Spotlight On: Esmaeil Porsa, President & CEO, Harris Health System
May 2024 — In an interview with Invest:, Esmaeil Porsa, president and CEO of Harris Health System, provided insights into the impactful initiatives enabled by a $2.5 billion bond, designed to substantially enhance healthcare services. He emphasized the role of innovative technologies and programs like Harris Health’s Food Farmacies in tackling health disparities.
What improvements or other initiatives are planned with the $2.5 billion bond approved for the Harris Health System?
The $2.5 billion bond referendum, approved by nearly 73% of Harris County voters, marks the first time in our history that we sought and received voter approval for such funding. This referendum will fund significant projects, including the creation of a new, Level I capable trauma hospital on the LBJ campus with twice the capacity of the current facility — about 400 beds, expandable to 450. We’re also reimagining the existing LBJ hospital building to convert it to needed inpatient and outpatient behavioral health services, among other improvements. Furthermore, we plan to expand our Level 1 trauma center in the Texas Medical Center by approximately 120 beds and invest half a billion dollars in community clinics, including three new ones and enhancing the capabilities of existing facilities. This entire project is expected to span 10 to 12 years.
How will the new community clinics address healthcare disparities?
Our master facilities plan, aligned with our five-year strategic plan approved in 2021, aims to transition toward a more community-based organization. This includes addressing social determinants of health and enhancing community engagement. We identified three key areas lacking healthcare services: northwest, southwest, and east Harris County, which also house a significant portion of socioeconomically disadvantaged populations. Our focus will be on establishing new clinics in these areas. Additionally, we’re addressing the need for upkeep and expansion of existing clinics, some over 50 years old. Our goal is not just to treat diseases but to become a health hub addressing broader health determinants, including food insecurity, housing, employment, and transportation issues.
How are you integrating technological advancements into the system’s operations and patient care?
A prime example of integrating technology is our rapid expansion of virtual care services. In March 2020, we had only four instances of virtual care. By last year, that number had soared to half a million virtual care encounters. The necessity brought by COVID-19 accelerated our adoption of technologies to meet changing societal needs. Moreover, Texas has the highest number of uninsured residents, with Harris County being the highest in Texas. To address this and future needs, we’ve embraced innovations like virtual care and other initiatives.
What are the innovative programs you have implemented to address health disparities?
One innovative approach to addressing health disparities is the creation of a community farm operated on one of our campuses, a unique feature for a health system. Additionally, our food farmacy program, currently in three clinics, is particularly exciting. By the end of this year, six clinics will offer this program. It involves screening patients for food insecurity and providing those in need with prescriptions for fresh fruits and vegetables. Patients receive 30 pounds of produce every two weeks for six months, along with dietary advice tailored to their chronic health conditions. This program not only addresses immediate food insecurity but also connects patients with longer-term resources, showcasing our commitment to holistic healthcare.
How is the Harris Health System preparing to meet the future demand of healthcare professionals?
We’re proactively addressing the future needs for healthcare professionals by expanding our capacities and workforce. Recognizing the necessity for more doctors, nurses, and medical staff, we’ve initiated programs to cultivate our own talent pool. One example is our culinary program aimed at high-school graduates from economically disadvantaged areas in Houston, such as parts of Third Ward and Fifth Ward. We offer these graduates opportunities to enter the healthcare field, starting with basic roles and progressing to more specialized positions like medical assistants. We finance their education and training, providing a pathway to nursing and other healthcare professions. This approach not only helps individuals advance their careers but also uplifts entire communities economically. Additionally, we’ve partnered with Houston Community College to create an apprenticeship program, further expanding our capacity to train future healthcare technicians and nurses. This initiative is about building a sustainable pipeline of healthcare professionals and making a significant impact on community health and well-being.
How are you addressing the challenges of cost control within the healthcare system?
Controlling costs is challenging because we don’t have control over the workforce market. For example, during COVID, travel agencies attracted many nurses away from hospital systems with high salaries. We then had to contract with these agencies, paying significant sums to rehire the same nurses. Post-COVID, inflation has kept prices high, including wages and other costs. For instance, the estimated cost for the project on the LBJ campus escalated from $1.2 billion to $1.6 billion over four years. As a public health system, we focus on reducing waste and increasing efficiency to manage costs. Unlike for-profit hospitals where each additional patient represents more revenue, for us, every additional patient is an added cost. This requires us to continuously seek ways to make ends meet, a challenge that also brings excitement in working within the public health sector.
What is your vision for the future of Harris Health, especially regarding its impact on community health?
My long-term vision for Harris Health is to become a leading example of a health system focused on disease prevention and health promotion. I’m incredibly proud of our hospitals, including our Level I and Level III trauma centers. We aim to be the only public health system in the country with two adult Level I trauma centers. More importantly, I want Harris Health to be recognized for its efforts in preventing illness and promoting health to the extent that we have empty hospital beds. Achieving this would indicate we’ve significantly improved community health, marking the fulfillment of my ultimate goal.
What is the impact of public health systems on the healthcare ecosystem?
A point I’ve emphasized before is the critical role of public health systems within the entire healthcare ecosystem. While our statutory mandate focuses on serving the uninsured and underinsured — a role we take pride in — many overlook the foundational impact of public health systems. Without them, both not-for-profit and for-profit hospital systems would face significant challenges. This is because uninsured and underinsured individuals, lacking access to regular healthcare, often delay seeking treatment until their conditions necessitate emergency care, which is considerably more expensive than clinic-based care.
If public health systems were to be overwhelmed by the demand or face insufficient funding, these individuals would still seek care, but they would turn to the emergency rooms of not-for-profit and for-profit hospitals. This shift would not only strain these facilities, reducing access to care for everyone, but also escalate their operational costs. Since these hospitals must maintain financial viability, they would pass these increased costs onto health insurance companies, which, in turn, would adjust by increasing the costs for their consumers—us. Consequently, we’d see higher co-pays, out-of-pocket costs, and insurance premiums. Essentially, public health systems act as a stabilizer for healthcare costs and access, underscoring their indispensable value to our healthcare ecosystem.
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