Houston hospitals have been reported to have an excess of unnecessary health care tests and procedures. Photo by Dwight C. Andrews/Greater Houston Convention and Visitors Bureau

Houston boasts of being home to the Texas Medical Center, the world's biggest medical complex. Yet Houston's medical community also holds a distinction that's hardly boast-worthy: It's the worst major metro area in Texas for unnecessary health care tests and procedures.

A study released May 4 by the Lown Institute, a health care think tank, shows hospitals in the Houston area collectively fare worse than their counterparts in Dallas-Fort Worth, San Antonio, and Austin for overuse of tests and procedures that the institute says offer little to no benefit.

To come up with its ranking, the institute looked at Medicare data for more than 1 million tests and procedures performed at over 3,100 U.S. hospitals from 2016 to 2018. Among the overused tests and procedures identified in the study are hysterectomy for benign disease, placement of coronary stents for stable heart disease, and diagnostic tests like head imaging for fainting.

"Overuse in American hospitals is a pervasive problem that needs to be addressed," Dr. Vikas Saini, president of the Lown Institute, says in a news release. "Hospitals want to do better, and these objective measures of performance can help them move forward."

Hospitals in Texas ranked fourth worst among all the states for overuse of hospital tests and procedures, the institute says.

Among hospitals in the Houston area, Houston Methodist Sugar Land Hospital ranked worst for overuse of tests and procedures, preceded by Memorial Hermann Northeast Hospital in Humble, OakBend Medical Center in Richmond, Memorial Hermann Sugar Land Hospital, and St. Luke's Health - The Woodlands Hospital, the study says.

At the other end of the spectrum, Houston's Doctors Hospital Tidwell ranks first among Houston-area hospitals for avoiding overuse of tests and procedures, followed by the University of Texas Medical Branch at Galveston, Memorial Hermann-Texas Medical Center, Harris Health System, and HCA Houston Healthcare Clear Lake in Webster.

Estimates suggest that overuse of tests and procedures contributes $75.7 billion to $101.2 billion to wasted U.S. health care spending each year, according to a study published by the journal JAMA Open Health.

"Although clinicians are responsible for ordering tests and treatments, their practice patterns may be influenced by hospital policies and culture. Hospital-level interventions to reduce overuse exist, but to measure and compare their success, a hospital-level measure is required," the study says.

In 2017, a study appearing in the Journal of Hospital Medicine declared that overuse of medical services contributes to low-quality health care and high health care costs. It's estimated that 42 percent of Medicare patients, 15 percent of Medicaid patients, and 11 percent of traditionally insured patients are subjected to at least one overuse of medical services each year, according to an article published by the Journal of Health Affairs.

"We can leverage the circumstances created by the pandemic to advance our understanding of low-value care with the goal of better measurement, appreciation of its harms, and a deeper understanding of its drivers and determinants, so that interventions can be implemented," authors of the Journal of Health Affairs article wrote. "Low-value care harms patients; there has never been a better time to push toward eliminating hurtful practices."

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2 Houston space tech cos. celebrate major tech milestones

big wins

Two Houston aerospace companies — Intuitive Machines and Venus Aerospace — have reached testing milestones for equipment they’re developing.

Intuitive Machines recently completed the first round of “human in the loop” testing for its Moon RACER (Reusable Autonomous Crewed Exploration Rover) lunar terrain vehicle. The company conducted the test at NASA’s Johnson Space Center.

RACER is one of three lunar terrain vehicles being considered by NASA for the space agency’s Artemis initiative, which will send astronauts to the moon.

NASA says human-in-the-loop testing can reveal design flaws and technical problems, and can lead to cost-efficient improvements. In addition, it can elevate the design process from 2D to 3D modeling.

Intuitive Machines says the testing “proved invaluable.” NASA astronauts served as test subjects who provided feedback about the Moon RACER’s functionality.

