Stories about: clinical innovation

An energy boost to the heart: Infant’s own mitochondria save her life

20160606_AveryHeart-12_with MomShe’s small for a 6-month-old, but otherwise Avery Gagnon looks perfectly healthy. She smiles, kicks, laughs and grabs her toys and pacifiers. What you’d never know is that Avery has complex congenital heart disease and might not be alive today if it weren’t for an innovative procedure that used mitochondria from her own cells to boost her heart’s energy.

The procedure is the brainchild of James McCully, PhD, a cardiovascular research scientist at the Heart Center at Boston Children’s Hospital, who spent most of his career working to solve a common complication of heart surgery: damage to heart muscle cells.

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At this pediatric ‘shark tank,’ the children win

Part of a continuing series of videotaped sessions at Boston Children’s Hospital’s recent Global Pediatric Innovation Summit + Awards 2014.

It was an ABC “Shark Tank” lover’s dream: At this pediatric Innovation Tank moderated by Daymond John, venture capitalists and clinicians fielded pitches from innovators looking to advance their care solution before a packed audience. The contenders:

  • A soft sleeve and wrap to keep catheter central lines in place, created by a parent
  • A handheld device that cleanses central line hubs, freeing up clinicians’ time
  • A mobile weight-loss program for kids and teenagers, designed to teach healthy habits

We won’t disclose the results–you’ll just have to watch the proceedings–but as emcee Bruce Zetter, PhD, of Boston Children’s put it, “The children win.”

Stay tuned as we post more sessions from the Pediatric Innovation Summit (also available on YouTube) and read our blog coverage.

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Creating a culture of crowd-sourced innovation: A look back at Hacking Pediatrics

The Hacking Pediatrics team 2013Michael Docktor, MD, is a pediatric gastroenterologist, director of clinical mobile solutions at Boston Children’s Hospital and a co-founder of Hacking Pediatrics. Above: The Hacking Pediatrics executive team: Judy Wang, MS; Michael Docktor, MD; Alex Pelletier, MBA; Margaret McCabe, PhD, RN, PNP; Kate Donovan, PhDc, MBA, BS, from Boston Children’s Hospital. (Photos: K.C. Cohen)

A hackathon is most easily explained by relating it to the crowd-sourced, time-crunched challenges that we see every day in pop culture. From “Top Chef” to “The Apprentice” to “Extreme Makeover,” television is teeming with passionate individuals trying to solve a difficult task with incredibly constrained resources and time. What results is often remarkable by any standard and speaks to the power of concentrated, collaborative problem solving.

When the challenge involves children and their health, the results can be magical, as witnessed by the weekend-long Hacking Pediatrics in late October, the first event of its kind. More than 150 “hackers,” including engineers, designers, software developers, entrepreneurs and roughly 40 clinicians gathered to create ground-breaking solutions for children and their families.

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The Comfy Ball: A ‘hack’ to help children express their pain

Comfy_Ball_prototype_built_at_Hacking_PediatricsIsrael Green-Hopkins, MD, is a second-year fellow in Pediatric Emergency Medicine at Boston Children’s Hospital and a fierce advocate for innovation in health information technology, with a passion for design, mobile health, remote monitoring and more. Follow him on Twitter @israel_md.

At the Hacking Pediatrics event in late October, I was fortunate to collaborate with a team interested, like I am, in patient engagement. After the initial idea-pitching phase of the hackathon, where clinicians present unsolved problems to an audience of techies and entrepreneurs, I joined a group of nearly 15 hackers who felt our desires to be similar. The prototype at left was our end result, but we had no idea then where our interest would lead.

At the beginning, in fact, our greatest challenge was determining exactly what problem we would try to solve.

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Scaling up quality improvement: How do we motivate providers?

Engaging clinicians in change will require a cultural shift. (David Oliva/Wikimedia Commons)
Engaging clinicians in change will require a cultural shift. (David Oliva/Wikimedia Commons)
Alyssa Bianca Velasco, ScB, is a clinical data specialist for the Standardized Clinical Assessment and Management Plans (SCAMPs) program at Boston Children’s Hospital.

