Pamela Johnson, MD
Disclosures: Royalties or Patent Beneficiary-Under a license agreement between AgileMD and the Johns Hopkins University, Dr. Pamela Johnson and the University are entitled to royalty distributions related to the the AgileMD electronic prior authorization platform. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies - 09/22/2022
OMB No. 0925-0046, Biographical Sketch Format Page

OMB No. 0925-0001 and 0925-0002 (Rev. 09/17 Approved Through 03/31/2020)

BIOGRAPHICAL SKETCH

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NAME: Johnson, Pamela T

eRA COMMONS USER NAME (credential, e.g., agency login): pjohnso5

POSITION TITLE: Vice President of Care Transformation for Johns Hopkins Health System; Vice Chair of Quality and Safety in Radiology; Professor of Radiology, Oncology and Urology, Johns Hopkins Medicine

EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and residency training if applicable. Add/delete rows as necessary.)

INSTITUTION AND LOCATION

DEGREE

(if applicable)

 

Completion Date

MM/YYYY

 

FIELD OF STUDY

 

Harvard University, Cambridge, MA

BA

06/1987

Biology

Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA

MD

06/1991

 

Medicine

 

Presbyterian Hospital, University of Pennsylvania, Philadelphia, PA

Internship

06/1992

Internal Medicine

Johns Hopkins Hospital, Baltimore, MD

Residency

06/1997

 

Diagnostic Radiology

 

Thomas Jefferson University Hospital, Philadelphia, PA

CT/MRI/US Fellowship

06/1998

Radiology

 

 

A.              Personal Statement

My current professional focus is on physician-led optimization of health care delivery to increase care effectiveness, with the mission of better patient outcomes at a lower cost of care. In 2016, I was appointed by Dr. Redonda Miller (then VPMA and current president of Johns Hopkins Hospital) to co-direct the Johns Hopkins Health System High Value Care Committee. This committee designs, resources and advances initiatives to safely improve appropriate use of tests and treatments across 5 hospitals in our health system and Johns Hopkins Community Practice, through education, clinical decision support and provider feedback reports. This work was recognized with the 2017 Innovations in Clinical Care Award from Johns Hopkins Hospital and 2018 Excellence in Quality Improvement Teamwork Award from the Society of Hospital Medicine. Since FY17, our imaging and laboratory appropriateness improvement work has reduced charges to patients and payers by >$10 million. More recently we implemented system-wide evidence-based guidelines in the EMR to improve diagnostic and management decision making at the point of care, focused on CMS 8 priority areas (coronary artery disease, pulmonary embolism, headache, neck pain, back pain, shoulder pain, hip pain, and lung cancer). Our strategic plan for Johns Hopkins Medicine aims to improve health and care across the continuum for patients with CHF, CAD, COPD, diabetes, hypertension and other key conditions by leveraging our clinical experts and performance improvement resources.

In 2016, I co-founded the High Value Practice Academic Alliance (HVPAA) with the Vice Dean of Education, Roy Ziegelstein, MD with the mission of improving value on a national scale. The organization now includes >100 academic institutions representing 30 different medical specialties. At the core of the alliance is a national conference designed to broadly disseminate value-based performance improvement, entering its 4th year. AHRQ awarded HVPAA a 3-year conference grant in 2018. Beyond the conference, HVPAA faculty and trainees collaborate on value improvement guides, with 6 published in JAMA Internal Medicine. We direct professional development programs for trainees and junior faculty, and monthly conference calls serve as an ongoing information-sharing platform. HVPAA became a CMS Qualified Provider Led Entity in June 2018, approved to write Appropriate Use Criteria for their advanced imaging program.

Radiology quality and safety leads have a responsibility to refine practice in our own field by improving the appropriateness of imaging ordered by non-radiologists. To this end, in 2017 I created a national CME/MOC conference for ordering providers (“Order Wisely©”) sponsored by the Johns Hopkins University School of Medicine Office of Continuing Medical Education. The Order Wisely® program was selected for the Teaching Value Award in the 2018 Value Challenge, co-directed by Costs of Care and the ABIM Foundation. Additional relevant experience includes serving as the Chair of the American College of Radiology Choosing Wisely® Committee from 2016-present.

