November 20, 2019
Hot off the press, I am pleased to announce that Dr. Esmaeil Porsa, a graduate of our internal medicine residency training program and of our School of Public Health, has been unanimously selected as Harris Health’s new president and chief executive officer. He will start his new job March 2, 2020, succeeding George Masi, who announced his intent to retire last May. Dr. Porsa comes to us from Parkland Health & Hospital System, where he serves as executive vice president and chief strategy and integration officer. We look forward to welcoming him to Houston and working with him at LBJ General Hospital.
This week we are highlighting the Department of Diagnostic and Interventional Imaging (DII), aka Radiology.
The mission of the department is “to excel in image-driven clinical care, research, and education.” Dr. Susan John, chair of the department, recently gave an overview of the program at our monthly clinical chairs meeting. She explained how the department’s core values — professional and responsive, collegial and compassionate, diverse and innovative, ethical and safe, expert and evidence-based — underpin all decisions and behaviors.
Dr. John joined our faculty in 1998 and was named the John S. Dunn Distinguished Chair in Radiology in 2004. She earned her medical degree from UTMB in Galveston, where she also completed her residency in radiology and fellowship in pediatric radiology.
The department has a robust clinical program. Radiology is a core hospital-based service and is therefore and important part of Memorial Hermann-TMC, Harris Health LBJ, Memorial Hermann Orthopedic and Spine Hospital, and Shriners Hospital. The department also provides services at various imaging centers in Houston, including at Memorial Hermann Plaza, Memorial Hermann Bellaire, Memorial Hermann Bayshore, and Memorial Hermann Upper Kirby. In addition, the department offers teleradiology at Premise Health, Bellaire Family Group Practice, E-Plus, and Women’s Hospital.
The department has 200 faculty, trainees and staff: 63 MD radiologists, five PhD basic scientists, four medical physicists, four informaticians, 54 residents, 13 fellows, and 57 staff. In addition to Dr. John, departmental leadership includes five vice chairs: Dr. Clark West, clinical operations and informatics; Dr. Emma Ferguson, education: Dr. Ponnada Narayana, research; and Drs. Eduardo Matta and Susanna Spence, quality. Section chiefs are: Dr. Susan John, pediatric imaging; Dr. Roy Riascos, neuroradiology; Dr. Clark West, emergency radiology; Dr. Manickam Kumaravel, emergency radiology musculoskeletal; Dr. David Wan, nuclear medicine; Drs. Eduardo Matta and Venkat Surabhi, body imaging; Dr. Emma Ferguson, cardiothoracic imaging; and Dr. Heather He, breast imaging. Dr. Ahmed Kamel just joined the department as chief of Vascular and Interventional radiology. Medical directors are Dr. Joseph Hasapes, LBJ; Dr. Marcelle Mallery, MHHS-OPID Upper Kirby; Dr. Manickam Kumaravel, MHHS OPID, Plaza; Dr. Paul Horwitz, MHHS-OPID, Bellaire/Bayshore; and Dr. Nicholas Beckmann, MHOSH.
Dr. Kumaravel directs the medical student education program, which includes radiologic anatomy correlation in the first year, the core radiology course in the second year, and general and subspecialty imaging electives in the fourth year. Of note Dr. Kumaravel was recently honored by the UT System with the Regents Outstanding Teaching Award. He is an outstanding educator, clinician, and role model, who exemplifies the very best of our faculty.
The DII residency program was re-accredited in 2018 for 10 years. The diagnostic radiology residency is a 5-year program that operates in parallel to the new IR residency program, which is a joint program between McGovern Medical School and MD Anderson Cancer Center that was accredited in 2018. Together the two programs accept 14 residents each year for a total of 56 trainees, one of the largest programs in the United States. Dr. Ferguson is the residency program director for the diagnostic radiology program. Second-year residents are participating in a new quality course. So far, their work has led to decreased turnaround times for stroke MRI in the Memorial Hermann-TMC emergency department. The Medical Physics Residency Program is also relatively new – its first resident joined in 2017. The department offers fellowships in Body Imaging, Body MRI, Cardiothoracic, Neuroradiology, Orthopedic/Sports Medicine, and Emergency Radiology, with a total of 13 fellows this year.
To focus on wellness, the department created a resident and faculty wellness center at LBJ Hospital, providing workshops to help faculty and residents cope with stress and workload. The program is designed to improve resident and faculty well-being and in the process to also reduce error. The group is collecting outcome data to understand the impact of well-being on patient safety. Residents and faculty members are collaborating in an international outreach program through a non-profit service called RAD-AID, providing education and training to radiologists and trainees in underserved areas of Morocco for the past several years.
Dr. Pan Narayana has been vice chair of research for 26 years. Research highlights of the department include studies in precision patient-adaptive MRI techniques, effects of microgravity in space on astronauts, quantitative MRI for imaging brain trauma, MS, and other neurologic disorders. Dr. He has enrolled the second highest number of patients in a large multicenter Tomosynthesis Mammographic Imaging Screening Trial that is evaluating best methods for breast cancer screening. Dr. John commented on a number of new collaborations with other departments, including orthopedic surgery, pediatrics, neurology, and basic science departments as well as industry collaborations and clinical trials.
Increased clinical volumes for radiology have resulted in a weekend sports imaging service and significant growth of musculoskeletal imaging procedures with more expansion planned in UT Physicians Orthopedic Clinics. Clinical expansion for the department includes a new dedicated dual-energy pediatric CT scanner and ongoing upgrades in MRI. New advanced post-processing services are available through the Center for Advanced Image Processing at MHH-TMC, developed and directed by Dr. Roy Riascos. The center provides valuable enhancements to current sectional imaging in CT and MRI, such as 3D image rendering and printing, volumetric analysis, and vessel tracking. MRI also has expanded with prostate imaging and biopsy guidance and magnetic resonance liver elastography. New molecular imaging studies for dementia and prostate cancer have been introduced. The Interventional Radiology service provides 24/7 high level image guided interventions supporting our complex subspecialty services, despite a severe shortage of space and equipment. We are one of the few services in the country that meets a 30-minute response time for angiographic services on Level I trauma activations. Our pediatric radiologists provide pediatric imaging standards and education for radiologists and technologists throughout the Memorial Hermann System.
The department has undertaken strategic planning as they look ahead and consider current needs and growth opportunities. A recent SWOT analysis revealed strengths in culture, residency program, and reputation with opportunities in research infrastructure and referrals. In response to the strategic plan, the department is converting to a new PACS platform, overhauling work schedules to coordinate clinical rotations with academic responsibilities, focusing on referring physician processes, and tracking revenue impact.
We all read items in the news about artificial intelligence and radiology. Will computers be able interpret films as well—or even better than trained radiologists? Dr. John is confident that the field of radiology will thrive with the help of new AI programs that improve efficiency and accuracy of radiologists, not replace them. The department is actively engaged in research and development of AI tools and infrastructure to support research in AI and machine learning, as well as working to prepare trainees and faculty for a future that integrates AI into medical diagnostics and patient care.
Please join me in thanking Dr. John and her team.
P.S. Giving Tuesday is Dec. 3, please remember our McGovern Medical School crowdfunding efforts this day, which may be found on the website.