Reducing health care costs doesn’t have to involve making sacrifices in patient safety or quality of care or holding clinicians to rigid guidelines. Over the past several years, Boston Children’s Hospital has rolled out a methodology known as Standardized Clinical Assessment and Management Plans (SCAMPs). Described in the May issue of Health Affairs, SCAMPs are based on the idea that clinicians should be able to diverge from established medical best practices, provided they document the reasons and track the results—in essence making continual data-driven modifications to practice.

The success of SCAMPs in reducing practice variability and costs and improving outcomes at Boston Children’s has led other institutions, one by one, to adopt them. In the next phase, we plan to expand SCAMPs much more broadly, creating a network of hospitals that will pool pertinent clinical data into a centralized non-profit institution, the Institute for Relevant Clinical Data Analytics (IRCDA).

I am part of a team that is providing training, analytics and IT support to help make that large-scale implementation happen.

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Top 10 science and innovation trends for 2013

(Garry Knight/Flickr)

Vector has been deliberating about its predictions for 2013, consulting its many informants. Here’s where we’re putting our money this year; if you have other ideas, scroll to the bottom and let us know.

Genome sequencing scaling up at health care institutions

Last year we predicted genome sequencing’s entry into the clinic; this could be the year it goes viral. Technology companies with ever-faster sequencers and academic medical centers are teaming up at a brisk pace to offer genomic tests to patients. Just in the past two weeks, a deal was announced between The Children’s Hospital of Philadelphia and BGI-Shenzhen to sequence pediatric brain tumors; Partners HealthCare and Illumina Inc. announced a network of genomic testing laboratories;

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Top 10 science and clinical innovation trends: Looking forward to 2012

Here once again is Vector’s take on some exciting trends we’ve been watching in the pediatric health arena and what we expect to see more of this year. If you’ve got others to propose, scroll to the bottom and let us know!

Genomics is starting to provide clinically actionable information (Michael Knowles/Flickr)

Whole-genome sequencing enters the clinic
In 2000, with our genome deciphered, the Human Genome Project promised to transform medicine, predicting and preventing all that ails us. The project spawned next-generation technologies, accelerated the development of bioinformatics and shaped new perspectives on research. But if, say, a stroke patient was asked the question, “Is your life any better than 10 years ago thanks to advent of genomics?” the answer would have to be “no.” Hence the New York Times’s assertion in 2010 that the project yielded few new cures.

Now that paradigm seems to be shifting. Whole-genome sequencing has begun moving into the clinic, sleuthing out problems, offering hope for a medicine that’s more effective and more personal. 2011 saw genomic information provide biochemical insights timely and actionable enough to improve the treatment of individuals with cancer and dystonia, and, in a case at Children’s, failure to thrive and severe kidney calcification.

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8 steps to succeed at a risky medical “first”

James Lock, MD, Cardiologist-in-Chief, Children's Hospital Boston

Ever since second grade, when he was suspended from school, Jim Lock has challenged the status quo — in sixth grade pulling off the much harder feat of being expelled. Today, the Cardiologist-in-Chief at Children’s Hospital Boston is credited with a long list of pioneering cardiac procedures going back to 1979, many of them in children with congenital heart defects. More recently, these have included fetal interventions, like reversal of hypoplastic left heart syndrome and implanting a stent in a fetal heart. Nearly all are now established procedures in pediatric cardiology.

These procedural innovations didn’t arise from a rare flash of inspiration, Lock argues, but from perception of a medical need followed by methodical vetting and sometimes years of due diligence.

“Innovation is not a completely random event,” Lock told the Innovators’ Forum at Children’s last week, sponsored by the Innovation Acceleration Program.  “It’s a process.”

Here’s Lock’s instruction set for safe and successful clinical firsts:

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