Telehealth

Bear Institute PACK logo

Winners of the third annual Bear Institute PACK Event

Bear Institute PACK logoOracle Health and Children’s National Hospital, announced the winners of the third annual Bear Institute’s Pediatric Accelerator Challenge for Kids (Bear PACK), a start-up competition aimed at fostering digital health innovation for children. The winners — Bend Health Inc., Kismet Health, RareCareNow, and Thynk Inc. — were recognized across four innovation tracks for their efforts to improve child health outcomes, enhance the care experience for patients, family, and clinicians and reduce the cost of care for patients and health systems.

With more than 250 standalone pediatric hospitals in the U.S. today, there is a significant opportunity for technology startups focused on pediatric care to overcome unique funding and go-to-market challenges to more successfully build and sustain their businesses and have a positive impact on the lives of thousands of children and their families.

“Bear PACK targets the entire pediatric healthcare community to help close the gap in innovative solutions dedicated to helping children, said Jessica Herstek, M.D., chief medical information officer, Children’s National Hospital. “Together, Oracle Health and Children’s National Hospital are helping startups accelerate innovation and technology adoption by showcasing new products and connecting startups with pediatric healthcare providers and administrators.”

“With less than one percent of global digital health funding being allocated for children’s health1, the Bear PACK challenge has never felt more important or needed,” said Nasim Afsar, M.D., MBA, MHM, senior vice president and chief health officer, Oracle Health. “Working with Children’s National Hospital, we’re continuing to make meaningful progress on bringing more digital health solutions for kids to market, helping to improve pediatric patient experience and health outcomes globally.”

The 2023 winners in each category are:

Using a telehealth platform, RareCareNow is helping patients who have been diagnosed and are seeking treatment for rare and genomic diseases in the U.S. With molecular diagnostics integrated earlier in the care process, patients can more quickly identify and connect with a specialist using RareCareNow’s network of physicians providing care specific to their needs. Patients will not only receive genetic counseling and treatment plans but will have a long-term provider for ongoing care coordination and symptom management.

“Our goal is to reimagine how genomic medicine is practiced by bringing cutting edge molecular diagnostics into the care process earlier and then providing ongoing care and coordination for all patients so they can benefit from their genomic results. While we’re improving access to care for patients with genomic and rare diseases, we also aim to ease the uncertainty of the diagnosis and the diagnostic odyssey. By embracing telehealth and technology, we will enable patients and families to be more proactively involved in their own care.” — Alexander Katz, chief medical officer and co-founder, RareCareNow

Designed by and for providers, Kismet Health’s pediatric virtual care platform offers a digital playspace that allows clinicians to communicate with patients through their language of play, increasing overall patient engagement and effectiveness. Kismet’s collaborative care technology allows providers to bring healthcare access to families where and when they need it most, allowing for longitudinal care throughout the entire year and more equitable outcomes.

“It’s an honor to be selected for this innovative program with like-minded individuals who are also passionate about revolutionizing the future of pediatric healthcare. Kismet has launched with digital health companies and smaller clinics, with the goal now to integrate with EHRs like Oracle Health’s to expand to children’s hospitals, health systems, and government programs — ultimately meeting families where they are and closing the gap in care access.” — Christie Sander, co-founder, president and COO, Kismet Health

Thynk Inc. developed an immersive game designed to help children improve cognitive skills and overall mental wellness in a safe and fun environment. Youth play an adventure game on a mobile device while wearing a headset that uses proprietary EEG technology that reads brainwaves to determine their level of focused attention. This measured focus level also controls the speed and success of the in-game character as it completes various missions, and the difficulty level adjusts accordingly. With regular use, children can improve 13 cognitive skills including focused attention, impulse management, and develop their self-regulation skills, all of which are important for academic success and personal growth.

“Our product has proven lasting effects in improving focus and attention for children who may be struggling with such skills. The outcomes of eight successful clinical studies with more than 300 users of our product have shown improvements in behavior, test scores, homework completion, and math and reading fluency. In addition to teaming with healthcare organizations, we’re working to also reach underserved populations who may lack access to the tools needed to improve cognitive skills.” — Christopher Tracy, co-founder, board director and chief operating officer, Thynk Inc.

Bend Health designed a virtual mental health platform for kids and their families to increase access, reduce wait times, and decrease costs of pediatric mental healthcare. As the only provider using the Collaborative Care Model in partnership with pediatric primary care, Bend’s data-driven platform allows primary care providers to easily refer and connect patients with virtual therapists. They then receive regular updates on care progress, more closely aligning medical and behavioral care. Offering services such as coaching, therapy, and expedited psychiatric care, Bend integrates virtual video visits, chat messaging, and digital experiences to achieve better outcomes through measurement-based care. Collaborating with leading insurers, employers, health systems, and providing self-pay options, Bend Health ensures widespread accessibility to its services.

“At Bend Health, pediatricians receive regular patient progress updates, empowering them to make informed care decisions based on timely mental health measures. Bend’s collaborative care teams enable practitioners to accurately diagnose children and provide a holistic approach that consistently achieves clinically significant results for both kids and their families. Our six peer-reviewed studies demonstrate these positive outcomes, with 80% of kids showing improvement in 60-90 days, and 4 out of 5 caregivers reporting reduced stress within a month of joining Bend.” — Dr. Monika Roots, President and Co-Founder, Bend Health

More information on this year’s winners can be found on the Bear Institute PACK website.

1Children’s digital health innovation received less than 1% ($167 million) of global digital health funding ($22 billion) in 2020, according to StartUp Health’s annual report on digital health funding.

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Children’s National in the News: 2023

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Explore some of the notable medical advancements and stories of bravery that defined 2023, showcasing the steadfast commitment of healthcare professionals at Children’s National Hospital and the resilient spirit of the children they support. Delve into our 2023 news highlights for more.

1. COVID during pregnancy dramatically increases the risk of complications and maternal death, large new study finds

According to a study published in British Medical Journal Global Health, women who get COVID during pregnancy are nearly eight times more likely to die and face a significantly elevated risk of ICU admission and pneumonia. Sarah Mulkey, M.D., prenatal-neonatologist neurologist, discussed findings based on her work with pregnant women and their babies.
(Fortune)

2. Rest isn’t necessarily best for concussion recovery in children, study says

A study led by Christopher Vaughan, Psy.D., pediatric neuropsychologist, suggests that — despite what many people may presume — getting kids back to school quickly is the best way to boost their chance for a rapid recovery after a concussion.
(CNN)

3. Pediatric hospital beds are in high demand for ailing children. Here’s why

David Wessel, M.D., executive vice president, chief medical officer and physician-in-chief, explained that one reason parents were still having trouble getting their children beds in a pediatric hospital or a pediatric unit after the fall 2022 respiratory surge is that pediatric hospitals are paid less by insurance.
(CNN)

4. Anisha Abraham details impact of social media use on children: ‘True mental health crisis’

Anisha Abraham, M.D., M.P.H., chief of the Division of Adolescent and Young Adult Medicine, joined America’s Newsroom to discuss the impact social media access has had on children’s mental health.
(FOX News)

5. Saving Antonio: Can a renowned hospital keep a boy from being shot again?

After 13-year-old Antonio was nearly killed outside his mom’s apartment, Children’s National Hospital went beyond treating his bullet wounds. Read how our Youth Violence Intervention Program team supported him and his family during his recovery.
(The Washington Post)

6. Formerly conjoined twins reunite with doctors who separated them

Erin and Jade Buckles underwent a successful separation at Children’s National Hospital. Nearly 20 years later they returned to meet with some of the medical staff who helped make it happen.
(Good Morning America)

7. Asthma mortality rates differ by location, race/ethnicity, age

Shilpa Patel, M.D., M.P.H., medical director of the Children’s National IMPACT DC Asthma Clinic, weighed in on a letter published in Annals of Allergy, Asthma & Immunology, asserting that the disparities in mortality due to asthma in the United States vary based on whether they occurred in a hospital, ethnicity or race and age of the patient.
(Healio)

