“Innovation happens at the borders of disciplines.”
—Toby Cosgrove, MD, CEO, Cleveland Clinic

Renal & Urology News was established in 2002 based on recognition of natural synergies of nephrology and urology. The insight was not immediately intuitive, as care delivery remained largely specialty-based. Almost simultaneously, Michael Porter, PhD, the father of modern strategy, and Cleveland Clinic CEO Toby Cosgrove, MD, were formulating the concept of integrated practice units (IPU’s) as the natural progression in subspecialty care. Their idea was that “the business is not a specialty”, but rather it is the delivery of care for patient conditions such as chronic kidney disease, urolithiasis, kidney cancer, etc.

Inherent necessity for complex care to be delivered by coordinated teams led Cleveland Clinic to transform its structure of departments and divisions into 25 patient-oriented Institutes (IPU’s) in 2007. The second one formed was Glickman Urological and Kidney Institute, combining the departments of Nephrology & Hypertension, Urology, and Regional Urology. Glickman Tower opened a few months later, co-locating members of all three departments to provide care and services under one roof—the highest roof at Cleveland Clinic. Since that time, we have provided a full spectrum of coordinated, patient-centered genitourinary care. Patients can go from the cystoscopy suite to clinics or the dialysis unit without leaving the building.

Cleveland Clinic urologists and nephrologists also collaborate in multiple shared health center and hospital locations throughout northeast Ohio. Finally, through relationships with top-tier hospitals outside our traditional geography, CCF transplant surgeons provide advanced care in West Virginia, Indiana, and the United Arab Emirates.

Beyond obvious alignments of the disciplines, integrated care continues to evolve. For example, we routinely work side by side with medical and radiation oncologists as well as urological pathologists and radiologists. Across all subspecialties we seek ways to provide better patient care through an integrated approach to diseases and conditions that don’t fit neatly into departmental boxes.

Thus, it is natural that the pioneers who first placed urology and nephrology together in one publication team up with the organization that first integrated the disciplines under one roof. We will share experiences in clinical integration, innovation, and patient centered care, and hope that the readership will incorporate some of our successful concepts and will share back with us some of your own. (See page 12 for the inaugural installment.)

We look forward to working with colleagues in both disciplines, and with Renal & Urology News, to provide ever better care for the patients who depend on us to do so regardless of specialty.

J. Stephen Jones, MD, FACS, MBA
Professor and Chairman, Cleveland Clinic Department of Regional Urology
Leonard Horvitz and Samuel Miller Distinguished Chair in Urological Oncology Research
Cleveland Clinic Lerner College of Medicine at Case Western Reserve University