camls 2014 annual report

Center for Advanced Medical Learning and Simulation

2014

The loss of 400,000 lives annually due to avoidable medical errors, is believed to now be the third leading cause of death in the U.S. after heart disease and cancer. This renewed wakeup call came during a Senate subcommittee hearing convened July 17, 2014 by Chairman Sen. Bernie Sanders (Ind., VT).

The leadership of the University of South Florida Center for Advanced Medical Learning and Simulation (CAMLS) has heard this concern and remains ever more committed to creating a national model for improving medical education and patient safety, as well as developing aggressive and needed healthcare solutions through cutting-edge technology, innovation and simulation.

CAMLS’ commitment to transform medical education from an apprenticeship model, “see one, do one, teach one,” to a competency-based model that adheres to evidence-based, best practices remains strong and our instructional design process has proven effective for training medical students, residents and practicing clinicians across all healthcare disciplines. We continue to expand the impressive range of simulators and simulated clinical environments we offer to enhance this approach to cognitive learning, skills development and team training.

Deborah M. Sutherland, Ph.D.CEO, USF Health CAMLS;Associate Vice President, USF Health; Associate Dean, USF Morsani College of Medicine

2014 CAMLS ANNUAL REPORT

EDUCATE, TRAIN, INNOVATEImproving Patient Safety Remains CAMLS’ Priority

USF Health Professions Conferencing Corporation (HPCC)

2014

Board of DirectorsRhea Law, Chairperson

Hilliard Eure II, Chairman, Finance and Audit Committee

Charles Hammond, M.D.

Charles Lockwood, M.D.

David Smith, Jr., M.D.

OfficersDeborah Sutherland, Ph.D., CEO

Joann Strobbe, Secretary/Treasurer

AdvisorsFell Stubbs, Treasurer, USF

R.B. Burford, Deputy General Counsel, USF

Stephen Mitchell, Liaison, USF Health Board of Trustees Workgroup

“CAMLS has successfully transitioned from a ‘nascent venture’ to an ‘early-stage’ company.”

Deborah M. Sutherland, Ph.D., CEO, USF Health CAMLS

This past year, our team expanded relationships with area hospitals and healthcare systems; other academic and training institutions that can benefit from CAMLS’ high-tech environment; medical malpractice insurance companies; and attorneys interested in clinically accurate, 3-D models for trial exhibits.

We furthered our commitment to research and innovation by fully operationalizing the services of the Tampa Bay Research and Innovation Center (TBRIC). TBRIC’s location inside CAMLS uniquely positions it to offer the complete portfolio of sophisticated engineering and clinical services that faculty and medical device clients require to facilitate efficient development and commercialization of new products designed to improve patient outcomes. Specific accomplishments include the development of services in accordance with Good Laboratory Practices (GLP), which involves the pre-clinical testing required for FDA approval and the initiation of an Ethnographic Studies Service with neighboring Tampa General Hospital, required to observe and evaluate how medical products are actually used in the day-to-day clinical setting.

I am pleased to report that CAMLS has successfully transitioned from a “nascent venture” to an “early-stage” company using proven metrics and data to inform business decisions and launched new educational

and research products that are in demand and valued by multiple market segments. Our effective governance structure has enabled CAMLS’ unique academic and entrepreneurial model to flourish.

CAMLS is operated through the not-for-profit corporation, USF Health Professions Conferencing Corporation (HPCC), a direct support

organization of the University of South Florida. The corporation is governed by a seven-member board, chaired by Ms. Rhea Law, a local attorney and business leader. Our newest addition to the HPCC Board of Directors, is Charles Lockwood, M.D., Senior Vice President, USF Health and Dean, Morsani College of Medicine. Dr. Lockwood comes to USF from Ohio State University and brings academic leadership and entrepreneurial vision that will further advance CAMLS’ mission.

We are proud of the many accomplishments achieved at CAMLS during our second year of operations and are pleased to share the highlights in this 2014 Annual Report.