8. How one Afghan family made the perilous journey across the U.S.-Mexico border

After one family embarked on a perilous journey from Afghanistan through Mexico to the U.S.-Mexico border, they eventually secured entry to the U.S. where Karen Smith, M.D., medical director of Global Services, aided the family’s transition and provided their daughter with necessary immediate medical treatment.
(NPR)

9. When a child is shot, doctors must heal more than just bullet holes

With the number of young people shot by guns on the rise in the U.S., providers and staff at Children’s National Hospital are trying to break the cycle of violence. But it’s not just the physical wounds though that need treating: young victims may also need help getting back on the right track — whether that means enrolling in school, finding a new group of friends or getting a job.
(BBC News)

10. This 6-year-old is a pioneer in the quest to treat a deadly brain tumor

Callie, a 6-year-old diagnosed with diffuse intrinsic pontine glioma, was treated with low-intensity focused ultrasound (LIFU) at Children’s National Hospital and is the second child in the world to receive this treatment for a brain tumor. LIFU is an emerging technology that experts like Hasan Syed, M.D., and Adrianna Fonseca, M.D., are trialing to treat this fatal childhood brain tumor.
(The Washington Post)

11. F.D.A. approves sickle cell treatments, including one that uses CRISPR

The FDA approved a new genetic therapy, giving people with sickle cell disease new opportunities to eliminate their symptoms. David Jacobsohn, M.B.A., M.D., confirmed that Children’s National Hospital is one of the authorized treatment centers and talked about giving priority to the sickest patients if they are on Vertex’s list.
(The New York Times)

12. 6-year-old fulfils wish to dance in the Nutcracker

After the potential need for open-heart surgery threatened Caroline’s Nutcracker performance, Manan Desai, M.D., a cardiac surgeon, figured out a less invasive procedure to help reduce her recovery time so she could perform in time for the holidays.
(Good Morning America)

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The best of 2023 from Innovation District

2023 with a lightbulbAdvanced MRI visualization techniques to follow blood flow in the hearts of cardiac patients. Gene therapy for pediatric patients with Duchenne muscular dystrophy. 3D-printed casts for treating clubfoot. These were among the most popular articles we published on Innovation District in 2023. Read on for our full list.

1. Advanced MRI hopes to improve outcomes for Fontan cardiac patients

Cardiac imaging specialists and cardiac surgeons at Children’s National Hospital are applying advanced magnetic resonance imaging visualization techniques to understand the intricacies of blood flow within the heart chambers of children with single ventricle heart defects like hypoplastic left heart syndrome. The data allows surgeons to make critical corrections to the atrioventricular valve before a child undergoes the single ventricle procedure known as the Fontan.
(3 min. read)

2. Children’s National gives first commercial dose of new FDA-approved gene therapy for Duchenne muscular dystrophy

Children’s National Hospital became the first pediatric hospital to administer a commercial dose of Elevidys (delandistrogene moxeparvovec-rokl), the first gene therapy for the treatment of pediatric patients with Duchenne muscular dystrophy (DMD). Elevidys is a one-time intravenous gene therapy that aims to delay or halt the progression of DMD by delivering a modified, functional version of dystrophin to muscle cells.
(2 min. read)

3. New model to treat Becker Muscular Dystrophy

Researchers at Children’s National Hospital developed a pre-clinical model to test drugs and therapies for Becker Muscular Dystrophy (BMD), a debilitating neuromuscular disease that is growing in numbers and lacks treatment options. The work provides scientists with a much-needed method to identify, develop and de-risk drugs for patients with BMD.
(2 min. read)

4. First infants in the U.S. with specially modified pacemakers show excellent early outcomes

In 2022, five newborns with life-threatening congenital heart disease affecting their heart rhythms were the first in the United States to receive a novel modified pacemaker generator to stabilize their heart rhythms within days of birth. Two of the five cases were cared for at Children’s National Hospital. In a follow-up article, the team at Children’s National shared that “early post-operative performance of this device has been excellent.”
(2 min. read)

5. AI: The “single greatest tool” for improving access to pediatric healthcare

Experts from the Food and Drug Administration, Pfizer, Oracle Health, NVIDIA, AWS Health and elsewhere came together to discuss how pediatric specialties can use AI to provide medical care to kids more efficiently, more quickly and more effectively at the inaugural symposium on AI in Pediatric Health and Rare Diseases, hosted by Children’s National Hospital and the Fralin Biomedical Research Institute at Virginia Tech.
(3 min. read)

6. AAP names Children’s National gun violence study one of the most influential articles ever published

The American Academy of Pediatrics (AAP) named a 2019 study led by clinician-researchers at Children’s National Hospital one of the 12 most influential Pediatric Emergency Medicine articles ever published in the journal Pediatrics. The findings showed that states with stricter gun laws and laws requiring universal background checks for gun purchases had lower firearm-related pediatric mortality rates but that more investigation was needed to better understand the impact of firearm legislation on pediatric mortality.
(2 min. read)

7. Why a colorectal transition program matters

Children’s National Hospital recently welcomed pediatric and adult colorectal surgeon Erin Teeple, M.D., to the Division of Colorectal and Pelvic Reconstruction. Dr. Teeple is the only person in the United States who is board-certified as both a pediatric surgeon and adult colorectal surgeon, uniquely positioning her to care for people with both acquired and congenital colorectal disease and help them transition from pediatric care to adult caregivers.
(3 min. read)

8. First-of-its-kind holistic program for managing pain in sickle cell disease

The sickle cell team at Children’s National Hospital received a grant from the Founders Auxiliary Board to launch a first-of-its-kind, personalized holistic transformative program for the management of pain in sickle cell disease. The clinic uses an inter-disciplinary approach of hematology, psychology, psychiatry, anesthesiology/pain medicine, acupuncture, mindfulness, relaxation and aromatherapy services.
(3 min read)

9. Recommendations for management of positive monosomy X on cell-free DNA screening

Non-invasive prenatal testing using cell-free DNA (cfDNA) is currently offered to all pregnant women regardless of the fetal risk. In a study published in the American Journal of Obstetrics and Gynecology, researchers from Children’s National Hospital provided context and expert recommendations for maternal and fetal evaluation and management when cfDNA screening is positive for monosomy X or Turner Syndrome.
(2 min. read)

10. Innovation in clubfoot management using 3D anatomical mapping

While clubfoot is relatively common and the treatment is highly successful, the weekly visits required for Ponseti casting can be a significant burden on families. Researchers at Children’s National Hospital are looking for a way to relieve that burden with a new study that could eliminate the weekly visits with a series of 3D-printed casts that families can switch out at home.
(1 min. read)

11. Gender Self-Report seeks to capture the gender spectrum for broad research applications

A new validated self-report tool provides researchers with a way to characterize the gender of research participants beyond their binary designated sex at birth. The multi-dimensional Gender Self-Report, developed using a community-driven approach and then scientifically validated, was outlined in a peer-reviewed article in the American Psychologist, a journal of the American Psychological Association.
(2 min. read)

12. Cardiovascular and bone diseases in chronic kidney disease

In a study published by Advances in Chronic Kidney Disease, a team at Children’s National Hospital reviewed cardiovascular and bone diseases in chronic kidney disease and end-stage kidney disease patients with a focus on pediatric issues and concerns.
(1 min. read)

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Children’s National selected as member of ARPA-H Investor Catalyst Hub spoke network

ARPA-H logoThe hospital will advocate for the unique needs of children as part of nationwide network working to accelerate transformative health solutions.

Children’s National Hospital was selected as a spoke for the Investor Catalyst Hub, a regional hub of ARPANET-H, a nationwide health innovation network launched by the Advanced Research Projects Agency for Health (ARPA-H).

