dr. Montaner was appointed as the Director of the AIDS Research Program at St. Paul’s Hospital. He was involved in the Canadian clinical trial of the rst antiretroviral drug candidate, azidothymidine, but found that the treatment would fail as the virus developed resistance. To solve this problem, he took inspiration from tuberculosis treatment, which his father had specialized in. Tuberculosis similarly becomes resistant to single antibiotics over time, but treatment with a combination of medicines at once is eective. Dr. Montaner became convinced that this could be the solution for HIV. He played a key role in designing the international INCAS trial, which tested treatment with a combination of three antiretroviral drugs. This treatment, known as highly active antiretroviral therapy (HAART) was so eective, the study’s virologist thought something was wrong with the samples when he could not get the virus to grow. At the same time these ndings were coming out, Dr. Montaner was an organizer of the 1996 International AIDS Conference. “I said, we need to redraw the program for the conference, because I think we have the solution for the treatment of HIV,” says Dr. Montaner. Given the urgency of the pandemic, this treatment was immediately rolled out in B.C. This meant that Dr. Montaner and his colleagues had even more data to support a new treatment guidance paper, A representation of human immunodeciency viruses (HIV) “I said, we need to redraw the program for the conference, because I think we have the solution for the treatment of HIV.” - Dr. Julio Montaner
9 Winter 2025 published in The Journal of the American Medical Association (JAMA), which was unveiled at the conference. “That conference became the coming out party for highly active antiretroviral therapy for HIV. And since that conference, morbidity and mortality for HIV and AIDS has gone down,” says Dr. Montaner. Developing the Treatment as Prevention Strategy As more people received HAART, data showed that while life expectancy was rising for people with HIV, new cases were unexpectedly decreasing. Dr. Montaner established that there was a proportional relationship between the number of people receiving antiretroviral therapy and the number of missing HIV cases. “I said, bingo, this is treatment as prevention. Treatment prevents morbidity, mortality and transmission,” says Dr. Montaner. Treatment as Prevention forms the basis for the 90-90-90 by 2030 Target, created by Dr. Montaner and adopted by the United Nations, which aims to reach a ninety per cent decrease in morbidity, mortality and transmission of HIV by 2030 by expanding access to HIV testing and treatment. That goal has been surpassed in B.C., where AIDS-related mortality is now negligible and new HIV infections have virtually disappeared – most new cases now come in from other provinces and countries. “Dr. Montaner’s recognition of the need to go beyond conventional patterns of healthcare delivery was essential in reaching marginalized hard-to-reach patient populations, who were fueling the epidemic,” says Dr. Peter Phillips, medical director of the BC-CfE’s Urban Health Acute Care Unit and a longtime colleague of Dr. Montaner’s. “His ability to engage provincial, federal, and international leaders in order to provide adequate support for essential HIV-related health programs has been critical in controlling the HIV pandemic, not just in British Columbia, but elsewhere in Canada and abroad.” Dr. Montaner feels fortunate that his work has been widely recognized, most recently with the King Charles III Coronation Medal. “For me, this is a reection of the work of the centre, the province, and the team,” says Dr. Montaner. Dr. Montaner, a medical pioneer in his eld, is highly deserving of this prestigious recognition. His prolic research has saved lives and shaped health care in the eld of HIV/AIDS treatment, in Canada and around the world. Dr. Montaner in 1996
10 Winter 2025 Providence Research Proles: Dr. Nadia Khan Clinician Scientist, Advancing Health (L-R) Dr. Darryl Knight, President, Providence Research, Dr. Nadia Khan, Fiona Dalton, CEO, Providence Health Care In this Providence Research Prole, we feature Dr. Nadia Khan, Head of the Division of Internal Medicine at the University of British Columbia, a Clinician Scientist with the Centre for Advancing Health Outcomes (Advancing Health), and a Professor of Medicine at the University of British Columbia. Dr. Khan’s research focuses on diversity, equity and inclusion in health services care delivery to dierent gender and ethnic groups, and she has conducted signicant research into physician wellness at Providence Health Care (PHC). She is the 2024 winner of the PHC Research and Mission Award, which recognizes a scientist in the organization who demonstrates the mission and values of PHC while conducting outstanding research. Research explores how health conditions dier between groups Early on in her career, Dr. Khan began asking why they were seeing people from dierent demographic groups present with varying kinds of
11 Winter 2025 conditions. For instance, when she was working as a clinician, she noticed that there were many South Asian people in the cardiology ward. She began exploring how health conditions distinctly impact people from dierent ethnic and gender groups. Through this research, she and her team found stark dierences in the development of diabetes, cardiovascular disease, hypertension, stroke, and kidney disease between ethnic and gender groups. Dr. Khan’s research also explores how healthcare service delivery functions for dierent groups, with a current focus on the delivery of heart failure and stroke care. One such study that Dr. Khan conducted on how gender impacts the presentation of heart attacks found that one in ve young women did not present with classic chest pain symptoms, adding to the knowledge that it is necessary to consider other symptoms when young women present with heart attacks. In addition, she is working with the Canadian Consortium of Clinical Trial Training Platform (CANTRAIN) to develop a training program to improve clinical trials skills among researchers in B.C. and Canada. Research focus aligns with Providence values Dr. Khan’s work centres around social justice and equity in health care. She was drawn to work at PHC because of the social justice focus included in its mission, and because of the outstanding research conducted by PHC and its research centres. “When I was moving to Vancouver, at that time everybody told me that if I wanted to do research, then I should denitely work at Providence - that all of the best research was happening at Providence Health,” says Dr. Khan. She has been able to work with many great people and fantastic mentors at PHC, including Advancing Health scientist Dr. Anita Palepu and Advancing Health Centre Director Dr. Aslam Anis. “I’m really pleased to have Nadia as part of our group, especially her research interest on the ethnic determinants of health outcomes. Being a visible minority myself, it is very important to see healthcare being targeted to the special characteristics of dierent ethnic groups,” says Dr. Anis. “Seeing her be so passionate about her research and the mission at Providence is extremely gratifying,” says Dr. Palepu. Dr. Nadia Khan
12 Winter 2025 Making an impact on physician wellness Dr. Khan was instrumental in creating a new initiative at PHC that examined systems issues to improve physician wellness in the Emergency Department and the departments of Anesthesia and General Internal Medicine. Physicians had expressed their dissatisfaction to her, which intrigued her as a researcher. To go beyond informal conversations, she set up a series of surveys to determine the source of the problem. She found that the issue was not that individual physicians were struggling to cope, but that there were widespread frustrations with the health care system itself. As a result of this research, PHC was able to implement systems-level interventions to support physicians and improve wellness. In one group surveyed, these interventions improved physician wellness by twenty per cent. As a physician-researcher, Dr. Khan is motivated and inspired by what she sees in her practice and what she hears from her patients. While research can be dicult and can present many obstacles, she nds it to be incredibly rewarding. “For people who are curious about why things are the way they are, and who really want to dig in and try to make even a small change in health care, it’s an incredibly rewarding role,” says Dr. Khan. “For people who are curious about why things are the way they are, and who really want to dig in and try to make even a small change in health care, it’s an incredibly rewarding role.”—Dr. Nadia Khan PHC Mission Awards
