Resident-led innovation
By Sam Marie Engle
Hanssen Li, John Moon, Maxwell Cooper, Josh Brown, Kenneth Shiao, and Christian Gomez are wave-makers. Change agents. Young doctors turning good ideas into game-changing approaches to clinical care and residency training.
They’re also first-year residents: Drs. Gomez, Cooper, Shiao, and Brown are diagnostic radiology residents and Drs. Moon and Li are interventional radiology – integrated residents. First-year residents who are following an Emory Radiology tradition of resident-led innovation with their research and teaching projects.
Hanssen Li, John Moon, Maxwell Cooper, Josh Brown, Kenneth Shiao, and Christian Gomez are wave-makers. Change agents. Young doctors turning good ideas into game-changing approaches to clinical care and residency training.
They’re also first-year residents: Drs. Gomez, Cooper, Shiao, and Brown are diagnostic radiology residents and Drs. Moon and Li are interventional radiology – integrated residents. First-year residents who are following an Emory Radiology tradition of resident-led innovation with their research and teaching projects.
adopt-a-resident radar
Hassen Li, MD, is part of the Integrated Imaging Informatics Track (I3T), the brainchild of then-resident and now assistant professor Patricia Balthazar, MD. The track requires participating residents to develop an informatics-based project that improves either clinical care or resident training. Dr. Li is aiming for the latter with his proposed Radiology Analytics Dashboard for Residents (RADAR).
Dr. Li envisions RADAR as a secure, customizable, and open-source system providing residents with real-time, data-driven feedback from their on-call experiences and routine daily clinical rotations.
“Residents may receive subjective feedback about their performance throughout their rotations, but without objective data such as reading speed, accuracy, volume, and the like, especially in comparison to their peers, residents do not actually know how well they are doing or if they are behind until recourse is needed,” Dr. Li explains. “RADAR will correct this so residents can continually monitor their performance and see where they might need to improve.”
RADAR also will provide residency leaders – program directors, program coordinators, and chief residents – with an administrative component to spot trends that might suggest need for additional training in certain areas, as well as provide the information needed for semi-annual resident reviews.
The idea is so good, Dr. Li secured the 2022 Adopt-A-Resident grant from Emory Radiology. The Adopt-A-Resident program, now in its 15th year, provides a resident or resident team with a $10,000 grant to purchase equipment and supplies needed to implement their project. Faculty mentors provide guidance throughout the project and provide access to additional department resources such as workspace as needed.
With an undergraduate degree in computational biology and work experience as a full-stack programmer and data analyst developing web applications for surgeon/radiologist feedback, Dr. Li brings an impressive range of computer skills to the work. He also brings big plans for his career.
“This award is extremely valuable for my career plans to be at the intersection of radiology and informatics,” he says. “It allows me to utilize my computer science skillsets in the field of radiology and jumpstart my career in developing analytics tools in aid of clinical practice. I want to start establishing myself as an innovator in the field of healthcare analytics software and an advocate for data-driven quality improvement initiatives.”
Dr. Li envisions RADAR as a secure, customizable, and open-source system providing residents with real-time, data-driven feedback from their on-call experiences and routine daily clinical rotations.
“Residents may receive subjective feedback about their performance throughout their rotations, but without objective data such as reading speed, accuracy, volume, and the like, especially in comparison to their peers, residents do not actually know how well they are doing or if they are behind until recourse is needed,” Dr. Li explains. “RADAR will correct this so residents can continually monitor their performance and see where they might need to improve.”
RADAR also will provide residency leaders – program directors, program coordinators, and chief residents – with an administrative component to spot trends that might suggest need for additional training in certain areas, as well as provide the information needed for semi-annual resident reviews.
The idea is so good, Dr. Li secured the 2022 Adopt-A-Resident grant from Emory Radiology. The Adopt-A-Resident program, now in its 15th year, provides a resident or resident team with a $10,000 grant to purchase equipment and supplies needed to implement their project. Faculty mentors provide guidance throughout the project and provide access to additional department resources such as workspace as needed.
With an undergraduate degree in computational biology and work experience as a full-stack programmer and data analyst developing web applications for surgeon/radiologist feedback, Dr. Li brings an impressive range of computer skills to the work. He also brings big plans for his career.
