LIFTING ALL BOATS

If you want to meet Emory University’s new executive vice president for health affairs, you shouldn’t look for him in his office. Instead, you are more likely to find him striding across campus, visiting researchers in their labs, and walking the halls of hospitals and clinics. That’s how Ravi Thadhani gets to know the institutions he leads.

At Mass General Brigham, where he was chief academic officer and dean for faculty affairs at Harvard Medical School, Thadhani says he visited every square foot of the institution’s two and a half million square feet of research space. It was the best — and perhaps the only — way to truly understand the experiences, the challenges, and the mindset of the system’s physicians, nurses, researchers, care team members, and staff as well as to connect with them on a personal level.

“In his position, Ravi could have easily insisted people come to his office in the corporate headquarters,” says Seun Johnson-Akeju, anesthetist in chief at Massachusetts General Hospital. “Ravi has a way of personalizing meetings. He would often take meetings in everyone else’s offices across our different hospital and research campuses. He goes out of his way to make sure people around him are seen, heard, and valued.”

On the first of January, Thadhani assumed the role of executive vice president of health affairs as well as executive director of the Woodruff Health Sciences Center (WHSC) and vice chair of Emory Healthcare Board of Directors. He is a renowned researcher in kidney disease and preeclampsia — a serious blood pressure condition that can occur during pregnancy. His discoveries have made the leap from bench to bedside. A test he developed to predict the onset of preeclampsia has been in use in Europe for years and has been approved by the Food and Drug Administration (FDA) for use in the U.S. Thadhani is a skilled administrative leader who has overseen the integration of research, education, and clinical functions at Mass General Brigham. He is also a committed mentor who has helped launch and support the careers of scores of younger researchers inside and outside of his specialty.

“Dr. Thadhani is a dynamic and innovative leader for Emory’s Woodruff Health Sciences Center,” says Emory President Greg Fenves. “He has deep experience in delivering the highest quality health care, biomedical research, training health professionals, and serving the public to improve the health of all. He will inspire Emory’s talented doctors, nurses, frontline staff, faculty, and researchers to reach new heights of excellence. In his many years of academic health system leadership, he has never stopped his research and clinical work, which is a testament to his lifelong commitment to serving patients and improving community health.”

FROM BENCH TO BEDSIDE

Thadhani’s research into kidney disease has run the spectrum from basic science to animal studies to human clinical trials. The brass ring, however, has remained just out of reach. While advances in medications and treatment can delay the onset of dialysis, and while dialysis and transplantation extend the life spans of people with chronic kidney disease, Thadhani and others in the field have not yet been able to find the magic intervention to extend the life expectancy of people once they get on dialysis, which remains three to four years.

Thadhani’s many dialysis studies, while they have not yet yielded a breakthrough, have laid the foundation for future studies that may meet with more success. “It’s been a very humbling experience,” he says. “All the animal, observational, and human studies I have done have not been able to uncover an intervention to extend the lives of patients on dialysis. But everything we’ve learned during the process of those studies will inform future research. Hopefully, one day we will be able to crack the ceiling in making a difference in these patients’ lives.”

Though Thadhani selected kidney disease as the area of his research focus, another area caught his attention and became his true passion — preeclampsia. This disorder is characterized by high blood pressure in pregnant woman which, if untreated, can be fatal for both mother and baby. A common treatment for preeclampsia is delivering the baby early, a process that usually resolves the problem for the mother but can lead to myriad issues for the premature infant.

Thadhani became hooked when he discovered research into this area was noticeably lacking but in dire need.

Preeclampsia is the third highest cause of maternal mortality in the U.S., and it affects five percent to seven percent of pregnant women worldwide. Black women have a threefold to fivefold increase in risk of suffering from preeclampsia than White women. And women who have hypertension during pregnancy are more likely to get kidney disease in future years and more likely to undergo dialysis.

Compounding the problem, health care providers had no way to predict which pregnant women would develop preeclampsia. “A woman can appear completely normal and feel terrific and within 24 hours go into a coma,” says Thadhani.

So Thadhani and his colleagues set out to identify a marker that could predict the onset of preeclampia, and they found it. A protein released by the placenta serves as a harbinger for the condition, and that protein can be detected in the blood weeks before the patient falls ill. Thadhani and his colleagues licensed the technology, and it has been in wide use in Europe for more than seven years. A recent study of 1,000 women in the US showed the marker works equally well for women from diverse backgrounds, and the FDA has approved the technology as a standard test in US hospitals. “We look forward to this test becoming widely available in the U.S.,” he says.