Charles J. Lockwood, M.D., MHCMSenior Vice President, USF Health; Dean, Morsani College of Medicine


1

EDUCATE, TRAIN, INNOVATE3rdRanking cause of deaths in U.S.: “medical errors”

Improving Patient Safety Remains CAMLS’ Priority

400,000Premature deaths associated with

preventable harm to patients


LEARN, PRACTICE, DEBRIEF:Simulation Builds Skill and Confidence

2

CAMLS’ Surgical and Interventional Training Center (SITC) provides surgeons and residents across all specialties, an unmatched clinical environment to learn and perfect the latest techniques and procedures, build their confidence and refresh their skills. Its 39 fully-equipped surgical stations make CAMLS one of the nation’s largest free-standing centers dedicated to surgical training.

Fourth- and fifth-year orthopedic residents are instructed on various approaches to elbow surgery. They are practicing internal fixation of VariAx elbow plates using Stryker tools in CAMLS’ 21-station wet lab in SITC.MARK PETTY, MPETTYPHOTOGRAPHY


3

“CAMLS’ truly clinical environment immerses our surgeons and their OR teams into the stressful realities of their work. Our goal is to build their skills proficiency, but also their confidence.”

David J. Smith, Jr., M.D., Medical Director, CAMLS

Trauma and Labor & Delivery are two high-risk specialties in which hospital teams train at CAMLS to improve communication in an effort to reduce medical errors. Today, fifteen years since the Institute of Medicine’s report on medical errors, hospital patients are no safer, according to patient safety leaders at a July 2014 Senate hearing.

Lakeland (FL) Regional Hospital’s trauma team responds to an incoming casualty. The training scenario in CAMLS’ Trauma OR was a simulated motor vehicle crash with a head injury and collapsed lung. Lakeland Regional Hospital committed to training its entire trauma unit at CAMLS. MARK PETTY, MPETTYPHOTOGRAPHY


TEAM TRAINING IMPROVES PATIENT OUTCOMES

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1 in 3Hospital admissions result in harm to a patient

Nurses in the Tampa General Hospital’s Neonatal Resuscitation Program quickly assess a newborn in distress in CAMLS’ labor and delivery simulation team-training room.

Vice Admiral Matthew L. Nathan, Surgeon General of the U.S. Navy and USF graduate, speaks with Luis E. Llerena, M.D., Medical Director (SITC) in the CAMLS Trauma OR. Adm. Nathan was in Tampa to deliver the commencement address at the spring 2014 M.D. class graduation. Military medical teams train here for combat readiness and skills retention.

MARK PETTY, MPETTYPHOTOGRAPHY



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“CAMLS’ emphasis on TEAM training, its ability to offer custom, tailored services to meet our needs as they arise, and its use of our policies and procedures with evidence-based best practice assures our staff is getting training that is the standard of care.”

Maureen Ogden, RN, BS, MHA; Vice President, Cardiovascular Services, Tampa General Hospital

USF Healthcare Academic Partners

• Morsani College of Medicine (MCOM)

• College of Nursing

• College of Pharmacy

• College of Public Health

• College of Arts & Sciences (Psychology)

7,392Total number of USF Health

students and residents served by CAMLS in fiscal

years 2013 & 2014

6


CAMLS’ ACADEMIC EXPERIENCES SET APART USF GRADS

Robert Lorch, M.D., fourth-year USF medical student, examines a standardized patient in one of CAMLS’ six physician exam rooms located in its virtual center for outpatient and inpatient care. Learners gain communication skills and are immersed into realistic clinical situations before practicing on actual patients. MARTY PETTY, CAMLS

(L-R) Judy Genshaft, President, USF System; Donna Petersen, Dean, College of Public Health; Catherine Lynch, Associate Vice President, Women’s Health, USF Health; and Dianne Morrison-Beedy, Dean, College of Nursing, hold a Certificate of Commendation presented by Hillsborough County at the USF Women’s Health Collaborative Luncheon in May 2014.

College of Pharmacy’s retail and inpatient simulation pharmacy fosters the interdisciplinary team training CAMLS’ curriculum emphasizes. Here, a pharmacy resident counsels a standardized patient (actor) on her prescription medication in a simulated scenario.

ERIC YOUNGHANS, USF HEALTH COMMUNICATIONS


7


“CAMLS’ educational model emphasizes inter-disciplinary team training and best-practices, and mirrors USF Health’s academic model; requiring students from all our colleges to take classes together and develop an understanding of each other’s roles.”

Charles J. Lockwood, M.D., MHCM, Dean, Morsani College of Medicine

CAMLS is Ideal Home for CRNA ProgramJuniors in the USF Health Certified Registered Nurse Anesthetist (CRNA) Program participate in advanced central line training using ultrasound guidance in a porcine lab at CAMLS. The learners also simulated the regional anesthesia procedure during the exercise.


