An innovator is someone who helps to open up a new line of research, technology or art—and below, you’ll meet 25 “Innovators” who are making a mark on clinical, administrative and IT excellence as well. These trailblazers—hospital executives, physicians, department chiefs, researchers, CTOs and a chief medical information officer—are focused on improving the quality and safety of healthcare by speeding workflow and clinical decision-making and bettering outcomes. Their projects aim to improve hospital networks, initiate evidence-based medicine and decision support programs, and advance cardiac CT and MR, breast CAD and radiation oncology. We salute their excellence, expertise and commitments to bettering healthcare for us all.
Nominations for “Innovators” employed by healthcare providers were solicited via online ballot at healthimaging.com and from subscribers of Health Imaging News and Health Imaging & IT.
Ballots were accepted from March 21 through April 4, 2006.
Eran Bellin, MD
Director of Outcomes Analysis Decision Support,
Montefiore Medical Center, Bronx, N.Y.
After serving as the medical director of the Rikers Island Prison System for 10 years, Dr. Bellin embarked on a mission to create a tool for research and quality improvement utilizing clinical system data records and “off the shelf” tools to analyze aggregate patient data across a continuum of care in real time. He has delivered a clinical research engine that is now operational at Montefiore—Clinical Looking Glass. The system consolidates patient information into an intuitive analytical plat-form that provides critical hospital intelligence, essentially providing answers about the quality and efficacy of medical treatment. It processes patient information collected by clinical care systems—that track the 56,000 patient discharges and 850,000 outpatient visits there each year—through a statistical server to create meaningful summaries and graphic representations of outcomes, efficiencies and other modeled criteria. Dr. Bellin is in the process of transforming Clinical Looking Glass into a transportable product for other institutions.
Kimberly A. Bonzheim
Director, Noninvasive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Royal Oak, Mich.
Bonzheim’s work in improving the safety of patients monitored by centralized telemetry has reduced critical response times from 9.5 minutes to 39 seconds. The alarm communication process had been plagued with inherent communication delays. Bonzheim led a multidisciplinary team that studied the communication process. They selected a hands-free, voice-activated communication badge that allowed telemetry technicians to immediately communicate heart rhythm alarm information directly to the patients’ nurses so treatment could begin immediately.
Chief Technology Officer, Community Health Network, Indianapolis, Ind.
After evaluating the services provided by the hospital’s local carrier, Copple began to investigate new network infrastructure options, specifically migrating from a carrier-based network to a private optical network to deliver new, flexible services and state-of-the-art patient care. He found that in addition to increased flexibility and the ability to roll-out new applications, Community Health could save more than $11 million in the span of 13 years by implementing a private optical network. The new network connects data centers at Community Hospital, Indiana Heart Hospital, and a disaster recovery site in downtown Indianapolis. One of the sites has a centralized repository of digitized medical images and electronic medical records which doctors, clinicians, and authorized administrators can immediately access from any of the sites. The hospital also is well-positioned to handle the future bandwidth requirements of an all-digital state-of-the-art pediatrics facility, opening in 2007.
Tommy E. Cupples, MD
Private Practice, Breast Imaging and Interventional Specialist, ImageCare, LLC, Columbia, S.C.
Dr. Cupples was the lead investigator of a two-year study that prospectively evaluated CAD’s impact on the size of tumors detected and women’s age at diagnosis. Rather than following the traditional approach of studying increased detection rates, he studied not only the increased number of cancers detected with CAD, but also looked at other factors such as type of lesion and patient age. Dr. Cupples is a frequent speaker on breast imaging and breast biopsy techniques. He studies human pattern cognition and perception, human behaviors and how and why CAD works in his ongoing efforts to improve patient outcomes.
Robert Del Campo
IT Manager, Data Networking, Children’s Hospital of Philadelphia
Del Campo is leading a major network infrastructure initiative to improve the quality of patient care. A complex optical and storage network was implemented to support the growing imaging requirements across the facility and select remote sites, including PACS, electronic medical records and cardiology. Video conferencing will soon be added. The new infrastructure allows for quick downloading of medical records and images for remote patient diagnosis. The project is working toward reducing the time to diagnosis as well as cutting costs over the next several years.