13 Winter 2025 Providence Research Proles: Dr. Pascal Bernatchez Principal Investigator, HLI Dr. Pascal Bernatchez is a Principal Investigator with the Centre for Heart Lung Innovation (HLI) and an Associate Professor in the Department of Anesthesiology, Pharmacology and Therapeutics at the University of British Columbia. He has conducted signicant research into the health of blood vessels, working to develop medications that enhance the ability of blood vessels to protect themselves against cardiovascular diseases, and revealing how changes in cholesterol metabolism impact muscle health in muscular dystrophy. "Dr. Bernatchez is an outstanding scientist, translational researcher, and colleague who deploys the full suite of biomedical methods, from discovery and pre-clinical models, through to human clinical trials, in order to better understand endothelial biology and treat blood vessel-related disease,” says Dr. Scott Tebbutt, Director, Research, Providence Research, and Director, Education, HLI. Tapping into the hidden capacities of blood vessels Dr. Bernatchez obtained a Master’s and PhD in Pharmacology at the Montreal Heart Institute and the University of Montreal’s Department of Pharmacology. He trained as a postdoctoral fellow at Yale University, where he studied the self-protective properties of blood vessels, which he believed were being under-utilized. He found that small synthetic chains of amino acids called peptides stimulated the same response in the vascular system as aerobic exercise, which protects against a range of cardiovascular diseases. “It became clear to me that these properties need to be developed and rened, and that they could lead to new therapeutic approaches to tap into the hidden capacities of our blood vessels,” says Dr. Bernatchez. In 2007, he came to the University of British Columbia and the HLI, where the vibrant cardiovascular and cholesterol research Dr. Pascal Bernatchez “It became clear to me that these properties need to be developed and rened, and that they could lead to new therapeutic approaches to tap into the hidden capacities of our blood vessels.” - Dr. Pascal Bernatchez
14 Winter 2025 community at Providence Research provided collaboration that helped take his ndings to the next level. New perspectives on diseases of the aorta Dr. Bernatchez’s research into the protective properties of blood vessels uncovered mounting evidence that diseases of the aorta, which aect the main artery carrying blood from the heart, are not caused by high blood pressure, as was previously thought, but by disfunction of the endothelium, the layer of cells lining blood vessels. He found that a group of blood pressure-lowering medications commonly used to treat aortic diseases also activate the endothelium and the capacity for blood vessels to protect themselves. These ndings, which are currently being tested in an observational study at the Heritable Aortopathies Clinic at St. Paul’s Hospital, could potentially lead to new therapeutic approaches and treatments for these conditions. Uncovering how cholesterol impacts muscle health Another of Dr. Bernatchez’s signicant discoveries is identifying cholesterol as a link between how muscular dystrophy (MS) causes muscle damage, and muscle pain caused by statin medications. Studies conducted by him and his team have shown that many people with MS have abnormally high levels of lipids, including cholesterol, known as dyslipidemia. They found that MS interferes with enzymes that regulate cholesterol metabolism, and that cholesterol may actually be a prominent regulator of muscle health. This could help to explain why statins, commonly prescribed medications to lower cholesterol and prevent heart disease, often cause muscle pain as a side eect. These ndings could lead to new treatments for managing chronic muscle diseases, such as using cholesterol-modulating medications to help stabilize weakened muscles in patients with MS. Developing medications to make cardiovascular diseases a thing of the past Dr. Bernatchez is motivated in his work as a pharmacologist by the possibility of developing a medication that is fully optimized to stimulate the innate protective properties of blood vessels, enabling treatments that would minimize the impact of cardiovascular diseases. “I think this concept is under-utilized or under-developed, especially from a clinical perspective. We have a range of collaborators and projects that we hope will allow us to make cardiovascular diseases a thing of the past, by providing new pharmacotherapeutic options,” says Dr. Bernatchez. An aorta that has lost the ability to protect itself, with neo-intimal hyperplasia and medial degeneration, a thickening and deterioration of the blood vessel walls.
15 Winter 2025 Providence Research Proles: Dr. Scott Tebbutt Director, Research, Providence Research In this Providence Research Prole, we feature Dr. Scott Tebbutt, the newly appointed Director, Research at Providence Research. In addition to this new role, Dr. Tebbutt is a Principal Investigator and Director of Education with the Centre for Heart Lung Innovation (HLI), the Chief Executive Ocer of the Prevention of Organ Failure (PROOF) Centre of Excellence, and a Professor in the Respiratory Division of the University of British Columbia’s Department of Medicine. In this well-deserved new role, Dr. Tebbutt will apply his extensive experience and expertise to support Providence Research’s vision and mission as outlined in the Discovery Forward Strategic Plan. Dr. Scott Tebbutt’s research is focused on molecular understanding of diseases and biomarker development Dr. Tebbutt knew that he wanted to be a scientist since he was a child, when his interest in genetics was spurred by his curiosity while working on a farm. He received a degree in biochemistry at Oxford, then completed a PhD in plant molecular biology at the University of East Anglia’s John Innes Centre. He then returned to Oxford, and to human biology, for a postdoctoral fellowship focused on cystic brosis. He was recruited to the University of Otago in New Zealand as a Research Fellow. At that time, the initial results of the Human Genome Project and the new tools of microarray technology were beginning to enable high-dimensional proling of genes and genomes. “It was this big revolution in biology, where it was hypothesis-generating, rather than hypothesis-testing, because you’re literally able to test almost the entire output of the human genome using these new devices,” says Dr. Tebbutt. He was recruited by Dr. Peter Paré to join the HLI and continue his work with microarrays, developing disease-focused applications. Dr. Scott Tebbutt
16 Winter 2025 His research focuses on understanding diseases and other health conditions at the molecular and cellular levels. His publications cover topics including inammatory lung disorders, allergic rhinitis, heart failure, and newborn vaccine responses. One such study that will soon come to fruition is a clinical validation of a biomarker blood test for heart transplant rejection. Dr. Tebbutt is driven in his work as a researcher both by curiosity and the ability to help people. “The ability to marry helping people and health care with scientic curiosity - that is a very powerful, engaging and compelling combination,” says Dr. Tebbutt. Role as Director, Research In Dr. Tebbutt’s role as Director, Research, he will be supporting research activities within Providence, leading initiatives to enhance the integration of research and clinical care, and helping to ensure the organization is working towards the goals of its strategic plan. Drawing on his experience as the HLI’s Director of Education, he will be supporting greater collaboration between existing training programs at Providence Research, enhancing learning by connecting trainees across dierent research centres. He will additionally be continuing the work of previous Research Director, Dr. Mari DeMarco, with the biobanks at Providence Research, particularly surrounding the wider rollout of the OpenSpecimen database. Dr. Tebbutt will also be involved in the continued development of the Clinical Support and Research Centre (CSRC) at the new St. Paul’s Hospital, strategizing how to best optimize researchers’ abilities to work at the new site and create new opportunities for collaboration. He will help Providence Research prepare to move to the new building while continuing to push forward patient-oriented, cutting-edge research. “We’re going to be at a big, brand-new hospital and brand-new research and clinical support building. How do we best utilize this amazing opportunity?” asks Dr. Tebbutt. “The ability to marry helping people and health care with scientic curiosity - that is a very powerful, engaging and compelling combination.” - Dr. Tebbutt A rendering of the Clinical Support and Research Centre
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18 Winter 2025 Supporting heart transplant patients beyond the clinic L-R: Rachel Milligan, Josie Mackey, Wynne Chiu, Kristi Coldwell, Dr. Sandra Lauck, Kim Brownjohn, Naomi Lee, Marc Bains, Katrien Moore, Dr. Brian Clarke A new study will evaluate the implementation of a peer mentorship program (PMP) to improve patients’ experience of the journey of care to and after heart transplant. The program will connect patients with heart transplants or mechanical heart pumps with new patients to provide support and mentorship. This project, led by Wynne Chiu, a Clinical Nurse Specialist with the Heart Failure and Transplant Team at St. Paul’s Hospital, has received funding through the 2024 Vancouver Coastal Health Research Institute (VCHRI) Team Grant Awards, as well as the Transplant Foundation of BC (TRF). The VCHRI Team Grant Awards support projects that contribute to the improvement of health care delivery and address pressing challenges in health care. This project is a continuation of work that Chiu and her team began as a pilot through the Providence Health Care (PHC) Practice-based Research Challenge. Providing support beyond the clinic While heart transplants and mechanical heart pumps are life-saving treatments that improve patients’ health outcomes, the process of
