Zulfiqar Bhutta, MBBS, PhD, inaugural chair in global child health at the Hospital for Sick Children, Toronto, and founding director of the Center of Excellence in Women and Child Health, Aga Khan University, Pakistan, is a global child health superstar. Presidents, prime ministers and princes welcome his advice. Yet India ignored him when he called its proposed innovation to curb infant mortality “nonsense.” “I was dead wrong,” says Bhutta. “What happened is remarkable.”
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By the time Cameron Shearing arrived at the South Shore Hospital Emergency Department (ED) during a December snowstorm, he wasn’t breathing. He didn’t have much time. The two-year-old had aspirated a chocolate-covered pretzel, which sent tiny bits of material into his lungs.
The odds of a good outcome were not high. Pretzel is one of the worst foods to aspirate for two reasons: The small pieces can block multiple small airways, and the salt, which is very irritating, causes a lot of inflammation.
“Cameron was one of the sickest patients I ever cared for as an emergency physician. I did everything I could within my scope of practice, but he needed the tools and expertise of pediatric subspecialists,” recalls Galina Lipton, MD, from Boston Children’s Department of Emergency Medicine, who was staffing the South Shore Hospital emergency room that evening. Full story »
Israel 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. Full story »
But she never fancied herself an innovator—until recently. After participating in Hacking Pediatrics, sponsored by Boston Children’s Hospital in collaboration with MIT’s H@cking Medicine, she now sees potential innovations and innovators everywhere.
“To be an innovator, you don’t need to be extraordinary, you just need to recognize that a problem exists and be dedicated to fixing it,” she says.
The problem she took to last month’s Hacking Pediatrics Hackathon stems directly from her work. As co-medical director at Boston Children’s Eosinophilic Gastrointestinal Disease (EGID) Program, which treats specific food allergies causing gastrointestinal inflammation, she sees families constantly struggling to find new (and healthy) meals that won’t trigger an allergic reaction in their kids.
“Many of our patients can only safely eat a handful of foods, so feeding them with any kind of variety is extremely hard,” she says. “Then if you factor in the likes, dislikes and other food intolerances that often exist in a family, just planning one family meal can feel like a nightmare.” Full story »
In the health care industry, we rely heavily on regulations to ensure the safety of our patients, procedures and drugs. New national health care regulations can even spur innovation in care delivery, but in the case of telehealth, they can be an impediment.
Telehealth, the remote delivery of care via computers, mobile devices, videoconferencing and other technologies, has great potential to improve the patient experience and reduce health care costs by removing the barriers of brick and mortar. At Boston Children’s Hospital, the Innovation Acceleration Program’s pilot telehealth programs have focused on both direct patient care and virtual clinician-to-clinician consultations.
Unfortunately, most states’ regulations are limiting providers’ ability to broadly offer telehealth services. Full story »
Malaria presents a formidable global challenge. It affects more than 200 million people worldwide every year, and more than 1 million people die from it, primarily pregnant women and children under the age of 5 years. Resistance to existing anti-malarial medications is a constant, and vaccines have not proven effective. But the disease also presents a unique opportunity for researchers to uncover innovative solutions. As a result, even the cash-conscious National Institutes of Health (NIH) is investing in malaria research.
Boston Children’s Hospital physician Jeffrey Dvorin, MD, PhD, recently received a High-Risk, High-Reward New Innovator Award from the NIH. The award is reserved for early-stage investigators whose research has potential for significant impact, but who may lack enough data for a traditional NIH R01 grant. Dvorin will use the $1.5 million, five-year grant to pursue research that could lead to new tools to combat malaria.
The challenges of treating malaria begin at the molecular level. To develop new anti-malarial tools, the research community needs to understand how the parasite replicates. Determining which genes are essential to parasite replication could provide the data needed to develop new medications or an effective vaccine. But scientists have not yet determined functions for more than half of the 5,500 genes in Plasmodium falciparum, which causes the majority of malaria infections in Africa. Full story »
But beyond individual events, could hackathons signal the beginnings of a new ecosystem for medical innovation?
