S3E3 Virtual Pediatric Care

HOP’s framework utilizes a software suite with deep learning algorithms, data analytics, and a large data science team to improve the quality of care for patients with autism spectrum disorder. HOP’s machine learning technology offers a level of flexibility that enables the adaptation of care to meet the needs of each unique individual. 

Meanwhile, in the health system sphere, McCafferty and Jouvet rely on digital innovations to improve care both within and outside the walls of the hospital. At Nicklaus Children’s Hospital, digital transformation has been a key pillar of the organization since the mid 2000s. From the establishment of an advanced ICU care pavilion to preventative medicine, McCafferty and her team are focused on using digital platforms and methods to elevate the experience of patients and families. Similarly, Jouvet and the providers at CHU Sainte-Justine use data from digital monitoring to manage care in the ICU environment. Jouvet tells viewers that the ultimate goal is to capture the abundance of data available and create systems that can analyze this data in real time to help caregivers manage the health of children in the ICU. 

In the era of COVID, digital approaches have changed the face of care delivery for a large portion of the population. Virtual visits are more available (and often preferred) as patients and providers alike strive to maintain a safe distance. Nonetheless, pediatric medicine in the time of COVID-19 is a peculiar case. According to Jouvet, the relatively low impact of the novel coronavirus in children is unusual: 

“It’s rare to have an infectious disease that doesn’t have a strong impact on the pediatric population. When it comes to infectious diseases, there are usually two demographics that are hit the hardest: children and the elderly. It’s very strange to see that children are not as likely to become ill with COVID-19.”

Jouvet posits that the reason for the disproportionate impact on older adults lies in the inflammatory reaction to infection. Jouvet explains that the multisystem inflammatory reaction seen in severe presentations of COVID-19 is associated with age, and he believes that the ability of a child’s immune system to effectively “cool itself down” quickly contributes to better outcomes in the pediatric population. Despite the positive trajectory for pediatric COVID patients, the full picture is far more complicated. When children arrive at the emergency department with COVID, they do not come alone; adult caretakers accompany them. This means that the child’s guardians and relatives are often exposed. According to McCafferty, many of the patients at Nicklaus in Miami come from multigenerational families, thus there are often at-risk individuals over 60 years of age that want to be part of the care environment. This has posed a challenge for providers at Nicklaus and other hospitals, as healthcare providers seek to keep everyone safe while keeping children connected to their loved ones. McCafferty summarizes this “dual reality” of COVID-19 in pediatric patients:

“We know, as pediatric care providers, that children are at lower risk for severe presentation as it relates to a COVID-19 diagnosis. The jury’s still out on how children spread it, the role of asymptomatic spreaders, and all of those pieces.”

In sum, pediatric care extends beyond the child to family members and other relatives. It’s important to consider the roles of and risk to caregivers in the pediatric environment, especially as COVID remains a daunting threat. 

COVID-19 has challenged the norms and expectations inherent to the care environment. In many ways, the pandemic has strained healthcare systems, but it has also created new opportunities for improving the lives of children and families. With the transition to largely virtual schooling, children with autism spectrum disorder may experience less anxiety and agitation relating to the social events of the school day. Pelletier points out that this can add a layer of security and comfort to a child’s daily life. At a system level, Nicklaus Children’s Hospital and other regional healthcare institutions have created partnerships aimed at ameliorating the burden of COVID-19. Faced with the possibility of an overwhelming surge in cases, systems that normally compete with one another came together to create a regional care ecosystem. Nicklaus and other hospitals in the area established a transfer agreement that enabled adults to be cared for in an adult setting, and children to be cared for in a pediatric setting. The establishment of this collaboration has implications beyond the current moment. McCafferty tells viewers that the partnership has enabled everyone involved to think more broadly about how working together might improve quality outcomes for patients in the region. 

As systems face the fallout of the COVID crisis, individuals like McCafferty, Jouvet, and Pelletier hope to learn from the demands of the pandemic to improve the quality of patient care. Pelletier predicts an increase in remote patient monitoring for patients in the autism spectrum population, and Jouvet sees promise in continuous monitoring for all pediatric patients through the use of wearable devices. 

McCafferty provides viewers with a powerful closing sentiment: “we have seen glimmers of positivity around what we can learn, particularly as it relates to being nimble and resilient, and keeping our focus on why we do what we do, which is providing quality care to kids who need it.” One thing is clear: despite the obstacles and challenges of the current moment, there is always room for hope. 

DHIT thanks its guests for serving on the panel, and everyone who tuned in! If you were not able to catch last week’s webinar, check out DHIT’s Media page to see what you missed. For more information, see the latest edition of the DHIT Digest, and mark your calendar for Friday, November 20th for the next installment of the DHIT Frequency Webinar Series, which will focus on Precision Medicine. You can register NOW for the episode here. Until then, stay safe, everyone! 

Resources

• To view previous recordings, visit DHIT’s Media page here: https://www.dhitglobal.org/media/
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ABOUT DHIT

The Digital Health Institute for Transformation (DHIT)  is a non-profit education and research institute supporting organizations and communities through the process of digital health transformation. We collaborate with leading academic institutions, associations, and industry to cultivate talent and ecosystems with our immersive learning platform, harnessing real-world experiences that drive the adoption of next generation skills, emerging technologies, and mindsets needed to foster the digital health leaders and innovators of the future, today. For more information, visit dhitglobal.org.

ABOUT THE QUÉBEC GOVERNMENT OFFICE IN ATLANTA

The Québec Government Office in Atlanta opened its doors in 1978 to take advantage of the strong

growth of the southern United States. In addition to defending and advancing Québec’s interests, the mandate of the Québec Government Office in Atlanta is to develop and promote economic, political and institutional ties with the seven states in the region, that is, Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, and Tennessee, as well as the U.S. Virgin Islands and Puerto Rico. It also contributes to the activities of the Southeastern United States – Canadian Provinces Alliance (SEUS-CP), of which Québec is a founding member.