Predicting preeclampsia is valuable. Preventing it would be even better. For this goal, Thadhani drew on his expertise in dialysis, a process in which the blood of a kidney disease patient is removed via a needle from the arm, run thought a filter to remove the wastes and toxins that have built up, and returned — filtered and cleansed — through a different needle. Thadhani devised a similar mechanism to remove just the offending protein from the blood. His studies have shown that this therapy can allow women to extend their pregnancies to 30 weeks or 32 weeks, keeping mother and baby safe. This therapy is being tested for approval in Europe and the U.S.

THE SERVANT LEADER

In his post as chief academic officer and dean for faculty affairs at Mass General Brigham, Thadhani oversaw the system’s research, education, and health delivery at its medical centers. In recent years, his focus has been on integrating the many disparate units — a task that requires both vision and tact.

“There are many talented and highly motivated professionals at Mass General Brigham, so efforts to change the way things have always been done can be difficult,” says Robert Higgins, president of Brigham and Women’s Hospital. “But Ravi personifies the servant leader. He listens and provides valuable insight without necessarily telling people what they have to do but leading them toward it.”

Within the research enterprise, Thadhani worked to get away from the practice of each hospital doing its own research and move toward a unified, and more successful, approach. “Instead of competing against each other for grants, we are now coming together, and in this way, we’ve been successful on another level,” says Thadhani. “For example, in the last year and a half we were able to get several post-acute sequelae COVID grants totaling $60 million primarily because we brought together research teams from across the system. If each unit would have applied separately, we would not have been competitive at the national level.”

Thadhani has brought the same unified approach in research administration, streamlining agreements that historically took three months to complete down to less than 30 days and reducing the turn-around time for grants from several weeks to a couple of days. He has consolidated vendor agreements across the system, saving hundreds of thousands, if not millions, of dollars. And he has integrated the educational component, so the system’s 2,500 residents and fellows can float seamlessly between hospitals to get the educational opportunities that best suit them.

He accomplished all of these feats by focusing on people rather than numbers. “When tasked with Mass General Brigham system integration priorities, Ravi’s approach was to bring teams together to develop shared patient-centric goals,” says Johnson-Akeju. “You left those meetings confident in his leadership and vision, and with the firm understanding that a rising tide was about to lift all our boats.”

EVERYONE NEEDS A CHAMPION

Over the course of his career, Thadhani has won numerous awards. He says, however, that he is most proud of awards won by the numerous scholars he has mentored. Indeed, his track record for mentorship is extensive, particularly among women and underrepresented staff, trainees, and faculty. Consider a recent, rather spur-of-the-moment dinner Johnson-Akeju threw for Thadhani prior to his departure from Mass General Brigham. “I called several people whom Ravi had mentored and invited them to an intimate dinner celebration,” he says. “Every one of them said yes, no questions asked, and some of them flew across the country to join us in Boston.”

Mentoring others comes naturally to Thadhani because he benefitted from generous mentors at various stages in his career.

Chief among them is his wife of 27 years, Valerie, a primary care physician who has traded practicing medicine for teaching elementary school children with learning disabilities. “She has helped me understand empathy. She has helped me understand mental illness — she has experienced that in her family,” says Thadhani. “If someone were to ask me why I am where I am today, I would say it is my wife times 10.”

AIMING FOR THE NEXT LEVEL

When Thadhani joined Emory on Jan. 1, he succeeded David Stephens, who served as interim executive vice president for health affairs beginning Sept. 1, 2022. Stephens succeeded Jon Lewin, who had held the post since 2016.

Thadhani comes to Emory with a mandate. “What I heard from board members and leadership was a real desire to move to the next level,” he says. “This organization is aiming to be one of the premiere academic medical institutions in the country. The leadership team here is committed to making Emory a true national powerhouse.”

To reach that lofty goal, Thadhani will start by walking. “I will throw some granola bars in my backpack, put on my walking shoes, and go out to meet people where they are,” he says. “I’ll spend my first 6 to 12 months getting to know the special sauce that makes Emory what it is.”

This story was updated and republished in July 2023 for Emory Health Digest. Photography by Jack Kearse.