CAMLS HEEDS THE CALL FOR TRAINING

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Critical Care and Anesthesia High-Risk Need

“We’ve had simulations in nursing school, but here things are real…this is how your patients will be. CAMLS trains you for the little

things that happen under pressure.”

Camille Shine, RN, StaRN Graduate, Brandon (FL) Regional Hospital

Parallon Academy StaRN at CAMLS Launched in 2014CAMLS launched Parallon Workforce Solutions’ StaRN program, called Parallon Academy, for their mutual hospital system client HCA West Florida Division. Before the end of 2014, more than 150 new nurse graduates will complete a seven-week curriculum in critical care that includes more than 80 hours of hands-on simulation training in CAMLS’ state-of-the-art facility. The nurses then complete a 6-week preceptorship at their respective hospitals. In the fall of 2014, an additional 125 practicing nurses will receive trauma team training in CAMLS’ Trauma OR. (Left) Parallon Academy Program Director Jim Ostmann Sr., RN, uses CAMLS’ Anatomage Table to teach a module on the cardiovascular system. (Right) CAMLS and Parallon faculty prepare to train nurses on how to position a patient in the Arjo Hunt Leigh Pronate Bed, which can alleviate respiratory distress in critical care patients while sedated.




9

800,000U.S. Nurse shortage in 6 years

At CAMLS, the USF Health Morsani College of Medicine (MCOM), Department of Obstetrics and Gynecology, led by Chairman Jerome Yankowitz, M.D., fully utilizes the center’s wide range of simulation-based education to train medical students, residents, fellows and practicing clinicians in the skills and procedures required for the best-practice of patient care. “In a high-risk specialty like OBGYN, the value of CAMLS’ programs is immeasurable,” says Dr. Yankowitz. “Patient outcomes are the first concern and CAMLS is committed to improving those outcomes.”

The Department of OBGYN, along with CAMLS, is a founding member of the American College of Obstetrics and Gynecology (ACOG) Simulation Consortium and an early adopter of simulation-based education within the MCOM. In addition to clinical training, the department is engaged in research focused on developing new medical devices to improve patient care and in sponsoring a variety of Women’s Health initiatives, which include faculty development and community outreach.

Jerome Yankowitz, M.D. Professor and Chairman, James M. Ingram, OBGYN, MCOM


USF HEALTH OBGYN FACULTY LEAD SIMULATION ADOPTION

Fourth-year medical students Jessica Alvarez and Patrick Blackburn perform a difficult vaginal delivery complicated by a shoulder dystocia presentation. Shelly Holmstrom, M.D. coaches the learners in best-practices for freeing the baby’s shoulder from her mother’s pelvis. CAMLS volunteer Andrea McClary assists. MARK PETTY, MPETTYPHOTOGRAPHY


982,000Diagnosed complications of pregnancy annually

Physicians in cadaveric pelvic surgery training learn advanced laparoscopic surgical techniques in gynecologic surgery, co-developed by Stuart Hart, M.D., Associate Professor OBGYN, MCOM and (pictured left) Craig Sobolewski, M.D., Chair, Minimally Invasive Surgery, OBGYN, Duke University. MARK PETTY, MPETTYPHOTOGRAPHY

Stuart R. Hart, M.D.Associate Professor, OBGYN, MCOM;Director, Tampa Bay Research and Innovation Center, CAMLS

Courses

• Minimally Invasive Pelvic Cadaver Lab

• Total Laparoscopic Hysterectomy

Mitchel S. Hoffman, M.D.Associate Vice President, Oncology Services, USF Health; Professor, OBGYN, MCOM; Director, Gynecologic Oncology, MCOM

Courses

• Minimally Invasive Surgery in Gynecologic Oncology: Techniques and Complications

• Robotic Surgery for Pelvic Surgeons

• Laparoscopic Pelvic Surgery

• Cadaver Course in Abdominal and Pelvic Anatomy and Surgical Maneuvers

• Repair of Incidental Cystomy and Incidental Enterotomy Utilizing Porcine Tissue

Shelly W. Holmström, M.D.Associate Professor, OBGYN, MCOM; Associate Residency Program Director ACOG Obstetrical Emergencies