The Investor Catalyst Hub seeks to accelerate the commercialization of groundbreaking and accessible biomedical solutions. It uses an innovative hub-and-spoke model designed to reach a wide range of nonprofit organizations and Minority-Serving Institutions, with the aim of delivering scalable healthcare outcomes for all Americans.

“The needs of children often differ significantly from those of adults. This partnership reflects our commitment to advancing pediatric healthcare through innovation and making sure we’re addressing those needs effectively,” said Kolaleh Eskandanian, Ph.D., M.B.A., vice president and chief innovation officer at Children’s National. “Leveraging the strength of this hub-and-spoke model, we anticipate delivering transformative solutions to enhance the health and well-being of the patients and families we serve.”

Children’s National joins a dynamic nationwide network of organizations aligned to ARPA-H’s overarching mission to improve health outcomes through the following research focus areas: health science futures, proactive health, scalable solutions and resilient systems. Investor Catalyst Hub spokes represent a broad spectrum of expertise, geographic diversity and community perspectives.

“Our spoke network embodies a rich and representative range of perspectives and expertise,” said Mark Marino, vice president of Growth Strategy and Development for VentureWell and project director for the Investor Catalyst Hub. “Our spokes comprise a richly diverse network that will be instrumental in ensuring that equitable health solutions reach communities across every state and tribal nation.”

As an Investor Catalyst Hub spoke, Children’s National gains access to potential funding and flexible contracting for faster award execution compared to traditional government contracts. Spoke membership also offers opportunities to provide input on ARPA-H challenge areas and priorities, along with access to valuable networking opportunities and a robust resource library.

child being evaluated for autism

Using a multisystem approach to improve access to autism care in Washington, D.C.

child being evaluated for autism

Children with autism face significant barriers to accessing evaluations and intervention services.

An article in the journal Pediatrics reviews the outcomes from a collective, targeted advocacy approach to improving access to autism supports and resources for children and their families in Washington, D.C. The effort was led by Children’s National Hospital and engaged a multidisciplinary team from within the hospital and across a wide range of community sectors.

What this means

Children’s National and DC Autism Parents worked collaboratively with a coalition of organizations from the broader District of Columbia community to address some of the biggest challenges and barriers that prevent autistic children and their families from receiving the resources and support they need in the nation’s capital.

Why it matters

Children with autism face significant barriers to accessing evaluations and intervention services often because of confusing referral processes, lack of centralized coordination across organizations serving children with autism, insurance coverage gaps, multiyear waitlists for diagnostic services and limited provider knowledge about autism. Racism and systemic inequities also persist in autism care across the United States.

Long and growing wait times in autism diagnostic clinics and lack of centralized care coordination for autistic children are prevalent across the District of Columbia, and as a result, many children and families in the region continue to lack access to the support they need.

What’s unique

The study describes multiyear efforts (2017–2022) to improve autism care throughout the District of Columbia using a collective impact framework to unite organizations from different sectors. This approach features the creation of a common agenda (including defining goals and priorities), shared measurement, mutually reinforcing activities, continuous communication and infrastructure support.

Together, the group members sought to address barriers and overcome challenges at multiple levels of the healthcare system at the same time by focusing advocacy in three specific areas:

  • Infrastructure-building initiatives/system-level approaches.
  • Population- and community-level services to build capacity and connect providers and families to needed resources.
  • Direct services that provide innovative, gap-filling supports to children and families as a stopgap until the necessary supports can be more sustainably provided across the board.

Bottom line

While more work is needed to continue expanding the availability of needed services, the findings from this initial effort can inform the next steps in Washington, D.C., and serve as a model for a collective framework approach for autism services in other parts of the United States.

You can read the full study “A Multisystem Approach to Improving Autism Care” in the journal Pediatrics.

More information and resources about these autism initiatives can be found at:

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Children’s National Hospital at the 2023 American Academy of Pediatrics meeting

There will be over 20 Children’s National Hospital-affiliated participants at this year’s American Academy of Pediatrics National Conference and Exhibition. The meeting will take place in Washington, D.C., from October 20 – October 24. We have compiled their sessions into a mini schedule below.

 

Date Time Presenter Title Division
10/20/2023 8:30 AM Vanessa Madrigal, M.D., M.S.C.E. Section on Cardiology & Cardiac Surgery Program: Day 1 Critical Care
10/20/2023 2:30 PM Kibileri Williams, M.B.B.S Appy Hour: a Current Update on Pediatric Appendicitis Surgery
10/20/2023 3:30 PM Roopa Kanakatti Shankar, M.D., M.S. Precocious Puberty: Puberty Suppression or Not? Endocrinology
10/21/2023 7:30 AM Allison Markowsky, M.D. What is Trending in the Newborn Nursery: Controversies and Evidence Hospital Medicine
10/21/2023 8:00 AM Jessica Herstek, M.D. Joint Program: Council on Clinical Information Technology and Council on Quality Improvement and Patient Safety Medical Informatics
10/21/2023 8:00 AM Nazrat Mirza, M.D., Sc.D. Section on Obesity Program IDEAL Clinic (Obesity Program)
10/21/2023 8:00 AM Hans Pohl, M.D. Section on Urology Program: Day 2 Urology
10/21/2023 9:00 AM Anil Darbari, M.D., M.B.B.S., M.B.A. Constipation: Getting it to Work Out in the End Gastroenterology, Hepatology and Nutrition
10/21/2023 9:00 AM Kibileri Williams, M.B.B.S Appy Hour: a Current Update on Pediatric Appendicitis Surgery
10/21/2023 1:30 PM Olanrewaju (Lanre) Falusi, M.D. Educational Program and Annual Assembly for Medical Students, Residents, and Fellowship Trainees Pediatrician
10/21/2023 2:00 PM Brian Reilly, M.D. Noise 201 – More than Headphones! Otolaryngology
10/21/2023 2:00 PM Erin Teeple, M.D. Hernias, Hydroceles, and Undescended Testicles: When to Wait and When to Operate Surgeon
10/21/2023 3:30 PM Amanda Stewart, M.D. Section on Emergency Medicine Program: Day 2 Emergency Medicine
10/21/2023 3:30 PM Shideh Majidi, M.D., M.S.C.S. Healthcare Disparities in Management of Type 1 Diabetes and Diabetes Technology Endocrinology
10/21/2023 3:30 PM Natasha Shur, M.D. Genetic Testing Boot Camp Geneticist (RDI)
10/21/2023 5:00 PM Danielle Dooley, M.D., M.Phil Connecting School Systems and Health Systems: Successes and Opportunities Pediatrician
10/22/2023 8:00 AM Jaytoya Manget, DNP, FNP Pediatricians and School Attendance: Innovative Approaches to Prevent Chronic Absenteeism
10/22/2023 8:00 AM Simone Lawson, M.D. Section on Emergency Medicine Program: Day 3 Emergency Medicine
10/22/2023 8:00 AM Hans Pohl, M.D. Section on Urology Program: Day 3 Urology
10/22/2023 1:00 PM Lenore Jarvis, M.D., M.Ed. Section on Early Career Physicians Program
10/22/2023 5:00 PM Brian Reilly, M.D. Pediatric Hearing Loss: What’s New in Diagnostics, Prevention and Treatments Otolaryngology
10/23/2023 8:00 AM Rosemary Thomas-Mohtat, M.D. Point-of-Care Ultrasound Fundamentals Course Emergency Medicine
10/23/2023 9:00 AM Matthew Oetgen, M.D., M.B.A. Section on Radiology Program: Imaging Diagnosis and Management of Osteoarticular Infections Orthopaedic Surgery and Sports Medicine
10/23/2023 9:00 AM Christina Feng, M.D. Masses for the Masses: Abdominal Masses in Children Surgeon
10/23/2023 9:00 AM Narendra Shet, M.D. Section on Radiology Program: Imaging Diagnosis and Management of Osteoarticular Infections Radiology
10/23/2023 9:00 AM Shireen Atabaki, M.D., M.P.H. Section on Advances in Therapeutics and Technology Program Telemedicine
10/23/2023 1:00 PM Brian Reilly, M.D. Pediatric Otolaryngology: Back to Basics Otolaryngology
10/23/2023 1:00 PM Sonali Basu, M.D. Point-of-Care Ultrasound Critical Competency Course CCM
10/23/2023 1:00 PM Vanessa Madrigal, M.D. Joint Program: Section on Bioethics, Section on LGBT Health and Wellness and Section on Minority Health, Equity, and Inclusion Critical Care
10/23/2023 2:00 PM Rebecca Persky, M.D. Menstrual Disorders: Primary or Secondary Amenorrhea Endocrinology
10/23/2023 5:00 PM Christina Feng, M.D. Masses for the Masses: Abdominal Masses in Children Surgeon
10/24/2023 9:00 AM Vanessa Madrigal, M.D. Section Showcase: Applying Ethics Principles and Tools To Advocate for Vulnerable Populations Critical Care