 

B.              Positions and Honors
 

Positions and Employment

1997 – 2000

Assistant Professor of Radiology, Thomas Jefferson Univ. Hospital, Philadelphia, PA

2001 – 2002

Assistant Professor of Radiology, Johns Hopkins Hospital, Baltimore, MD

2005 – 2009

Sr Research Assistant, Radiology, Johns Hopkins School of Medicine, Baltimore, MD

2009 – 2010

Fellow, Body CT, Department of Radiology, Johns Hopkins Hospital, Baltimore, MD

2010 – 2014

2014 to 2019

2014 to 2018

2016 to present

2017 to 2018

2018 to present

2018 to present

2019 to present

2019 to 2024

2020 to present

2020 to present

Assistant Professor, Body CT, Department of Radiology, Johns Hopkins Hospital,

Associate Professor of Radiology, Johns Hopkins Medicine

Diagnostic Radiology Residency Director, Johns Hopkins Hospital

Physician Lead, Johns Hopkins Health System High Value Care Committee

Vice Chair of Education, Johns Hopkins Department of Radiology

Vice Chair of Quality, Safety & Value, Department of Radiology, Johns Hopkins Hospital

Associate Professor of Urology and Oncology (joint appointments)

Professor of Radiology

Stanley Levenson Scholar, Center for Innovative Medicine, Johns Hopkins Medicine

Vice President of Care Transformation, Johns Hopkins Health System

Sheldon B. Bearman, MD, Professor of Radiology

 

Other Experience and Professional Memberships

Radiology Society of North America                                                                      1996 to present
American Roentgen Ray Society                                                                      1996 to present
American College of Radiology                                                                                    1997 to present

Chair, ACR Choosing Wisely® Committee                                                        2016 to present

Chair, ACR PE-RADS Committee                                                                      2018 to present

 

Editorial Boards

Radiology, Body CT Editorial Board, 2003 through 2006

 

Honors and Memberships

  1. AOA, 1990, Elected in Junior Year, Jefferson Medical College
  2. Outstanding Intern Award, 1992, Presbyterian Medical Center, Internal Medicine Internship
  3. Chief Resident, 1995-1996, Johns Hopkins Hospital, Radiology Residency
  4. Homar Branch Award for outstanding fellow, 1997, TJUH, Ultrasound/CT/MRI Fellowship
  5. Radiology Editor’s Award for Distinction in reviewing 1997, 1998, 1999, 2002, 2007
  6. First author or coauthor recipient of 15 RSNA or ARRS Education Exhibit Awards
  7. Aunt Minnie Award for Best Radiology Training Program, 2015
  8. Aunt Minnie Award for Most Effective Radiology Educator, 2016
  9. Johns Hopkins Hospital, Nominee for Best Consulting Physician, 2018
  10. Johns Hopkins Hospital, Innovations in Clinical Care Award (for high value care), 2017
  11. Society of Hospital Medicine, Excellence in Quality Improvement Teamwork Award, 2018
  12. Johns Hopkins Hospital, Nominee for Physician of the Year, 2018
  13. Costs of Care/ABIM Foundation Teaching Value Challenge awards for Order Wisely CME program and for the HVPAA Future Leaders Program, 2018
  14. Baltimore Magazine Top Doc, 2020

 


C.              Contributions to Science
 

1. Value-based Care Transformation

My scholarly activity is currently focused on engaging physicians in the performance improvement work necessary to transform healthcare from volume to value. In radiology, this requires appropriate exam selection, optimizing acquisition parameters and selecting the most efficacious post contrast acquisitions to maximize image quality and diagnostic efficacy while modulating radiation exposure.

a.   Rowe SP, Rowe KH, Hill P, Johnson PT. Challenges in quality improvement: appropriate utilization of computed tomography angiograms for evaluation of pulmonary embolism. Am J Med 2017; 130:652-656.

b.   Johnson PT, Pahwa AK, Feldman LS, Ziegelstein RC, Hellmann DB. Advancing high-value health care: a new AJM column dedicated to cost-conscious care quality improvement. Am J Med 2017; 130:619-621.

c.   Johnson PT, Alvin MD, Ziegelstein RC. Transitioning to a high value health care model: academic accountability. Acad Med. 2018; 90:850-855. Related editorial by Sklar D. Using evidence to change practice: From knowing the right thing to doing the right thing. Acad Med 2018; 93:813-815.

