8

The Evolving Global Biomedical Research Environment and Its Implications for NIH Capital Assets

BACKGROUND AND CONTEXT

Based on its deliberations over the course of 18 months, the committee believes that the Intramural Research Program (IRP) on the Bethesda Campus is a vital and essential part of the National Institutes of Health (NIH). In this vein, the committee feels that NIH needs to give more attention to the evolving and increasingly competitive global biomedical research environment that is driving the need for a different type of research-built environment. Without serious consideration of and attention to these dynamics (refer also to Chapter 2), the committee believes that the IRP is likely to be increasingly disadvantaged when competing against other national and international biomedical research centers.

The committee identified multiple issues that were not within its investigational charge per se, but that materially bear on the management of the Bethesda campus’s capital assets. The committee feels that it would be remiss if it did not note these issues and call for their further assessment. These issues relate to (1) NIH’s organizational structure and culture; (2) organizational and structural barriers to team science; and (3) data access and management issues.

The committee was not able to delve into these issues in great depth, but it did spend significant time evaluating and discussing them through the lens of their implications for space and facilities use on the Bethesda Campus, especially in the long term. The committee concluded that the issues called out above deserve to be investigated more thoroughly, with an eye toward their implications for both the NIH scientific enterprise and its capital assets management.

ORGANIZATIONAL STRUCTURE AND FUNDING

As mentioned in Chapter 3, NIH has a unique organizational structure that has developed less by forethought than by happenstance as its health and national security missions have evolved over the years. This disparate funding and political support across the ICs means that some institutes are essentially

functionally independent organizations from NIH as a whole. For example, with the exception of some patient care and clinical research at the Clinical Center, the National Cancer Institute performs most of its intramural research at locations other than the Bethesda Campus (e.g., at the Frederick National Laboratory located 50 miles northwest of Washington, D.C., and at the Shady Grove campus).

In FY 2017, NIH’s appropriated funds totaled $33 billion, including $5.9 billion for the National Cancer Institute (18 percent of NIH’s budget), $4.7 billion for the National Institute of Allergy and Infectious Diseases (14 percent of NIH’s budget), and $3 billion for the National Heart, Lung and Blood Institute (9 percent of NIH’s budget) (see Figure 8.1).

The confluence of widely disparate IC budgets, NIH’s intrinsically fractured and siloed organizational structure, and a culture led by individuals recognized for their deep expertise within narrowly defined areas of science has led to a palpable organizational bias to use funds to support scientific research over integration of strategic plans and promotion of shared facility assets that support team science.

Since 2003, NIH funding has not kept pace with inflation, and the agency has lost 22 percent of its research purchasing power. Likewise, funding for the Buildings and Facilities account has remained relatively static over the last 20 years, not allowing the organization to keep up with inflation or aggregate funding for larger capital expenditures (see the section “Funding for Capital Projects,” in Chapter 4). And while difficult to measure, there is a linkage between the level of funding for facilities and the NIH intramural programs, the latter charged in the NIH-Wide Strategic Plan (NIH OD, 2015) with the following:

• To prevent dire impact to individual and community’s health;
• To retain a world-class biomedical workforce; and
• To remain competitive in the global business environment.

The Bethesda Campus’s challenge is not a uniquely NIH challenge. Many of the same forces affect biomedical research facilities across the nation and globe. Today’s biomedical research organizations are large, complex, and highly sophisticated enterprises, although they are not always viewed as such and enabled with appropriate infrastructures for planning and management.

NIH’s challenges for setting priorities, developing sound administrative capital asset strategies, and managing according to them is compounded by it being a federal government agency that must contend with the vagaries and intrinsic challenges of government funding. State research universities often also struggle with this reality, in comparison to private universities, but federal government agencies must contend with even more public attention and scrutiny.

As noted earlier, each NIH institute or center receives congressional appropriations, albeit often from different House and Senate committees. These congressional entities, who often represent powerful health advocacy groups, often define major capital asset investments, such as new buildings, but have not generally recognized overall NIH-wide and campus needs.

The above-noted funding dynamics lead to widely different amounts of funding for the 27 ICs and the overall IRP. This presents a significant challenge to enterprise-wide coordination and planning. Each of the units comprising NIH has its own staff members that relate to strategic and facilities planning, with the individual ICs enjoying different perceptions and levels of support.

