Houston Methodist MITIE Annual Report 2012

Houston, Texas

M E T H O D I S T I N S T I T U T E F O R T E C H N O L O G Y , I N N O V A T I O N & E D U C A T I O N

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MITIE | The Methodist Hospital6670 Bertner Avenue, 5th Floor

Houston, Texas 770301-888-MITIE-TXmitietexas.com

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01 LEADERSHIp MESSAGE

02 ABOUT MITIE Mission and history

06 TIMELINE Developing a world-class Institute

08 DESIGN FOCUS Housing all essential elements for training and research under one roof

12 TECHNOLOGY AND RESEARCH Serving as a platform for advancing medical technology

14 INNOVATION Collaborating with leading institutions and scientists

16 EDUCATION Training more practicing health care professionals than any

other institution

19 MOVING FORwARD Expanding medicine as the world knows it

ACADEMIC pArTnErSThe University of Houston Department of Computer ScienceThe Department of Computer Science at the University of Houston was founded in 1967 and is one of the first established in the country. It is among the top 50 in the U.S. according to the 2011 Academic Ranking of World Universities. Dr. Marc Garbey has a joint appointment with Methodist’s Department of Surgery and has led a series of collaborations in education and research. These range from establishing a new discipline of computational surgery to developing image recognition technology to track operative tools real-time during surgery. This collaborative work is described in the Technology / Research section of this report. Learn more by visiting computationalsurgery.org.

Rice University Department of Mechanical Engineering and Materials ScienceThe Mechanical Engineering Department was founded in 1913, one year after the university opened. In 1962 the department was renamed the Department of Mechanical Engineering and Materials Science (MEMS). MEMS faculty specialize in a wide number of areas including biomechanics, materials, heat transfer, and computational fluid dynamics, control systems/robotics, mechanics, C.A.D., aero/astronautics, and applied mathematics. MITIE research teams have partnered with Marsha O’Malley, Ph.D. from MEMS to develop validated measures of procedural competence in robotic and endovascular surgery. Learn more about MEMS by visiting memsweb.rice.edu.

InDuSTry pArTnErSBehind every new surgical device developedto improve patient care is a multidisciplinarycollaboration among medical professionals,research scientists, and the medical deviceindustry. MITIE’s success is not only a resultof the innovative spirit within the organization,but also of the technology and supportprovided by our industry partners. Some ofthe industry leaders whose support has helpedMITIE to thrive include:

Boston Scientific EndoscopyBoston Scientific Endoscopy seeks to be a global leader in the development of innovative medical technologies used to diagnose, palliate, and treat a variety of digestive diseases. The long-standing commitment of Boston Scientific Endoscopy to advance the field of endoscopy is reflected in a broad spectrum of diagnostic and therapeutic devices for disease states throughout the GI tract. Boston Scientific Endoscopy has committed to be one of three founding partners in the development of a National Science Foundation funded collaborative industry-academic center that will utilize MITIE as an experimental platform for developing novel technology in the areas of surgery, gastroenterology, and education.

CovidienCovidien is a global healthcare products leader dedicated to creating innovative medical solutions for better patient outcomes. Covidien pioneered endomechanical devices for minimally invasive surgery and is a world leader in energy platforms and soft tissue repair products. Covidien was an inaugural education partner with MITIE and has fostered the development of multiple educational events benefiting thousands of practicing health care professionals.

Image Stream Medical Inc.Image Stream Medical provides products targeted at minimally invasive surgery image management. Over the last decade ISM has developed the most advanced network-based image management and virtual collaboration solutions to share medical video throughout hospitals. Image Stream has been a key partner in developing the audio-video integration platform in MITIE which allows real time, high definition linkage to all procedural environments in Methodist. Image Stream also collaborates with MITIE on research projects to develop wearable technology for surgeon-to-surgeon proctoring in the OR.

Karl Storz EndoskopeSince its founding in 1945, Karl Storz Endoskope has established itself as a highly regarded international company that produces medical instruments and devices. The company has developed a comprehensive and extremely sophisticated range of endoscopes and instruments for the fields of internal medicine, general surgery, urology, gynecology and pediatric surgery. Storz was an inaugural partner with MITIE, and the first industrial collaborator to support and dedicate resources to the Institute. MITIE and Storz collaborate on a broad range of educational and research initiatives.

OlympusOlympus is an international company focused on improving people’s lives through innovation. As a precision technology leader, Olympus designs solutions in medical and surgical products. Olympus has particular expertise in flexible gastrointestinal endoscopy and has partnered with MITIE to advance the field of endolumenal surgery – a new method of performing surgical procedures from inside the GI tract to avoid pain and scars.

SiemensSiemens is a world leader in providing health care products for image-guided procedures. The company has particular expertise creating advanced operating rooms that combine the imaging capabilities of a radiology department with state-of-the-art surgical devices. The combination allows surgeons to perform more accurate and less invasive procedures. Siemens has partnered with MITIE to develop two experimental operating rooms – an MRI-capable operating suite, and a “hybrid” operating room that includes advanced, robotically guided X-ray imaging. These combined imaging operating rooms bring to MITIE advanced image-guided capability beyond that of any other Institute. SterisSteris Healthcare provides operating room surgical equipment and sterile processing equipment. It has partnered with MITIE to innovate technologies around operative booms and lights for efficient procedural environments.

Leadership Message

Dear Colleagues,

Since MITIE began in 2007, it has been astounding to see the growth of the Institute. In six short years we have progressed from a single room for robotic surgery training, to a world-class purpose-built facility that is among the most advanced in the world. In fact, more than 15,000 learners across 26 specialties have already come through our doors. This level of activity led not only to initial accreditation as an Advanced Education Institute by the American College of Surgeons in our second year of existence, but also to re-accreditation in 2012!

