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    Matthew Warner, MD

    Protecting Patient Outcomes Through Patient Blood Management

    Global Impact: Rebecca Rock, RN and SABM CFO talks with HPI about two roles across two countries

    From Lab Trend Visionary to Dark Group CEO: HPI connects with the Founder and Editor of the Dark Report, Robert Michel

    Two Imaging Leaders, Two Systems, One Outcome: Communication

    From Communication Strength to Just in Time Reopening at MGH A conversation with Dr. James Brink, Chief of Radiology at Massachusetts General Hospital

    From Time Magazine to PBM Influencer: Sherri Ozawa's Mission to Define the Value of Blood

    Buried Blessings: Pandemic perspective from Tom Strauss, CEO at Sisters of Charity Health System

    Katie Castree, Career Healthcare Process Improvement Connoisseur

    Solving Lab Challenges through Recruiting Innovation: HPI connects with Lighthouse Lab Services President, Jon Harol

    Providing Value-Based Care in a Pandemic through Telehealth and Data Resources: An HPI exclusive with Dr. Darrel Weaver

    From Supply Chain Crisis to Innovation in a Pandemic

    From Navy Medic to running a Clinical Laboratory . . . during a pandemic

    Planning for Blood Shortages in a Pandemic with Dr. Claudia Cohn

    Blood Banking is more complex today than ever before. Rob Van Tuyle, President of Vitalant's Blood Division, tells us why.

    Profoundly Impacting Healthcare with Breakthrough Anemia Management

    Supporting Imaging Precisely Where You Need It

    Working Together Makes End of Life Conversations Easier to Have

    The Future of Imaging: Assessing the early impacts of COVID-19 and the path to innovation through Artificial Intelligence (AI) A conversation with Dr. Geoff Rubin

    Pivoting in a Pandemic: How a U.S. 3D printing manufacturer is helping healthcare in its time of need

    Mara G. Aspinall: Diagnostic evangelist educating the world on the power of diagnostics today

    How The Joint Commission is addressing the COVID-19 Pandemic

    CHI Nebraska’s Laboratory Director Connie Wilkins, describes How To Manage a Clinical Laboratory During the pandemic

    Former Commercial Lab Leader Highlights the Hospital Lab as the Solution to Community Sustainability in a Healthcare Crisis

    Three Phases Essential to Crisis Preparedness in Patient Blood Management with Anne Burkey of St. Luke's Health in Boise, ID

    The Importance of Agility in Your Lab

    Dr. Paul Biddinger Shares Three Ways to Prepare for COVID-19

    Bringing Clinical Skills to Operational Leadership During a Time of Crisis; Dr. Blanton, Chief Medical Officer at Peterson Health

    7 Team Attributes to Teams that Work in Challenging Times & Through Rapid Innovation

    From Finding Problems to Saving Lives: The Evolution of Interventional Radiology

    Identifying the Potential with AI in Radiology with Dr. Chung

    Communication in the C-Suite with Cliff Robertson of Catholic Health Initiatives

    Reviewing Your Patient Financial Journey with Melody W. Mulaik, President of Revenue Cycle Coding Strategies

    Ask An Accumen Expert: Carolyn Burns, MD, a Patient Blood Management Advocate

    Linda DeVee, Leads Radiology Services at Edward-Elmhurst Health

    Theresa Mouton, Market Chief Financial Officer with Steward Health

    PELITAS President and CEO Steven Huddleston Wants Patients to Have a Great Experience – Both Clinically and Financially

    How Do You Deal with 2 Billion Forms a Year? Ask Randy Campbell

    Medical Director of Telehealth for UAB Knocks Barriers Down to Treat Patients on Their Terms

    C-Suite Spotlight: Wayne Bohenek Chief Ancillary Services Officer, Bon Secours Mercy Health

    A Leader in the Laboratory Service Line : Pierre Mouawad

    Healthcare Partner: Autumn Farmer, Chief Laboratory Officer, Bon Secours Mercy Health

    How Imbio is using AI to close the gap of missed diagnosis with Mike Hostetler

    Spit Matters with Bill Phillips from Spectrum Solutions

    How COVID-19 inspired TeraRecon to accelerate their imaging solutions to the point of care with Jeff Sorensen

    We caught up with anesthesiologist and critical care specialist Matthew Warner, MD, who leads patient blood management and anemia management at the Mayo Clinic, to find out how focusing on anemia and patient blood management profoundly impacts healthcare.

    Dr. Warner was always interested in science and the natural processes that sustain life on earth, including disciplines like biology, physics, and chemistry. As an undergraduate, he traveled to Panama to conduct research as part of a professor-led team. That experience crystallized his enthusiasm. I was hooked on science. I was hooked on research, and I love that part of the world. So, I spent the next two years basically traveling around Central and South America, doing research and living in fantastic places. And it was during this time that I actually had my first exposure to a hospital setting.

    He first had experience as a patient, and then as a volunteer, at a hospital in coastal Ecuador. He knew then that medicine was his path. I loved it, and I wanted to connect with patients. After I returned to the United States, I applied for medical school.

    The field of anesthesiology combined three of his favorite aspects of medicine: a focus on physiology, the direct patient care environment epitomized by critical care, and the opportunity to conduct impactful research. Anesthesiology proved to be the perfect fit.

