Stories about: Pediatrics

Embracing the future of pediatric quality measurement

Pediatric quality of care researchWhile studying quality of care in the 1990s, Mark Schuster, MD, PhD found that few studies on pediatric quality had been conducted. The typical explanation that he was given was that the federal government wasn’t funding research into quality measures because children on Medicaid don’t drive federal health-care costs nearly as much as adults on Medicaid and Medicare do.

But Schuster, chief of General Pediatrics at Boston Children’s Hospital and William Berenberg Professor of Pediatrics at Harvard Medical School, believes there have been other challenges in measuring care quality in children. In an acceptance speech upon receiving the 2014 Douglas K. Richardson Award for Perinatal and Pediatric Healthcare Research, published today in the journal Pediatrics (PDF), Schuster points to factors including the relative rarity of many pediatric conditions and that many of the benefits of excellent pediatric care are not observed until adulthood.

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Epilepsy surgery: When it’s not good to wait

epilepsy surgery life expectancyAbout a third of children with epilepsy do not get better with drug treatment. Many physicians are inclined to try additional drugs to control the seizures—and there are many to choose from. However, analysis of data from tens of thousands of patients suggests that if two or more well-chosen drugs have failed, and surgery is a safe option, there’s no benefit in holding off.

The decision analysis, published in the February issue of Epilepsia, found that average life expectancy was more than five years greater when eligible children had surgery rather than prolonged drug treatment. And children spent more of their lives seizure-free.

Although clinical guidelines currently do call for earlier surgery, physicians tend to use it as a last resort—even when brain-mapping studies indicate that it’s unlikely to endanger vital brain structures.

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What we’ve been reading: Week of February 9, 2015

Children what we've been reading Flickr thomaslife https://www.flickr.com/photos/thomaslife/4508639159
(Photo: thomaslife/Flickr)

Vector’s picks of recent pediatric healthcare, science and innovation news.

Encryption wouldn’t have stopped Anthem’s data breach (MIT Technology Review)
Hackers got their hands on the personal information and Social Security numbers of 80 million people when they broke into the network of health insurer Anthem health. But encryption alone wouldn’t have been enough to keep those data safe.

Could a wireless pacemaker let hackers take control of your heart? (Science)
Medical devices like pacemakers, insulin pumps and defibrillators are getting ever smaller and more wirelessly connected. But are those connections secure enough?

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Autism-like behaviors, impaired nerve tracts found in institutionalized children

Sad child-shutterstock_92102072 croppedThe sad experience of abandoned children in Romanian orphanages continues to provide stark lessons about the effects of neglect and deprivation of social and emotional interactions. The long-running Bucharest Early Intervention Project (BEIP) has been able to transfer some of these institutionalized children, selected at random, into quality foster care homes—and documented the benefits.

In a review article in the January 29 Lancet, BEIP investigator Charles A. Nelson, PhD, and medical student Anna Berens, MsC, both of Boston Children’s Hospital, make a strong case for global deinstitutionalization—as early in a child’s life as possible. Currently, it’s estimated that at least 8 million children worldwide are growing up in institutional settings.

The BEIP studies have documented a series of problems in institutionalized children, especially those who aren’t placed in foster care or are placed when they are older:

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What we’ve been reading: Week of February 2, 2015

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Vector’s pick of recent pediatric healthcare, science and innovation news.

The problem with precision medicine (The New Yorker)
President Obama’s recently announced plan to invest $215 million in precision medicine – which uses DNA testing to personalize medical care- has many in the medical community cheering. Others, however, are concerned that DNA sequencing is still far from optimized and many of the best doctors remain unfamiliar with how to appropriately integrate genetic results into their care plans.

Schools may solve the anti-vaccine parenting deadlock (The Atlantic)
The recent outbreak of measles in the U.S. shed light on the growing number of parents “opting out” of vaccinating their kids.  Public schools are fighting anti-vaxxers in the courts- and precedent is on their side.

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HD1829: Advancing telemedicine in Massachusetts

Massachusetts telehealth legislationJudy Wang, MS, is a program manager in the Telehealth Program at Boston Children’s Hospital.

This post is a frank call to action. Massachusetts is one of the few remaining states in the country that does not provide coverage for telemedicine services through its Medicaid program, and credentialing and reimbursement issues have helped limit the expansion of telehealth programs at Boston Children’s Hospital and beyond.

That could change. Legislation supported by Boston Children’s Office of Government Relations, filed on January 16, includes a bill that would advance and expand access to telemedicine services across the Commonwealth.

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Pitching pediatric innovation at SXSW Interactive

Pitching pediatric digital health innovationsJudy Wang, MS, is a program manager in the Telehealth Program at Boston Children’s Hospital.

A major theme at Taking on Tomorrow 2014 was the difficulty in making the business case for innovation in pediatrics, since the market size is small relative to the adult market. Muna AbdulRaqqaq Tahlak, MD, CEO of Latifa Hospital in Dubai, was among many who urged innovators to collaborate and aggregate their data to make the most impact.

It’s in that spirit that the upcoming Impact Pediatric Health Startup Pitch Competition (March 16) was born. Hosted by organizers of the South by Southwest Interactive (SXSWi) conference in Austin and the four top pediatric hospitals in the country—Boston Children’s, Cincinnati Children’s, Texas Children’s and Children’s Hospital of Philadelphia—the event will identify the most promising digital health and medical device innovations for pediatrics.

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CEO panel: Making health care work for children

Last in a series of videotaped sessions from Boston Children’s Hospital’s Global Pediatric Innovation Summit + Awards 2014. View Vector’s full coverage of the Summit.

Children’s hospitals face the challenges of a relatively small patient population, regulatory barriers and care outcomes that may not be measurable for decades. But challenges also bring opportunities. This fall 2014 panel, hosted by Children’s Hospital Association President and CEO Mark Wietecha, gathered CEOs from some of the world’s most respected pediatric hospitals:

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Intelligent ICU monitoring for patients in status epilepticus: BurSIn

The BurSIn system, in development, interprets EEG data along several key parameters and accurately identifies burst and suppression patterns.
The BurSIn system, in development, interprets EEG data along several key parameters and accurately identifies burst and suppression patterns.

Status epilepticus, a life-threatening form of persistent seizure activity in the brain, is challenging to treat. It requires hospitalization in an intensive care unit, constant monitoring and meticulous medication adjustment. An automated, intelligent monitoring system developed by clinicians and engineers at Boston Children’s Hospital could transform ICU care for this neurological emergency.

Typically, children in status epilepticus are first given powerful, short-acting seizure medications. If their seizures continue, they may need to be placed in a medically induced coma, using long-acting sedatives or general anesthetics. “The goal,” explains biomedical engineer Christos Papadelis, PhD, “is to supply enough sedating medication to suppress brain activity and protect the brain from damage, while at the same time avoiding over-sedation.”

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15 health care predictions for 2015

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2014 continued to see massive evolution in health care—from digital health innovations to the maturation of technologies in genomics, genome editing and regenerative medicine to the configuration of the health care system itself. We asked leaders from the clinical, research and business corners of Boston Children’s Hospital to weigh in with their forecasts for 2015. Click “Full story” for them all, or jump to:
The consumer movement in health care
Evolving care models
Genomics in medicine
Stem cell therapeutics
Therapeutic development
New technology
Biomedical research

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