We also have developed multiple research programs and garnered funding through organizations such as the National Science Foundation, the Department of Defense, national surgical societies, the Houston Endowment, and multiple industry partners.

The MITIE team has grown to include 15 full-time employees and contract personnel who provide incomparable service to members of the educational and research teams. This progress is possible through tremendous support from The Methodist Hospital System and the hard work and dedication of the MITIE team.

This first annual report will take you through MITIE’s development, explain its unique role in medical education, and share its accomplishments. As you review the following pages, we know you will share our enthusiasm for the outstanding contributions of MITIE faculty and staff to leading medicine.

BRIAN J. DUNKIN, MD, FACSProfessor of Clinical Surgery, Weill Cornell Medical CollegeJohn F., Jr. and Carolyn Bookout Chair in Surgical Innovation and TechnologyMedical Director, MITIE

BARBARA LEE BASS, MD, FACSProfessor of Surgery, Weill Cornell Medical CollegeChair, Department of SurgeryJohn F. and Carolyn Bookout Distinguished Endowed ChairExecutive Director, MITIE

What is MitiE?

the Methodist institute for technology,

innovation, & Education (MitiEsM) is a

world-class institute, focused on helping

practicing health care professionals stay

at the top of their field throughout their

careers. MitiE creates an “educational

home” where procedurally-based

clinicians intermittently return to

learn innovative techniques and use

new technologies. MitiE research

focuses on developing validated

measures of procedural skill for

these professionals to provide

meaningful feedback on their

performance. the institute is

also advancing image-guided

surgery, making medical

procedures of all types more

accurate and less invasive.

Why MitiE?

MITIE was built to serve a specific need

in the medical workforce – maintaining

top performance of practicing health

care professionals who treat patients.

Medical training in the U.s. immerses a

future clinician in a rich environment with

progressive independence performing

procedures and using technology over

a relatively long period of time. General

surgery training alone requires five years

of immersion in patient care beyond four

About MITIE Mission Statement: MITIE will be an educational resource for health care professionals seeking to maintain excellent clinical skills and acquire new ones. It will improve patient safety through these educational pursuits and conduct research on skills acquisition and technological development.

years of medical school. Many trainees

do additional subspecialty training

resulting in six to eight years of a

postgraduate, hands-on experience

in a structured environment before

independently caring for a patient. as a

result, physicians in the U.s. are among

the best trained in the world when they

complete their post-graduate work.

Once a surgeon goes into practice,

learning new techniques and exposure

to technology is left to an ad hoc system

of attending medical meetings that

may not offer hands-on training.

Compounding this problem is the

unprecedented pace of advancements

in surgical technology. Within a decade

of completing training, a surgeon who

has not actively worked to remain current

will no longer be practicing the standard

of care. Operative environments also

are becoming more complex with the

introduction of image guidance and

robotics and operative teams are larger

and more diverse than ever.

a busy practicing clinician needs an

“educational home” where one can return

intermittently throughout a career to learn

from experts both through observation

and hands-on practice. ideally the

institute would form a relationship with the

clinician to understand his or her skills and

training needs and provide an experience

that does not require being away

from one’s practice for an extended

period of time. MitiE serves as this

educational home.

since the methods of delivering a

meaningful educational experience for

procedurally based clinicians have not

been fully developed, MitiE also serves

as a place of research. One research

goal focuses on measuring a surgeon’s

competence to perform a specific

procedure and understanding whether a

patient has a better outcome as a result.

MitiE also serves as a platform for

advancing procedurally based medicine.

it is logical for new procedures and

technology to be developed in MitiE

research operating rooms, tested in

a busy clinical environment such as

the Methodist hospital, and then

brought back to the institute to educate

practitioners and their teams on how to

safely use this new technology.

2 METHODIST INSTITUTE FOR TECHNOLOGY, INNOVATION & EDUCATION

TXL O C AT E D I N T E X A S

G L O B A L LY K N O W N

What is MitiE?

the Methodist institute for technology,

innovation, & Education (MitiEsM) is a

world-class institute, focused on helping

practicing health care professionals stay

at the top of their field throughout their

careers. MitiE creates an “educational

home” where procedurally-based

clinicians intermittently return to

learn innovative techniques and use

new technologies. MitiE research

focuses on developing validated

measures of procedural skill for

these professionals to provide

meaningful feedback on their

performance. the institute is

also advancing image-guided

surgery, making medical

procedures of all types more

accurate and less invasive.

Why MitiE?

MITIE was built to serve a specific need

in the medical workforce – maintaining

top performance of practicing health

care professionals who treat patients.

Medical training in the U.s. immerses a

future clinician in a rich environment with

progressive independence performing

procedures and using technology over

a relatively long period of time. General

surgery training alone requires five years

of immersion in patient care beyond four

About MITIE Mission Statement: MITIE will be an educational resource for health care professionals seeking to maintain excellent clinical skills and acquire new ones. It will improve patient safety through these educational pursuits and conduct research on skills acquisition and technological development.

years of medical school. Many trainees

do additional subspecialty training

resulting in six to eight years of a

postgraduate, hands-on experience

in a structured environment before

independently caring for a patient. as a

result, physicians in the U.s. are among

the best trained in the world when they

complete their post-graduate work.

Once a surgeon goes into practice,

learning new techniques and exposure

to technology is left to an ad hoc system

of attending medical meetings that

may not offer hands-on training.