19 Winter 2025 consultations, diagnostic testing, medication adjustments, screening and decision-making can cause uncertainty and distress in patients and families. With a peer mentorship program, patients with similar conditions and experiences are matched to provide guidance and support for each other. Chiu and her colleagues with the Heart Failure and Transplant Team had heard from patients for years about the need for this type of program, which can provide mentorship and resources for patients that go beyond the clinic. “There’s so much more to living with a heart transplant or a ventricular assist device, also known as a heart pump or VAD, that you can only get from people who have experienced it and walked in those shoes,” says Chiu. While clinicians can answer patients’ questions about medical status, and nurses and psychologists on the clinical team provide support, PMPs provide a community that clinicians can’t. “It’s so scary, to go through something that is life-changing for these patients. Having someone who is like you, at least in the fact that you both have heart failure, makes you feel less isolated,” says Chiu. Without a formal program, patients still nd ways to meet with each other, and health care workers sometimes informally facilitate these connections. Chiu and her team knew that patients could benet from a more formal program, but they lacked the resources to get it going. This brought them to the PHC Practice-based Research Challenge. Pilot project funded through Research Challenge provided groundwork for current study The PHC Practice-based Research Challenge is an annual competition that oers nurses and other health care professionals the opportunity to work with a mentor and learn to design and implement a research project. The team was mentored by Chiu and led by heart transplant clinic nurse and patient educator Josie Mackey. Their pilot project, which also received funding from the TRF, studied patient perspectives on a PMP and gathered information on what the structure, process and content of the program should look like. The team collaborated with ten patient partners for a series of guided interviews. They collected foundational evidence on how the program should be implemented, including what factors create a good peer match, feedback on how to facilitate impactful partnerships, and processes to conclude the mentorship experience in an appropriate way. “With this information, we now want to actually implement the program. That’s why we pursued the VCHRI grant, because now this is something bigger. We want to make this program a permanent service Clinical Nurse Specialist Wynne Chiu
20 Winter 2025 we can oer to patients, and we want to do it right, so that it can be sustained,” says Chiu. Implementation of the project funded through VCHRI Team Grant The VCHRI Team Grant gives Chiu and her team the opportunity to translate the innovative knowledge gained from the pilot program into practice, and to measure the impact of the program on outcomes that matter most to patients and families. Before the new PMP is implemented, Chiu and her team will be conducting focus groups with both patients and clinicians to gather more feedback on potential barriers the program may face and strategies to help it succeed. When the program begins, the team will collect information from the mentors and mentees and evaluate the process as they move forward. When the study is complete, the team will have evidence on the best roadmap to successfully and sustainably implementing a PMP as a standard of care. Study made possible through the collaboration of patient partners Chiu and her research team were honoured to receive the VCHRI Team Grant Award and are excited by the opportunity to pursue this project. Chiu is pleased to partner with co-principal investigator Dr. Sandra Lauck, who holds the St. Paul’s Professorship in Cardiovascular Nursing at UBC and is a UBC Knowledge Exchange & Mobilization Scholar. She gives credit to all of the patient partners who supported the pilot program, many of whom will also be involved in the new study, including Kristi Coldwell, Naomi Lee, Jillianne Code and Mark Bains. The pilot study was successful due to their contributions, and the research team is hoping for the same level of engagement for the upcoming study. “As a patient partner and heart transplant recipient, I know rsthand the profound impact that peer mentorship can have on heart transplant patients,” says Bains. “The peer mentorship program bridges the gap between clinical support and the day-to-day realities of living with a heart transplant or articial heart.” Once this peer mentorship program is in place and sustained, it will be a complement to what the Heart Failure and Transplant Team does for patients. “It’s funny, a lot of people’s feedback is ‘I can’t believe this isn’t already in place,’” says Chiu. Dr. Sandra Lauck “It’s so scary, to go through something that is life-changing for these patients. Having someone who is like you, at least in the fact that you both have heart failure, makes you feel less isolated” - Wynne Chiu.
21 Winter 2025 PHIR+E: Advancing Innovation with Providence Research Providence Health Innovation, Research + Engagement (PHIR+E), a part of and the link between Providence Research and Innovarium, makes vital connections between researchers and other members of the Providence Health Care community and the resources they need to innovate. PHIR+E supports the creation and implementation of new solutions to healthcare challenges in real-world settings. Enabling innovation through connection PHIR+E is an integral part of Innovarium, Providence Health Care’s innovation engine that unites various complementary research elements, creating an environment that provides resources and support to accelerate innovation. The PHIR+E team specializes in forming strategic partnerships and helps bring together a diverse range of stakeholders, including individuals, academic institutions, and government and industry partners. In this way, PHIR+E connects resources, opportunities and platforms to advance innovative medical research ideas. PHIR+E amplies PHC’s position as a leader in healthcare innovation, building visibility and interest amongst peers, stakeholders, and other potential collaborators, while helping to retain and attract the best minds. It hosts workshops, networking events, competitions and other programs that provide opportunities for researchers, clinicians and other innovators to acquire the skills and experiences vital to develop innovative ideas and healthcare solutions. It also connects them with experts in areas such as ethics, contracts and nance. “PHIR+E was established to maximize the impact of research at PHC. By establishing these bidirectional partnerships between our researchers and external stakeholders, and through working in collaboration with the other components of Innovarium, PHIR+E enables research translation and a greater return on investment,” says Dr. Darryl Knight, President, Providence Research, Vice-President, Research & Academic Aairs, Providence Health Care, Associate Dean, Faculty of Medicine, University of British Columbia. PHIR+E in Action A signicant part of the initiative involves hosting and organizing novel events and opportunities meant to spark new ideas and accelerate healthcare solutions. PHIR+E’s agship event, Skunkworks, brings together a diverse range
22 Winter 2025 of participants to address local issues that have global signicance, such as Pain, Wounds and Aging, themes of previous Skunkworks. This year, Skunkworks’ theme is Chronic Disease. Skunkworks is an opportunity for people from dierent disciplines to collaborate and brainstorm creative solutions, presenting their ideas to a panel of judges. Winning teams participating in the Skunkworks competition receive funding, sector expertise, and support to make their proposed solution a reality. You can learn more about the event here. “It was wonderful to meet so many colleagues from other parts of the system,” says Dr. Sammy Chan, a participant in Skunkworks: Hacking Aging. “The wide range of perspectives made the solutions so much richer and well thought out.” PHIR+E supports ideas originating at Skunkworks by providing funding or by connecting the teams with needed resources. For example, the Mend & Tend pilot program, which brings wound care to residents of Vancouver’s Downtown East Side, originated at Skunkworks: Hacking Wounds in 2022. Another project in development is the Oasis Connect App, which is designed to enhance care delivery and family engagement within Canadian long-term care homes. PHIR+E enabled the team that pitched the idea at Skunkworks: Hacking Aging in 2023 to develop a prototype with support from the Centre Dr. Darryl Knight speaks at Skunkworks: Hacking Aging “PHIR+E was established to maximize the impact of research at PHC. By establishing these bidirectional partnerships between our researchers and external stakeholders, and through working in collaboration with the other components of Innovarium, PHIR+E enables research translation and a greater return on investment.” - Dr. Darryl Knight
23 Winter 2025 for Digital Media. Maximizing opportunities at the CSRC The new state-of-the-art Clinical Support and Research Centre (CSRC) at the new St. Paul’s Hospital will see scientic breakthroughs translated into real-world health care, extending the continuum of care to ensure patients get the right care, in the right place, at the right time. The CSRC will include infrastructure for cutting-edge technology such as 3D bio-printing, data, and analytics which will contribute to B. C’s positioning as a global hub in life sciences. Building on our culture of innovation PHIR+E is dedicated to cultivating an environment where innovation thrives. The program works to clear the path to discovering and implementing new solutions, and to empower innovators in the process of rening their ideas and achieving breakthroughs. PHIR+E supports innovations developed by Providence Research and PHC clinicians, connecting them with the resources needed for implementation. Along with the other elements of Innovarium, including Providence Health Care Ventures and Ideas Forward, PHIR+E plays a pivotal role in advancing innovation at Providence Health Care. The CSRC will see scientic breakthroughs translated into real-world health care.