Courses

• Resident Gynecology Simulation Stations (Fundamentals of Laparoscopy)

• Obstetrical Simulation: Emergencies and Catastrophes

Lennox Hoyte, M.D.Professor, OBGYN, MCOM;Director, Division of Urogynecology and Pelvic Reconstructive Surgery, MCOM; Medical Director, Robotic Surgery, CAMLS

Courses

• Advanced Robotic Sacrocolpopexy

Catherine M. Lynch, M.D.Associate Vice President, Women’s Health, USF Health; Professor, OBGYN, MCOM

Courses

• Facuty Development Activities

• Women’s Health Initiatives

James C. Mayer M.D.Associate Professor, Obstetrics & Gynecology, MCOM

Courses

• Spontaneous Vaginal Delivery Clerkship

James M. Palmer, M.D., M.S.Assistant Professor, OBGYN, MCOM

Courses

• Resident Laparoscopic Skills Curriculum

Patrick R. Teefey, M.D.Assistant Professor, OBGYN, MCOM

Courses

• Gynecologic Surgery Simulation for Medical Students

(Above) Pinellas County (FL) Fire and Rescue teams train at CAMLS in an emergency rescue of a mother having a difficult delivery away from a clinical environment. (Left) Mitchel Hoffman, M.D. observes residents in CAMLS’ robotics lab as they “dock the robot” by attaching robotic “arms” to instruments and a camera inserted inside the porcine model. A computer enables these objects to be controlled remotely by the surgeon. ERIC YOUNGHANS, USF HEALTH COMMUNICATIONS

“In a high-risk specialty like OBGYN, the value of CAMLS’ programs is immeasurable. Patient outcomes are the first concern and CAMLS is committed to improving those outcomes.” Jerome Yankowtitz, M.D., Professor and Chairman, James M. Ingram, OBGYN, MCOM

Patrick Teefey, M.D. works with a third-year medical student, introducing him to the fundamentals of gynecologic surgery through simulation in CAMLS’ skills lab. The hysteroscopy simulator is one of several training platforms utilized by the OBGYN Department. MARK PETTY, MPETTYPHOTOGRAPHY

2.1Number of OBGYNs per 10,000 women30-year low



Device Development: Why CAMLS?The Team• Surgeons and Other Subject Matter Experts • Engineers • Quality Assurance & Regulatory Specialists • Human Factors Engineers • Usability Experts • Ethnographers • Study Directors • Veterinarians • Animal Specialists

The Services• Pre-Clinical Lab Studies • Formative Studies • User Evaluations • Focus Groups • Physician Recruitment for Research • Testing and Validation • Education and Training • Design and Development • Investigational Studies • Prototyping

The Resources• Good Lab Practices (GLP) Facility • International Physician Network • Simulated Surgical & Clinical Environment • Project-Customizable Engineering Lab • ESD-Controlled Area • Reverse Engineering • Animal Husbandry • On-Site Tissue Center

The Credibility• Partnership with Tampa General Hospital • Certified GLP Quality Assurance Professional • USF Comparative Medicine • AAALAC • OLAW • USDA • Certified Manager of Animal Resources (CMAR) • Institutional Animal Care and Use Committee (IACUC) • 21 CFR Part 5 • 21 CFR Part 820

On-Site Lab Streamlines Testing and Validation Inside CAMLS’ state-of-the-art surgical center, Pre-Clinical testing of a medical device is conducted by a veterinary and a clinical subject matter expert in accordance with Good Laboratory Practices (GLP), as engineers observe, time and record the process. MARK PETTY, MPETTYPHOTOGRAPHY


NEW SERVICES ADVANCEEXISTING CAPABILITIES

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Tampa Bay Research & Innovation Center

New Services: GLP and Ethnographic Studies With the expansion of services, CAMLS’ research and innovation center provides medical device companies and researchers the ideal engineering and clinical environment for the most challenging and complex stages of device development, Pre-Clinical Testing and Usability Studies.

“Our new services make TBRIC a one-stop-shop for the medical device industry. We are now

able to offer a full range of services that impact every step in the medical device life cycle.”