Compounding this problem is the

unprecedented pace of advancements

in surgical technology. Within a decade

of completing training, a surgeon who

has not actively worked to remain current

will no longer be practicing the standard

of care. Operative environments also

are becoming more complex with the

introduction of image guidance and

robotics and operative teams are larger

and more diverse than ever.

a busy practicing clinician needs an

“educational home” where one can return

intermittently throughout a career to learn

from experts both through observation

and hands-on practice. ideally the

institute would form a relationship with the

clinician to understand his or her skills and

training needs and provide an experience

that does not require being away

from one’s practice for an extended

period of time. MitiE serves as this

educational home.

since the methods of delivering a

meaningful educational experience for

procedurally based clinicians have not

been fully developed, MitiE also serves

as a place of research. One research

goal focuses on measuring a surgeon’s

competence to perform a specific

procedure and understanding whether a

patient has a better outcome as a result.

MitiE also serves as a platform for

advancing procedurally based medicine.

it is logical for new procedures and

technology to be developed in MitiE

research operating rooms, tested in

a busy clinical environment such as

the Methodist hospital, and then

brought back to the institute to educate

practitioners and their teams on how to

safely use this new technology.


TXL O C AT E D I N T E X A S

G L O B A L LY K N O W N

MITIE was built to serve a specific need in the medical

workforce – keeping practicing health care professionals who

do procedures on patients at the top of their game.

T H E M E T H O D I S T H O S P I TA L R E S E A R C H I N S T I T U T E

B Y T H E N U M B E R S

S T O R I E S

M E M B E R S

I N PAT I E N T S I N 2 0 1 2 *

I N N I H F U N D I N G I N 2 0 1 2

S q U A R E F E E T

C R E D E N T I A L E D R E S E A R C H E R S

N U M B E R O F A RT I C L E S B Y METHODIST RESEARCHERS

L A B B E N C H E S

*Projected

What MaKEs MitiE UNiQUE?

step into MitiE’s 35,000-plus square

feet of education and research space,

and it becomes obvious that there is no

other place quite like it. the facility was

built specifically for practicing health

care professionals who are serious

about remaining current in their field and

providing leading care for their patients.

While parts of the functional spaces

of MitiE are similar to other training

institutes, only MitiE gathers all the

elements – procedural training laboratory,

virtual hospital, and research core –

together under one roof. this allows for

a logical progression from procedure

development to training and dissemination

all within the institute. MitiE’s capacity

for training also is unparalleled with an

infrastructure and professional support

team to train hundreds of practitioners

simultaneously.

MitiE’s physical location in the heart of

the texas Medical Center is an advantage,

providing access to world-class health

professionals from various specialties

who work within blocks of the institute.

its central location in the U.s. and in

houston, the fourth largest city in the

country, also allows for easy access by

visitors internationally.

MITIE’s capacity for training is unparalleled with an infrastructure and professional support team to train hundreds of practitioners simultaneously.

Square feet of E D U C AT I O N and R E S E A R C H S PA C E


What MaKEs MitiE UNiQUE?

step into MitiE’s 35,000-plus square

feet of education and research space,

and it becomes obvious that there is no

other place quite like it. the facility was

built specifically for practicing health

care professionals who are serious

about remaining current in their field and

providing leading care for their patients.

While parts of the functional spaces

of MitiE are similar to other training

institutes, only MitiE gathers all the

elements – procedural training laboratory,

virtual hospital, and research core –

together under one roof. this allows for

a logical progression from procedure

development to training and dissemination

all within the institute. MitiE’s capacity

for training also is unparalleled with an

infrastructure and professional support

team to train hundreds of practitioners

simultaneously.

MitiE’s physical location in the heart of

the texas Medical Center is an advantage,

providing access to world-class health

professionals from various specialties

who work within blocks of the institute.

its central location in the U.s. and in

houston, the fourth largest city in the

country, also allows for easy access by

visitors internationally.

MITIE’s capacity for training is unparalleled with an infrastructure and professional support team to train hundreds of practitioners simultaneously.

Square feet of E D U C AT I O N and R E S E A R C H S PA C E


The John F., Jr. and Carolyn Bookout Chair in Surgical Innovation and Technology was established to foster the clinical, educational and research missions of MITIE and The Methodist Hospital. Dr. Brian Dunkin has held this chair since its inception, in recognition of his invaluable leadership in the development and program growth of MITIE.

J O H N F. , J R . A N D C A R O LY N B O O K O U T C H A I R I N S U R G I C A L I N N O VAT I O N A N D T E C H N O L O G Yheld by Brian Dunkin, M.D., F.A.C.S.


The John F., Jr. and Carolyn Bookout Chair in Surgical Innovation and Technology was established to foster the clinical, educational and research missions of MITIE and The Methodist Hospital. Dr. Brian Dunkin has held this chair since its inception, in recognition of his invaluable leadership in the development and program growth of MITIE.

J O H N F. , J R . A N D C A R O LY N B O O K O U T C H A I R I N S U R G I C A L I N N O VAT I O N A N D T E C H N O L O G Yheld by Brian Dunkin, M.D., F.A.C.S.


2008 2009 2010 2011 2012

June 2008 – MITIE is accredited as an American College of Surgeons Level One education institute.

July 2008 – West Pavilion renovations are completed. MITIE now encompasses 17,000 square feet for research, training and education.

Robotic surgical training expanded to three robots.

MITIE trains nearly 1,000 clinicians this year – more than 2,300 since inception.

April 2010 – MITIE receives accreditation from the Society of American Gastrointestinal and Endoscopic Surgeons.

August 2010 – MITIE begins its move to the 5th floor of the new Methodist Hospital Research Institute.

MITIE trains more than 2,500 clinicians this year.

January 2011 – MITIE hosts a grand opening in its new 35,000 square-foot site for approximately 250 guests from all over the world.

June 2011 – MITIE is reaccredited by the American College of Surgeons.

MITIE trains 4,400 clinicians this year.