Anand S. Dighe, MD, PhD
Associate Director of the Core Laboratory, Massachusetts General Hospital, Boston
Dr. Dighe has developed, in association with software engineers and pathologists, software that enables a patient-specific, expert-driven interpretation of complex clinical laboratory interpretations. Unlike radiology and anatomic pathology where physician interpretation of results is standard, clinical laboratory results, even the most complex, are returned to ordering physicians with just a canned comment suggesting their meaning. The software designed by Dr. Dighe enables a physician expert to promptly and accurately interpret the results of lab tests for ordering physicians, who have indicated that the information has a major impact on medical errors.
Keith J. Dreyer, MD
Vice Chairman of Radiology Informatics, Corporate Director of Medical Imaging, Instructor of Radiology, Massachusetts General Hospital/Harvard University, Boston
Dr. Dreyer has advanced research in data mining of radiologic and genetic image data for disease discovery and presymptomatic disease detection. He also has received patent approval for LEXIMER, the industry’s only natural language processing that understands and structures a radiology report. He created the first Harvard fellowship for medical informatics and the MGH Advanced Imaging Laboratory. Earlier this year, the second edition of his book on PACS and medical informatics was published. He also has given more than 100 lectures on these subjects nationally and internationally in the past two years.
A. Hugh Greene
President and CEO, Baptist Health, Jacksonville, Fla.
Greene has led Baptist Health through unprecedented growth and achievement, including the openings of two major healthcare facilities last year. With one, Greene created a 100 percent digital workplace where clinical, laboratory, pharmacy, radiology and surgery departments are automated thro ugh the use of electronic health records. A group of clinical staff with an understanding of the technology served as “translators,” conveying the needs of physicians, technologists and clinical and ancillary personnel to IT programmers. Greene’s leadership has led to a more “IT literate” workforce at Baptist Health. Hospitals and health systems from across the nation and abroad have visited the facility as they undertake similar initiatives.
Mark Halsted, MD
Chief, Radiology Informatics Research Core, Cincinnati Children’s Hospital Medical Center Radiology
Dr. Halsted led a team from Cincinnati Children’s and the University of Cincinnati College of Business that developed RadStream, a new approach for optimizing radiology workflow. RadStream prioritizes cases by medical and operational urgency and provides sorted and filtered electronic worklists that support decentralized reading and dynamic workload balancing. In all, RadStream has increased radiology report turnaround time by about 40 percent, with the department average for outpatient results now at 36 minutes. Radiologists staffing outpatient imaging centers have increased their productivity by 25 percent. It will soon be commercialized by a third party. Dr. Halsted also has helped develop new educational software about the most common errors made by radiology residents and fellows.
David Hellman, MD
Chief of Medicine, Johns Hopkins Bayview Medical Center, Associate Dean, School of Medicine, Johns Hopkins Center for Innovative Medicine, Baltimore, Md.
Dr. Hellman recently founded the Center for Innovative Medicine at Johns Hopkins University which integrates technology into medical practice at a faster rate, breaking down some of the traditional barriers presented by the evidence-based mantra. Its objective is to bring the best technology to the bedside, to improve physician communication and teamwork skills, to accelerate the pace at which laboratory discoveries are translated into better treatments, to promote health by reorganizing the way care is provided and disease is prevented, and the development of innovative programs to support healthy aging. Dr. Hellman and his colleagues have now published two studies on teaching residents how to perform simple bedside echocardiography exams using hand-carried ultrasound units. Both studies showed that residents or hospitalists could quickly integrate the technology into their rounds, reducing the need for expensive echo techs to perform the same exams without compromising on quality.
James Keel, III, MD
Chief Medical Information Officer, Mission Hospitals, Asheville, N.C.
Dr. Keel has been instrumental in establishing a workflow that is conducive with appropriate care practices for both clinicians and physicians. He established protocols for order sets, order sentencing, order synonyms and appropriate procedures for electronic medications administration. He has gotten 100 percent of the medical staff to use the electronic medical record (EMR) and is now working with eight teams on successfully implementing computerized physician order entry. Dr. Keel is focused on a cost-effective clinical information system that improves the process of patient care and reduces documentation time.