d.   Johnson PT, Bello JA, Chatfield MB, Flug JA, Pandharipande PV, Rohatgi S, Fishman EK, Megibow AJ. New ACR Choosing Wisely recommendations: judicious use of multiphase abdominal CT protocols. J Am Coll Radiol. 2019 Jan;16(1):56-60

e.      Adenaw N, Wen J, Pahwa AK, Sheth S, Johnson PT. Decreasing duplicative imaging: Inpatient and emergency medicine abdominal ultrasound within 72 hours of abdominal CT. J Am Coll Radiol. 2020; 17:590-596. Epub 2020 Apr 2.

f.                    Haj-Mirzaian A, Eng J, Khorasani R, Raja AS, Levin AS, Smith SE, Johnson PT, Demehri S. Use of Advanced Imaging for Radiographically Occult Hip Fracture in Elderly Patients: A Systematic Review and Meta-Analysis. Radiology 2020; 296:521-531. Epub 2020 Jul 7. 

g.                  Ellenbogen MI, Prichett L, Johnson PT, Brotman DJ. Development of a Simple Index to Measure Overuse of Diagnostic Testing at the Hospital Level Using Administrative Data. J Hosp Med. 2021 Feb;16(2):77-83. 

h.      England RW, Sheikhbahaei SS, Solomon AJ, Zadeh A, Solnes LB, Bronner J, Johnson PT. When more is better: Underused advanced imaging exams that can improve outcomes and reduce cost of care. Am J Med. 2021 Apr. Epud adhead of print

 

2. Body CT protocol design for vascular imaging

As advances in scanner technologies reduce acquisition times, contrast infusion and data acquisition protocols must be modified to ensure that scan timing is performed during peak vascular enhancement. This is an active area of research in our CT division, where we perform state of the art vascular imaging with 3D reconstructions, critical for defining management algorithms.

a.      Johnson PT, Christensen GM, Fishman EK. I.V. contrast administration with dual source 128-MDCT: a randomized controlled study comparing 18-gauge nonfenestrated and 20-gauge fenestrated catheters for catheter placement success, infusion rate, image quality, and complications. Am J Roentgenol 2014; 202:1166-1170.

b.      Malayeri AA, Zimmerman SL, Lake ST, Fishman EK, Johnson PT. 128-Slice dual source coronary CTA: defining optimal arterial enhancement levels. Emerg Radiol 2014; 21:499-504.

c.      Wadgaonkar AD, Black JH 3rd, Weihe EK, Zimmerman SL, Fishman EK, Johnson PT. Abdominal aortic aneurysms revisited: MDCT with multiplanar reconstructions for identifying indicators of instability in the pre- and postoperative patient. Radiographics 2015; 35:254-268.

d.      Jensen J, Lin T, Fishman EK, Johnson PT. Pulmonary CTA in sickle cell patients: quantitative assessment of enhancement quality. Emerg Radiol 2017; 24:667-674.

 

3. Body CT protocol design to optimize detection and characterization of abdominal pathology

Paramount to diagnostic efficacy in body CT is tailoring protocol design to the clinical indication. A body of literature provides guidance with respect to data acquisition and reconstruction parameters for different clinical indications. With each advance in CT hardware and software, protocols are refined to capitalize on the improved spatial and temporal resolution, a research interest of our division.

a.      Johnson PT, Horton KM, Kawamoto SK, Eng J, Bean MJ, Shan SJ, Fishman EK. MDCT for suspected appendicitis: effect of reconstruction section thickness on diagnostic accuracy, rate of appendiceal visualization and reader confidence levels using axial images. AJR 2009; 192:893-901.

b.      Johnson PT, Horton KM, Fishman EK. Adrenal imaging with multidetector CT: evidence-based protocol

c.      optimization and interpretative practice. Radiographics 2009; 29:1319-1331.

d.      Johnson PT, Horton KM, Fishman EK. Optimizing detectability of renal pathology with MDCT: protocols, pearls, and pitfalls. AJR 2010; 194:1001-1012.

e.      Johnson PT, Fishman EK. Routine use of precontrast and delayed acquisitions in abdominal CT: time for change. Abdom Imaging 2013; 38:215-23.

f.        Johnson PT, Mahesh M, Fishman EK. Image Wisely and Choosing Wisely: Importance of adult body CT protocol design for patient safety, exam quality, and diagnostic efficacy. J Am Coll Radiol 2015; 12:1185-1190.

