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For med school’s backers, big dreams meet mundane details


Sit down at the round, glass-topped table in state Sen. Kirk Watson’s office, and you can never quite be sure where the conversation will take you.

But that’s kind of the point when you’re discussing the dreams and designs for the Dell Medical School, an innovation district built around it and the impact those entities could have on the health and economic wellbeing of Central Texas.

When Watson, Central Health, the Seton Healthcare Family and University of Texas officials pitched the whole concept to taxpayers, they sold it as an innovative driver of improved health across the community — but also as a critical missing piece that could help expand the Central Texas economy in ways previously unavailable.

That second part of the plan promised an especially visionary idea: A medical school, supported by a voter-approved property tax increase, would turbocharge the local economy, much like IBM, MCC and Sematech transformed Austin from a university and state government outpost to the tech-driven, knowledge-based metro area it is today.

“I think in 20 years we’ll be looking back at that and saying it’s one of the pivotal moments in the history of Central Texas,” Watson said. “How often can you do something like that? It’s pretty rare.”

Watson sees the school, hospital and innovation district as especially promising because they’re rooted in a community-backed effort that capitalizes on Austin’s richest assets — its people, its mind, its brainpower. They provide new outlets for those strengths.

Watson admits believes what emerges from that will have a transformative effect on Central Texas.

“This was a place that was a college town with state government as the dominant part of the economy, so it was all people-oriented,” he said. “That transferred into a focal point in a worldwide smart economy, and now it’s going to go to the next phase of that knowledge economy. Without the medical school I don’t think it would’ve done that.”

Getting to something that remarkable, however, will require what Clay Johnston, the dean of the school, describes as a balance of visionary and pragmatic forces.

On one hand, it requires the ability to dream big, to imagine Austin as the model healthy community. It requires a school and teaching hospital at the vanguard of a major new digital health economy, developing technologies that both fit within and help shape new models of healthcare delivery.

On the other hand, it also requires a sense of perspective — when it comes to life sciences, Central Texas will not become San Francisco, Boston or San Diego, where venture capital, grants and funding resources are measured in the billions of dollars.

As local economic development expert Brian Kelsey noted in a recent report, the Silicon Valley tech economy is roughly the same size as the entire Austin-area economy.

“People love the vision part, and that’s great,” Johnston said in an interview this month. “But we have to put some meat, some proof, around it.”

We’ve started to see bits of meat grow around the bone. The medical school is preparing to roll out a new model of health care delivery that it calls, wonkily enough, “integrated practice units,” or IPUs.

The IPUs are designed to bring together a diversity of caregivers around a particular ailment — the first one targets osteoarthritis and will be launched in a month or so. They collectively coordinate care in a way that’s guided by patient needs rather than by physician specialties.

So instead of a primary doctor referring a patient to a surgeon, who can’t see them until next week, the surgeon can walk the patient down the hall and consult with a physical therapist, a nutritionist or other specialists—including a surgeon—all with expertise in that ailment.

For the next few years, those sorts of health care benefits might provide the most tangible evidence of the medical school’s impact on the community. The school’s support to helping provide safety net care in Travis County should improve community care, especially if the new delivery models prove to be as efficient and effective as school and local health officials hope.

But, absent a big-splash move from a major corporation or funder, the community-wide economic benefits could be more difficult to see — and, in an odd way, the innovation zone might actually have countervailing effect on those efforts.

The notion of “place-making” undergirds innovation districts and much of urban development today. Create the type of place that draws people, industry and activity, and it will start to pull in and generate its own creative energy.

Even much of the place-making terminology – “anchor institutions,” for instance – has a grounded, centered connotation to it. Yet the promise of community-wide benefits means that energy, resources and opportunities will have to generate enough energy to break free of the gravitational pull and radiate into disadvantaged neighborhoods and workers.

In that sense, perhaps the biggest advantages of the innovation zone will stem from the connections it forges with local businesses.

“What you really want to do is build local wealth, to have good jobs locally,” said Christina Gabriel, president of the University Energy Partnership, an energy-technology research collaboration among several mid-Atlantic universities.

In any region, jobs tend to emerge in local clusters, Gabriel said. When the population expands, so does employment at stores, gas stations and restaurants. When an agglomeration of certain industries coalesces, that concentration tends to spur even greater levels of activity.

What’s key for building wealth, Gabriel said, is expanding the traded clusters — the concentrated sets of industries that bring in dollars from outside the region, through exports, venture capital, grants and the like.

But spreading that wealth throughout the community requires “local ownership of the local cluster that serves the traded cluster,” she said.

“Startup companies need to buy a lot of supplies for the products and services they sell,” she said. “The more of that supply chain and service chain that can trade in local businesses … (the more) those jobs are actually better jobs.”

How well Capital City Innovation, the organization overseeing the new district, can build those connections with local businesses remains to be seen. Officials have only announced the formation of the entity. We have yet to see a staff, a budget or any strategic plan.

But back at the Capitol, sitting around the table in Watson’s office, the same themes emerge.

No one could have predicted that the arrival of IBM or Sematech would shape Austin the way they have. Nor can anyone know whether the medical school will become one of those landmarks — an economic and health care engine beneficial enough to pay back the price of the property tax increase that made it a reality.

Even Watson will tell you: “The beauty of the future is I can’t predict it.”


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