Innovative Research Builds Healthier Communities Across New England
Since 1991, Maine Medical Center Research Institute (MMCRI) has been at the center of MaineHealth’s mission to improve patient health and outcomes by advancing the science of medicine through biomedical research. Chronic diseases such as cancer, obesity, heart disease, Alzheimer’s and substance abuse — prevalent in northern New England’s aging and largely rural population — are some of the health challenges MMCRI is tackling through innovative research and partnerships.
In 2017, the National Institutes of Health awarded $20 million to MMCRI and its partner institutions, the University of Vermont and the University of Southern Maine, to create the Northern New England Clinical & Translational Research Network (NNE-CTR), a consortium to enhance collaborative research and medical treatments for the many chronic diseases prevalent in our region.
NNE-CTR’s focus is defining optimal methods of disease prevention and health care delivery in rural environments. The network is also training the next generation of biomedical scientists, physicians and nurses in research methodology to attract additional research support. Clifford Rosen, MD, director of the Center for Clinical and Translational Research at MMCRI, and Gary Stein PhD, director of the University of Vermont Cancer Center, co-lead the program.
“Our goal is to support innovative and transformative research, increase participation in clinical research and improve access of our rural residents to clinical studies. This will ultimately improve the health and vitality of the people of Maine, Vermont and New Hampshire,” said Dr. Rosen.
Small-Scale Pilot Projects Tackle Big Problems
Neonatal and pediatric neurologist Alexa Craig, MD, leads a Pilot Project focused on improving the detection of and treatment for neonatal encephalopathy in rural areas. Neonatal encephalopathy is a type of brain injury that can occur in newborn infants due to lack of oxygen and blood flow to the brain around the time of birth.
Therapeutic hypothermia is the only known treatment for neonatal encephalopathy; this involves placing the baby on a cooling blanket that maintains a temperature of 91 degrees Fahrenheit for 72 hours followed by 12 hours of rewarming. The baby is monitored in an intensive care unit during this treatment, and magnetic resonance imaging is then performed to determine presence or absence of brain injury.
“One of the clinical challenges of this treatment is that it must be started within the first six hours of life, and earlier treatment is known to be associated with improved outcomes. For the 75 percent of infants treated with hypothermia who are born in rural Maine hospitals, recognizing neonatal encephalopathy and getting the baby cooled quickly are particular challenges, especially for providers in rural locations who do not see these babies all that often,” said Dr. Craig.
To combat these challenges, Dr. Craig developed her NNE-CTR pilot study to employ a telemedicine consult, a three-way, realtime interactive communication via video among the rural physician, the neonatologist at MMC and Dr. Craig. For infants and their families, this means faster diagnosis and treatment via a live consultation, thereby improving their chances of a better outcome or avoiding unnecessary treatment. Dr. Craig will assess the results of her Pilot Project in the next year to determine whether the real-time consultations successfully decrease the time to initiate therapeutic hypothermia. “It is exciting to be a part of a study that has such potential to improve patient care and outcomes,” said Dr. Craig.