March 2012 – The John F. and Carolyn Bookout Chair in Surgical Innovation and Technology is established at The Methodist Hospital . It is awarded to MITIE Medical Director Dr. Brian Dunkin.

April 2012 – Dr. Barbara Bass presents “What is the Surgeon’s Flight Simulator?” at TEDMED 2012.

September 2012 – MITIE hosts over 200 clinicians for hands-on training in a single day.

September 2012 – MITIE surpasses 15,000 trainees.

December 2012 – MITIE breaks ground on a combined MRI and robotically guided X-ray operating suite for research and education.

Timeline of Technology, Innovation & Education

Design FocusMITIE is designed to house all the essential elements for training and research under one roof. Located in The Methodist Hospital Research Institute (TMHRI) in the heart of the Texas Medical Center, MITIE is directly connected to The Methodist Hospital.

The educational process usually begins with attendance of

lectures by experts in the field followed by live procedure

demonstration projected from an operating room into an

immersive viewing environment known as the Medical Presence

Suite. Afterward, “learners” move into the Procedural Skills

Laboratory for hands-on training using life-like models and state-

of-the-art equipment. Multispecialty team training is conducted

in the Virtual Hospital, to allow all members of a procedure team

to gather and rehearse.

ProcedurAL SkiLLS LAb houses 15 operating and endoscopy

environments where numerous medical and surgical procedures

are taught using state-of-the-art models. each skills station

features tools to conduct procedures across multiple specialties.

This area includes the Medical Presence Suite – an immersive

environment where learners can observe live procedures across

the entire Methodist campus.

• 15 small-scale operating rooms

• Medical Presence Suite

VirTuAL HoSPiTAL uses simulation technology to recreate

a patient care environment, including a hospital’s critical care

areas, such as an or or icu. Full-body patient mannequins

that breathe, blink, talk and respond to medications are used to

recreate patient care situations, including low-frequency, high-

risk events which typically offer few opportunities for training.

Audiovisual recording in the virtual hospital also allows for

debriefing after simulations.

• Pre-brief/debrief rooms

• Simulation suites

• Partial task training areas

• inanimate skills lab

reSeArcH core contains multiple image and robotically

guided operating rooms for technology and procedure

development.

• research ors

• Two robotic training labs

• Proprietary-technology development rooms

• cT-capable or

• Mri-capable or

• robotically guided x-ray imaging or

Only MITIE brings all the elements – procedural skills laboratory, virtual hospital, and research core – together under one roof.


Design FocusMITIE is designed to house all the essential elements for training and research under one roof. Located in The Methodist Hospital Research Institute (TMHRI) in the heart of the Texas Medical Center, MITIE is directly connected to The Methodist Hospital.

The educational process usually begins with attendance of

lectures by experts in the field followed by live procedure

demonstration projected from an operating room into an

immersive viewing environment known as the Medical Presence

Suite. Afterward, “learners” move into the Procedural Skills

Laboratory for hands-on training using life-like models and state-

of-the-art equipment. Multispecialty team training is conducted

in the Virtual Hospital, to allow all members of a procedure team

to gather and rehearse.

ProcedurAL SkiLLS LAb houses 15 operating and endoscopy

environments where numerous medical and surgical procedures

are taught using state-of-the-art models. each skills station

features tools to conduct procedures across multiple specialties.

This area includes the Medical Presence Suite – an immersive

environment where learners can observe live procedures across

the entire Methodist campus.

• 15 small-scale operating rooms

• Medical Presence Suite

VirTuAL HoSPiTAL uses simulation technology to recreate

a patient care environment, including a hospital’s critical care

areas, such as an or or icu. Full-body patient mannequins

that breathe, blink, talk and respond to medications are used to

recreate patient care situations, including low-frequency, high-

risk events which typically offer few opportunities for training.

Audiovisual recording in the virtual hospital also allows for

debriefing after simulations.

• Pre-brief/debrief rooms

• Simulation suites

• Partial task training areas

• inanimate skills lab

reSeArcH core contains multiple image and robotically

guided operating rooms for technology and procedure

development.

• research ors

• Two robotic training labs

• Proprietary-technology development rooms

• cT-capable or

• Mri-capable or

• robotically guided x-ray imaging or

Only MITIE brings all the elements – procedural skills laboratory, virtual hospital, and research core – together under one roof.


Team Structure

Administrative director Lead lab techProject specialist uH liaison

operations manager Associate lab techProject specialist outcomes researchers

business manager Associate lab techProject specialist MiTie surgical skills researcher

iT specialist

Project coordinator

research fellow

research fellow

Administration SupportOperations Research

MiTie employs an open access model for developing educational and research programs. This allows experts both internal to The Methodist Hospital System and external

to utilize the institute to develop and disseminate best medical practice. To support this model, MiTie employs an integrated team to manage all aspects of program

development from the more complex, such as research or educational design, to the more logistical such as transportation and housing. MiTie’s “one-stop-shopping”

model makes it easy for users to host events.



Unprecedented growth has enabled MITIE to achieve significant milestones over the last year. Here we share key accomplishments in Technology, Innovation, and Education.

Technology

Measuring technical expertise

in an ideal world, when a surgeon comes to Mitie to learn a new procedure he or she would leave with

a valid measure of competence that would reassure patients and credentialing bodies of readiness to

perform real cases. Yet, the current methods of measuring competence take years to develop for each

individual operation and require teams of researchers to validate. Dr. Barbara Bass, chair of Methodist’s

Department of surgery, and Dr. ioannis pavlidis, a computer scientist from the university of houston,

have teamed up to create a better method of measuring procedural competence using thermal imaging.

a special camera is focused on a surgeon’s face while performing a surgical procedure and quantitatively

measures the surgeon’s level of stress. the scientists have proved that stress correlates with performance;

less skilled surgeons exhibit more stress than experts. By measuring a surgeon’s reaction to performing

a procedure rather than measuring the procedure itself, Dr. Bass and Dr. pavlidis have discovered a new

method of measuring procedural competence that can be rapidly adapted to any procedure. this novel

work was published in the journal Scientific Reports, a primary research publication from the publishers of

Nature.