24 Winter 2025 Cultivating innovation and entrepreneurship at Providence Research Innovation plays a vital role in advancing health care. By identifying areas for improvement in care, creating solutions, and implementing them in real-world settings, clinician-scientists can positively impact patients and the health system. A special lunch-and-learn event at St. Paul’s Hospital, a part of the Innovarium Empowering Innovation Series, provided information on becoming an innovator as a clinician-scientist and how cultivating an entrepreneurial mindset can help translate those innovations into impact. The event was presented by Providence Health Innovation, Research and Engagement (PHIR+E) and Discover, Learn, and Innovate for Impact Physician Advisory Committee (DLII PAC), a part of PHC Innovarium, in partnership with Simon Fraser University (SFU) and PHC Physicians and Surgeons. Special guest Dr. Elicia Maine, Associate Vice-President, Knowledge Mobilization and Innovation, SFU, shared insights from the award-winning Invention to Innovation (i2I) program. Dr. Jesse Greiner, Chair of DLII PAC and a General Internal Medicine Specialist with Providence Health Care (PHC), gave a presentation on simplifying clinical innovation. The healthcare landscape is evolving, driven by factors including an aging population, increasingly complex diseases, and technological advancements. Providence is strategically developing the new St. Paul’s Hospital and the Clinical Support and Research Centre to address these changes and advance patient care. In addition, PHC Innovarium was created to enable the organization to swiftly and eectively adapt to change and approach problems. As PHC’s innovation engine, Innovarium supports the realization of innovative solutions created by Dr. Elicia Maine
25 Winter 2025 clinicians, researchers and other innovators within PHC. “In the context of health care, innovation goes way beyond advances in therapies and better technology. Really, what we’re trying to aspire to is a new way of thinking, a better way of preventing, diagnosing and treating patients,” says Dr. Darryl Knight, President, Providence Research. An innovator in all of us Dr. Jesse Greiner has been involved with several health care startups and innovation at PHC, including the COVID-19 Recovery Clinic, the Post-Discharge Internal Medicine Clinic, and the Hospital at Home program. As the chair of DLII PAC, he is a key member of Innovarium. DLII PAC’s mission is to guide and engage with the innovation-focused energy at St. Paul’s Hospital to better address patients’ needs. Dr. Greiner’s presentation aimed to simplify clinical innovation by making the concepts of innovation and entrepreneurship accessible to clinicians and researchers. He emphasized that the basic steps for innovation – identifying a problem, creating a solution, validating the solution, and applying it to help people – are activities that many clinicians and researchers already perform daily. There are many opportunities within the health care eld to innovate and drive impacts that benet patients. “I am hoping that… you’ll be able to see there’s an innovator in all of you,” says Dr. Greiner. “I would just encourage you to try to imagine solutions, to imagine the world as being slightly better than it was yesterday.” Enabling research mobilization with an entrepreneurial mindset Dr. Elicia Maine gave a talk emphasizing the benets of scientists developing an entrepreneurial mindset. Developing Dr. Jesse Greiner “In the context of health care, innovation goes way beyond advances in therapies and better technology. Really, what we’re trying to aspire to is a new way of thinking, a better way of preventing, diagnosing and treating patients” Dr. Darryl Knight.
26 Winter 2025 entrepreneurial capabilities can help researchers form well-constructed science-based ventures, increase science-based innovation in industry, and increase meaningful translational research. Dr. Maine founded the i2I program in 2015, which trains scientists and clinicians to commercialize their breakthrough innovations. It teaches them how to mobilize research and transition innovations from the lab to the market, potentially creating signicant societal and economic impacts. The program does not just focus on brand new ventures, but on how to set the stage for all sorts of industry collaboration. Science-based innovation poses unique challenges compared to other sectors. Research mobilization is a long endeavor, and breakthroughs can happen over decades. In addition to taking more time, science-based innovation involves a higher level of uncertainty and requires larger commercialization costs. “So, why would you even invest in this space? I think it’s clear, to this room, that you would do it because there are chances to solve very real patient problems,” says Dr. Maine. A key objective of the i2I program is to train researchers to frame their work ways that reduce this uncertainty. An entrepreneurial mindset encourages scientists to think dierently about their research and how to mobilize it. Early-stage actions in the lab can signicantly impact the outcomes of knowledge mobilization and product development. “It’s important, when you’re looking at the types of things that are going to impact patient health, and that are addressing really wicked problems, to be thinking about this systematically from an early stage,” says Dr. Maine. Equipping innovators at PHC Through events like this lunch-and-learn, PHIR+E aims to equip researchers and other health care professionals with the tools and knowledge needed to create and implement impactful, real-world solutions. A video recording of the session is available here. Providence has a long history innovation, ranging from groundbreaking HIV treatments developed by the BC Centre for Excellence in HIV/AIDS to the annual Skunkworks competitions. Skunkworks, a PHIR+E initiative, is enabling health care professionals to come together and collaborate to brainstorm innovative solutions to health care problems. “I am hoping that you’ll be able to see there’s an innovator in all of you. I would just encourage you to try to imagine solutions, to imagine the world as being slightly better than it was yesterday.” - Dr. Jesse Greiner
27 Winter 2025 Interdisciplinary teams hack chronic disease at fourth annual Skunkworks The fourth annual Skunkworks, Hacking Chronic Disease, brought together interdisciplinary teams of allied health and industry professionals, students, and patient partners to collaborate on innovative solutions to address the complex challenges surrounding chronic disease treatment and prevention. Hosted by Providence Research and Providence Health, Research and Engagement (PHIR+E) in partnership with St. Paul’s Foundation, Skunkworks is a unique event series that aims to facilitate innovation to address complex local health problems that resonate globally. The term "skunkworks" originated in the 1940s as an alias for an American engineering lab that worked on top-secret and innovative programs at Lockheed Aircraft Corporation, and now refers to a project developed by a loosely structured group of people who identify issues and pilot creative solutions. “Skunkworks was an amazing experience to have with my colleagues. It made us think dierently, and to explore out-of-the-box solutions. It was also wonderful to meet and work with new people, including passionate patient partners,” says Courtney Symes, a Nurse Educator at Providence Health Care (PHC) who participated in Skunkworks: Hacking Chronic Disease. Previous Skunkworks have ‘hacked’ the topics of pain, wounds, and aging, producing pilot projects such as the Mend & Tend drop-in wound clinic, and Brainstorming at work at Skunkworks: Hacking Chronic Disease
28 Winter 2025 Oasis Connect, an app to enhance care delivery and family engagement within Canadian long-term care homes. Speakers provide context on major global health challenge The treatment and prevention of chronic disease presents a major global health challenge. According to Health Canada’s latest report, Health of Canadians, forty-ve per cent of Canadians live with at least one major chronic disease. The prevalence of chronic disease increases with age, so as the population ages, so will rates of chronic disease. To provide greater context to this issue, speakers at Skunkworks: Hacking Chronic Disease gave insightful talks highlighting the need for innovative, eective solutions to reimagine chronic disease treatment and prevention. Dr. Kate Smolina, Scientic Director, Data & Analytics Services and Knowledge Translation, BC Centre for Disease Control, spoke about why managing chronic disease matters. Chronic disease has signicant costs to the health system and to patients, so it is important to invest in both treatment and prevention strategies. Patient advocate Claire Snyman shared her experience as a person living with multiple chronic diseases – asthma, endometriosis, and a brain tumour. Managing chronic diseases can feel like a full-time job, and Snyman emphasized that there are many opportunities to improve the health system to better cater to the needs of patients. Dr. Muhammad Mamdani, Vice President of Data Science and Advanced Analytics, Unity Health Toronto spoke about AI use in chronic disease treatment and prevention. AI has incredible potential to improve health care, such as AI scribes that free up time for physicians to focus on patients. However, AI also has the potential to cause harm, and issues including ethics and clinical validation need to be taken into account when considering the use of AI in the treatment of chronic disease. Innovation strategist Lucien Engelen, who is based in the Netherlands, spoke about determinants of health and the importance of preventing illness and advancing personalized medicine. He emphasized that more health care is not the solution to current challenges – more health is. Investment in health translates into economic growth through improved productivity, reduced healthcare cost, and other factors. Dr. Darryl Knight, President, Providence Research, speaks at Skunkworks: Hacking Chronic Disease “Skunkworks was an amazing experience to have with my colleagues. It made us think dierently, and to explore out-of-the-box solutions.” - Courtney Symes
29 Winter 2025 “This meeting of minds, from medical care service providers, patient engagement partners, policy makers, and supporters from the business industry through their funding, was a great opportunity to solicit ideas on the use of digital technology to improve on how medical care is delivered to people with chronic illnesses,” says Mario Gregorio, a patient partner and member of the University of British Columbia’s Innovation in Dementia and Aging (IDEA) Lab. Gregorio also participated in Skunkworks: Hacking Aging in 2023. Creating solutions with design thinking Skunkworks is framed around design-thinking, an approach to problem solving anchored in human-centred design. Participants ‘voted with their feet’ to choose their teams based on which challenge surrounding chronic disease they wanted to ‘hack.’ Participants brought their expertise from across the health sector, including acute, outpatient, and long-term care, and other elds such as data analytics, to develop solutions for these challenges. “Skunkworks was an incredible opportunity to connect and collaborate with colleagues and patient partners I might never have crossed paths with otherwise. The dynamic environment allowed everyone to bring their unique viewpoints and ideas to the table, broadening my perspective,” says PHC Occupational Therapist Sarah England. Facilitators Marlies van Dijk, Josh McCutcheon, and Rob Paquin from The Pivot Group led participants through a variety of design-thinking activities to help them brainstorm and ideate on their solutions, such as using analogies to think dierently about their challenges and rapidly sketching solutions in one-minute intervals. Based on this work and their learnings from the lightning talks, the teams developed storyboards to present their pitches to a panel of judges. Four teams receive awards for their innovative solutions This year’s Skunkworks judges were Jaimie Boriso, Director, BCIT MAKE+, Jason Elliott, MDM and pre-MDM faculty member, Centre for Digital Media, Liz Flores, Executive Director, Quality, Patient Safety and Accreditation, PHC, Amanda Tong, Investment Associate, InBC Investment Corp, Sara Khosravi, Senior Manager, Technology Commercialization, SFU Technology Licensing Oce, Jonathan Jafari, A Skunkworks participant works on a design-thinking activity. Pivot Group facilitator Rob Paquin speaks at Skunkworks: Hacking Chronic Disease.
