Author: Justine Varieur

How do you define innovation? Part VII

innovation-box-cropped-purchased-no-creditAs part of our ongoing effort to pin down this increasingly ambiguous term, five thought leaders offer their definitions of innovation, including the ABC News health and medical editor, Richard Besser, MD, and MIT inventor and professor Robert Langer, PhD—both of them keynote speakers at this month’s Pediatric Innovation Summit + Awards.

Please submit your definition to join the conversation!

Innovation in health is using new tools, approaches, or processes to improve or promote health, prevent illness and treat disease. —Richard Besser, MD, Chief Health and Medical Editor, ABC News

Innovation involves taking a creative approach to addressing a problem, often a persistent problem. It can produce a result where people say, “Why didn’t I think of that?” —Mark Schuster, MD, PhD, Professor of Pediatrics, Harvard Medical School; Chief of General Pediatrics and Vice Chair for Health Policy, Department of Medicine, Boston Children’s Hospital

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Surgeons have a responsibility to be innovators

Surgeons at workInnovation is inherent in surgery, says Thomas Krummel, MD, so for surgeons, the gap in launching an innovation isn’t the invention process but in the commercialization process. “Discovery and emerging technologies have shaped surgical practice from the start,” he said at a lecture at Boston Children’s Hospital this summer titled “Building on Robert E. Gross’s Legacy of Innovation.”

Krummel, who co-directs the Biodesign Innovation Program at Stanford University and and is Surgeon-in-Chief at the Lucile Packard Children’s Hospital, challenged his audience of residents and surgeons. “A surgeon in an academic department must pull a new rabbit out of his hat” with some frequency, he argued, pointing to historical examples ranging from the pulse oximeter to the more recent development of the video laparoscopic camera.

He also noted the variety of attitudinal approaches that surgeons can take to potential innovations. Some involve fear, and some surgeons try to ignore the potential for change, hoping it will go away. In Krummel’s estimation, “that is not a very surgical approach.”

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How do you define innovation? Part VI

Open box glowing with inner lightIn preparation for Boston Children’s National Pediatric Innovation Summit + Awards, we have asked thought leaders from beyond our walls to join our internal experts in a collaborative effort to define innovation from the perspective of pediatric researchers and caregivers. Add your voice to the comments, and register for our summit on Sept. 26-27 to join the conversation.

A new and unexpected idea, understanding, method or product that can be harnessed to solve a problem and improve our lives…It needs to go beyond an incremental advance – it should represent a “quantum leap.”
—Judy Lieberman, MD, PhD, chair of Cellular and Molecular Medicine, Program in Cellular and Molecular Medicine, Boston Children’s Hospital

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How do you define innovation? Part V

innovation box-purchased no creditThought leaders from beyond of the walls of Boston Children’s are coming together with our internal experts in a collaborative effort to define innovation from the larger clinical and scientific community. Add your voice to the comments—or register for our National Pediatric Innovation Summit + Awards (Sept. 26-27) and join the conversation.


Innovation is putting creativity into practice; but is much more complex than it sounds, as it requires development of an idea, testing and validation of an idea, creation of a product or process and defining how that can impact (in health care) a patient, and then commercializing or implementing that idea or process within the appropriate institutional context. Innovation continues to be in action, ideally with review and improvements over time. It can be as simple as changing how a patient makes an appointment to building the next surgical robot.
—Craig A. Peters, MD, Chief, Division of Surgical Innovation, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Medical Center, Washington, D.C.

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Time for surgery to go global — even cost data support the argument

Cost-effectiveness ratios for many surgical procedures turn out to be comparable to those for many accepted global public health strategies.
Cost-effectiveness ratios for many surgical procedures are comparable to those for accepted global public health strategies.
While moral arguments have been made to bring surgical treatments to resource-poor countries, researchers from Boston Children’s Hospital have discovered that it also may be cost-effective.

Traditionally, global health initiatives have focused on infectious disease or HIV/AIDS outreach. However, more recent data, including a 2012 study in The Lancet, show a growing global burden of noncommunicable diseases, such as cancer, that require surgical treatment.

Surgical disease was previously thought to comprise at least 11 percent of the total global burden of disease, but the Lancet paper showed approximately 25 percent of people requiring surgical assessment, based on a widespread survey in Sierra Leone. Additional research has revealed that up to 85 percent of pediatric patients in Africa have a surgical condition by the age of 15 years.

“However, the prevailing perception is that surgical care is too expensive and not cost-effective enough to bring to developing countries,” states Tiffany E. Chao, MD, a Paul Farmer Global Surgery Fellow in the Plastic and Oral Surgery Department at Boston Children’s.

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How do you define innovation?

innovation out of the boxInnovation is an increasingly popular term, with wide applications across multiple fields. Yet, a clear-cut definition remains ambiguous, and becomes even more elusive and complex when applied to health care.

Seeking a better understanding, we’ve been asking thought leaders from varied perspectives in pediatric medicine or health care technology from Boston Children’s Hospital and beyond to tell us how they define innovation.

Over the next several months, in our ramp-up to our Pediatric Innovation Summit + Awards, we’ll be unveiling these varied responses. Read on to see a few.

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Dads to blame? Genetic research reveals cause for precocious puberty

Whole-exome sequencing reveals a gene mutation that comes into play only if inherited from the father.
Whole-exome sequencing reveals a gene mutation that comes into play only if inherited from the father.

For a small subset of boys and girls who undergo early puberty, there’s now a specific explanation. New genetic research, involving whole-exome sequencing, has identified four novel heterozygous mutations in a gene known as MKRN3. Interestingly, while precocious puberty is more common in girls, all 15 affected children in the study inherited the mutations from their fathers.

Precocious puberty—the development of secondary sexual characteristics before 8 years in girls and 9 years in boys—has been associated with short stature, long-term health risks and an increase in conduct and behavioral disorders during adolescence. Physiologically, there are two types: central and peripheral. Central, the more common form, occurs when the pituitary gland, which controls puberty development, is activated too early.

“While a great deal of genetic studies have focused on the overall genetic contribution to pubertal timing, far less research has been conducted to find specific genetic causes of central precocious puberty,” says Andrew Dauber, MD, MMSc, of the Division of Endocrinology at Boston Children’s Hospital, who co-authored the study, published online this week by The New England Journal of Medicine.

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Pediatric hospitals challenged by new adult heart population

Adult and child-mikecogh-FlickrAdvances in medical care sometimes present challenges on the flipside. Case in point: Over the past three decades, progressive developments in pediatric cardiac care have allowed many babies born with congenital heart disease (CHD) to survive. And longevity continues to improve. This progress, however, has brought hospitals a burgeoning patient population with tremendously complex and varied disease states.

About 90 percent of children born with heart defects now survive to adulthood, thanks to diagnostic, interventional and critical care improvements. Specifically, one-year survival has improved from 67.4 percent from 1979 to 1993, to 82.5 percent from 1994 to 2005.

“The number of pediatric hospital admissions for congenital heart disease is increasing relatively slowly, but as the patients live longer and develop common adult medical issues, adult patient admissions are increasing much more rapidly,” says Alexander Opotowsky, MD, MPH, cardiologist at the Boston Adult Congenital Heart (BACH) and Pulmonary Hypertension services at Boston Children’s Hospital.

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