MITIE serves as a core facility for state-of-the-art work in less invasive and more accurate surgical procedures.

since its inception, researchers from the Methodist hospital system, the texas Medical center,

the university of houston and rice university have used the sophisticated surgical and simulation

environments in Mitie to foster their work. While impossible to list every project, examples are provided

within three key areas:


Scientists can point a special camera at a surgeon’s face while he or she is performing a procedure and quantitatively measure their level of stress.

SuPPorTing SurgeonS during THeir

FirST ProcedureS

even with advanced training, most surgeons welcome expert

guidance when first performing a new procedure on a patient.

ideally, an expert would guide a novice surgeon during his first

cases in the or at his own hospital -- an arrangement that, today, is

difficult to support.

A lack of mentorship while learning a new procedure is a significant

barrier to successful adoption into practice. To address this, MiTie

researchers have developed technology that allows practicing

surgeons to communicate wirelessly with MiTie experts. After a

surgeon completes training, he or she returns to a home hospital

with a suitcase-sized telementoring platform. inside the suitcase is

a computer, backpack and headset with a microphone and high-

definition camera. during a procedure, the surgeon switches on the

computer and wears the backpack and headset. At MiTie, an expert

surgeon working on a laptop computer communicates with the

novice surgeon over the internet, sees what the surgeon sees, and

guides him or her through the new surgical procedure.

dr. brian dunkin has been awarded a grant from the department

of defense to support the development of this “wearable”

telementoring technology. Working in MiTie, dr. dunkin has

developed the mobile platform and tested it on multiple surgeons

proving that he can effectively help them safely adopt a new surgical

procedure, with expert guidance over distance.

ProcedurAL

A sophisticated research environment allows MiTie scientists to develop and rehearse new

procedures on simulators rather than real patients. once perfected, the procedure then

can be performed safely on patients.

For example, dr. gerald Lawrie, a Methodist cardiovascular surgeon, sought to perform

robotically assisted mitral valve repair surgery for his patients. He had traveled the

world and watched the handful of surgeons performing the procedure and had ideas on

improving it. dr. Lawrie and his operating room team came to MiTie and perfected his

approach using the same robot he has in the operating room and a simulated open-heart

surgery model. He and his team practiced the technique, measuring simulated pump

times -- the time required for the patient to be on a heart-lung machine to complete the

valve repair -- comparing them to his usual open procedures. When the team reached

a proficiency level that resulted in pump times close to open valve repair times, they

performed their first human case. Within months, dr. Lawrie successfully performed over

35 robotically assisted mitral valve repairs.

Work is currently underway to develop new procedures in other areas of cardiovascular

medicine as well as gastrointestinal, transplant, and hernia surgery.

InnovationModern medicine requires

collaboration among experts

in medicine and in the fields

of computer science, mathematics,

and engineering.

such collaboration, requires that these diverse groups speak a common language.

MITIE is leading this effort by creating a new scientific discipline called Computational

surgery, (www.computationalsurgery.org). Under the direction of dr. Marc Garbey,

and in collaboration with the University of houston, the University of Florida at

Gainesville, and two European institutions (the Ecole Nationale supérieure de Physique

de strasbourg and the Politecnico di Milano), a master’s degree program has been

developed, three international conferences held, two books published, and the Journal

of Computational surgery created. this exciting program is forging a way for scientists

and surgeons to collaborate to build the next generation of medical technology.

MitiE also is forming a collaborative platform between industry and academia to foster

the development of novel medical technologies. MitiE, the University of houston,

and the University of Florida at Gainesville, in collaboration with key industry partners,

are working to create the first National Science Foundation Industry and University

Cooperative Research Center, (I/UCRC), focused on creating a computer infrastructure

in the operating room that will optimize performance and lead to improved patient

outcomes. a planning grant meeting was held with the NsF reviewers in the spring and

approval of the Center is expected by the first quarter of 2013.

as an international leader in education and research, MitiE is a consultant institution

helping develop national simulation centers in the United arab Emirates and the

Kingdom of saudi arabia. surgical training programs have already been piloted at King

Fahad Medical City in riyadh where saudi arabian surgeons enhance their mastery of

minimally invasive surgery.


COMPUTATIONAL SURGERYnew scientific discipline

Developing cutting-edge medical devices is an interactive process between industry and medicine. MITIE serves as a platform for joining these partners.

6,400

15,000

26

L E A R N E R Sin 2 0 1 2

L E A R N E R Ssince inception

S P E C I A L T I E Sfrom across the world

EducationMITIE has become the busiest procedural education Institute in the world with more than 6,400 medical professionals coming through our doors in 2012 and more than 15,000 since inception. Our learners cross 26 specialties and hail from all over the globe.

more than

more than

TRAINEE GROWTH

0

1000

2000

3000

4000

5000

6000

7000

8000

2006 2007 2008 2009 2010 2011 2012

6403

4447

2514989

886

471

38


sPONsOrEd MEEtiNGs

MitiE has hosted multiple state and national meetings for

the american College of surgeons, the society of american

Gastrointestinal and Endoscopic surgeons, the society for

robotic surgery, the Computational surgery international

Network, and the texas association of surgical skills

Laboratories.

