DHMC Plans New Research Building

Goal Is to ‘Translate’ Discoveries Into Care

An artist's rendering shows a $116.5 million addition at Dartmouth-Hitchcock Medical Center, which aims to bring the medical research happening at Dartmouth closer to the practicing physicians who can use it to treat patients. (Courtesy Dartmouth-Hitchcock)

An artist's rendering shows a $116.5 million addition at Dartmouth-Hitchcock Medical Center, which aims to bring the medical research happening at Dartmouth closer to the practicing physicians who can use it to treat patients. (Courtesy Dartmouth-Hitchcock)

Lebanon — Preparations are being made to start construction on a $116.5 million addition at Dartmouth-Hitchcock Medical Center aimed at bringing research from Dartmouth’s medical school closer to the physicians who can use it to treat patients.

Spray painted orange markers on the grounds by the main entrance outline the footprint of the planned six-story Williamson Translational Research Building. Dartmouth-Hitchcock officials expect to break ground in May or June, and construction will last two years, said Gail Dahlstrom, DHMC’s vice president of facilities management.

Dartmouth-Hitchcock’s pathology lab will expand onto one floor in the new building, but the Williamson building is mostly a project of Dartmouth’s Geisel School of Medicine, which considers it a key component of meeting its strategic goals by 2020.

Geisel researchers will occupy five of the six floors in Williamson. One of those floors will become the new home for The Dartmouth Institute for Health Policy & Clinical Practice, bringing TDI’s 150 faculty and staff together in the same building for the first time in at least six years.

“The new building is going to have a big impact on Geisel,” said Duane Compton, the senior associate dean for research at the medical school. “Our goal here is to use this building for what we call here translational science. ... It’s literally about translating discoveries that are made in the research laboratories into things that go to better and safer care for patients.”

There’s a two-way street in this relationship between researchers and clinicians, Compton said, as the lessons learned in the hospital can be fed back to the laboratories. Geisel has always been integrated with Dartmouth-Hitchcock — many of its faculty are practicing physicians at DHMC — but bringing the two institutions physically closer though this building would further those collaborations.

“It’s actually been demonstrated that physical proximity has a lot to do with what sort of discoveries get made and how they get made,” Compton said. “If you’re physically separating your basic scientists from your clinical activity, you’re creating a boundary. We’re trying to overcome that boundary by putting a building out there that’s going to have direct access to the clinicians, to the basic science that’s going on, to create that sort of proximity effect, to generate those new discoveries.”

Geisel will pick up the bulk of the construction cost using donations, reserves and borrowing, while $20 million will come from Dartmouth-Hitchcock. The hospital’s portion is coming out of existing funds and will require no borrowing, Dahlstrom said. Geisel is paying for the building with a $20 million gift from Peter and Susan Williamson in 2007, as well as other philanthropic sources, Compton said. The translational research building will be named in honor of the couple.

Peter Williamson, a 1958 Dartmouth College graduate and Lyme resident, was a world-renowned neurologist and epilepsy expert who died from cancer in 2008.

Cancer research will be a significant focus within the Williamson building, Compton said. Geisel will also bring researchers in the neurosciences, inflammation and infectious disease, and computational medical sciences, which pull together statistics and data to develop better diagnoses and treatment plans.

There will be some shuffling of people at Geisel when the building opens, but Compton said the new Williamson facility is expected to be used as a recruitment tool for bringing in new faculty. That’s a big part of meeting the school’s goal of becoming a top-20 medical school by the end of the decade. It is ranked 31st in primary care in U.S. News and World Report’s graduate school rankings, and 38th in research.

“We’re going to use this as the opportunity to do some recruitment to increase our research activity through the new faculty,” Compton said.

For Dartmouth-Hitchcock, expanding pathology labs has been a critical need for years, said Wendy Wells, chairwoman of the pathology department.

The cramped quarters presented safety issues for workers and threatened the department’s accreditation status with the College of American Pathologists, as well as the groups that accredit residency and fellowship programs, Wells said.

The pathology department hasn’t expanded its footprint since the Lebanon campus was built more than 20 years ago, Wells said. Meanwhile, the volume of tests it performs has doubled since 2004 to 3 million tests a year. As a result, pathology sends tests to outside labs, costing Dartmouth-Hitchcock an additional $8 million a year, Wells said. This is work that it could be keeping in-house if pathology had the proper facility.

“We’re compressed,” she said, “and we need to decompress.”

The workload for Wells’ 300-person department will continue to grow, particularly in the esoteric realm of molecular and genetic testing, she said. These are the kinds of tests that allow doctors to develop more specific, personalized treatments.

“Instead of just giving details of a tumor, one-size-fits-all and one treatment fits all, we’ll now be looking at the genetics and molecular signatures of those tumors or other diseases,” Wells said. “We’ll be looking at the genetic signatures more specific to the patients rather than to the patient category as a whole, and therefore you can personalize treatment or drug therapies or whatever to that patient rather than to a group of patients.”

Being able to save money by keeping tests in-house will help Dartmouth-Hitchcock make back its $20 million investment over the next eight to 12 years, Dahlstrom said.

DHMC received Lebanon Planning Board approval in January and the state’s OK last month through the certificate-of-need process, which reviews hospital expansion proposals.

Traffic is expected to rise after Williamson opens, adding about 150 cars during the morning and afternoon peak hours. DHMC has developed a traffic mitigation plan with the city and state, Dahlstrom said.

There may be some additional revenue coming to the city, too, though exactly how much is not yet certain, said Dave McMullen, Lebanon’s chief assessor.

DHMC pays the city about $1.2 million annually in lieu of taxes. Payments are made according to a calculation set in an agreement established in 2002, which goes for 20 years. It is scheduled to be renegotiated in 2018.

“My gut would tell me yes, if they put new square footage on campus, it would most likely affect the payment calculation,” McMullen said.

The expansion won’t translate to bigger profits for Dartmouth-Hitchcock, Dahlstrom said, nor is it intended to be a money-maker. The idea is to smooth the pathway for greater collaboration between Geisel researchers and the clinicians at the hospital.

The Williamson building could have the same kind of effect that the Barbara E. Rubin Building had when it went up more than a decade ago, Compton said. The Rubin building is now the home of the Norris Cotton Cancer Center.

“The impact that (the Rubin building) has had both on the research activity and on the clinical care through the cancer center has been immeasurable,” Compton said. “That building forms the physical home for the cancer center. We’re looking for this Williamson Translational Research Building to be the home for these other activities. … It can have the same type of impact that the Rubin building did.”

Chris Fleisher can be reached at 603-727-3229 or cfleisher@vnews.com.