“This award is extremely valuable for my career plans to be at the intersection of radiology and informatics,” he says. “It allows me to utilize my computer science skillsets in the field of radiology and jumpstart my career in developing analytics tools in aid of clinical practice. I want to start establishing myself as an innovator in the field of healthcare analytics software and an advocate for data-driven quality improvement initiatives.”
novel catheter wows school of medicine grantmakers
Dr. John Moon
John T. Moon, MD, PhD, developed and patented an anti-occlusion catheter while in medical school. He just received a $250,000 two-year research pilot grant from the School of Medicine's Imagine, Innovate, Impact (I3) grants program to further refine the technology with his faculty mentor Zachary Bercu, MD, RPVI. Called Bioflow, the anti-occlusion drainage device is the kind of innovation the Resident Medical Innovation Track encourages and supports, which is why Dr. Moon is pursuing the track as part of his residency training.
"The Bioflow anti-occlusion catheter is something I conceived of and patented during medical school while caring for a cancer patient who had undergone multiple catheter exchanges over a week to due to catheter occlusions leading to catheter dysfunction. I am honored and thrilled to be supported in developing this novel technology, which will be a great help to patients," Dr. Moon says.
The Resident Medical Innovation Track is itself a resident-led innovation. Alex Dabrowiecki, MD, a 2018 Adopt-A-Resident grantee proposed and developed the track with the support of faculty mentors Dr. Bercu and Janice Newsome, MD, FSIR, director of the Division of Interventional Radiology. Dr. Bercu co-directs the track.
The I3 grants program is funded through the Georgia Clinical & Translational Science Alliance (CTSA). Launched in 2017 by Emory with funding from the National Center for Advancing Translational Sciences of the National Institutes of Health, the Georgia CTSA includes Georgia Tech, Morehouse School of Medicine, and the University of Georgia. The CTSA aims to accelerate clinical and translational education, research, and community engagement to positively impact health in Georgia and beyond.
"The Bioflow anti-occlusion catheter is something I conceived of and patented during medical school while caring for a cancer patient who had undergone multiple catheter exchanges over a week to due to catheter occlusions leading to catheter dysfunction. I am honored and thrilled to be supported in developing this novel technology, which will be a great help to patients," Dr. Moon says.
The Resident Medical Innovation Track is itself a resident-led innovation. Alex Dabrowiecki, MD, a 2018 Adopt-A-Resident grantee proposed and developed the track with the support of faculty mentors Dr. Bercu and Janice Newsome, MD, FSIR, director of the Division of Interventional Radiology. Dr. Bercu co-directs the track.
The I3 grants program is funded through the Georgia Clinical & Translational Science Alliance (CTSA). Launched in 2017 by Emory with funding from the National Center for Advancing Translational Sciences of the National Institutes of Health, the Georgia CTSA includes Georgia Tech, Morehouse School of Medicine, and the University of Georgia. The CTSA aims to accelerate clinical and translational education, research, and community engagement to positively impact health in Georgia and beyond.
RSNA Research Grant Supports ground-breaking epilepsy imaging study
Dr. Joshua Brown
Joshua Brown, MD, PhD, understands epilepsy is a devastating disease that can cause unprovoked and recurring seizures. It worries him that current imaging techniques are unable to identify the source of seizures in up to one-third of epilepsy patients and that limits treatment options.
He proposes using an advanced magnetic resonance imaging (MRI) technique called glutamate chemical exchange saturation transfer (GluCEST) imaging to improve evaluation of these epilepsy patients and guide successful surgical management. If successful, it will produce a major paradigm shift in epilepsy evaluation and improve the prognosis of a large medical-refractory epilepsy population.
"GluCEST imaging has demonstrated higher sensitivity and already has demonstrated promising results in epilepsy evaluation on 7T MRI scanners," explains Dr. Brown. "The use of GluCEST makes sense because glutamate levels in the brain are known to be higher in areas of the brain where seizure activity is happening."
The plan is to optimize the way 3T scanners capture and process GluCEST-enhanced images on a 3T MRI scanner using volunteers who are "healthy controls" and then assess epilepsy patients using the GluCEST-enhanced imaging protocol to see if it accurately detects the areas of the brain the team thinks are where seizure activity is taking place. Dr. Brown is guided by faculty mentors Ranliang (Ron) Hu, MD, assistant professor in the Division of Neuroradiology, and Phillip Zhe Sun, PhD, research professor and director of the Emory National Primate Research Center Imaging Center.
The project has enough scientific promise, the Radiological Society of North America (RSNA) has awarded Dr. Brown an RSNA Resident Research Grant to help fund the initial trial. Such grants are highly prized among radiology residents: they're intended to fund trainees who aren't professionally established and support their growth as researchers. Emory Radiology residents have received RSNA Research Grants nearly every year for the past decade.