 

U.S. News Badges

Children’s National Hospital ranked #5 in the nation on U.S. News & World Report’s Best Children’s Hospitals Honor Roll

U.S. News BadgesChildren’s National Hospital in Washington, D.C., was ranked #5 in the nation on the U.S. News & World Report 2023-24 Best Children’s Hospitals annual rankings. This marks the seventh straight year Children’s National has made the Honor Roll list. The Honor Roll is a distinction awarded to only 10 children’s hospitals nationwide.

For the thirteenth straight year, Children’s National also ranked in all 10 specialty services, with eight specialties ranked in the top 10 nationally. In addition, the hospital was ranked best in the Mid-Atlantic for neonatology, cancer, neurology and neurosurgery.

“Even from a team that is now a fixture on the list of the very best children’s hospitals in the nation, these results are phenomenal,” said Kurt Newman, M.D., president and chief executive officer of Children’s National. “It takes a ton of dedication and sacrifice to provide the best care anywhere and I could not be prouder of the team. Their commitment to excellence is in their DNA and will continue long after I retire as CEO later this month.”

“Congratulations to the entire Children’s National team on these truly incredible results. They leave me further humbled by the opportunity to lead this exceptional organization and contribute to its continued success,” said Michelle Riley-Brown, MHA, FACHE, who becomes the new president and CEO of Children’s National on July 1. “I am deeply committed to fostering a culture of collaboration, empowering our talented teams and charting a bold path forward to provide best in class pediatric care. Our focus will always remain on the kids.”

“I am incredibly proud of Kurt and the entire team. These rankings help families know that when they come to Children’s National, they’re receiving the best care available in the country,” said Horacio Rozanski, chair of the board of directors of Children’s National. “I’m confident that the organization’s next leader, Michelle Riley-Brown, will continue to ensure Children’s National is always a destination for excellent care.”

The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals and recognizes the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News.

“For 17 years, U.S. News has provided information to help parents of sick children and their doctors find the best children’s hospital to treat their illness or condition,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “Children’s hospitals that are on the Honor Roll transcend in providing exceptional specialized care.”

The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.

The eight Children’s National specialty services that U.S. News ranked in the top 10 nationally are:

The other two specialties ranked among the top 50 were cardiology and heart surgery, and urology.

mother and baby doing a telehealth call

Using telehealth to study babies born to mothers infected with SARS-CoV-2

mother and baby doing a telehealth call

Continued advancements in telehealth methods to follow child neurodevelopment will help ensure robust child follow-up and inclusion of diverse cohorts.

Multiple studies have shown that SARS-CoV-2 infection can impact pregnant mothers and their fetuses but more research is needed to understand the long-term impact on the neurodevelopment of these children as they get older. Child neurodevelopmental evaluations are typically performed in-person. Since the COVID-19 pandemic began, the transition to telehealth methods was needed.

Continued advancements in telehealth methods to follow child neurodevelopment will help ensure robust child follow-up and inclusion of diverse cohorts, says a commentary in JAMA Network Open.

Why it matters

Commentary author Sarah Mulkey, M.D., prenatal-neonatal neurologist at Children’s National Hospital, highlights a new study that used a novel telehealth method to look for neurodevelopmental differences in infants ages 6-12 months born to mothers with SARS-CoV-2 infection compared to nonexposed infants of the same age and found no differences in neurodevelopment among the two cohorts. The study adapted a standardized assessment to a telehealth method.

“The results of this study provide needed reassurance to the many mothers who have experienced SARS-CoV-2 infection during pregnancy,” says Dr. Mulkey.

What’s been the hold up in the field?

“Developmental assessments that rely on observation of infants’ developmental skills can naturally make the transition to a telehealth platform,” says Sarah Mulkey, M.D., prenatal-neonatal neurologist at Children’s National Hospital and commentary author. “General movement assessment is an observation-based assessment of infants that can be captured by a parent or caregiver on video, and it has been used in neurodevelopmental outcomes studies of children after antenatal SARS-CoV-2 exposure.”

Moving the field forward

Child outcomes research can have improved enrollment and continuity of participant follow-up due to the availability of remote assessments. Neurodevelopmental tools are being developed that can be used on a telehealth platform or by parent recorded videos.

Researchers from the Children’s National Congenital Zika Virus Program have also developed telehealth-based methods for child outcome research that has been utilized in international Zika outcome studies funded by the Thrasher Research Fund and the NIH.

Read the full commentary, Use of Telehealth Methods to Track Infant Neurodevelopment After In Utero SARS-CoV-2 Exposure, in JAMA Network Open.

President Joe Biden and First Lady Jill Biden tour the telehealth command center at Children's National Hospital

President Biden, First Lady tour cardiac telehealth command center

President Joe Biden and First Lady Jill Biden paid a recent visit to the Cardiac Intensive Care Unit (CICU) at Children’s National Hospital, where leaders of our cardiology services toured them through the state-of-the-art telehealth command center embedded on the unit.

The big picture

Children’s National is pioneering the integration of telemedicine into CICU care. It’s one of the few pediatric hospitals in the world to do this.

Experts liken the telehealth command center to an ‘air traffic control tower’ for the most vulnerable patients with critical heart disease. The President and First Lady saw how complex the environment is, with real-time monitoring of all 26 high-risk patients in the CICU. The system combines traditional remote monitoring, video surveillance and artificial intelligence tools.

What this means

“With this technology, we’re helping to predict and prevent major adverse events,” said Ricardo Munoz, M.D., executive director of the Telemedicine Program and chief of the Division of Critical Care Medicine at Children’s National. “For example, our neuromonitoring system can help signal an impending brain injury before it happens.”

Dr. Munoz says President Biden expressed interest in the prevention strategy of adverse events and this new approach to caring for children with critical cardiac illness.

What they’re saying

  • “It was important to share with the Biden’s that caring for these kids is a long-term endeavor, not simply a single surgery or procedure to fix their heart abnormality,” said Yves d’Udekem, M.D., Ph.D., chief of Cardiac Surgery at Children’s National. “That means making sure they have the earliest diagnoses, the best treatments from surgeons and others who truly understand their condition, and a technologically advanced, attentive place to recover and heal as safely as possible.”
  • “Many people don’t believe that ‘pediatrics’ and ‘innovation’ can co-exist,” said Annette Ansong, M.D., medical director of Outpatient Cardiology at Children’s National. “During the Biden’s visit, they were at the crux of a novel way to closely monitor some of our sickest children with the added ability to predict bad events before they happen.”

Dr. Ansong hopes bringing awareness of these cardiac capabilities to the President and First Lady is the first of many steps in seeking support for children with congenital and acquired heart disease.