Ramin Khorasani, MD, MPH
Director of Medical Imaging IT, Director, Medical Imaging Information Technology, Vice Chair, Department of Radiology, Medical Director, Center for Evidence-Based Imaging, Brigham & Women’s Hospital, Boston
Dr. Khorasani teaches abdominal imaging to Brigham & Women’s trainees, educates physicians, administrators and other caregivers on a national level on how to use information technology tools to improve patient safety, quality and efficiency of care, and uses IT to institute change in clinical practice to reduce medical errors and improve quality and efficiency. He is the project director of a hospital-wide initiative to enable researchers to design and deploy novel knowledge delivery methods using information systems and analyze multidisciplinary data to enable the practice of evidence-based medicine and measure its impact on quality of care. Other projects he heads are addressing ways to reduce duplicate outpatient imaging test ordering and measuring the impact of an automated preapproval program using IT to reduce inappropriate use of imaging.
Peter M. Kuzmak
Senior Software Developer and Architect, DICOM, Department of Veterans Affairs, Silver Spring, Md.
Kuzmak has been working on the VistA (Veterans Health Information Systems and Technology Architecture) Imaging project for 15 years and was instrumental in the first interface between a hospital information system and a PACS. More recently, he has pioneered use of the DICOM standard for areas outside of radiology. Using the Integrating the Healthcare Enterprise (IHE) Scheduled Workflow Integration Profile, Kuzmak has interfaced VistA Imaging to about 225 different models of radiology modalities, allowing the VA to acquire about 500,000 DICOM images a day. Last October, he organized a hands-on demonstration for the IHE Eye Care Showcase. He was instrumental in an IHE proposal for automating the importing of DICOM objects into PACS. He also was a key player in developing a telemedicine worklist reading application for ophthalmologists that will be used to create the world’s largest diabetic retinopathy surveillance network.
Nathan Levitan, MD, MBA
Chief Medical Officer, University Hospitals Health System, Cleveland, Ohio
Dr. Levitan has led the development and implementation of University Hospitals Health System’s Clinical Portal, which allows caregivers to share patient information across eight hospitals and 200 outpatient delivery sites among more than 2,500 affiliated physicians across northeast Ohio. The system unifies the participating hospitals’ different IT platforms, registration systems, and patient medical record numbers in a virtual master patient index. Enhancements to the system are ongoing. The organization and the Clinician Portal were selected as one of four lead institutions in the United States in a grant from the Department of Health and Human Services to develop the platform for a National Health Information System.
Joao A.C. Lima, MD, MBA
Director of the Cardiovascular CT Program, Associate Professor of Medicine, Radiology & Epidemiology Co-Director, Project 2, Johns Hopkins University School of Medicine, Baltimore, Md.
Dr. Lima focuses on introducing new technology into mainstream medicine. He is the principal investigator for the Coronary Evaluation on 64 (CorE 64) study, the first international multicenter trial focused on validating 64-slice CT as the primary tool for diagnostic cardiac imaging. The study was designed to compare cardiac CTA with 64-slice CT technology to the catheterization lab. Dr. Lima also has done significant work in cardiac MRI, namely how it can measure the early benefits of cholesterol-lowering drugs and plaque reduction, in echocardiography and specifically in the pathophysiology of the left ventricular remodeling after myocardial infarction.
Kevin W. McEnery, MD
Associate Professor, Department of Diagnostic Radiology,
The University of Texas M.D. Anderson Cancer Center, Houston
Dr. McEnery facilitated M.D. Anderson Cancer Center’s digital clinical transformation by seamlessly integrating one of the country’s largest single facility PACS environments with its ClinicStation EMR. He also co-developed the EMR system. He and his team have since used the integration of PACS and EMR to create a unique method of interpretation prioritization based on the time of a patient’s appointment. That included a customized worklist engine which prioritized study queues. CT service was then able to achieve 97 percent success in exam interpretations prior to patient appointment.
Jeffrey Mendel, MD
Chair, Department of Radiology, Caritas St. Elizabeth’s Medical Center, Boston
Dr. Mendel implemented an enterprise PACS at St. Elizabeth’s and is dedicated to improving all aspects of soft-copy reading, including workflow, image quality and final distribution. He also researches all components of imaging, from monitors to compression calculations to designing reading rooms. He continually challenges vendors to provide the best imaging system available to all modalities.
Gilbert Padula, MD
Radiation Oncologist, Saint Mary’s Health Care, The Lacks Cancer Center, Grand Rapids, Mich.
Dr. Padula has performed breakthrough work in clinical trials for innovative radiation treatments for women with breast cancer. He was the first in his area to participate in Phase III clinical trials for partial breast radiation. Dr. Padula also has been involved in research on prostate imaging that found early-stage prostate cancer patients who undergo intensity modulated radiotherapy (IMRT) can expect their PSA level to normalize in a few months, or even quicker with the addition of hormone therapy.