That’s what groups like MIT’s H@cking Medicine, Brigham and Women’s Hospital (BWH)’s new iHub and the New Media Medicine group at the MIT Media Lab are betting on. By tapping the same creative entrepreneurial energy that hackathon culture has brought to the technology industry, they believe they can fundamentally reimagine health care, one device, app and system at a time.
“The Boston area is the most fertile ground for medical innovation you could ever imagine,” says Michael Docktor, MD, a gastroenterologist at Boston Children’s and one of the organizers, with the H@cking Medicine team, of this weekend’s Hacking Pediatrics hackathon. “We need to make the case with the local medical and technology community that hackathons are a viable way of innovating in this day and age, that this is the way we ought to be innovating.” Full story »
When James Mandell, MD, outgoing CEO of Boston Children’s Hospital, introduced keynote speaker Robert Langer, PhD, at the National Pediatric Innovation Summit + Awards, he shared one of Langer’s favorite quotes. “When scientific literature says something isn’t possible, you just have to create possibilities that don’t exist.”
Langer, the David H. Koch Institute Professor at the Massachusetts Institute of Technology (MIT) and the most cited engineer in history, walked the audience through the trials and tribulations he encountered in his four-decade career as an innovator.
When he finished his ScD in chemical engineering in 1974, Langer was heavily courted by the oil and gas industries, which aimed to leverage the knowledge of young chemical engineers to address the oil crisis. But that work didn’t appeal to him.
Instead, Langer was taken with the idea of teaching chemistry to underserved youth. Unfortunately, he could not secure a position with any of the 40-odd programs to which he applied.
Eventually, a colleague suggested to him that Judah Folkman, MD, a pioneering cancer researcher at Boston Children’s, sometimes hired “interesting people.” Langer took the bait and joined Folkman’s lab in the mid-1970s.
“I may have been the only engineer in the place. I learned so much because everyone’s backgrounds were so different,” he recalled. Full story »
Over the past few months, the Vector team has been collecting definitions from varied thought leaders—inside and outside Boston Children’s—and the responses have reflected the varied nature of their respective fields. In this series, the term has been called “clichéd” at one extreme to “necessary” for the evolution of care delivery at the other. This week’s respondents range from former FDA leaders to informatics experts to critical care specialists to bioengineers. Follow our continuing coverage of innovative efforts through this week’s National Pediatric Innovation Summit + Awards.
Innovation is the belief that we have an obligation to move the world forward through positive and lasting change, leaving it better than we found it. —Jeffrey P. Burns, MD, MPH, Chief of Critical Care Medicine; Director, Medical/Surgical Intensive Care Unit, Boston Children’s Hospital
Innovation is the process of significantly and meaningfully changing the way things are done, operate or perform. Most people think of innovation in terms of the individual developing a novel idea and inspiring or causing change. I think what is often overlooked is the power of a large organization to provide meaningful innovation on a broad scale—it’s not just the single individual that can innovate. Great examples of this are the Apollo mission to the moon, Google, the Internet, the Boeing 747 or, in health care, the development of advanced medical devices. The key to innovation, either as an individual or as a large organization, is to provide transformative change. —Robert “Chip” Hance, CEO of Creganna-Tactx Medical; former Entrepreneur-in-Residence at the FDA Full story »
“Technology developed specifically for children has been a low priority,” Krummel began at a two-part talk at Boston Children’s Hospital this summer (read our coverage of the other part). “The FDA barriers are incredibly high, and ultimately, investors just demand returns that pediatric markets won’t necessarily deliver.”
As Krummel detailed, the FDA barriers are there for a reason: a past history of ethical abuses in human subjects research. In 1966, physician Henry Beecher, MD, exposed many examples in The New England Journal of Medicine, such as withholding effective treatment for the sake of research, proceeding with a treatment despite recognized hazards, or failing to disclose risk to patients. Institutional Review Boards (IRBs) arose in the mid-1970s to protect research subjects—protections that are especially strict when that research is done in children.
But there’s also a deep-seated reluctance to break with the status quo. Full story »