Abstract Happy 2022 New Year greeting card with light bulb

The best of 2022 from Innovation District

Abstract Happy 2022 New Year greeting card with light bulbA clinical trial testing a new drug to increase growth in children with short stature. The first ever high-intensity focused ultrasound procedure on a pediatric patient with neurofibromatosis. A low dose gene therapy vector that restores the ability of injured muscle fibers to repair. These were among the most popular articles we published on Innovation District in 2022. Read on for our full top 10 list.

1. Vosoritide shows promise for children with certain genetic growth disorders

Preliminary results from a phase II clinical trial at Children’s National Hospital showed that a new drug, vosoritide, can increase growth in children with certain growth disorders. This was the first clinical trial in the world testing vosoritide in children with certain genetic causes of short stature.
(2 min. read)

2. Children’s National uses HIFU to perform first ever non-invasive brain tumor procedure

Children’s National Hospital successfully performed the first ever high-intensity focused ultrasound (HIFU) non-invasive procedure on a pediatric patient with neurofibromatosis. This was the youngest patient to undergo HIFU treatment in the world.
(3 min. read)

3. Gene therapy offers potential long-term treatment for limb-girdle muscular dystrophy 2B

Using a single injection of a low dose gene therapy vector, researchers at Children’s National restored the ability of injured muscle fibers to repair in a way that reduced muscle degeneration and enhanced the functioning of the diseased muscle.
(3 min. read)

4. Catherine Bollard, M.D., M.B.Ch.B., selected to lead global Cancer Grand Challenges team

A world-class team of researchers co-led by Catherine Bollard, M.D., M.B.Ch.B., director of the Center for Cancer and Immunology Research at Children’s National, was selected to receive a $25m Cancer Grand Challenges award to tackle solid tumors in children.
(4 min. read)

5. New telehealth command center redefines hospital care

Children’s National opened a new telehealth command center that uses cutting-edge technology to keep continuous watch over children with critical heart disease. The center offers improved collaborative communication to better help predict and prevent major events, like cardiac arrest.
(2 min. read)

6. Monika Goyal, M.D., recognized as the first endowed chair of Women in Science and Health

Children’s National named Monika Goyal, M.D., M.S.C.E., associate chief of Emergency Medicine, as the first endowed chair of Women in Science and Health (WISH) for her outstanding contributions in biomedical research.
(2 min. read)

7. Brain tumor team performs first ever LIFU procedure on pediatric DIPG patient

A team at Children’s National performed the first treatment with sonodynamic therapy utilizing low intensity focused ultrasound (LIFU) and 5-aminolevulinic acid (5-ALA) medication on a pediatric patient. The treatment was done noninvasively through an intact skull.
(3 min. read)

8. COVID-19’s impact on pregnant women and their babies

In an editorial, Roberta L. DeBiasi, M.D., M.S., provided a comprehensive review of what is known about the harmful effects of SARS-CoV-2 infection in pregnant women themselves, the effects on their newborns, the negative impact on the placenta and what still is unknown amid the rapidly evolving field.
(2 min. read)

9. Staged surgical hybrid strategy changes outcome for baby born with HLHS

Doctors at Children’s National used a staged, hybrid cardiac surgical strategy to care for a patient who was born with hypoplastic left heart syndrome (HLHS) at 28-weeks-old. Hybrid heart procedures blend traditional surgery and a minimally invasive interventional, or catheter-based, procedure.
(4 min. read)

10. 2022: Pediatric colorectal and pelvic reconstructive surgery today

In a review article in Seminars in Pediatric Surgery, Marc Levitt, M.D., chief of the Division of Colorectal and Pelvic Reconstruction at Children’s National, discussed the history of pediatric colorectal and pelvic reconstructive surgery and described the key advances that have improved patients’ lives.
(11 min. read)

CICU telemed command center

New telehealth command center redefines hospital care

CICU telemed command center

The new CICU command center redefines hospital care for children with the riskiest heart conditions.

Children’s National Hospital has opened a new telehealth command center that uses cutting-edge technology to keep continuous watch over the most fragile children with critical heart disease. The new command center, located in the Cardiac Intensive Care Unit (CICU), builds off a care model deployed outside the CICU in 2019, but now offers improved collaborative communication to better help predict and prevent major events, like cardiac arrest.

“The new center acts like an air traffic control tower. It allows our telehealth team to remotely monitor each patient room and alert the bedside team to any abnormal trends,” says Ricardo Munoz, M.D., executive director of the Telemedicine Program and chief of the Division of Critical Care Medicine at Children’s National. “Better communication with the bedside team and easier access to all members of the medical and surgical teams means we can provide the best possible care to these fragile infants.”

In the early stages of recovery after heart surgery, vulnerable patients can regress quickly with few outward physical symptoms. The telehealth virtual surveillance system flags early warning signs that a critically ill infant may suffer a serious adverse event.

The system combines traditional remote monitoring, video surveillance and an artificial intelligence algorithm. New features include:

  • Neuromonitoring: Doctors are developing an adaptable neuromonitoring system that can help signal an impending brain injury before it happens.
  • Echocardiography: A cardiologist, embedded in the new command center, is available to expedite and improve communication within the multidisciplinary team.
  • Real-time audio and video: A telemedicine cart is placed in the room of high-risk patients to allow for rapid communication with a bedside nurse.
  • E-CICU team: A team of CICU nurses and physicians implement a second layer of safety over patient care by doing a systematic review of video feeds from patient rooms, patient monitors, artificial intelligence tools trained to detect dangerous trends, labs and imaging studies.

Since the center’s launch, the system’s virtual surveillance has tracked 8,697 virtual surveillance activities, resulting in:

  • 2,350 non-critical communications
  • 199 critical communications that prevented major adverse events

“Parents of our highest-risk patients are comforted knowing our team of doctors and nurses are watching their child at every moment,” says Dr. Munoz. “We are one of the few pediatric hospitals in the world integrating telemedicine into our CICU. Our goal is to expand our monitoring capabilities both nationally and internationally to improve pediatric heart care.”

Children’s National is a recipient of the Telehealth Accreditation from URAC and is the first pediatric hospital to receive this recognition for its ability to leverage technologies to advance high-quality care that promotes clinical best practices, consumer protections and care continuity between patients and providers.

The Board of Visitors Telehealth Command Center was funded by an Auxiliary Board of Children’s National.

telemedicine

Children’s National Hospital technology recognized

telemedicine

Being designated with this recognition recognizes that Children’s National has deployed technologies and strategies to help analyze its data and is starting to achieve meaningful clinical and efficiency outcomes. It’s also experimenting with more advanced technologies, like telehealth, that expand access to care.

Children’s National Hospital received the 2021 Digital Health Most Wired recognition by The College of Healthcare Information Management Executives (CHIME) as a certified ambulatory level nine and acute level eight. The CHIME Digital Health Most Wired program conducts an annual survey to assess how effectively health care organizations apply core and advanced technologies into their clinical and business programs to improve health and care in their communities.

“Children’s National is honored to again receive the Most Wired distinction for our inpatient and ambulatory venues,” said Matt MacVey, chief information officer at Children’s National. “We are particularly excited to see our ongoing consumer digital experience investments propel us to a level 9 in ambulatory.”

Being designated with this recognition recognizes that Children’s National has deployed technologies and strategies to help analyze its data and is starting to achieve meaningful clinical and efficiency outcomes. It’s also experimenting with more advanced technologies, like telehealth, that expand access to care.

“Digital transformation in health care has accelerated to an unprecedented level since 2020, and the next few years will bring a wave of innovation that empowers health care consumers and will astound the industry,” said CHIME President and CEO Russell P. Branzell. “The Digital Health Most Wired program recognizes the outstanding digital leaders who have paved the way for this imminent revolution in health care. Their trailblazing commitment to rapid transformation has set an example for the entire industry in how to pursue a leadership vision with determination, brilliant planning and courage to overcome all challenges.”