Stuart R. Hart, M.D., Director, Tampa Bay Research and

Innovation Center, CAMLS


NEW SERVICES ADVANCEEXISTING CAPABILITIES

17

47Projects conducted in the last year

Gynecological surgeons from across the U.S. come to CAMLS to practice laparoscopic suturing in Covidien’s Total Laparoscopic Hysterectomy course co-developed by Stuart Hart, M.D., director of CAMLS’ research and innovation lab, and Craig Sobolewski, M.D., Chair, Minimally Invasive Surgery, OBGYN, Duke University.

The extensive clinical and engineering capabilities of CAMLS provide a one-of-a-kind facility - a single location where healthcare professionals can learn and perfect skills with new instruments and devices, and where medical device companies can develop, test and perfect their products to speed improved solutions to surgeons and their patients.

26CAMLS’ Innovation Partners

Synergy Health Newest Partner

MARTY PETTY, CAMLS

In the spring of 2014, Synergy Health, a global leader in specialized healthcare support services, became CAMLS’ newest partner and its exclusive provider of surgical instrument processing, investing to enhance the center’s instrument processing capabilities. With the relocation of its Americas corporate headquarters to close proximity of CAMLS in

downtown Tampa (FL), the partnership makes CAMLS the first medical simulation training center in the United States to offer instrument processing in both a classroom and hands-on, simulation setting. Synergy also designated CAMLS as its Academy for all training within the Americas region.


INNOVATING TO IMPROVE OUTCOMES

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CAMLS Partners on Patient Safety Initiatives

CAMLS PartnersBeckBlackHägen DesignCooper SurgicalCovidienEarlySenseEMSKForceMcKessonMedCureMedtronicNDH MedicalPhilipsRegulatory Compliance Associates Inc.Simbionix3DS Solid WorksStratasysStrykerSynDaver LabsSynergy HealthZeiss

University of South FloridaMorsani College of Medicine College of NursingCollege of PharmacyCollege of Public HealthCollege of Arts & SciencesCollege of EngineeringDepartment of Sponsored Research:

Division of Patents and Licensing Division of Comparative Medicine


19

In CAMLS’ 21-station wet lab, surgeons practice a Total Knee Arthroplasty in a Stryker program using their cordless saw specially designed to cut through bone.MARK PETTY, MPETTYPHOTOGRAPHY

U.S. Rep. Frank Pallone (left), the ranking House Democrat on the subcommittee responsible for health research spending, was invited to visit CAMLS by Tampa’s advocate in Washington, U.S. Rep. Kathy Castor (center) in April. Accompanied by USF System President Judy Genshaft (right), Pallone stressed to reporters the need for renewed research funding for places like CAMLS, where transformational work is being done. ERIC YOUNGHANS, USF HEALTH COMMUNICATIONS


REGIONAL MAGNET FOR ECONOMY

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CAMLS Attracts Conferences and Research Dollars

One of the more than 100 members of the American College of Emergency Physicians who met at CAMLS, intubates an infant in an emergency simulation scenario.

More than 20 healthcare associations & societies met at CAMLS. Among those were: • American College of Cardiology • American College of Emergency Physicians • American College of Healthcare Executives • American Congress of Obstetricians and Gynecologists • American Society of Abdominal Surgeons • Blue Cross Blue Shield of Florida Foundation • Florida Urologic Society • International Spine Intervention Society • MedSim • National Association of Specialty Pharmacy • Society of Gynecologic Oncology

$6.4million

Dollars spent at local hotels, restaurants and attractions


Total Economic Impact Since February 2012 Opening

$3.1 million Revenue from 22,300 room nights

$3.3 million Total discretionary spending


21

“CAMLS’ reputation as a world-class training and research center for the healthcare industry has grown rapidly in its first two years; its economic impact is significant and the international community’s interest and support will provide a steady visitor pipeline for the future.”

Stephen J. Mitchell, Liaison, USF Health Board of Trustees Workgroup

Operating Highlights(Year-Over-Year)

Physician and Nurse Attendees Combined Grew 20%

Residents*

1,5351,198

Medical Students

1,027

1,888

Pharmacy Students

321622

Physicians

7,511

9,384

Nurses

1,2681,635

2013 2014

CAMLS’ global reputation for setting standards for healthcare education, research and innovation and its concierge-level service have fueled a 26-percent growth rate in the second full year of operation. For fiscal year 2014, CAMLS served more than 19,000 domestic and international learners and delivered 638 programs.