    Importance of patient blood management

    Dr. Warner’s interest in patient blood management emerged when he became aware of the logical fallacy behind red-cell transfusions for the treatment of anemia. That fallacy is rooted in the concept that red blood cells are the primary delivery vehicles for oxygen throughout the body. And hence, if we give more red blood cells to a patient and try to maintain a normal hemoglobin concentration with them, we could potentially improve oxygen delivery to tissues and improve patient outcomes. But we've learned that, that's not the case. There have been landmark transfusion trials, and it's obvious that this notion of giving transfusions to optimize patient outcomes is flawed. 

    Despite this flawed practice, liberal transfusion practices were still the norm during his medical education. He found a mentor in Dr. Daryl Kor, who was an anesthesiologist and ICU physician at the Mayo Clinic and had recently taken over the Mayo Clinic’s patient blood management program. I hitched my wagon onto his given our shared interest in transfusion management, and since that time, we've really worked together collaboratively over the last 10 years. He's my close friend. He's a great mentor for me. And together, we currently co-direct the patient blood management efforts at the Mayo Clinic.

    Dr. Warner is currently the director of the Mayo Clinic blood management subcommittee, a multidisciplinary committee consisting of physicians, administrators, nurses, and transfusion medicine specialists that are charged with ensuring transfusion safety and congruence with the health system’s patient blood management practices and institutional objectives. As part of that, we have a day-to-day team that assures all patient blood management activities are being performed appropriately throughout our hospital, which I co-direct with Dr. Kor. I'm also the director for the Mayo Clinic preoperative anemia clinic and the director for our bloodless surgery and medicine program here at the Mayo Clinic.

     

    Setting the standard for patient blood management and anemia management

    Anemia and blood health in general are extremely important for patient outcomes, and the concept of patient blood management revolves around improving patient outcomes. Anemia and blood health have important implications for blood patient outcomes directly, in and of themselves, and in the sense that abnormalities in our hematologic status increase our risk for allogeneic transfusions, which has adverse downstream consequences.

    Yet, anemia and other aspects of blood health have traditionally been ignored as necessary consequences of medical care. To Dr. Warner, ignoring it is tantamount to ignoring any other instance of patient harm. For example, we know that hospitalized patients tend to become anemic, but since transfusion may make them worse; we often simply tolerate the anemia. But instead of tolerating it, what we really are doing is ignoring anemia and accepting that our hematologic system is collateral damage in our current vision of proper medical care. To me, it’s a completely backwards way of thinking.

    Instead, Dr. Warner takes a proactive approach to avoid the patient injury that results from ignoring anemia. We work to identify why it's occurring. We take corrective actions to ensure that we are tightening the ship. There's mounting evidence that anemia is far from benign, and it may have lasting consequences on the function of our hospital survivors and in the greater community.

    Finally, health systems should rethink their approach to transfusions and focus on decreasing the reliance on allogenic blood products. Transfusion therapies have traditionally been utilized as a treatment for anemia and perturbations in blood health. And while they certainly have their place, and transfusions can be lifesaving for patients with a massive hemorrhage, we know that allogeneic transfusions are expensive, they're susceptible to critical shortages, and they're associated with adverse clinical outcomes.

     

    Career highlights

    Working in the ICU, Dr. Warner gets to make a real impact every day. There's been much tragedy in that environment, but there's also been incredibly moving and powerfully positive moments, even those associated with very difficult decisions and end-of-life care. So, it's hard to say one moment's more impactful than another, but every day, caring for patients is impactful for me.

    Patient blood management is one of the keyways Dr. Warner is able to make that impact in his clinical practice. Some of the most impactful moments in my career have been taking patients that have been denied, for example, surgical or procedural interventions at other institutions because they're deemed to be too high risk from a blood loss perspective and working in a multidisciplinary fashion to get them the care they need. Whenever we care for those types of patients, it just leaves a tremendous impact on me that when we work together, and when we're smart in how we approach things from a blood management perspective, we can truly improve outcomes for patients and improve lives.

     

    Three ways to profoundly impact healthcare

    Dr. Warner seeks to profoundly impact healthcare on three levels. First, he focuses on taking great care of patients in his clinical practice. Every day, I have the absolute honor to take care of patients. Patient care remains at the heart of why I'm in medicine, and it's truly a way that I can impact patients on a very individual and personal level. 

    Secondly, he impacts healthcare by helping to train the next generation of physicians. Every day, I'm involved in educating the next generation of clinicians and scientists, helping them to be better than I am and to carry the torch forward. Thirdly is a focus on clinical and translational research. I continue to do research evaluating the long-term consequences of anemia in our hospitalized patients, particularly in survivors of critical illness.  

    COVID-19’s effect on patient blood management

    The pandemic re-centered health systems’ focus on blood products as a resource that can run out. We had a lot of decreases in blood donations and collections early on in the pandemic, which led to some critical shortages. We're still feeling many of those blood shortages in many parts of the country. Patient blood management is a way that makes sense for our institutions and for our patients to rethink our use of blood supplies. Let's do everything we can to prevent our patients from needing transfusion therapies. Let's optimize their hematologic status, the best we can. Coming out of COVID-19, I hope that we're able to keep that momentum and that focus on the importance of patient blood management, and to extend that importance to other institutions and hospitals that might not have dedicated patient blood management programs.

    Matthew Warner, MD

    Matthew Warner, MD

    Anesthesiologist and Critical Care Specialist