Michael Poon, MD
Chief of Cardiology, Cabrini Medical Center, New York, N.Y.
Dr. Poon has been a pioneer in cardiovascular CT and MRI. He has been recognized by several professional associations as a national leader in the development of cardiac imaging. He is actively involved in the early screening and detection of cardiac disease in the African-American and Latino populations, namely in the CORE—Congress of Racial Equality—trial now underway to determine if an increased risk of heart attacks in blacks may be based on the frequency of certain genes or on cultural factors, or both. He has worked on new diagnostic techniques for the treatment of primary pulmonary hypertension, such as noninvasive magnetic resonance for a definitive diagnosis and an MRI-based technique to measure blood flow in the lungs.
Jean Pouliot, PhD
Associate Professor in Residence, Radiation Oncology, University of California at San Francisco
Dr. Pouliot has done pioneering research on MegaVoltage Cone Beam imaging and advanced its use in radiology oncology departments. He established clinical studies of more than 100 patients that determined clinical requirements for MVCB and identified new applications and potentials for MCVB modality. Dr. Pouliot also is active in research into radiation therapy dose conformation. The focus is on the clinical integration of Electronic Portal Imaging Devices (EPID) for patient verification and organ motion study during cancer irradiation and on dose distribution optimization and Relative Biological Effectiveness (RBE) of image-guided brachytherapy.
Richard Prager, MD, FCCP
Clinical Medical Director of Intensive Care, Intensive Care Services, Pinecrest, Fla.
Dr. Prager recently developed CARAD (Computer Assisted Risk Assessment for Deep Vein Thrombosis Prophylaxis), a computer program that provides evidence-based medicine to guide therapy and bases prophylaxis on the Risks Assessment Score of each individual patient hospitalized, and when utilizing system default therapy lowers the risks of omission for DVT prevention. It allows healthcare providers to complete a risk assessment score for the condition. The program also will generate an order sheet with the best treatment plan for DVT prophylaxis based on established guidelines and allow a hospital to meet the JCAHO accreditation for this as well.
Director of IT Research and Development, Providence Health System, Portland, Ore.
Reagin led the development of an interactive disease management system in conjunction with the system’s Providence Medical Group. The system is integrated with the ambulatory EMR and allows for better management of chronic disease, as well as eliminating duplicate data entry. The system is being used by all of the 200+ employed physicians and is showing statistically significant results in all national benchmark indicators of care. The system has shown such promise that it is now being marketed by a third party to other healthcare entities.
Eliot Siegel, MD
Professor and Vice Chairman, University of Maryland Department of Diagnostic Radiology, Chief Imaging, VA Maryland Healthcare System, Baltimore, Md.
Dr. Siegel helped design and implement the world’s first enterprise-wide filmless radiology department at the Baltimore VA Medical Center. He also had the foresight to collect data before and after the transition to filmless operation to allow for studies sharing the economic consequences and the impact on productivity, image interpretation, and more. He also is involved in the Medical Imaging Resource Center through RSNA. The development of an XML (extensible markup language) schema for use by the imaging community has become a standard for teaching files and for clinical trials. Dr. Siegel is the lead for the imaging workspace, part of the National Cancer Institute’s cancer Bioinformatics Grid, and is in charge of the NCI’s Imaging Informatics Product Line.
Furqan Tejani, MD, FACC
Director of Advanced CV Imaging, Long Island College Hospital
Dr. Tejani is a cardiologist raising awareness in the cardiology community about CT and MRI in cardiovascular imaging. He is a leading researcher of protocols, agents and sequences in cardiac MRI. Dr. Tejani has interpreted about 1,000 electron beam CTs and angiograms for coronary calcium scoring, aortic plaque and calcification and for evidence of atherosclerosis and visceral fat assessment. He also is the lead scientist on an initiative in Bangladesh to provide sustainable tools of medical and cardiovascular care in developing countries.
System Manager, PACS, Provena Health, Joliet, Ill.
With new technologies and staff shortages in radiology, Watts has set up Provena Health’s PACS to serve as a quality monitoring device. Review of a percentage of all images will include grading image quality. Medical imaging directors at Provena hospitals receive a report to help them provide follow up and presentations that will lead to standardized imaging.