tExas MEdiCaL CENtEr PrOGraMs

MitiE is a core resource for education and

research benefitting Texas Medical Center

institutions. the University of texas Md

anderson Cancer Center conducts an

annual “boot camp” for incoming surgical

fellows to quickly get them up to speed

with new technology and techniques that

they will use in patient care. Methodist’s

department of Medicine conducts

a similar boot camp for its incoming

residents and fellows. in 2012, more

than 100 Md anderson fellows and 40

Methodist internal medicine residents and

fellows perfomed hands-on training in

MitiE during two-day training courses.

thE dEbaKEy iNstitUtE FOr

CardiOVasCULar EdUCatiON aNd

traiNiNG (diCEt)

the debakey institute for Cardiovascular

Education and training (diCEt), the

educational arm of the heart center,

is a first-of-its-kind institute for

comprehensive training in cardiovascular

disease. the didactic college offers

practical instruction, while the skills

academy provides procedural simulations

using a team approach. diCEt provides

training for cardiovascular professionals

at every stage of their medical career,

collaborating with MitiE for hands-on

training activities. to learn more, visit

debakeyheartcenter.com.

COURSE GROWTH

0

200

400

600

800

1000

2006 2007 2008 2009 2010 2011 201280

5

730

578

441

301

256

38

T O T A L L E A R N E R S B Y S P E C I A L T Yin 2 0 1 2

T O T A L C O U R S E S B Y S P E C I A L T Yin 2 0 1 2

1% Plastics

1% Pulmonary

1% Quality2% Anesthesiology

14% Cardiovascular

4% Emergency medicine

27% General surgery

5% Medicine

8% Multi-disciplinary

1% Neurology

16% Nursing

6% Obstetrics

Gynecology

16% Orthopedic

1% Quality 1%

Urology

19% Anesthesiology

6% Cardiovascular

1% Emergency Medicine

22% General Surgery

7% Medicine

2% Multi-Disciplinary

8% Nursing

20% OB/GYN

6% Orthopedic

6% Plastics

TOTAL LEARNERS BY TYPE in 2012

LEARNER TYPE NUMBER OF LEARNERS %

Physician 2097 32.75%

Nurse 1102 17.21%

Resident 915 14.29%

Fellow 820 12.81%

Industry 449 7.01%

Medical Student 359 5.61%

Multi-disciplinary 215 3.36%

EMT 211 3.30%

Anesthesia Assistant 68 1.06%

Respiratory Therapist 62 0.97%

Physical Therapist 41 0.64%

Physician Assistant 35 0.55%

Other 29 0.45%

Grand Total 6403 100.00%


Looking AheadMITIE continues to grow and innovate in unprecedented ways. In December 2012 MITIE “broke ground” on a combined suite of MRI and Hybrid radiology operating rooms exclusively dedicated to education and research.

This first in the world program brings key

industry partners together to create an

operating environment where both magnetic

resonance and three dimensional robotically

guided x-ray imaging can be used during

a surgical procedure to perform operations

with improved safety and accuracy. this suite

will come on-line in MitiE in 2013 – in time to

partner with Memorial hermann hospital to

host the first national conference on Trauma

hybrid Operating rooms (thOr).

Houston Endowment

through a generous grant from the

houston Endowment, MitiE will host a

national conference entitled “40 years of

clinical practice? Ensuring a lifetime of high

quality surgical performance: incentives,

pressures, technology.”

The conference will focus on three issues: 1 a marked variation in outcomes across the

U.s. for both established procedures and

surgical innovations.

2 Pressures and incentives placed on

surgeons and hospitals to improve

patient outcomes.

3 Learning opportunities and policies that are

needed for practicing surgeons to update

skills and use new technology.

Leaders from all stakeholders in delivering

high quality surgical care will come together

during this conference to map the way

forward in supporting continuing education

and training throughout a surgeon’s career.

MRI-Hybrid Suite construction MRI-Hybrid Suite construction

thE MEthOdist hOsPitaL bOard OF dirECtOrs

Ewing Werlein, Jr.Chairperson

John F. BookoutSenior Chair

Marc L. Boom, M.D.President & CEO

David M. UnderwoodVice Chair

Gregory V. NelsonSecretary

Robert K. Moses, Jr.Assistant Secretary

Carlton E. BaucumTreasurer

Joseph C. “Rusty” Walter IIIAssistant Treasurer

Morrie K. Abramson

Emily A. Crosswell

Mary A. Daffin

Connie Dyer

Gary W. Edwards

Eric J. Haufrect, M.D.President of the Medical Staff

Mark A. Houser

Bishop Janice Riggle Huie

Lawrence W. Kellner

Rev. Kenneth R. Levingston


MEthOdist EdUCatiONaL PartNErsMITIE partners with educational groups within The Methodist Hospital System to provide a hands-on training venue for their professional education.

The DeBakey Institute for Cardiovascular Education and Training (DICET)The educational activities of the Methodist DeBakey Heart and Vascular Center are housed within DICET, which promotes training and education for cardiovascular professionals during all phases of their careers. Established in 2010 through a generous gift from the DeBakey Medical Foundation, DICET incorporates a didactic college, skills academy, public education, and an educational forum. DICET collaborates with MITIE for hands-on learning. To learn more about DICET, visit debakeyheartcenter.com/education.

The Methodist Hospital Department of NursingAs a Magnet® designated institution and one of America’s leading health care facilities, Methodist Nursing is committed to achieving national prominence in clinical practice, education and research by advancing the art and science of nursing worldwide.