"I am excited to receive this award because it allows me to advance my research momentum and physician-scientist training," says Brown, who is well on his way to a career in academic medicine. "I'm thankful for the faculty at Emory and the Radiology Research Track for providing the support and resources to make this possible."
He proposes using an advanced magnetic resonance imaging (MRI) technique called glutamate chemical exchange saturation transfer (GluCEST) imaging to improve evaluation of these epilepsy patients and guide successful surgical management. If successful, it will produce a major paradigm shift in epilepsy evaluation and improve the prognosis of a large medical-refractory epilepsy population.
"GluCEST imaging has demonstrated higher sensitivity and already has demonstrated promising results in epilepsy evaluation on 7T MRI scanners," explains Dr. Brown. "The use of GluCEST makes sense because glutamate levels in the brain are known to be higher in areas of the brain where seizure activity is happening."
The plan is to optimize the way 3T scanners capture and process GluCEST-enhanced images on a 3T MRI scanner using volunteers who are "healthy controls" and then assess epilepsy patients using the GluCEST-enhanced imaging protocol to see if it accurately detects the areas of the brain the team thinks are where seizure activity is taking place. Dr. Brown is guided by faculty mentors Ranliang (Ron) Hu, MD, assistant professor in the Division of Neuroradiology, and Phillip Zhe Sun, PhD, research professor and director of the Emory National Primate Research Center Imaging Center.
The project has enough scientific promise, the Radiological Society of North America (RSNA) has awarded Dr. Brown an RSNA Resident Research Grant to help fund the initial trial. Such grants are highly prized among radiology residents: they're intended to fund trainees who aren't professionally established and support their growth as researchers. Emory Radiology residents have received RSNA Research Grants nearly every year for the past decade.
"I am excited to receive this award because it allows me to advance my research momentum and physician-scientist training," says Brown, who is well on his way to a career in academic medicine. "I'm thankful for the faculty at Emory and the Radiology Research Track for providing the support and resources to make this possible."
the nexus of collaborative Research
Drs. Maxwell Cooper and John Moon
Fellow resident Maxwell Cooper, MD, is joining Dr. Moon and Dr. Bercu in investigating the feasibility of integrating nano-membrane sensors into arteriovenous endografts (AVGs) to wirelessly monitor hemodialysis access health. Drs. Moon and Cooper conceived the idea after noting how imprecise the existing diagnostic paradigm is for AVGs. Their proposed solution allows for continuous, wireless, and objective measures of AVG performance to detect and address complications before serious problems arise.
This remarkable solution—placing a tiny sensor within a graft that connects an artery and a vein for hemodialysis access—represents a significant clinical advancement and follows clinical trends toward increased digital health monitoring. The solution is possible thanks to Woon Hong Yeo, PhD, associate professor and Woodruff Faculty Fellow in the George W. Woodruff School of Mechanical Engineering of Georgia Tech. Dr. Yeo, who directs the Center for Human-Centric Interfaces, invented the sensor technology and is an enthusiastic co-PI on the project.
"Emory was my first-choice for residency for its excellence in clinical training and its culture of innovation, which is only enhanced by the collaborative relationships with Georgia-Tech,” Dr. Moon says. “This multi-disciplinary team and key partnership with Dr. Yeo at Georgia Tech highlights the intersection of healthcare and innovation."
The Nexus Research Awards program, also funded through the CTSA, provides seed money to fundamental biological and translational investigators who may not otherwise engage in multi- and interdisciplinary research. The goal is to take promising research projects to the level at which they can successfully compete for external funding. Nexus awards require collaboration: at least one team member must come from outside of the home department/division and bring a different discipline, expertise, or methodology to the project.
Rounding out the interdisciplinary team is School of Medicine colleague Victoria Teodorescu, MD, MBA, RVT, associate professor of surgery in the Division of Vascular Surgery and Endovascular Therapy, Department of Surgery.
This remarkable solution—placing a tiny sensor within a graft that connects an artery and a vein for hemodialysis access—represents a significant clinical advancement and follows clinical trends toward increased digital health monitoring. The solution is possible thanks to Woon Hong Yeo, PhD, associate professor and Woodruff Faculty Fellow in the George W. Woodruff School of Mechanical Engineering of Georgia Tech. Dr. Yeo, who directs the Center for Human-Centric Interfaces, invented the sensor technology and is an enthusiastic co-PI on the project.
"Emory was my first-choice for residency for its excellence in clinical training and its culture of innovation, which is only enhanced by the collaborative relationships with Georgia-Tech,” Dr. Moon says. “This multi-disciplinary team and key partnership with Dr. Yeo at Georgia Tech highlights the intersection of healthcare and innovation."