MULTIDISCIPLINARY TEAM SCIENCE

The concept of “team science,” defined as scientific collaboration by more than one individual in an interdependent fashion, has evolved because of the increasing need to bring experts from multiple disciplines together to address complex problems (NRC, 2015). The impact of funded scientific collaborations across organizations and institutional boundaries nationally and internationally is reflected by the increased number of multi-authored publications in peer-reviewed journals (Llewellyn et al., 2018). In 2010, the National Cancer Institute published “Collaboration and Team Science: A Field Guide” to help guide the institutional organizational and cultural change needed to support the change from single investigator-led projects to multidisciplinary team-led projects that emphasize collaboration across disciplinary dedicated departments and ICs (Bennett et al., 2018).

In 2015, the National Academies published a report requested by the National Science Foundation to provide guidance on how best to address the challenges of conducting research collaboratively (NRC, 2015). The report reviewed the emerging evidence from the new interdisciplinary scientific research field of “science of team science” (SciTS) on the effectiveness and challenges of team science.

This emerging field of empirical knowledge can guide funding agencies, policy makers, scientists, and organizational leaders on how to effectively support team science and a culture of collaboration (Hall et al., 2018; NRC, 2015). Of the seven key challenges for teams that were addressed in the study, geographical dispersion was identified as the main problem, and hence, the need for different facility and built-environment designs. The ability to co-locate research teams in an adaptable, technologically advanced contemporary biomedical work environment is essential to facilitate collaboration and support innovation. High-performance computing and a state-of-the-art information technology and communications infrastructure are necessary to support “big data” analytics and the connectivity requirements of local, national, and international team collaboration. Building an infrastructure to support team-based science is essential to stay viable in a global biomedical research environment that is intensely competing for top talent.

Having flexible and adaptable contemporary biomedical research space is essential to accommodate the current and future needs of multidisciplinary research teams. Team-based science requires a high degree

of social interaction, and the work environment needs to support various models of collaboration and interaction. For example, desire for adjacency of “dry lab”-based computational scientist and “wet lab”based researchers to support purposeful interaction and generation of new ideas requires buildings with access to a high-performance computational infrastructure and state-of-the-art laboratory and core facilities. The trend toward the development of interdisciplinary scientific neighborhoods made up of multiple open laboratories, shared lab support areas, office space, formal and informal meeting spaces, along with open shared collaboration spaces, breaks down the traditional alignment of space according to academic or research line disciplines. Furthermore, the growth of the innovation economy and the development of innovation districts and spaces to support institutional collaborations, incubators, and start-up spaces, create ecosystems that are changing the way people work and collaborate (Wagner and Watch, 2017). Biomedical research organizations focused on attracting the millennial generation of scientists will need to incorporate innovation into their building design and campus programming. With few exceptions, the current built environment at NIH is not well designed to support these new models of team-based and transdisciplinary science.

Most biomedical research organizations in the United States engage in enterprise-wide coordination and planning. The NIH Long-Term Intramural Research Program (LT-IRP) Planning Working Group (NIH ACD, 2014) recommends that such activities be strengthened in one of its recommendations, as follows:

An example noted in the above recommendation from the LT-IRP with respect to buildings and facilities is the John Edward Porter Neuroscience Research Center (PNRC)—one of the few examples of a built environment to support transdisciplinary research on the NIH campus. To quote an NIH website:

This vision for collaborative research seems to be experiencing several challenges in current operations. For example, the PNRC is already oversubscribed, often yielding cramped research space. Areas designed

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¹ National Institutes of Health (NIH), “The John Edward Porter Neuroscience Research Center,” https://www.nih.gov/about-nih/john-edward-porter-neuroscience-research-center, accessed February 7, 2019.

to facilitate casual interaction among researchers can be so small that the spaces feel constrictive, while circulation spaces, including massive hallways, can be underutilized. Current maintenance and repair issues, such as water leaks into new laboratory spaces, require researchers to hang plastic sheeting around expensive equipment to protect the equipment and allow research to continue.

The committee believes that NIH needs to achieve better coordination of planning for a built research environment that will result in a world-class infrastructure that includes facilities and state-of-the art technology that will enable interdisciplinary team-based research in flexible and adaptable facilities capable of supporting present needs and of accommodating future research demands. This will require breaking down traditional organizational silos, along with new approaches and cultural changes that drive collaboration and integration.