 

4. Improving interpretative efficacy: disease characterization with MDCT

Enhancement patterns and morphologic features of cystic and solid lesions on CT have been shown to be valuable in discriminating different tumor types. Investigations from our institution, many of which are multidisciplinary, have focused on CT findings that aid in distinction and staging of disease processes.

a.      Pierorazio PM, Hyams ES, Tsai S, Feng Z, Trock BJ, Mullins JK, Johnson PT, Fishman EK, Allaf ME. Multiphasic enhancement patterns of small renal masses (≤4 cm) on preoperative computed tomography: Utility for distinguishing subtypes of renal cell carcinoma, angiomyolipoma, and oncocytoma. Urology 2013; 81:1265-1271.

b.      Northcutt BG, Raman S, Long CM, Oshymansky A, Siegelman SS, Fishman EK, Johnson PT. MDCT of adrenal masses: can dual-phase enhancement patterns be used to distinguish between adenoma and pheochromocytoma. Am J Roentgenol 2013; 201:834-839.

c.      Reese AC, Johnson PT, Gorin MA, et al. Pathological characteristics and radiographic correlates of complex renal cysts. Urol Oncol. 2014; 32:1010-1016. 

d.      Northcutt BG, Trakhtenbroit MA, Gomez EN, Fishman EK, Johnson PT. Adrenal adenoma and pheochromocytoma: comparison of multidetector CT venous enhancement levels and washout characteristics. J Comput Assist Tomogr. 2016 Mar-Apr;40(2):194-200.

e.      Jones BC, Lipson EJ, Childers B, Fishman EK, Johnson PT. State-of-the-Art diagnosis and treatment of melanoma: Optimal multidetector computed tomographic practice to identify metastatic disease and review of innovative therapeutic agents. J Comput Assist Tomogr. 2018; 42:331-339

 

5.              Post processing of body CT data

Post processing of CT datasets with 2D multiplanar reconstructions and 3D rendering have proven essential for many vascular and oncologic applications. Our division was at the forefront of developing and refining these techniques, which enable extraction of additional diagnostic information from a CT dataset beyond what can be interpreted using axial images alone.

a.      Fishman EK, Ney DR, Heath DG, Corl FM, Horton KM, Johnson PT. Volume rendering versus maximum intensity projection in CT angiography: what works best, when, and why. Radiographics 2006; 26:905-922.

b.      Chen JK, Johnson PT, Horton KM, Fishman EK. Unsuspected mesenteric arterial abnormality: comparison of MDCT axial sections to interactive 3D rendering. Am J Roentgenol 2007; 189:807-813.

c.      Ahmed S, Zimmerman SL, Johnson PT, Lai H, Kawamoto S, Horton KM, Fishman EK. MDCT interpretation of the ascending aorta with semiautomated measurement software: improved reproducibility compared with manual techniques. J Cardiovasc Comput Tomogr 2014; 8:108-114. 

d.      Johnson PT, Schneider R, Lugo-Fagundo C, Johnson MB, Fishman EK. MDCT angiography with 3D rendering: a novel cinematic rendering algorithm for enhanced anatomic detail. Am J Roentgenol 2017; 209:309-312.

e.      Johnson PT, Fishman EK. Enhancing image quality in the era of radiation dose reduction: postprocessing techniques for body CT. J Am Coll Radiol. 2018;15:486-488.

 

 

Complete list of published work in NLM My Biography:

https://www.ncbi.nlm.nih.gov/sites/myncbi/1TOL7XmdAjEAn/bibliography/47306615/public/?sort=date&direction=ascending.

 

 


D.              Additional Information: Research Support and/or Scholastic Performance

 

Current Support

External

2018-2021                                          Agency for Healthcare Research and Quality

                                          High Value Practice Academic Alliance National Conference

                                          Grant number: 1R13HS026350-01

                                          $150,000

                                          PI: Johnson PT; 5%

Internal                           

2020- present                                                                                                  Vice President of Care Transformation

                                                                                                                                            Johns Hopkins Health System

                                                                                                                                            20% support

 

2019-2024                                                                                                                Stanley Levenson Scholar to advance high value health care

                                                                                                                                            Center for Innovative Medicine

                                                                                                                                            $50,000/year x 5 years

 

2018-2021                                                                                                                Clinical Decision Support Algorithm Standardization

Johns Hopkins Health System Strategic Plan Executive Council

$641,000

Co-PIs: Johnson PT and Hill P; 0%

 

2017-present              Vice Chair of Quality and Safety

Department of Radiology, Johns Hopkins Medicine

20% support

 

 

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