The Nexus Research Awards program, also funded through the CTSA, provides seed money to fundamental biological and translational investigators who may not otherwise engage in multi- and interdisciplinary research. The goal is to take promising research projects to the level at which they can successfully compete for external funding. Nexus awards require collaboration: at least one team member must come from outside of the home department/division and bring a different discipline, expertise, or methodology to the project.
Rounding out the interdisciplinary team is School of Medicine colleague Victoria Teodorescu, MD, MBA, RVT, associate professor of surgery in the Division of Vascular Surgery and Endovascular Therapy, Department of Surgery.
getting fit for teaching innovation
Dr. Moon has a third project underway, this time with colleagues Christian Gomez, MD, and Kenneth Shiao, MD. They're employing virtual reality technology to improve their training in performing image-guided procedures. The Emory University Center for Faculty Development and Excellence likes the idea so much, it awarded them a $5,000 Fund for Innovative Teaching (FIT) Grant to seed this pedagogical innovation.
“As residents, we came up with the idea of changing the traditional procedural paradigm of “see one, do one, teach one” by introducing a virtual reality-based curriculum to simulate hands-on learning before attempting to hone our skills in the clinical setting,” says Dr. Moon. “Using VR not only will increase trainee confidence when it comes time to work in the clinical setting, it can decrease potentially avoidable medical errors.”
“As residents, we came up with the idea of changing the traditional procedural paradigm of “see one, do one, teach one” by introducing a virtual reality-based curriculum to simulate hands-on learning before attempting to hone our skills in the clinical setting,” says Dr. Moon. “Using VR not only will increase trainee confidence when it comes time to work in the clinical setting, it can decrease potentially avoidable medical errors.”
Dr. Christian Gomez
FIT grants are open only to faculty, so the residents wrote a proposal and their faculty mentors Smyrna Tuburan, MD, assistant professor and pediatric radiologist, and Jay Shah, MD, assistant professor and pediatric interventional radiologist, submitted it.
The team plans to use the grant funds to develop and deliver a VR-based curriculum to augment their training in image-guided procedures. Enhancing resident training with VR makes sense in this era of COVID. “Using VR means training doesn’t have to be interrupted when cases spike,” says Dr. Gomez.
Dr. Gomez has a special interest in curricular innovation; he is pursuing the Clinical Educator Track of the Diagnostic Radiology Residency Program. Established by alumnus Dexter Mendoza, MD, as his 2015 Adopt-A-Resident project, the Clinical Educator Track provides training in pedagogy as well as teaching experience for residents like Dr. Gomez who aspire to careers in academic medicine. Track participants also must complete a capstone project, which this VR project may help fulfill.
“This project is exciting because we're developing a novel approach to teaching that benefits not just radiologists but also learners in other programs," Dr. Gomez says. "In fact, we're meeting with nursing faculty who are excited about adapting the technology to support their training.”
The team plans to use the grant funds to develop and deliver a VR-based curriculum to augment their training in image-guided procedures. Enhancing resident training with VR makes sense in this era of COVID. “Using VR means training doesn’t have to be interrupted when cases spike,” says Dr. Gomez.
Dr. Gomez has a special interest in curricular innovation; he is pursuing the Clinical Educator Track of the Diagnostic Radiology Residency Program. Established by alumnus Dexter Mendoza, MD, as his 2015 Adopt-A-Resident project, the Clinical Educator Track provides training in pedagogy as well as teaching experience for residents like Dr. Gomez who aspire to careers in academic medicine. Track participants also must complete a capstone project, which this VR project may help fulfill.
“This project is exciting because we're developing a novel approach to teaching that benefits not just radiologists but also learners in other programs," Dr. Gomez says. "In fact, we're meeting with nursing faculty who are excited about adapting the technology to support their training.”
Dr. Kenneth Shiao
Dr. Shiao, whose undergraduate degree is in biomedical engineering, is a strong advocate for integrating technology and medicine, especially given the limits on non-essential interactions with patients. "I truly believe that VR is the future of medical training. Unlike our interventional colleagues, as diagnostic residents, our time to hone procedural skills is much more limited; however, we are still expected to be proficient at several basic procedures. VR provides a relatively simple, yet elegant solution to this problem by allowing us to practice key procedures without having to lay hands on a patient. While certain aspects of training can only be learned in the operating room, working in a high fidelity virtual environment will help improve our skills and take us one step closer to the future of medical education."