30 Winter 2025 Entrepreneur in Residence, entrepreneurship@UBC, and Norm Peters, Chief Operating Ocer, PHC. The Digital Trailblazer Award was given to the idea involving the best use or adaptation of technology that will directly impact chronic disease. In Skunkworks’ rst tie, this award was given to Team #2, the Electronic Health Team, and Team #11, the COPD Flare-Up Plan. The Electronic Health Team proposed an AI interface, integrated into health databases, that would provide more detail and context on health data results while providing suggestions to patients on ways to improve their health. For chronic conditions like COPD, it is helpful to have an action plan for a are- up, but existing ones can be complicated, time consuming and generic. The COPD Flare-Up Plan team pitched an AI program that would assist physicians in creating personalized, patient-centred action plans. The Health Disruptor Award was given to the idea that seeks to advance research and yield new knowledge with ideas that could result in products, services or practices that will positively impact chronic disease. This was given to Team #6, Stairway to Health. In treating chronic disease, prevention is often more impactful than cure. This team proposed a program that would incentivize taking the stairs at PHC sites, while improving the experience by Team #6 receives the Health Disruptor Award. L-R: Daisy Lin, Abdul Cheema, Lisa Maks, Karen Sims, Vignesh Murthy. Team #2 and Team #11 receive Digital Trailblazer Award. L-R: Melissa Pang, Jonathan Dick, Olena Sklara, Lori Kamlah, Sarah England, Rachel Carter, Binhui Luo, Beth Snow, Charles Keenan, Gil Kimel, Mario Gregorio, Konrad Swic. “Skunkworks was an incredible opportunity to connect and collaborate with colleagues and patient partners I might never have crossed paths with otherwise. The dynamic environment allowed everyone to bring their unique viewpoints and ideas to the table, broadening my perspective.” - Sarah England
31 Winter 2025 adding art, educational components, and color themes to stairwells. The Patient Safety Technology Award is given to a technology-based solution to the areas of medication-related errors, medical complications with patient care, procedure or surgery-related errors, infections, or diagnostic errors. This award was funded by the Pittsburgh Regional Health Initiative through their Patient Safety Technology Challenge, and was given to Team #9, Health in your Hands. This AI program would help patients understand complex lab results by providing patient-focused lab reports in plain language, empowering patients to take control and make informed decisions about their care. “I really enjoyed the opportunity, as a patient, to work collaboratively with health professionals. I felt both seen and valued in the process, seeing so many passionate people wanting to improve the lives of patients,” says Carly Pistawka, patient partner and Health in Your Hands team member. “By the end, we were so excited about our project, and I am looking forward to being involved in the next steps for our idea.” Providence Health Care has a long history of creating innovative solutions to complex health care problems. These solutions created at Skunkworks: Hacking Chronic Disease will help continue this legacy. We want to extend a big thank you to the sponsors who made this event possible, and to our patient partners and mentors, who enriched the event with their experience and expertise. To learn more about Skunkworks, visit our website. Team #9 receives the Patient Safety Technology Award. L-R: Mark Elliott, Izzy Yixin Zhang, Courtney Symes, Carly Pistawka, Rodrigo Gomes Batista, Serena Eagland. I really enjoyed the opportunity, as a patient, to work collaboratively with health professionals. I felt both seen and valued in the process, seeing so many passionate people wanting to improve the lives of patients.” - Carly Pistawka
32 Winter 2025 Gene-editing treatment approved by Health Canada for sickle cell disease and thalassemia was tested in St. Paul’s Hospital clinical trial A gene editing treatment for sickle cell disease (SCD) and transfusion-dependent beta-thalassemia (TDT) has received marketing authorization from Health Canada, following the results of a rst-in-Canada clinical trial that took place in part at St. Paul’s Hospital. The treatment was tested in two global clinical trials. St. Paul’s Hospital was one of four active Canadian sites for the TDT-focused trial, along with BC Children’s Hospital, the Hospital for Sick Children, and Toronto General Hospital. “It’s been really exciting to be a part of this clinical trial for new therapeutics,” says Dr. Hayley Merkeley, the principal investigator of the St. Paul’s Hospital clinical trial. Dr. Merkeley, a hematologist, is the medical director of St. Paul’s Adult Red Cell Disorders Program, which serves nearly 400 adult patients in BC and the Yukon living with SCD and thalassemia. Hematologist Dr. Hayley Merkeley
33 Winter 2025 SCD and TDT signicantly impact patients’ quality of life SCD and TDT are genetic blood disorders that aect how oxygen is carried through the body. Both conditions can have serious complications, impacting patient’s quality of life and requiring lifelong treatment. SCD causes misshapen or "sickled" red blood cells, causing severe pain, organ damage and shortened life span. Thalassemia is a rare disorder that causes a shortage of red blood cells. Its most severe form, TDT, requires patients to receive regular blood transfusions. Many patients with SCD and TDT come from vulnerable patient populations, and historically there has been a lack of research dedicated to these conditions. St. Paul’s Hospital’s Role in clinical trial The follow-up trial, led by Dr. Merkeley, looked for any potential long-term side eects and tested the durability of the treatment. The trial is ongoing and will continue clinically assessing patients at regular intervals for fteen years after treatment. Emily Lee, a patient living with TDT who participated in the clinical trial, would originally visit St. Paul’s Hospital every three months to have blood work done and check in with Dr. Merkeley about how she was doing. She also had a yearly bone marrow biopsy and MRI to assess her degree of iron overload. Now that she is further along in her follow-up period, her assessments occur every six months. New data from the follow-up clinical trial was published at this year’s American Society of Hematology Annual Meeting and Exposition. Digital image of whole blood slides used to identify and count red cells, white cells and platelets. Clinical Trial participant Emily Lee “It’s been really exciting to be a part of this clinical trial for new therapeutics.” - Dr. Hayley Merkeley
34 Winter 2025 The Clinical Support and Research Centre 2024: A year in review for researchers Jim Pattison Medical Campus. Image is for illustrative purposes only and subject to change. This piece was originally published in the Clinical Support and Research Centre Newsletter. Subscribe here for updates on the CSRC and New St. Paul’s Hospital Project. A year ago, Premier Eby announced that the Clinical Support and Research Centre (CSRC) would help “dene the future of medicine” at the new Jim Pattison Medical Campus. With excavation set to begin in the new year, this milestone is a testament to the dedication and hard work of everyone involved in shaping this state-of-the-art facility that will unite groundbreaking research, clinical excellence, and innovation under one roof. For the research component, this year has been pivotal, marked by collaboration across each of the research centres, various clinical academic research teams, and subject matter experts to shape a space that fosters accelerated discoveries and real-world impact. Here’s what we’ve accomplished this year and what’s on the horizon for the CSRC. A year of collaboration and progress This year has been a landmark in planning and
35 Winter 2025 design for the CSRC. The research component completed over 198 hours of design meetings, with a group of 45 researchers who all worked together to ensure a collaborative and inclusive process that will result in a purpose-designed research space. Key achievements include: • Wet Laboratory Spaces: Detailed planning and design with subject matter experts from the Centre for Heart Lung Innovation (HLI) and the BC Centre for Excellence in HIV/AIDS (BC-CfE) have laid the foundation for cutting-edge wet laboratory spaces and core facilities. • Dry Research Spaces: Representation across all research centres and clinical academic research groups shaped the design to enable Providence Research’s Neighbourhood Model, fostering collaboration and innovation. Learn more here. • Specialized Laboratories: The design of the Physiology/Pulmonary Rehabilitation Laboratory exemplies how bench-top research and patient-facing research will be integrated seamlessly in the new space. • All oor-level and room-level designs were reviewed and approved by governance at every stage, including the Research Steering Committee and the Executive Steering Committee (ESC). Beyond research: get to know the CSRC In addition to the brand new, 5 levels of space dedicated to research, the CSRC will house amenities and features that are sure to give you even more to look forward to! From the Innovation Centre to a 49-space childcare centre, take some time to get to know the future CSRC. Step inside the CSRC Spotlight on the Innovation Centre The CSRC’s Innovation Centre is a purpose-driven space, designed to be the beating heart of Latest drone image of the CSRC construction site (left) at the Jim Pattison Medical Campus captured on December 5th, 2024. Pictured right is the new St. Paul’s Hospital under construction. Wet laboratory space. Image is for illustrative purposes only and subject to change.