A total of 36,674 organizations were represented in the 2021 Digital Health Most Wired program, which includes four separate surveys: acute, ambulatory, long-term care and international acute. The surveys assessed the adoption, integration and impact of technologies in healthcare organizations at all stages of development, from early development to industry leading.

This is the fourth year that CHIME has conducted the survey and overseen the program. In each successive year, CHIME has expanded the survey to capture more types of organizations that serve patients across the continuum of care. CHIME also continues to promote the program internationally to provide a global overview of digital health advancements.

“We are committed to investing in technology that helps us bring safe, high quality care to children,” said Jessica Herstek, M.D., chief medical informatics officer at Children’s National. “We are honored by the ‘Most Wired’ distinction and remain focused on our vision to help children grow up stronger.”

Bear Institute PACK logo

Winners of the first annual Bear Institute PACK Event

Bear Institute PACK logo

On August 26, 2021, the Bear Institute, along with Children’s National Hospital and Cerner Corporation, hosted the first annual Bear Institute PACK (Pediatric Accelerator Challenge for Kids). Bear Institute PACK is a start-up competition aimed to address the gap in digital health innovation funding dedicated to children.

“Children are a unique population that requires different health solutions than those designed for adults, which address their unique needs,” says Dr. Lu de Souza, Vice President and Chief Medical Officer, Cerner Corporation. “With Bear Institute PACK, we hope to increase focus and delivery of digital health innovations for kids. Bear Institute PACK brings together the pediatric health care community, including pediatric health care providers and hospital administrators from across the country to identify top start-up digital applications that best serve children.”

This year’s start-up participants competed across four innovation tracks, including rare disease, telemedicine, remote patient monitoring and patient education. Student teams competed in a separate student track. Bear Institute PACK consists of three rounds of judging: an initial review of applications from the Bear Institute PACK team, judging from participating pediatric healthcare providers and administrators and review from an expert panel of judges during finalist start-ups’ live pitches.

The start-ups competed for a rich prize pool, including cash prizes totaling over $100,000, on-site pilots and software development support. Winners were selected in each of the event’s four innovation tracks, as well as an additional two student team winners. This year winners are:

  • In the rare disease track, first place winner, Bloom Standard, Inc., with its solution Automated Ultrasound Wrap that screen infants and children for serious lung and cardiac conditions, and second place winner, Mira Medical LLC, with its solution Bear Growth: A Three-Dimensional Pediatric Growth Modeling App.
  • In the telehealth track, Keriton, Inc., with its solution Keriton Kare, a healthcare SaaS platform built to improve outcomes for neonatal and pediatric patients.
  • In the remote patient monitoring track, Sonavi Labs, with its solution Feelix, a platform that features proprietary hardware embedded with clinically validated diagnostic software capable of detecting respiratory diseases.
  • In the patient education track, Smileyscope, with its comprehensive virtual reality (VR) platform to help support patients with procedural pain management, drug-free anxiety care, education, and guided relaxation.
  • Student team first place winner, CASP Technologies, with its solution Operation Serenity, which allows pediatric patients to prepare for and understand their simulated surgery to reduce anxiety and second place winner, Ankle Rehab, with its solution Foot Joystick for Children with Cerebral Palsy meant to improve mobility.

More information on this year’s winners can be found on the Bear Institute PACK website.

“This year’s Bear Institute PACK had a lot of start-ups and student team participants with very impressive innovation solutions for kids. Selecting a single winner in each innovation track was a tough decision, and it was encouraging to see all the work being done to bring these solutions to market,” says Matt MacVey, Vice President and Chief Information Officer, Children’s National Hospital. “Thank you to everyone who participated and helped make the inaugural Bear Institute PACK a success! We hope to make next year even bigger as we continue to strive to close the gap in funding for children’s digital health innovation.”

More information on next year’s event will be forthcoming on the Bear Institute PACK website.

Utilization Review Accreditation Commission presents telehealth accreditation

Children’s National receives Telehealth Accreditation from URAC

URAC accredidation seal

Children’s National Hospital has received Telehealth Accreditation from URAC for its commitment to promoting quality virtual health services for patients and families. Children’s National is the first pediatric hospital to receive this recognition.

“This accreditation demonstrates our hospital’s commitment to continually improving the delivery of care by leveraging best practices in virtual care,” says Clarence Williams, MHA, MBA, director of Telehealth at Children’s National Hospital. “We’re dedicated to using digital tools in support of improving patient outcomes.”

URAC’s telehealth accreditation recognizes organizations that provide telehealth services with a focus on the best medical outcomes and improved safety for their patients.

“By earning Telehealth Accreditation from URAC, Children’s National Hospital operates at the forefront of health care delivery for their medically fragile patients,” said URAC President and CEO Shawn Griffin, M.D. “Meeting URAC’s telehealth standards means Children’s National Hospital provides more than a platform for transaction-based appointments. It demonstrates that Children’s National Hospital leverages technologies to advance high-quality care that promotes clinical best practices, consumer protections and care continuity between patients and providers. As telehealth becomes a more widespread option, Children’s National Hospital distinguishes itself as an established, accredited organization committed to improving the health and well-being of the children they serve.”

The COVID-19 pandemic spurred a rapid increase in virtual care services and this accreditation is one example of the hospital’s commitment to quality and coordination of care, consumer protection and regulatory compliance, all while quickly expanding access through virtual care during a public health emergency.

Utilization Review Accreditation Commission presents telehealth accreditation

US News badges

For fifth year in a row, Children’s National Hospital nationally ranked a top 10 children’s hospital

US News badges

Children’s National Hospital in Washington, D.C., was ranked in the top 10 nationally in the U.S. News & World Report 2021-22 Best Children’s Hospitals annual rankings. This marks the fifth straight year Children’s National has made the Honor Roll list, which ranks the top 10 children’s hospitals nationwide. In addition, its neonatology program, which provides newborn intensive care, ranked No.1 among all children’s hospitals for the fifth year in a row.

For the eleventh straight year, Children’s National also ranked in all 10 specialty services, with seven specialties ranked in the top 10.

“It is always spectacular to be named one of the nation’s best children’s hospitals, but this year more than ever,” says Kurt Newman, M.D., president and CEO of Children’s National. “Every member of our organization helped us achieve this level of excellence, and they did it while sacrificing so much in order to help our country respond to and recover from the COVID-19 pandemic.”

“When choosing a hospital for a sick child, many parents want specialized expertise, convenience and caring medical professionals,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “The Best Children’s Hospitals rankings have always highlighted hospitals that excel in specialized care. As the pandemic continues to affect travel, finding high-quality care close to home has never been more important.”

The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals. The rankings recognize the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News. The top 10 scorers are awarded a distinction called the Honor Roll.

The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.

Below are links to the seven Children’s National specialty services that U.S. News ranked in the top 10 nationally:

The other three specialties ranked among the top 50 were cardiology and heart surgerygastroenterology and gastro-intestinal surgery, and urology.

PAS Logo

Children’s National participants share their expertise at PAS meeting

PAS Logo

The 2021 Pediatric Academic Societies (PAS) Virtual meeting hosted live-streamed events, on-demand sessions with live Q+A, a virtual exhibit hall, poster presentations and networking events that attracted pediatricians and healthcare providers worldwide. Among the physician-scientists, there were over 20 Children’s National Hospital-affiliated participants at this year’s meeting, adding to the conversation of pediatric research in specialty and sub-specialty areas.

Children’s National experts covered a range of topics, including heart disease, neurology, abnormal glycemia in newborns and antibiotic use in hospitalized children.

The “Neurological Implications of Abnormal Glycemia in Neonatal Encephalopathy and Prematurity” was a hot topic symposium presented by a panel of experts, including Sudeepta Basu, M.B.B.S., M.S., neonatologist at Children’s National.

