SIHI and RMT-REACH Featured in UM's Vision Magazine
In 2019, Howard Beall, then dean of UM’s Skaggs School of Pharmacy, solicited proposals from faculty to apply for an exciting grant opportunity. Among the proposals he received, two stood out: one from Erica Woodahl about pharmacogenetics and precision medicine research for rural and tribal communities, and one from Hayley Blackburn to use telehealth and interprofessional education to connect rural Montana to health care.
“This was pre-pandemic, so telehealth sounded super exotic,” Woodahl says. “And the use of pharmacogenetics to guide clinical care also was starting to gain some traction in Montana.”
Beall thought the proposals complemented each other and asked them to combine their ideas. Then in February 2020 Woodahl and Blackburn were in La Jolla, California, pitching their ideas to The ALSAM Foundation — a philanthropic organization established by L.S. “Sam” and Aline Skaggs. L.S. Skaggs owned a successful chain of drug stores, and six schools of pharmacy are named for him around the West. Woodahl didn’t have to wonder what the foundation thought of their presentation.
“They were pretty enthusiastic,” she recalls. “They want to focus on expanding roles for pharmacists. Also, they have a longstanding mission for research benefiting underserved and rural communities.”
By the end of the week, Woodahl and Blackburn learned that they could expect good news on the order of $8 million. The gift would be unlocked once UM raised $2 million in challenge donations. Then the pandemic hit, which made fundraising difficult but also highlighted the pivotal roles of pharmacists in vaccine delivery and health care. Finally in December 2022, UM finished raising the $2 million and received the gift to fund the L.S. Skaggs Institute for Health Innovation.
SIHI, as it is known, will amplify the Skaggs School of Pharmacy’s work in three core areas: education, research and outreach. SIHI will create new opportunities to teach College of Health students cutting-edge skills while offering continuing education for existing health professionals in Montana. SIHI will foster new research into telehealth, pharmacogenetics and other subjects with a goal to improve health equity in rural Montana. Finally, it will serve as a public-facing entity within the Skaggs School of Pharmacy to engage the public in patient services, medication therapy management, clinical research and health-related seminars.
“I’m excited about all three,” Woodahl says. “This program hits all pieces of pharmacy and pharmaceutical sciences.”
Woodahl, who is the director of SIHI and a professor in the Skaggs School of Pharmacy, is particularly excited about how SIHI will advance her own research into pharmacogenetics, a field that explores how an individual’s genetic makeup affects their response to medications.
Traditionally, she says, patients seeking treatment for cardiovascular disease, pain, cancer, mental health or infectious disease would get a prescription from their physician and then wait for several weeks for a follow-up appointment. After assessing the patient’s response, a physician might adjust the dose or change medications.
“This can take a really long time,” Woodahl says. “Instead of this trial-and-error approach, if you had that genetic information first, ideally you’re getting someone closer to that stable dose sooner.”
Woodahl says much of the existing clinical research has focused on patients of European descent. That’s part of what inspired her to partner with the Confederated Salish and Kootenai Tribes on the Flathead Reservation on longstanding pharmacogenetics research projects. Woodahl has found, for example, the genetic makeup of one in 10 Native American patients makes them poor candidates for tamoxifen, a widely prescribed treatment for breast cancer.
As the understanding of pharmacogenetics spreads, even to Montana communities with little access to health care, Woodahl hopes UM can help train medical professionals on how to use genetic information to prescribe medicines more effectively.
“That’s one of the services we will be offering within SIHI,” she says. “We have the experts here, people who are well trained in pharmacogenetics who can help interpret the tests and then help physicians make decisions based on the test results.”
Woodahl says expanding access to pharmacogenetic testing will be one way SIHI helps equalize access to health care across Montana, a state where most counties are designated as health professional shortage areas. Some of the SIHI funding will be used to buy a new van to provide mobile health screenings by UM students through the IPHARM program in collaboration with external partners.
“I want to see Montanans have better access to these new health innovations,” she says. “There’s a well-documented rural/urban health disparity. I’d like to narrow that gap. It’s just going to get worse if people have to go to Seattle or Salt Lake or Denver to access state-of-the-art health technologies. How can we make something like that a little more local?”
SIHI will amplify other research, too. Woodahl and colleague Karen Brown recently won a $4 million grant from the National Institutes of Health to fund Rocky Mountain-REACH, or Research, Evaluation And Commercialization Hubs. The goal of that program is to help innovators and entrepreneurs move their research from an academic lab to a commercial product.
The institute also will accelerate research by Blackburn, SIHI’s associate director and an associate professor in the Skaggs School of Pharmacy. Blackburn remains committed to advancing the role of the pharmacist through development of interprofessional training opportunities for pharmacy students and other health professions trainees across the state.
“It’s essential for our students to learn to work in teams and to bring all of their expertise as future pharmacists to the table to enhance health care services in all settings — hospital, outpatient clinic or community pharmacy. It’s also important to think about where pharmacists can bridge the gaps in health care services across the state. Telehealth and mobile clinic outreach can be just a few of the tools we can use to improve access.”
Additionally, Blackburn leads other innovative projects on the intersection of human health and climate change.
The SIHI grant also will allow the Skaggs School of Pharmacy to build two floors on top of the Bio Research Building. Construction could begin in 2025. The new space will be an outward-facing clinical service site, where students can work in a telehealth call center to conduct medication therapy management and chronic disease management with real patients. The space could foster interprofessional education opportunities within the various disciplines of UM’s College of Health. Woodahl hopes it will provide a centralized simulation center, for example, where students of all health professions can practice their skills with virtual reality or high-tech mannequins. On top of all that, Woodahl envisions a community space where SIHI can bring speakers to campus to educate academic audiences and the wider community of Missoula and Montana.
“SIHI kind of umbrellas everything that the school of pharmacy has been doing,” says Donna Beall, interim dean of the Skaggs School of Pharmacy. “I’m hoping it will be a strong point for recruiting pharmacy students. Our passion in our school is rural outreach. This just gives us the opportunity to enhance our programs and shine a light on them.”
With this new influx of cash to pave the way for more education, research and outreach, Beall says, the real beneficiaries will eventually be the residents of this state.
“Patients in rural Montana will benefit from all of the services and programs that SIHI is initiating now, sustaining and growing in the future,” she says. •