Children's Hospitals Today - Winter 2017 - 21


INNOVATION / FEATURE

CRISPR
next-generation EMRs and
advanced data analytics,
you see that a physician's
assistant or clinical nurse
practitioner or other
extenders can safely
practice advanced medicine
or specialty medicine with
the guidance of a specialist
physician," Kini says. "So
the days of networks where
a neurology extender can
do neurology far away from
the hospital and be backed
up by a neurologist using
telemedicine are here."

11 | Stem cells
Stem cells have the potential
to turn into anything-a skin
cell, a liver cell, a brain cell.
And stem cell transplants
have the power to treat a
wide range of diseases in
children, from cancers
like leukemia, lymphoma
and neuroblastoma to
blood disorders, immune
system diseases and bone
marrow syndromes.

12 | Surgical
advances
Radical advances-
from fetal surgery
to the world's first
bilateral hand transplant
performed on a child at
The Children's Hospital
of Philadelphia last
year-have transformed
pediatric surgery. Cardiac
catheterizations have even
reduced the need for heart
surgery, Kini says.

13 | Respiratory
supports
The adoption of surfactant-
a molecule sprayed into the
lungs of premature babies
that helps them breathe and
their lungs to grow-has
saved babies who otherwise
would have died. Another
advance: using sildenafil
citric (the same chemical
as Viagra) to reverse
pulmonary hypertension.

PUBLIC POLICY
14 | Accountable care organizations (ACOs)
ACOs-the groups of doctors, hospitals and other health care providers
that tie payment to quality metrics and cost of care-have become more
prominent in the last 10 years. "At the state and federal levels, there's a
big push to keep or require hospitals to be accountable for the health of
their patients and paying them for that, either in capitated payments or
risk/reward type of arrangements," Wolfe says. "There's more onus on
the provider to provide high-quality care in a value-based way."

15 | Laws that protect
Laws that prevent smoking in public places
reduced issues around exposure to secondhand
smoke, such as bronchitis and asthma. Laws on
the use of car seats, seat belts and helmets have
reduced trauma. In fact, a 1998 study published
in the Annual Review of Public Health showed that
bicycle helmets prevent up to 88 percent of brain
injuries. "These are examples of advances not in
the technology or therapeutic realms but they are
contributing to the health of children," Kini says.

"Clustered regularly
interspaced short
palindromic repeats
(CRISPR) is a genome
editing tool that
removes an infected
gene-HIV or cancer
as examples-and
fixes the gene to
eradicate disease. It's a
profound innovation.
The downside: the
potential for creating
'designer babies.'"
M. NARENDRA KINI
M.D., M.H.A., CEO,
Miami Children's
Health System
FETAL SURGERY
"We will change
outcomes by treating
complex conditions
and life-threatening
diseases in utero.
We will also correct
genetic disorders in
the developing fetus,
allowing for cures to
devastating diseases
before a baby is born."
BRAD FELTIS, M.D.,
surgical director, Fetal
Medicine, Children's
Hospitals and Clinics
of Minnesota
THE COMMUNITY
"Improving health
and well-being will go
beyond a hospital's
walls. Children's
hospitals need to
address social issues,
like hunger and
housing insecurity, to
improve the health
of communities."
LORI FERGUSON, vice
president, Patient Care
Services, ProMedica
Toledo Children's Hospital

CHILDREN'S HOSPITAL S TODAY Winter 2017

21



Table of Contents for the Digital Edition of Children's Hospitals Today - Winter 2017

Contents
Children's Hospitals Today - Winter 2017 - Cover1
Children's Hospitals Today - Winter 2017 - Cover2
Children's Hospitals Today - Winter 2017 - Contents
Children's Hospitals Today - Winter 2017 - 2
Children's Hospitals Today - Winter 2017 - 3
Children's Hospitals Today - Winter 2017 - 4
Children's Hospitals Today - Winter 2017 - 5
Children's Hospitals Today - Winter 2017 - 6
Children's Hospitals Today - Winter 2017 - 7
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Children's Hospitals Today - Winter 2017 - 21
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