USF Health (Incl. UME, GME, & Pharmacy)

303

Hospitals & Healthcare Systems

4055

Industry

143

Associations & Societies

20

223

20

208

Program Growth by Market Segment

*Reduction of funding for GME


NEW & EXPANDING MARKETS DRIVE STEADY GROWTH

22

26%CAMLS’ Year-Over-Year

Program Growth

CAMLS’ Leadership Team: (back row, L-R) Beverly Hughes, COO; David Smith, Jr., M.D., CMO; Deborah Sutherland, Ph.D., CEO; Luis Llerena, M.D., Medical Director, SITC; Marty Petty, Senior Director of Business Development; (front row, L-R) Carlos Callegari, M.D., Medical Director, International Affiliations; Gregory Vannette, Controller; Paul Ayres, Director of Sales & Marketing; Stuart Hart, M.D., Director, TBRIC. MARK PETTY, MPETTYPHOTOGRAPHY


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“As one of USF’s focal points for healthcare innovation, CAMLS continues to attract national and international attention thereby enhancing the economic opportunities for the Tampa Bay Area.” Rhea F. Law, Chairperson, HPCC Board of Directors

(Far right) Eighth-grade STEM students from Tampa Preparatory School test their skills in performing a Lap Chole gallbladder procedure using the Simbionix Laparoscopic Simulator with the guidance of Andre L. Nelson, Simulation Lead Operations Specialist. (Right) Emergency responders from across the Tampa Bay Region gathered at CAMLS May 20, 2014 for EMS Appreciation Day, jointly sponsored by CAMLS and MECA, Inc. Attendees discuss the center’s trauma training opportunities in the Trauma OR while on tour.

CAMLS’ commitment to the Tampa Bay Region includes the donation of services to the Florida Aquarium. The young, 22-pound, endangered green turtle named Freud, eventually regained his ability to dive for food, thanks to CAMLS. The center’s 64-slice CT Scanner revealed a lesion that permitted air to be trapped in Freud’s left lung, making him a “floater.” Trauma surgeon Luis Llerena, M.D., Medical Director of CAMLS’ surgical center, performed a bronchoscopy that, in combination with the scans, would guide the aquarium’s veterinarian in a treatment plan.




COMMUNITY ROLE TAKES MANY FORMS

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EDITORMarty Petty, CAMLS

CREATIVE DIRECTOR & DESIGNERChris Kozlowski

DIRECTOR OF PHOTOGRAPHYMark Petty, MPettyPhotography LLC

PHOTOGRAPHYMark Petty, MPettyPhotography LLCEric Younghans, USF Health Communications

COVER ILLUSTRATIONJohn Petty

PRODUCTION & PROJECT MANAGEMENTLindsay Petty Andrea McClary

EDITOR’S NOTE:The following sources were used for statistics cited in this report: American College of Obstetrics and Gynecology; “Journal of Patient Safety;” Senate Subcommittee on Primary Health and Aging (July 17, 2014); U.S. Department of Health and Human Services

How to reach usGeneral Information813-224-7840

camls-us.org124 S. Franklin St. Tampa, FL 33602

Departments Area of interest

Office of the CEO813-224-7898

CAMLS Licensing Opportunities

Development Office813-224-7848

PhilanthropyGrants

Continuing Professional Development813-224-7852

Continuing Education (CE)Practitioner Remediation Programs

Marketing and Business Development813-224-7840

• 813-224-7847Industry Professional Education ProgramsHealthcare Associations and SocietiesDental, Pharmaceutical, and VeterinarianFilm Production• 813-224-7848Hospitals and Healthcare Systems,Healthcare ConsultantsMedical Malpractice, Defense Attorneys, Insurers

Tampa Bay Research and Innovation Center (TBRIC)813-224-7835

Medical Device Design and InnovationMedical Device Validation and TestingGLP, GMP, QSR Compliance



• • •


4,300Number of people who toured CAMLS in its second year

“The Center for Advanced Medical Learning and Simulation is a tremendous local asset

with global reach. CAMLS helps ensure that the Tampa Bay Region offers the best training

available for health care professionals while establishing Tampa as a center for medical

excellence around the world. This center clearly demonstrates the depth of knowledge and skill that exists in our region as well as makes a bold statement about the innovative community we

are building for the future.”

Judy Genshaft President, USF System

©2014 CAMLS, ALL RIGHTS RESERVED

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