36 Winter 2025 innovation within the building. With its focus on fostering collaboration and enabling hands-on creation, this is where transformative ideas will come to life, and where research meets practical application. The Innovation Centre will be accessible only to Providence sta, medical sta, researchers, and invited guests (yes, that includes you!). Highlights: • Rapid prototyping capabilities: A hands-on innovation hub with a Makerspace, 3D Printing Room, “Micro Wet Lab,” Incubation Rooms, and specialized equipment such as a laser cutter and water jet cutting machine. These tools support idea development, rapid prototyping, and partnerships. • Team bookable space: A exible room for team collaboration, larger group discussions, or leadership meetings, with soft seating and breakout options. • Workspaces & meeting rooms: Includes 66 workstations, focus rooms, video conferencing spaces, and the CSRC’s largest meeting room with a 60-person capacity. • Nutrition zone: A vibrant area with seating for 200+, a self-serve kitchenette, and potential coee/snack retail space (tenant TBD). With a design that encourages visibility and engagement, the Innovation Centre is more than a workspace. It’s a destination for collaboration, a hub for cross-disciplinary connections, and a launchpad for groundbreaking discoveries. Fast forward: what’s to come in 2025 As we bid farewell to another year in health care, it’s 2025 that marks a transformative year for the CSRC. With excavation beginning in January, years of planning, collaboration, and hard work will begin to take shape. The next phases of planning for the research component will include: • Excavation starting in January: on-site mobilization is now underway for excavation to kick o in the rst quarter of 2025, setting the stage for construction. • Design: Shift from detailed design into Innovation Centre Dining Space. Images are for illustrative purposes only and subject to change.
37 Winter 2025 preparation of construction documents; continued specialty engagement with working groups on technical design details. • Research Neighbourhoods: Continued elaboration of the future operational strategy for the Research Neighbourhoods. • Desired Scope: Continued development on Phase 1 Clinical Trials Unit and Simulation Centre (contingent on securing additional funding). • CSRC operational readiness: Articulate the work that will need to be done to prepare teams for moving and working in the future spaces. • Gap planning: Advance planning for the period between the nSPH opening and the CSRC opening, referred to as the “Gap,” where Providence will operate the old Burrard site concurrently with the new hospital. Questions? Check out our research FAQ! Jim Pattison Medical Campus. Image is for illustrative purposes only and subject to change.
38 “A unique resource in the world.” How Providence Research biobanks enable groundbreaking research Special Feature
39 “Biobanks are a bridge between scientic inquiry and medical progress. Every sample stored in a biobank holds the promise of a breakthrough, a new understanding of a disease, and a potential solution to a life-threatening condition.” - Dr. Darryl Knight, President, Providence Research
40 In 2020, Ron Pavlakovic received a heart transplant due to his idiopathic dilated cardiomyopathy, a form of heart disease aecting as many as one in 250 people. Dilated cardiomyopathy causes the heart to enlarge and its normally muscular walls to thin and stretch, aecting its capacity to pump blood. Pavlakovic, a real estate professional, was not getting enough oxygen to his system, and was struggling with everyday activities like climbing stairs. He was in St. Paul’s Hospital, one of eighteen health and long-term care sites run by Providence Health Care (PHC), receiving a routine treatment when he got the sudden and exciting news that they had a new heart for him. At 1 a.m. the next morning, Pavlakovic received a heart transplant – but his old one did not go to waste. He donated it to the Bruce McManus Cardiovascular Biobank in the Centre for Heart Lung Innovation (HLI), a research centre at Providence Research, PHC’s research engine. What is a biobank, and why are they important? Biobanks are collections of biological samples, such as blood, tissue, and DNA, that are donated for research purposes and are often stored with their associated health data. These valuable resources empower scientic discoveries that improve healthcare, accelerate medical advancements, and help address pressing global health challenges. “Creating a biobank is often driven by a clinical need, some clinical demand, some question that remains unsolved in science and medicine,” says Dr. Mari DeMarco, former Research Director of Providence “Creating a biobank is often driven by a clinical need, some clinical demand, some question that remains unsolved in science and medicine.” - Dr. Mari DeMarco Dr. DeMarco and her biobank lab team. Dr. Mari DeMarco
41 Research and a Clinical Chemist at St. Paul’s Hospital. Biobanks are essential tools for understanding human health and disease, driving innovation in medicine and improving global health outcomes. They provide a critical scientic resource and means for researchers to access biospecimens donated from patients. “Biobanks provide invaluable insights into rare diseases and enable the creation of diverse datasets that enhance the inclusivity and accuracy of research, which are key components of precision medicine,” says Dr. Darryl Knight, President, Providence Research, Vice President, Research & Academic Aairs, Providence Health Care (PHC), Associate Dean, Research, Faculty of Medicine, University of British Columbia. “The importance of biobanks to precision health, information-based medicine, and the quality of health care is becoming increasingly recognized. In addition, biobanking has a huge economic impact, globally valued at around sixty-eight billion dollars in 2021 and anticipated to approximately one hundred and eighteen billion dollars by the end of 2031.” Biobanks drive breakthroughs that can transform how we prevent, diagnose, and treat diseases, ultimately saving lives and improving quality of life for patients worldwide. As part of a unied network, Providence Research provides tools and support for biobank researchers. Biobanking at Providence Research—our unique focus Providence Research has a unique focus on biobanking, positioning it at the forefront of research activities. Embedded within St. Paul’s Hospital with direct access to patients, Providence Research is home to a rst-in-Canada biobank network collecting a diverse range of samples. The HLI houses the largest heart and lung tissue biobanks in western Canada, the Bruce McManus Cardiovascular Biobank (BMCB), and the James Hogg Lung Biobank (JHLB), To house these and other specimens, HLI maintains sixty-eight -80°C freezers monitored 24/7 at St. Paul’s Hospital. “Providence Research has a long-standing history of exceptional biobanking, hosting two world-class biobanks: the Bruce McManus Cardiovascular Biobank and James Hogg Lung Biobank. Over the last forty years, these biobanks have created large and unique biospecimen collections that continue to actively support a growing number of research programs from around the world,” says Dr. Knight. The JHLB, directed by Dr. Tillie Hackett, contains more than 90,000 specimens from over 3000 patients. Established in 1977 by Drs. James Hogg and Peter Paré, it is the longest-running lung biobank in Canada. It has been a signicant resource for lung research, Freezer storage at the HLI. Dr. James Hogg, founder of the James Hogg Lung Biobank
