Guest column

New technology gives this Houston hospital a competitive edge

A new prostate cancer treatment at Houston Methodist is enhancing the system's patient care. Getty Images

As the top ranking hospital in Texas and one of the biggest employers in Houston, Houston Methodist Hospital is poised to treat the thousands of Texan men who will be diagnosed with prostate cancer this year.

Building on its legacy of delivering advanced cancer treatment, the healthcare giant is one of the first hospitals in the United States to offer men a benign approach to treating localized prostate cancer, using high intensity focused ultrasound, or HIFU. HIFU is a minimally invasive procedure that allows patients to maintain their quality of life with potentially fewer side effects.

Changing the standard of care

For decades, men diagnosed with prostate cancer have had three ways to manage their disease. The first is watchful waiting or active surveillance. Prostate cancer is often slow growing and may not impact the patient during his lifetime. Despite reassuring data in large randomized trials, some patients are still uncomfortable with a diagnosis of cancer and prefer treatment.

On the other end of the spectrum is the complete treatment of the prostate, which involves either surgically removing the entire organ (radical prostatectomy) or radiation, which can last up to eight weeks, with five rounds of treatment per week. Both treatments are known to cause long term erectile dysfunction and incontinence.

But for men diagnosed with localized prostate cancer, this new HIFU treatment bridges the gap between these three approaches. Unlike diagnostic ultrasound, which people are more familiar with, HIFU uses high-frequency sound waves to heat up and burn cancerous tissue, causing cell death. Think of holding a magnifying glass above a leaf on a sunny day. The sun's rays shine through the lens and cause the leaf to burn.

New and improved

Courtesy of Houston Methodist

With HIFU, the urologist destroys the cancerous tissue without damaging other surrounding structures, which include nerves, blood vessels and muscle tissue. While HIFU has only been able to treat the entire prostate or large areas, Houston Methodist has a new technology, called the Focal One, that can zero in on specific areas to treat. The doctor can draw precise contours around the diseased tissue, destroy only that portion of the prostate and minimize any damage to surrounding tissue. This further decreases the possibility of incontinence and erectile dysfunction.

A competitive edge

Focal One gives Houston Methodist Hospital urologists the ability to plum the depths of something until recently considered heresy. The possibility of focal therapy to ablate only the diseased portion of the prostate is similar to performing a lumpectomy to remove only the diseased tissue of the breast in breast cancer. And focal therapy still leaves doctors with the options of radical surgery or radiation, should the cancer return. They don't necessarily burn any bridges.

Although focal HIFU treatment is available around the world for localized prostate cancer and studies in Europe have demonstrated its safety and efficacy, there are no long term follow up data in the U.S. at this time. So far, treatment complication rates in HIFU have shown to be as good as or better than other therapies. But urologic surgeons in the US generally need 10 years of data to establish focal therapy as a standard treatment, which is why it is important for cancer centers that embrace HIFU to enroll patients in an ongoing registry trial.


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Brian Miles, M.D, is a practicing urologist and professor of urology at the Institute for Academic Medicine at Houston Methodist.

The new tech hub at Houston Methodist has trained hundreds of physicians in telemedicine practices. Natalie Harms/InnovationMap

Houston Methodist's recently opened its new Center for Innovation's Technology Hub in January, and the new wing has already been challenged by a global pandemic — one that's validating a real need for telemedicine.

The 3,500-square-foot tech testing ground was renovated from an 18-room patient wing and showcases new digital health technologies like virtual reality, ambient listening, wearables, voice control, and more. The hub was focused on giving tours to medical professionals and executives to get them excited about health tech, but in the middle of March, Josh Sol, administrative director of Innovation and Ambulatory Clinical Systems at Houston Methodist, says they saw a greater need for the space.

"We turned the technology hub into a training center where physicians could come on site and learn telemedicine," Sol says. "We had some foresight from our leadership who thought that telemedicine was going to be heavily utilized in order to protect our patients who might go into isolation based on the outbreak."

The hub has trained over 500 physicians — both onsite and digitally. Sol says that at the start of March, there were 66 providers offering virtual care, and by March 25, there were over 900 providers operating virtually. On March 12, Houston Methodist had 167 virtual visits, Sol says, and on March 25, they had 2,421. This new 2,000-plus number is now the daily average.

"Telemedicine is here to stay now with the rapid adoption that just happened," Sol says. "The landscape will change tremendously."

Another way new technology has affected doctors' day-to-day work has been through tele-rounding — especially when it comes to interacting with patients with COVID-19.

"We are putting iPads in those rooms with Vidyo as the video application, and our physicians can tele-visit into that room," Sol says.

It's all hands on deck for the tech hub so that physicians who need support have someone to turn to. Sol says the hub used to have a two-person support team and now there are eight people in that role.

Sol says the iPads are a key technology for tele-rounding and patient care — and they are working with Apple directly to secure inventory. But other tech tools, like an artificial intelligence-backed phone system, an online symptom checker, and chatbots are key to engaging with patients.

"We're looking at how we can get our patients in the right place at the right time," Sol says. "It's very confusing right now. We're hoping we can streamline that for our patients."

The hub was designed so that in case of emergency, the display hospital rooms could be transitioned to patient care rooms. Sol says that would be a call made by Roberta Schwartz, executive vice president and chief innovation officer of Houston Methodist Hospital.