The challenges described here are not unique to the NIH campus. For more than 10 years, major academic institutions such as Stanford University and Northwestern University have made major investments in replacing old infrastructure and in building research environments that support team science and encourage interdisciplinary studies to quickly move biomedical research into clinical practice.² Boston University’s newest research building was designed to foster collaboration between researchers, postdoctoral fellows, and graduate students via “communication staircases” connecting floors and labs. The former “corner office” prime real estate is shared collaboration space that is available to everyone.³ In 2016, the Crick Institute, Europe’s largest biomedical research building, was established through a collaboration among six founding partners: the Medical Research Council, Cancer Research UK, Wellcome, UCL, Imperial College London, and King’s College London. The facility brings together 1,500 investigators and staff working collaboratively across disciplines and makes state-of-the-art science technology platforms available to researchers across the United Kingdom.⁴ The Paul Allen Institute’s new 270,000-square-foot research building in Seattle, Washington, “is designed to process huge amounts of complex research data requiring information technology efficiencies and team-centered facility design. It implements an innovative floor plan to integrate lab space, office space, meeting space, natural lighting, air flow, and, most importantly, movement of people.” According to the institute’s director of operations, the goal was “to take the basic research model and scale it up to a more team-oriented environment” (Woofenden, 2018).

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² See Stanford University (2017b) and the Northwestern University website for the Louis A. Simpson and Kimberly K. Querrey Biomedical Research Center at https://www.feinberg.northwestern.edu/sites/simpson-querrey, accessed January 14, 2019.

³BU Today, 2017, “Designing Science: Newest BU Research Center Is Built for Collaboration,” updated September 14, http://www.bu.edu/today/2017/kilachand-center-for-integrated-life-sciences-and-engineering-science-building-design/.

⁴ Crick Institute, “The Francis Crick Institute,” https://www.crick.ac.uk, accessed January 14, 2019.

DATA DRIVEN SCIENCE

The development and advancement of “big data” science are materially changing the approaches to biomedical research, requiring new methods that span scientific disciplines and require cross-cutting integration of basic biology and human health sciences. To continue to be a global leader in biomedical research, NIH will need the financial and human resources to leverage advancements in big data and turn them into discoveries that improve health. One very promising area is the current activity with cloud computing for the entire NIH enterprise. Work with Google Cloud and Amazon Web Services through the Data Sciences Strategy is moving along, and plans are to use the cloud for data calculations as well as data storage. The committee believes that similar efforts are needed in the area of utilizing augmented and artificial intelligence across all of the intramural programs.

Building 12, which houses the data center, is slated for replacement in the Master Plan and currently has not been funded while awaiting completion of FY 2018-2022 priorities. The building is at risk due to inadequate utility capacity, including an estimate showing inadequate generator power capacity by 2020, and chilled water-cooling capacity in 2017. While there is a project to increase chilled water capacity by July 2019, it is contingent on new funding.

The recently enacted Twenty-First Century Cures Act (Public Law 114-255) includes an initiative at NIH known as the “All of Us” program.⁵ The goal is to collect comprehensive personal health information (PHI) in a secure database that is accessible for research. However, this very commendable effort is challenged by current federal policy regarding access to PHI for research purposes. Such policies do not bode well for “precision medicine” research. Indeed, it is easier for Facebook or Google to access PHI than it is for health researchers to do so through either informed consent or Institutional Review Boards. This issue is not unique to NIH, and major progress using big data may require changes in data access policies.

CONCLUSION

The dynamics discussed above and in Chapters 2 and 3 with respect to the national biomedical and health research enterprise have material implications for the size and scale of NIH’s physical plant, operations, and scholarly pursuits. It was beyond the committee’s charge to delve into NIH’s scientific and clinical programs per se, or into the forces driving the evolving and increasingly competitive global biomedical research environment, but in so far as biomedical and clinical research models substantially drive what is needed in the way of capital assets, the committee encourages the NIH leadership to more closely link planning for scientific inquiries with planning for its built environment. Further, in light of the multiple factors that are driving the evolution of biomedical research and the resultant changes in how biomedical research is conducted, the committee strongly encourages NIH to engage in a rigorous and ongoing strategic assessment of its investigative portfolio and how such relates to its capital asset needs.

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⁵ See the National Institutes of Health All of Us Research Program website at https://allofus.nih.gov/.