42 contributing to over 800 published research projects since its founding. The JHLB has been a leader in establishing lung biobanking research protocols that have been adopted internationally, including methods of preservation that allows the samples to be assessed both structurally and at the molecular level. The BMCB, directed by Dr. Ying Wang, contains over 100,000 human cardiovascular biospecimens with their clinical information, including 544 explanted hearts from heart transplants,14,000 heart valves, and 600 aorta specimens. Established by Dr. Bruce McManus in 1982, it is the longest-running cardiovascular biobank in Canada. Protocols for sample collection can vary, but all biobanks at Providence Research maintain the highest ethical and privacy considerations. When an explanted heart is donated to the BMCB, for example, the patient gives consent to donate their heart for research prior to their transplant, and then later gives specic consent for their sample to be maintained in the biobank. This enables the heart to be retrieved within ve minutes post-transplant. It is then taken to the laboratory, where it is anonymized and carefully photographed, measured and weighed before being preserved and assessed by a pathologist, after which it is directed to the biobank for longer-term storage. When a researcher requests the tissue, an appropriate biobank sample is identied, processed, and delivered. Biobanks advance research through two mechanisms: forward translation, where samples are actively collected for a specic study, and backwards translation, where research is done using pre-existing sample collections. The biobanks at Providence Research provide advice on how to best utilize existing samples and work with researchers to develop tailored collection protocols that best t their needs. They have an adaptable structure that makes it possible to quickly collect samples for emergent situations such as the COVID-19 pandemic, when biospecimens were urgently needed to understand the virus and develop vaccines and other therapies. Biobanks at St. Paul’s Hospital uniquely positioned for research As the home of the province’s adult heart transplant program, St. Paul’s Hospital is uniquely positioned to connect researchers with patients who have the ability to donate critically needed biospecimens, and to bring research directly to patients. Dr. Gurpreet Singhera displays biobank specimen slides Dr. Bruce McManus, founder of the Bruce McManus Cardiovascular Biobank
43 “For almost the entire time that heart transplants have been performed at St. Paul’s, patients have been donating their removed hearts to our tissue bank. This is an incredibly precious and unique resource in the world,” says cardiovascular endocrinologist and HLI Principal Investigator Dr. Gordon Francis, whose research relies on the use of biobanked samples. The BMCB, located within St. Paul’s Hospital, is one of the few biobanks within Canada that have the capacity for "fresh" biobanking cardiovascular tissue, a process of rapidly freezing tissue after collection that preserves biological integrity and allows researchers to perform a wide variety of analyses. St. Paul’s Hospital also hosts the B.C. Provincial Renal Pathology laboratory, which receives all diagnostic kidney biopsies in the province. The tissue remaining Researchers in Dr. DeMarco’s lab. A human coronary specimen provided by the BMCB for a study on markers of atherosclerosis, scanned with Aperio ImageScope. Its high-resolution imaging capability allowed for precise, microscopic examination of the human tissue. “For almost the entire time that heart transplants have been performed at St. Paul’s, patients have been donating their removed hearts to our tissue bank. This is an incredibly precious and unique resource in the world.” - Dr. Gordon Francis
44 after the biopsy can be donated to a biobank, and researchers are able to follow up with patients to gather data on their clinical outcomes. Nephrologist and Centre for Advancing Health Outcomes scientist Dr. Sean Barbour oversees a biobank focused on glomerulonephritis, a term for autoimmune kidney disease, which has a high risk of progressing to kidney failure. Currently, Dr. Barbour is studying the clinical outcomes of anti-nephrin antibodies in focal segmental glomerulosclerosis, to see if these antibodies impact the development and recurrence of the disease. This research could potentially point towards more targeted treatments. Providence Research is enhancing biobank infrastructure and connectivity While biobanks have historically operated independently, connecting and sharing resources within and between biobanks can further enhance research and impact. For instance, if two research groups are collecting dierent types of samples for the same condition, connecting those collections could enable a greater level of discovery than if they had remained separate. Providence Research is working to enhance connectivity between biobanks at PHC and across B.C. In her role as Research Director, Dr. DeMarco worked to create a modernized infrastructure for biobanks at Providence Research and to ensure that they have the tools needed to be interconnected with the provincial system. “The vision of Providence Research is to help support provincial infrastructure for biobanking that allows this connectivity between sites, allows the sharing of resources and, where permitted, information,” says Dr. DeMarco. She additionally established a suite of resources to streamline the process of setting up a biobanking program. Dr. Mei Lin Bissonnette is a renal pathologist at St. Paul’s Hospital and Director, B.C. Provincial Renal Pathology Laboratory. The laboratory has an archive of the history of renal disease in B.C., which she is expanding into a biobank. She is working with nephrologist Dr. Mark Elliot to create a genetic kidney disease research program as the starting point for this new biobank. Support from PHC and Providence Research, particularly from Dr. DeMarco and her team, has made this undertaking possible. “This would not be possible without the support of Providence Health Care and Providence Research,” says Dr. Bissonnette. “It’s overwhelming to know where to start, and that’s where the Providence Research biobank team have been a tremendous resource.” Dr. Bissonnette aims to eventually expand the biobank and work with other health authorities to oer the ability for patients across the province to donate. “We are located at St. Paul’s, but we serve every patient with kidney disease in B.C. Whether the patient is in downtown Vancouver or in a more rural area, it’s important that they’re able to participate in research if they’re interested. Their experience can help all of us better understand kidney disease, and how to treat Immuno-histological staining of an arteriole thrombotic injury among COVID-19 patients, using formalin-xed paran embedded (FFPE) blocks from the BMCB. High-resolution microscopy was used to detect micro-thrombi, with analysis performed through Aperio ImageScope, a pathological slide viewing software.
45 kidney disease in the future,” says Dr. Bissonnette. Providence Research biobanks advance research into many health conditions Pavlakovic consented to donate his heart for research. After receiving his heart transplant, he met with BMCB manager Dr. Gurpreet Singhera, who asked if he would allow his heart tissues to be stored in the biobank. He agreed, wanting to contribute to research that could improve care or help develop new treatments for others with his condition. Research from the biobanks at Providence Research has advanced the understanding of multiple health conditions and has identied new targets for treatment and prevention. Atherosclerosis, a hardening of the artery wall that is a primary cause of heart attack and stroke, is caused by excess cholesterol being taken up by arterial wall cells. By studying samples from the BMCB, Dr. Gordon Francis determined that most cholesterol accumulates in smooth muscle cells, rather than in immune cells called macrophages, as was previously thought. Having access to arterial heart samples was a major advantage to this research, which could lead to new treatments targeting smooth muscle cells for the reduction of heart attack and stroke. “We’ve been able to study the basic disease process in the arteries themselves and look at where the disease is happening at the cell level,” says Dr. Francis. Dr. Stephanie Sellers, an HLI and Centre for Cardiovascular Innovation researcher, leads the Cardiovascular Translational Laboratory, which runs an international multi-centre explanted heart valve biobank. The lab brings together an international network of collaborators to collect a larger variety of heart valves than each individual centre could collect on its own. “It allows us to get a more comprehensive look at what's going on in the pathology of these valves, to do studies that allow us to understand how these valves degenerate over time, and to model techniques to replace those valves,” says Dr. Sellers. While the Sellers lab works at the tissue and cellular levels to understand the process of degeneration, they “You get to hold your own heart in your hand. They tell you that your heart is the size of your st – well, mine was double the size. It had gotten that large.” - Ron Pavlakovic. Ron Pavlakovic, holding his heart in his hand. Photo courtesy Ron Pavlakovic.