The experts addressed the importance of recognizing early blood glucose disturbances in newborns with encephalopathy following birth asphyxia and its likely impact on brain injury and long-term outcomes. Although whole body cooling for newborns with encephalopathy after birth asphyxia is now standard of care in most advanced centers like Children’s National, many newborns still die or have neurological impairments. Dr. Basu emphasized on the need of continued advances in newer therapies and optimizing intensive care support for these vulnerable newborns immediately after birth. Dr. Basu’s presentation focused on the association of not only low blood glucose (hypoglycemia) but also high blood glucose (hyperglycemia) with abnormal motor, visual and intellectual outcomes in surviving newborns.

“Recognizing the problem is the first step for further advancement,” Dr. Basu said. “The scientific community needs to recognize the importance of early glucose status as an early marker for disease severity and risk of brain injury.” To sum up, Dr. Basu drew attention to recent newborn resuscitation guidelines from the International Liaison Committee on Resuscitation (ILCOR), which recommends close monitoring of blood glucose levels and optimizing supportive care to maintain it within normal range. Dedicated clinical trials are the need of the hour to guide what are “normal” glucose levels in newborns with encephalopathy and what treatment options are most beneficial.

Rana F. Hamdy, M.D., M.P.H., M.S.C.E., director of the Children’s National Antimicrobial Stewardship Program, delved into the increased number of children receiving care for acute conditions – like acute respiratory tract infections – from urgent care centers and direct-to-consumer (DTC) telemedicine companies during her session “Implementing Antibiotic Stewardship in Telemedicine and Urgent Care Settings.”

Telemedicine, in this case, refers to DTC telemedicine companies—not to be confused with the telemedicine established with primary care providers, like the services provided by Children’s National.

There has been little research focused on promoting good antibiotic stewardship in urgent care settings that tend to overprescribe antibiotics compared to a primary care setting. In addition to her work focusing on improving antimicrobial use within Children’s National, Dr. Hamdy has led collaborative quality improvement work nationally in both the pediatric urgent care and DTC telemedicine settings.

“What we’ve learned from our work with the DTC telemedicine setting is that leadership commitment coming from the company is a necessary core element,” Dr. Hamdy said. “There may be unique opportunities in the telemedicine setting to employ the home-grown computer systems for antimicrobial stewardship interventions, for example, incorporating clinical decision support or feedback reports into the electronic health record systems or displaying a commitment letter in the virtual waiting room.”

In the urgent care setting, Dr. Hamdy’s team recruited approximately 150 pediatric urgent care providers to participate in the national quality improvement initiative. Communication training modules for pediatric urgent care providers with scripted language for target infectious conditions — acute otitis media, pharyngitis and otitis media with effusion — were among the successful intervention approaches that led to improved appropriate antibiotic prescribing practices, according to her team’s findings.

“Understanding the prescribing practices in the urgent care setting is important to knowing where and how to focus on target conditions and to be able to support with education and resources,” Dr. Hamdy said. “And understanding the perceived barriers to judicious antibiotic prescribing can help to identify the highest yield interventions.”

This also reflects the approach taken by the outpatient antibiotic stewardship team at the Children’s National Goldberg Center, led by Ariella Slovin, M.D., primary care pediatrics provider at Children’s National Hospital. Dr. Slovin’s oral abstract entitled “Antibiotic Prescribing Via Telemedicine in the Time of COVID-19,” examined the effect that a shift to telemedicine due to the COVID-19 pandemic had on antibiotic use for acute respiratory tract infections. Overall, her team found a decrease in the proportion of acute respiratory tract infections prescribed antibiotics and concluded that the shift to telemedicine did not adversely affect judicious antibiotic prescribing for acute respiratory tract infections.

Other participants from Children’s National included: Taeun Chang, M.D.; Yuan-Chiao Lu, Ph.D.; Chidiogo Anyigbo, M.D., M.P.H.; Panagiotis Kratimenos, M.D.; Sudeepta Basu, M.B.B.S., M.S.; Ashraf Harahsheh, M.D., F.A.C.C., F.A.A.P.; Rana F. Hamdy, M.D., M.P.H., M.S.C.E.; John Idso, M.D.; Michael Shoykhet, M.D., Ph.D.; Monika Goyal, M.D.; Ioannis Koutroulis, M.D., Ph.D., M.B.A.; Josepheen De Asis-Cruz, M.D., Ph.D.; Asad Bandealy, M.D., M.P.H.; Priti Bhansali, M.D.; Sabah Iqbal, M.D.; Kavita Parikh, M.D.; Shilpa Patel, M.D.; Cara Lichtenstein, M.D.

To view the PAS phase I mini session list and the various areas of expertise at Children’s National, visit: https://innovationdistrict.childrensnational.org/childrens-national-hospital-at-the-2021-pediatric-academic-societies-meeting/

patient meets with ED robot

New robot helps care for kids in the emergency room at Children’s National Hospital

patient meets with ED robot

The robot, which is part of the FCC-funded COVID-19 Telehealth Program at Children’s National, is the latest innovation of the program that has rapidly evolved due to the ongoing pandemic.

Children and families who come into the emergency room at Children’s National Hospital may be surprised when their doctor comes in – in the form of a robot. Children’s National introduced a new robot to its Emergency Department (ED) for patients under evaluation for a COVID infection or being treated for other conditions. The robot, which is part of the FCC-funded COVID-19 Telehealth Program at Children’s National, is the latest innovation of the program that has rapidly evolved due to the ongoing pandemic.

“The robot can move in and out of spaces that otherwise we couldn’t get a significant number of providers in, especially with COVID-19 restrictions in place,” said  Shireen Atabaki, M.D., M.P.H., associate medical director of Telemedicine, emergency medicine physician and program director for the COVID-19 Telehealth Program at Children’s National. “This is a really exciting program and it implements innovation that we might not have been able to do without the insights we’ve gained from the pandemic.”

The robot is Wi-Fi-enabled and can be remotely controlled by the physician providing the teleconsultation to monitor patient vitals — such as heart rate, body temperature or respiration rate. This allows doctors to work virtually with their team while also having the flexibility to attend to patients faster.

“The pandemic has made us aware of the need to protect patients, families and staff from infectious diseases,” said  Alejandro Jose Lopez-Magallon, M.D., medical director of Telemedicine at Children’s National. The robot, he noted, spares clinicians from having to change their PPE, which saves time and gives them the ability to move on to the next patient while nurses and staff continue to provide bedside care.

“We have also seen that whenever a remote clinician is completely alone in the command center and can get on-screen without a mask, in a paradoxical way our patients may be more accepting of seeing a face on a screen that’s not covered with a mask and shield than a stranger using a mask in the same room,” Dr. Lopez-Magallon added.

Soon, the robot will also be used to coordinate subspecialty care — such as cardiac care — in the ED. This will provide more streamlined and expedited care for patients. Instead of leaving with a referral to set up a follow-up appointment with a specialist, patients would be able to receive the consult they need during the same appointment.

The robot is also presenting promising solutions for concerns around the number of restricted visitors. The team at Children’s National recently piloted using an iPad and other technology purchased with the FCC funds to remotely connect family members with patients.

“We downloaded the Zoom app to iPads in our ED to be able to coordinate calls between family members who can’t come in and see patients,” said Dr. Atabaki. “We are looking to implement this as a permanent solution keeping in mind how burdensome and emotionally stressful it has been for many not having the ability to be by the loved one’s side during such a challenging time.”

The FCC funds also covered the telehealth carts, tablets and other connected devices, the telehealth platform, telehealth equipment and innovative AI (augmented intelligence) to treat seriously ill COVID-19 pediatric patients.

The emergency department robot brings the robot-fleet at Children’s National up to three. The first robot was debuted in 2019 to serve children and families in the Cardiac Intensive Care Unit.