Methodist Nursing conducts hands-on training in MITIE as part of their ongoing educational programs.• Nurse Residency Program: Often a nurse graduate is thrust

into clinical care situations with little or no quantifiable

background. This program has been established to assist with this transition. Through formal and clinical instruction, the Nurse Residency Program focuses not only on strengthening proficiency, but also on ensuring the nurse’s role in improved patient safety and patient outcomes. All new graduate nurses at Methodist must participate in the Nurse Residency Program and experienced nurses transitioning into specialty areas are strongly encouraged as well. Each program is individualized based on the specialty area and specific learning needs. Nurse residents are paired with a formally trained clinical preceptor and meet weekly to ensure that milestones are met. Throughout the program, multiple topics are covered in a classroom setting and traditional learning experiences are supplemented by high fidelity simulation experiences in MITIE to improve teamwork, communication, decision making and situational awareness.

• The Methodist Advancement into Professional Practice Program (MAPP): This salaried program is offered to baccalaureate nursing students to enhance their learning and understanding of their chosen profession through a practical internship. Nurses in the program experience hands-on training while working along side lead Registered Nurses in direct patient care. This training is supplemented with skills practice in MITIE.

To learn more about Methodist nursing opportunities, visit methodisthealth.com/nursing.

Vidal G. Martinez

Dr. Thomas J. Pace, III

Keith O. Reeves, M.D.

C. Richard Stasney, M.D.Advisory, President-Elect of the Medical Staff

Elizabeth Blanton Wareing

Dr. Stephen Wende

Rev. B.T. WilliamsonAdvisory

Sandra Gayle Wright, RN, Ed.D.

Life Members

Jack S. Blanton

Ernest H. Cockrell

James C. Dishman

Charles W. Duncan, Jr.

Isaac H. Kempner, III

Nat S. Rogers

thE MEthOdist hOsPitaL bOard OF dirECtOrs

Ewing Werlein, Jr.Chairperson

John F. BookoutSenior Chair

Marc L. Boom, M.D.President & CEO

David M. UnderwoodVice Chair

Gregory V. NelsonSecretary

Robert K. Moses, Jr.Assistant Secretary

Carlton E. BaucumTreasurer

Joseph C. “Rusty” Walter IIIAssistant Treasurer

Morrie K. Abramson

Emily A. Crosswell

Mary A. Daffin

Connie Dyer

Gary W. Edwards

Eric J. Haufrect, M.D.President of the Medical Staff

Mark A. Houser

Bishop Janice Riggle Huie

Lawrence W. Kellner

Rev. Kenneth R. Levingston


MEthOdist EdUCatiONaL PartNErsMITIE partners with educational groups within The Methodist Hospital System to provide a hands-on training venue for their professional education.

The DeBakey Institute for Cardiovascular Education and Training (DICET)The educational activities of the Methodist DeBakey Heart and Vascular Center are housed within DICET, which promotes training and education for cardiovascular professionals during all phases of their careers. Established in 2010 through a generous gift from the DeBakey Medical Foundation, DICET incorporates a didactic college, skills academy, public education, and an educational forum. DICET collaborates with MITIE for hands-on learning. To learn more about DICET, visit debakeyheartcenter.com/education.

The Methodist Hospital Department of NursingAs a Magnet® designated institution and one of America’s leading health care facilities, Methodist Nursing is committed to achieving national prominence in clinical practice, education and research by advancing the art and science of nursing worldwide.

Methodist Nursing conducts hands-on training in MITIE as part of their ongoing educational programs.• Nurse Residency Program: Often a nurse graduate is thrust

into clinical care situations with little or no quantifiable

background. This program has been established to assist with this transition. Through formal and clinical instruction, the Nurse Residency Program focuses not only on strengthening proficiency, but also on ensuring the nurse’s role in improved patient safety and patient outcomes. All new graduate nurses at Methodist must participate in the Nurse Residency Program and experienced nurses transitioning into specialty areas are strongly encouraged as well. Each program is individualized based on the specialty area and specific learning needs. Nurse residents are paired with a formally trained clinical preceptor and meet weekly to ensure that milestones are met. Throughout the program, multiple topics are covered in a classroom setting and traditional learning experiences are supplemented by high fidelity simulation experiences in MITIE to improve teamwork, communication, decision making and situational awareness.

• The Methodist Advancement into Professional Practice Program (MAPP): This salaried program is offered to baccalaureate nursing students to enhance their learning and understanding of their chosen profession through a practical internship. Nurses in the program experience hands-on training while working along side lead Registered Nurses in direct patient care. This training is supplemented with skills practice in MITIE.

To learn more about Methodist nursing opportunities, visit methodisthealth.com/nursing.

Vidal G. Martinez

Dr. Thomas J. Pace, III

Keith O. Reeves, M.D.

C. Richard Stasney, M.D.Advisory, President-Elect of the Medical Staff

Elizabeth Blanton Wareing

Dr. Stephen Wende

Rev. B.T. WilliamsonAdvisory

Sandra Gayle Wright, RN, Ed.D.

Life Members

Jack S. Blanton

Ernest H. Cockrell

James C. Dishman

Charles W. Duncan, Jr.

