Interview

Excellence, Integrity and Collaboration

Kirsten Johansen, MD, president Hennepin Healthcare Research Institute

The Hennepin Healthcare Research Institute (HHRI) traces its roots back to 1952. Please share an overview of the journey from that point to today.

When HHRI was initially established in 1952, it was affiliated with Minneapolis General Hospital (the predecessor to Hennepin Healthcare, HHRI’s current parent). Ground was broken on the first research building in 1958 to support the scientific work of dozens of hospital providers. In the decades that followed, many research projects were carried out with support from the community and the National Institutes of Health (NIH), which remains the primary source of HHRI’s research funding today. Over the years, the organization has grown substantially and now supports the work of over 250 researchers who study a wide variety of topics. As the hospital’s structure evolved, HHRI adapted, but the mission of conducting medical research in support of the community remains a primary focus. 

In terms of research projects, what are some of the historical highlights?

One of our points of pride is our legacy of innovation in kidney care. Hennepin Healthcare performed the first kidney dialysis treatment and the first kidney transplant in the upper Midwest in 1963. These early innovations laid the foundation for our current research program in kidney disease that continues to transform how kidney disease is treated. I am honored to lead the United States Renal Data System (USRDS) contract at HHRI. USRDS is a large federal data system that leverages federal claims data for treating kidney disease to inform effective policy decisions and identify ways to better care for patients with kidney disease.

Also, in the early years, construction began at Hennepin Healthcare on the first hyperbaric chamber in the state of Minnesota in 1963. The chamber was originally designed to perform transplant surgery, but has also been used to treat wounds, carbon monoxide and nitrogen poisoning and a variety of other disorders. The chamber was replaced in 2012 and can now be used to create an oxygen environment up to three times the pressure and four times the oxygen concentration of normal conditions. Current HHRI research is exploring whether hyperbaric oxygen therapy can improve outcomes and reduce disability for people who experience a traumatic brain injury. 

More recently, HHRI researchers worked with colleagues around the country to quickly develop and validate new laboratory tests to detect COVID-19, even before the World Health Organization declared COVID-19 a pandemic in March 2020. HHRI researchers also launched early clinical trials to study how to treat patients infected with the disease. COVID-19 studies conducted at HHRI included a variety of trials of potential treatments such as Remdesivir and convalescent plasma as the world tried to figure out how to deal with this new disease. 

HHRI research affects not only the lives of local community members but also those from all across the globe. What can you share about some of your international work?

HHRI faculty in our Berman Center for Clinical Research recently completed a decades-long collaboration with colleagues at Monash University in Australia on the “ASPirin in Reducing Events in the Elderly (ASPREE)” study. ASPREE was the largest international trial ever funded by the U.S. National Institute on Aging and studied more than 19,000 participants 65 or older in the United States and Australia. Participants took either a daily low-dose aspirin or a placebo, and key study results found that daily low-dose aspirin had no benefit for healthy older people. The study also found a 38% higher risk of bleeding in those taking the daily aspirin. Because ASPREE was such a large and complex study, its data continue to be used for multiple sub-studies investigating other health issues affecting older adults.

Researchers in HHRI’s Center for Infectious Disease Research participate in other international collaborations including the Strategies and Treatments for Respiratory Infections and Viral Emergencies (STRIVE) network. STRIVE is a global clinical research consortium established to respond quickly to infectious disease emergencies, so we are ready when novel illnesses like COVID-19 need to be studied through rapid implementation of clinical trials. The HHRI international coordinating center is one of nine centers within the STRIVE network and oversees the conduct of study protocols at over 20 clinical sites in the United States and four clinical sites in Mexico.

Medical research provides widespread benefits to society, and good health is important for us all, regardless of one’s political orientation.

This past October, HHRI adopted a new mission and redefined its core values. Please tell us about why this happened and what it means.

We are excited about our new mission and core values. The new HHRI mission is “Transforming health and health care for all through ethical research and meaningful community partnerships.” The new core values for HHRI are “Excellence, Integrity, and Collaboration.”

These principles are the result of an extensive strategic planning effort that solicited input from a broad range of internal and external stakeholders over an 18-month period that started in 2024. The work began during our routine planning cadence but evolved into a larger initiative in response to the major changes occurring in research in the United States during this time. This updated strategic framework represents a new chapter in HHRI’s long history of pursuing research excellence by elevating the concepts of community and partnership in our vision of the future. It also better aligns with the commitment to transforming health and health care that we share with our parent organization, Hennepin Healthcare.