Natasha Shur

NORD names Natasha Shur, M.D., as hero of rare disease

Natasha Shur

Dr. Shur has a career working as a clinical geneticist for over a decade. She has been a part of the Children’s National community for more than two years. Dr. Shur as well serves as the lead for the Telemedicine Genetics Program under the Rare Disease Institute.

For her advancements in telemedicine genetics and rare diseases, Medical Geneticist Natasha Shur, M.D., received the 2021 Rare Impact Award from the National Organization for Rare Disorders (NORD). The recognition is the highest honor given to individuals that developed exceptional work benefiting the rare disease community.

“Despite the pandemic and the challenges we have faced, there are still heroes to be found among us from whom we can draw inspiration and motivation to keep moving forward,” said Peter L. Saltonstall, NORD president and CEO.

Given her involvement with several innovative projects at Children’s National Hospital, Dr. Shur built an active in-home telemedicine program where patients are being seen for first visits and follow-ups. Her work is helping families, including those with autistic children.

“Recently, in our division, we have been talking a lot about the concept of ‘failing forward.’ The idea is to try new approaches. These methods may not work, but the status quo does not always work either,” said Dr. Shur. “Since we have such a supportive and wonderful group, we can try new ways of working and new models of care.”

During the pandemic, the division led by Marshall Summar,.M.D., also created a telehealth first model of care and augmented educational apps and opportunities. The goal was to ensure that patients with rare disease would not lose access to care. The medical geneticists, genetic counselors, dieticians and administrative team met daily and cohesively to explore and improve new clinical approaches in order to put patients and families first.

Dr. Shur has a career working as a clinical geneticist for over a decade. She has been a part of the Children’s National community for more than two years. Dr. Shur as well serves as the lead for the Telemedicine Genetics Program under the Rare Disease Institute.

The Rare Disease Institute recently opened its new location on the Children’s National Research & Innovation Campus, a first-of-its-kind pediatric research and innovation hub located in Washington, D.C. The campus will provide a unique, state-of-the-art home for clinical genetic and specialty services.

FCC Chairwoman Jessica Rosenworcel visited Children’s National Hospital

Acting FCC chairwoman Rosenworcel highlights telehealth for pediatrics

FCC Chairwoman Jessica Rosenworcel visited Children’s National Hospital

Acting FCC Chairwoman Jessica Rosenworcel visited Children’s National Hospital yesterday to highlight the importance of connectivity in healthcare and learn more about how the hospital is using telehealth to serve families during the pandemic. Children’s National Hospital in Washington, D.C., has provided pediatric care for 150 years and is among the nation’s top 10 children’s hospitals. Last year, Children’s National, an academic pediatric health system, saw more than 219,000 children from the capital region and from across the country and around the world.

“So much more can be done to connect children and their families — in both urban and rural parts of the country — to the care they need not only to survive, but to thrive,” said Rosenworcel. “Telehealth can help bridge that gap by bringing specialty care available only in hospital centers to smaller clinics and even the home where problems can be addressed quickly, before they prove life threatening. I was encouraged by the creative work that Children’s National Hospital is doing to address the unique health needs of children from all backgrounds especially during these challenging times.”

Acting Chairwoman Rosenworcel was joined by her colleague FCC Commissioner Nathan Simington for a tour of the hospital, where they met with Shireen Atabaki, M.D., M.P.H., associate medical director of Telehealth, Emergency Medicine physician and program director for the COVID-19 Telehealth Program at Children’s National Hospital. The visit also included a demo of a telehealth robot by Ricardo Munoz, M.D., Cardiac Critical Care Medicine chief, and Alejandro Jose Lopez-Magallon, M.D., medical director of Telemedicine, both at Children’s National.

“The pandemic catapulted telehealth as a tool for the future of health care delivery,” said Dr. Atabaki. “With the support of the FCC, Children’s National is excited to introduce a robot and other state-of-the-art digital health technology to support provider-to-patient pediatric care and expert consultations in our hospital’s emergency departments and across our region. These innovations in telemedicine will facilitate access to specialized expertise and care of COVID-19 patients.”

In May 2020, Children’s National Hospital was approved for funding as part of the FCC’s COVID-19 Telehealth Program and established a regional pediatric telehealth consortium. This will enable the hospital to expand its telehealth platform to support 15 health care sites in the region serving children and young adults, providing care to children with COVID-19, as well as those who are medically vulnerable.

Acting Chairwoman Rosenworcel is committed to closing the digital divide and sees access to telehealth care services — especially for underserved and marginalized communities — as a top priority. To learn more about telehealth efforts at the FCC, including the COVID-19 Telehealth Program and the Connected Care Pilot Program, visit: https://www.fcc.gov/connecting-americans-health-care.

a telehealth video visit with a patient family

Steady rates of patient satisfaction, reimbursement for cardiac telehealth during COVID-19

a telehealth video visit with a patient family

In the first two weeks of COVID-19’s major impact on the U.S., Children’s National Hospital moved most of its subspecialty in-person day-to-day clinics to virtual care. Children’s National Heart Institute was one of the first divisions to offer telehealth visits — in part because the team was an early adopter of telehealth in cardiology for both physician-to-physician consultations and direct-to-patient care, and stood poised to widely implement it.

A poster presentation at the American Heart Association Scientific Sessions 2020 quantified how the rapid transition to direct-to-consumer telehealth services impacted families with children who have congenital heart disease. The findings were presented by first author Kristine Mehrtens, M.S., B.S.N., R.N., C.P.N., clinical manager for the Heart Institute’s Ambulatory Services.

The team found that though in-person cardiology visits decreased during the COVID-19 pandemic, direct-to-patient telehealth visits were able to partially compensate for the sudden drop.

Additionally, payer reimbursement rates for these direct-to-consumer telehealth visits were similar to in-person clinic visits.

”This is exciting as prior to COVID-19  we have seen a lower reimbursement rates for these cardiology direct-to-consumer telehealth visits compared to in-person cardiology clinic visits,” said Ashraf S. Harahsheh, M.D., a pediatric cardiologist at Children’s National Hospital who has utilized direct-to-consumer telehealth visits since 2016 and is a senior author on the new study.

Patient satisfaction scores for care providers, including the likelihood of recommending a care provider from Children’s National Hospital, was the same for telehealth follow-up visits as it was for in-person clinic visits before the pandemic.

“As a multidisciplinary team, we agreed that diagnostic studies such as echocardiograms were important to include with follow-up visits,” says Mehrtens. “Together we developed a strategy to ensure we could meet the needs of the patients and also safely conduct in-person visits when necessary.”

Why is this important?

The pandemic and the resulting temporary halt to in-person, non-urgent/emergent visits earlier this year put the most vulnerable people with congenital heart disease at high risk for complications or worsening of their existing heart disease because they are unable to follow the recommended schedule for follow-ups.

The readiness of the Children’s Heart Institute team to quickly move to a telehealth platform successfully bridged the gap between in-person visits for some patients, allowing cardiology surveillance to continue safely.

“I am proud of our team of physicians and advanced care providers,” Harahsheh concludes. “We went from three providers (8%) pre-COVID 19 to 31 (79%) providers offering direct-to-consumer telehealth visits during the pandemic.”

What’s next?

Building on previous, smaller studies of telehealth before the pandemic began, the team will continue to conduct research to assess the safety and efficacy of these telehealth visits over time. The increase in patients who are continuing to see their providers for routine follow-ups via telehealth will allow a larger sample for effective study of this care model.

American Heart Association Scientific Sessions 2020
Impact of Telemedicine on Pediatric Cardiac Center’s Ambulatory Response to the 2019 Novel Coronavirus Disease (covid-19) Pandemic
P1692
9:00am – 10:00am
Fri, Nov 13  (CST)

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