Isaac H. Kempner, III

Nat S. Rogers

1 2 3 1 4 5 6 7 8 9

1 Administration

2 Brief/Debrief Rooms

3 Principal Investigator Offices

4 Reception

5 Breakout Area

6 Coffee Bar

7 Virtual Surgical Amphitheatre

8 Locker Rooms

9 Board Room

10 MRI-Guided Operating Suite

11 Fifteen Procedural Training Stations

12 Collaboration Area

13 Research Scientist’s Office

14 CT Scan-Guided Operating Room

15 Confidential Research Suite

16 Surgical Robotic Suite

17 Simulation Suites

18 Partial Task Training Suites

18 17 16 15 14 13 12 11 10

1231456789

1 Administration

2 Brief/Debrief Rooms

3 Principal Investigator Offices

4 Reception

5 Breakout Area

6 Coffee Bar

7 Virtual Surgical Amphitheatre

8 Locker Rooms

9 Board Room

10 MRI-Guided Operating Suite

11 Fifteen Procedural Training Stations

12 Collaboration Area

13 Research Scientist’s Office

14 CT Scan-Guided Operating Room

15 Confidential Research Suite

16 Surgical Robotic Suite

17 Simulation Suites

18 Partial Task Training Suites

181716151413121110

01 LEADERSHIp MESSAGE

02 ABOUT MITIE Mission and history

06 TIMELINE Developing a world-class Institute

08 DESIGN FOCUS Housing all essential elements for training and research under one roof

12 TECHNOLOGY AND RESEARCH Serving as a platform for advancing medical technology

14 INNOVATION Collaborating with leading institutions and scientists

16 EDUCATION Training more practicing health care professionals than any

other institution

19 MOVING FORwARD Expanding medicine as the world knows it

ACADEMIC pArTnErSThe University of Houston Department of Computer ScienceThe Department of Computer Science at the University of Houston was founded in 1967 and is one of the first established in the country. It is among the top 50 in the U.S. according to the 2011 Academic Ranking of World Universities. Dr. Marc Garbey has a joint appointment with Methodist’s Department of Surgery and has led a series of collaborations in education and research. These range from establishing a new discipline of computational surgery to developing image recognition technology to track operative tools real-time during surgery. This collaborative work is described in the Technology / Research section of this report. Learn more by visiting computationalsurgery.org.

Rice University Department of Mechanical Engineering and Materials ScienceThe Mechanical Engineering Department was founded in 1913, one year after the university opened. In 1962 the department was renamed the Department of Mechanical Engineering and Materials Science (MEMS). MEMS faculty specialize in a wide number of areas including biomechanics, materials, heat transfer, and computational fluid dynamics, control systems/robotics, mechanics, C.A.D., aero/astronautics, and applied mathematics. MITIE research teams have partnered with Marsha O’Malley, Ph.D. from MEMS to develop validated measures of procedural competence in robotic and endovascular surgery. Learn more about MEMS by visiting memsweb.rice.edu.

InDuSTry pArTnErSBehind every new surgical device developedto improve patient care is a multidisciplinarycollaboration among medical professionals,research scientists, and the medical deviceindustry. MITIE’s success is not only a resultof the innovative spirit within the organization,but also of the technology and supportprovided by our industry partners. Some ofthe industry leaders whose support has helpedMITIE to thrive include:

Boston Scientific EndoscopyBoston Scientific Endoscopy seeks to be a global leader in the development of innovative medical technologies used to diagnose, palliate, and treat a variety of digestive diseases. The long-standing commitment of Boston Scientific Endoscopy to advance the field of endoscopy is reflected in a broad spectrum of diagnostic and therapeutic devices for disease states throughout the GI tract. Boston Scientific Endoscopy has committed to be one of three founding partners in the development of a National Science Foundation funded collaborative industry-academic center that will utilize MITIE as an experimental platform for developing novel technology in the areas of surgery, gastroenterology, and education.

CovidienCovidien is a global healthcare products leader dedicated to creating innovative medical solutions for better patient outcomes. Covidien pioneered endomechanical devices for minimally invasive surgery and is a world leader in energy platforms and soft tissue repair products. Covidien was an inaugural education partner with MITIE and has fostered the development of multiple educational events benefiting thousands of practicing health care professionals.

Image Stream Medical Inc.Image Stream Medical provides products targeted at minimally invasive surgery image management. Over the last decade ISM has developed the most advanced network-based image management and virtual collaboration solutions to share medical video throughout hospitals. Image Stream has been a key partner in developing the audio-video integration platform in MITIE which allows real time, high definition linkage to all procedural environments in Methodist. Image Stream also collaborates with MITIE on research projects to develop wearable technology for surgeon-to-surgeon proctoring in the OR.

Karl Storz EndoskopeSince its founding in 1945, Karl Storz Endoskope has established itself as a highly regarded international company that produces medical instruments and devices. The company has developed a comprehensive and extremely sophisticated range of endoscopes and instruments for the fields of internal medicine, general surgery, urology, gynecology and pediatric surgery. Storz was an inaugural partner with MITIE, and the first industrial collaborator to support and dedicate resources to the Institute. MITIE and Storz collaborate on a broad range of educational and research initiatives.

OlympusOlympus is an international company focused on improving people’s lives through innovation. As a precision technology leader, Olympus designs solutions in medical and surgical products. Olympus has particular expertise in flexible gastrointestinal endoscopy and has partnered with MITIE to advance the field of endolumenal surgery – a new method of performing surgical procedures from inside the GI tract to avoid pain and scars.

SiemensSiemens is a world leader in providing health care products for image-guided procedures. The company has particular expertise creating advanced operating rooms that combine the imaging capabilities of a radiology department with state-of-the-art surgical devices. The combination allows surgeons to perform more accurate and less invasive procedures. Siemens has partnered with MITIE to develop two experimental operating rooms – an MRI-capable operating suite, and a “hybrid” operating room that includes advanced, robotically guided X-ray imaging. These combined imaging operating rooms bring to MITIE advanced image-guided capability beyond that of any other Institute. SterisSteris Healthcare provides operating room surgical equipment and sterile processing equipment. It has partnered with MITIE to innovate technologies around operative booms and lights for efficient procedural environments.

Houston, Texas

M E T H O D I S T I N S T I T U T E F O R T E C H N O L O G Y , I N N O V A T I O N & E D U C A T I O N

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MITIE | The Methodist Hospital6670 Bertner Avenue, 5th Floor

Houston, Texas 770301-888-MITIE-TXmitietexas.com

Ar-SUnSet2-AA0113

Documents

Houston Methodist MITIE Annual Report 2012