The Moon RACER, featuring a rechargeable electric battery and a robotic arm, will be able to accommodate two astronauts and more than 880 pounds of cargo. It’s being designed to pull a trailer loaded with more than 1,760 pounds of cargo.

Another Houston company, Venus Aerospace, recently achieved ignition of its VDR2 rocket engine. The engine, being developed in tandem with Ohio-based Velontra — which aims to produce hypersonic planes — combines the functions of a rotating detonation rocket engine with those of a ramjet.

A rotating detonation rocket engine, which isn’t equipped with moving parts, rapidly burns fuel via a supersonic detonation wave, according to the Air Force Research Laboratory. In turn, the engine delivers high performance in a small volume, the lab says. This savings in volume can offer range, speed, and affordability benefits compared with ramjets, rockets, and gas turbines.

A ramjet is a type of “air breathing” jet engine that does not include a rotary engine, according to the SKYbrary electronic database. Instead, it uses the forward motion of the engine to compress incoming air.

A ramjet can’t function at zero airspeed, so it can’t power an aircraft during all phases of flight, according to SKYbrary. Therefore, it must be paired with another kind of propulsion, such as a rotating detonation rocket engine, to enable acceleration at a speed where the ramjet can produce thrust.

“With this successful test and ignition, Venus Aerospace has demonstrated the exceptional ability to start a [ramjet] at takeoff speed, which is revolutionary,” the company says.

Venus Aerospace plans further testing of its engine in 2025.

Venus Aerospace, recently achieved ignition of its VDR2 rocket engine. Photo courtesy of Venus Aerospace

METRO rolls out electric shuttles for downtown Houston commuters

on a roll

The innovative METRO microtransit program will be expanding to the downtown area, the Metropolitan Transit Authority of Harris County announced on Monday.

“Microtransit is a proven solution to get more people where they need to go safely and efficiently,” Houston Mayor John Whitmire said in a statement. “Connected communities are safer communities, and bringing microtransit to Houston builds on my promise for smart, fiscally-sound infrastructure growth.”

The program started in June 2023 when the city’s nonprofit Evolve Houston partnered with the for-profit Ryde company to offer free shuttle service to residents of Second and Third Ward. The shuttles are all-electric and take riders to bus stops, medical buildings, and grocery stores. Essentially, it works as a traditional ride-share service but focuses on multiple passengers in areas where bus access may involve hazards or other obstacles. Riders access the system through the Ride Circuit app.

So far, the microtransit system has made a positive impact in the wards according to METRO. This has led to the current expansion into the downtown area. The system is not designed to replace the standard bus service, but to help riders navigate to it through areas where bus service is more difficult.

“Integrating microtransit into METRO’s public transit system demonstrates a commitment to finding innovative solutions that meet our customers where they are,” said METRO Board Chair Elizabeth Gonzalez Brock. “This on-demand service provides a flexible, easier way to reach METRO buses and rail lines and will grow ridership by solving the first- and last-mile challenges that have hindered people’s ability to choose METRO.”

The City of Houston approved a renewal of the microtransit program in July, authorizing Evolve Houston to spend $1.3 million on it. Some, like council member Letitia Plummer, have questioned whether microtransit is really the future for METRO as the service cuts lines such as the University Corridor.

However, the microtransit system serves clear and longstanding needs in Houston. Getting to and from bus stops in the city with its long blocks, spread-out communities, and fickle pedestrian ways can be difficult, especially for poor or disabled riders. While the bus and rail work fine for longer distances, shorter ones can be underserved.

Even in places like downtown where stops are plentiful, movement between them can still involve walks of a mile or more, and may not serve for short trips.

“Our microtransit service is a game-changer for connecting people, and we are thrilled to launch it in downtown Houston,” said Evolve executive director Casey Brown. “The all-electric, on-demand service complements METRO’s existing fixed-route systems while offering a new solution for short trips. This launch marks an important milestone for our service, and we look forward to introducing additional zones in the new year — improving access to public transit and local destinations.”

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This article originally ran on CultureMap.