46 also run simulations using the explanted valves, including testing them in an articial beating heart, to better replicate clinical conditions. One recent study demonstrated how calcium deposits on the leaets of a failed heart valve impact its behaviour when a new valve is inserted. Cardiologist and HLI Principal Investigator Dr. Zachary Laksman and his team use biobanked heart samples from the BMCB to do genetic, biomarker, and other ‘omics testing. In a recent study, they looked at donated hearts of patients with hypertrophic cardiomyopathy using a new technology called single-cell transcriptomics, which lets them study messenger proteins at a single-cell level. Where dilated cardiomyopathy, Pavlakovic’s condition, causes the heart’s walls to thin stretch, hypertrophic cardiomyopathy causes the heart’s walls to thicken. Both conditions impact the heart’s ability to pump blood eectively. By combining this multi-omic approach with clinical testing, advanced imaging, and articial intelligence, Dr. Laksman’s team seeks to unlock the drivers of disease progression and develop novel therapies for hypertrophic cardiomyopathy. Dr. Tillie Hackett is a Principal Investigator with the HLI and the Director of the JHLB. With samples from the biobank, she and her team conducted a study that found that by the time a patient is diagnosed with mild chronic obstructive pulmonary disease (COPD), more than 40 per cent of the smallest airways in the lung are already destroyed, due to a progressive loss of alveolar attachments that normally hold those airways open. This research is helping shape new guidelines and treatment strategies to diagnose patients with COPD early and prevent lung damage. These are just a few examples of groundbreaking research enabled by access to the biobanks at Providence Research. Biobanks play a signicant educational role In addition to research, the biobanks at Providence Research also have a signicant educational role. They regularly host tours to help patients better understand From le to right: Felicia Liu-Fei, Coco Ng, Dr. Gurpreet Singhera, Ron Pavlakovic
47 their conditions, combat disease misconceptions, and raise awareness about research. For example, the BMCB and JHLB host tours for high school and UBC undergraduate students focused on dispelling common misconceptions about heart and lung disease, providing the opportunity for students to see the specimens and learn about the importance of biobanks to research. Donors also welcome to visit the biobanks and have the opportunity during these tours to see their own donated organ. At the BMCB, they can even hold their own heart! Pavlakovic came to tour the biobank at the earliest possible opportunity and found the experience of seeing his own heart fascinating. “You get to hold your own heart in your hand. They tell you that your heart is the size of your st – well, mine was double the size. It had gotten that large,” says Pavlakovic. “You learn a lot, it was eye-opening.” This experience can often help patients better understand their disease status and risk factors. Pavlakovic had been told by his doctor that his condition was enlarging his heart and causing its walls to become thin to pump properly, but physically seeing it in comparison with a healthy heart sample brought that concept home. Patients often return years after their tour to thank the biobank sta. Having made a valuable contribution to the advancement of research, they can feel a sense of partnership and closure. New research complex will have state-of-the-art biobanking facilities In the Clinical Support and Research Centre, our future research and medical complex, biobanks will be centralized in a purpose-built core facility, designed in consultation with researchers. This highly-customized research space will include state-of-the-art collection facilities, specimen processing infrastructure, and dedicated biobank storage space. Bookable drop-down lab space and access to shared equipment will increase Providence Research’s biobanking capacity and increase accessibility for early-career researchers. Along with modernizing our research facilities, Providence Research will be digitizing all biobank collections using OpenSpecimen, an inventory management software that will enable connectivity and enhance visibility of biospecimens. These changes will be reinforced by standardized policies and procedures, creating a rst-in-western-Canada, robust and reliable biobanking infrastructure poised to enable groundbreaking research. The CSRC will be directly connected to the new St. Paul’s Hospital via a skybridge. This proximity will enable researchers to quickly reach patients and give more patients the opportunity to consent to donate specimens to a biobank. The integration of research and clinical care will allow biobanking to be more ecient, reducing the time needed for research to be translated into therapeutic developments. Biobanking for the future In the eld of medical research, knowledge and technology are constantly evolving, but human biospecimens will always be necessary to advance health research. Biobanks are instrumental in advancing precision medicine - an approach that tailors medical treatment to the individual characteristics of each patient, including their genetic prole. A rendering of the future Clinical Support and Research Centre.
48 Supporting biobanks helps ensure that life-saving treatments are accessible and eective for diverse populations, particularly underserved communities, by providing a wealth of genetic diversity in research. Providence Research’s biobanking infrastructure is capable of adapting as technology advances and new research needs arise. When biobanks create their sample inventories, they try to keep in mind their potential utility for applications that are currently out of reach. For example, Drs. Bruce McManus and James Hogg both had the foresight to store the samples in their biobanks in ways that preserved cellular structure and RNA, anticipating that more advanced molecular tests would be developed. Now, heart and lung tissue stored decades ago can be used by researchers in ways that could never have been fully predicted from the start. Biobanks at Providence Research will revolutionize medical research by creating a standardized, globally accessible repository of diverse biological samples and comprehensive clinical data. The implementation of consistent protocols and standardized information will mean that researchers worldwide can condently compare results and validate ndings at unprecedented scales, leading to faster breakthroughs in disease understanding, clinical trials, and patient care. Bringing the donation cycle full circle Biobanks are critical in accelerating the development of new treatments, vaccines, and therapies. By providing researchers with diverse biological samples, they help identify new disease biomarkers, uncover risk factors, and evaluate the eectiveness of novel medical interventions. All biospecimen donations to biobanks, whether they be blood, tissue samples, or whole organs, are vitally important to research that advances patient care. A biobank is most eective when its samples are being actively used in research, not sitting in storage. “At Providence, we are all stewards of these samples. We want to honour these donations the best way we know how – that is, by getting them into the hands of researchers who can use them to make new discoveries,” says Dr. DeMarco. All biospecimen donations to biobanks, whether they are blood, tissue samples, or whole organs, are vitally important to research that advances patient care. Pavlakovic with his heart. Photo courtesy Ron Pavlakovic
49 For more information on biobanks, contact: research@providencehealth.bc.ca To make a monetary donation to support our biobank program, contact: spfoundation@providencehealth.bc.ca “At Providence, we are all stewards of these samples. We want to honour these donations the best way we know how – that is, by getting them into the hands of researchers who can use them to make new discoveries.” - Dr. Mari DeMarco “Biobanks are a bridge between scientic inquiry and medical progress. Every sample stored in a biobank holds the promise of a breakthrough, a new understanding of a disease, and a potential solution to a life-threatening condition,” says Dr. Knight. Particularly for those who donate organs, contributing to a biobank can be a full-circle moment. A person who receives a transplant due to a particular disease or condition, in turn, donates their explanted organ to a biobank, empowering research that could lead to new treatments and preventions for their condition and potentially reducing the need for transplants in the future. “Donate as much as you can, because they are excess body parts,” says Pavlakovic. “It’s a very thoughtful gesture, and one that doesn’t cost you anything. It potentially gives the people that are studying your condition an opportunity for further research.” Providence Research biobanks aim to create an enduring legacy that transforms countless lives, enabling researchers to crack the code on rare diseases and helping develop personalized treatments. Our biobanks will break down the barriers that currently slow medical breakthroughs, creating a powerful resource for scientists to access the biospecimens they need to develop a greater understanding of disease mechanisms and leading to better treatments with the potential to turn what are now deadly or debilitating conditions into manageable or curable ones.
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