What are some examples of your current research projects?

Our researchers are experts in their fields tackling a variety of health care challenges related to chronic disease, emergencies, trauma, addiction and many others. We conduct basic, translational, clinical and epidemiological research. There’s so much amazing work going on that it’s difficult to choose highlights, but here are a few examples of work that is directly impacting patient care.

Frostbite 

Hundreds of patients with frostbite seek care at Hennepin Healthcare’s Emergency Department each winter. Severe frostbite can be devastating, so quickly evaluating and treating it can improve the chances of salvaging affected tissue. To help improve outcomes for frostbite victims, our researchers have developed a tool to evaluate frostbite called the Hennepin Frostbite Score, a standardized measure of how much tissue has been affected. The tool has already helped determine that each hour of delay in treatment can reduce the chances of limb salvage by 28%. Because of this work, more providers recognize that frostbite is an emergency, leading to faster treatment and better outcomes for patients. We recently initiated a new multi-center study to collect and harmonize data about frostbite incidence, treatment, and outcomes from 14 sites in North America to enable comparison of tissue salvage using the Hennepin Frostbite Score.

Spinal Cord Injury

Our Restorative Neurotrauma Lab is conducting the Epidural Stimulation After Neurologic Damage (E-STAND) study, a clinical trial to test and optimize the use of epidural spinal cord stimulation to restore movement in patients suffering from spinal cord injury and paraplegia. The trial’s purpose is to examine how implanting an epidural stimulator can restore voluntary movement in people who haven’t been able to move since they were injured. The implant is remotely controlled through a tablet application with monthly in-person adjustments. Using the data from the tablet and the in-person check-up, the study team adjusts the stimulation settings of the implant to optimize quality of life improvements based on the patient’s unique preferences. Early results are promising, and patients in the study are also experiencing cardiovascular improvements, better core support, and reduced muscle spasticity.

New federal policies around funding medical research are creating disastrous results. What can you share about this?

The recent federal policies around funding medical research have been very disruptive. Medical research provides widespread benefits to society, and good health is important for us all, regardless of one’s political orientation. It’s mystifying to see our current leadership pulling back on these investments. One of the things these events might be indicating is a gap in our communication strategies as researchers. Perhaps we need to do a better job of communicating about our work in a more accessible way, so that when decision-makers prioritize where our collective resources are invested, there’s an established common understanding about the shared benefits of medical research.

Other elements of these policies, such as deleting access to scientific research, spreading blatant misinformation and conflating research with political agenda have also been debilitating. What are the best ways to deal with these issues?

The best way to deal with these issues is to keep the facts and data front and center in the conversation. Reasonable people can disagree about what the facts mean, and debate is healthy and necessary in a democracy and in science. However, we will continue to struggle to find solutions to our biggest problems if we don’t have a common understanding of the facts. It’s easier said than done, and this is definitely the long game, but facts are durable. Keeping the focus on hard data also requires clear, accessible communication.

Recently, some clinical trials have been abruptly canceled, in some cases with cancer patients denied access to potentially life-saving treatment over conflict with new federal research funding policies. What do you have to say about this?

 I think it’s a tragedy, and worse, it was unnecessary.

AI is changing medical research. What are some examples in terms of HHRI projects?

I’m working on a project where we’re training AI to “read” clinical notes to pull out mentions of specific concepts as well as positive and negative sentiments to see if these are related to access to kidney transplant. There are important considerations around patient privacy and data security that are unique to working with AI, and we are doing our due diligence to address those issues so we can harness the power of this potentially game-changing technology. There’s no doubt that AI is going to be a powerful tool that we need to learn how to use safely to enhance the effectiveness and efficiency of the research we do.

Is there anything else about HHRI that you would like to share with our readers?

HHRI has been at the forefront of many medical advances — leading the way with innovative research and treatments and showing that it can pivot and respond quickly to changing circumstances. As a small institution embedded within a safety net hospital, our work is particularly focused on improving care for people with fewer resources. Yet, our work in areas like trauma, frostbite, kidney disease, geriatrics, infectious disease, addiction and others has transformed care for people nationally and internationally. These are wild times, but we’ve weathered difficulty in the past, and we remain committed to our mission. 

Kirsten Johansen, MD is the president Hennepin Healthcare Research Institute.