Research Assessment #3

Topic: Pediatric Cardiology

Date: September 28, 2018
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Analysis:
Technology is an essential part of the medical field today. It’s used
everywhere from keeping digital medical records, in the form of cameras in the
operating theatres, and even in general physicians’ offices as blood pressure cuffs.
Another aspect of technology in the medical field can be found in the recent
pediatric expansion of UC Davis’ Medical Center called telemedicine. UC Davis’
Medical Center has debuted “FaceTime”-like camera devices that allow parents and
guardians to see and interact with their child in the Neonatal Intensive Care Unit
(NICU). This technological addition serves both locally based families and families
that are farther away to lessen their anxiety about their child as they would be able
to communicate with their child at any time via smart devices. Furthermore, this
article introduced me to the concept of in-utero invasive and non-invasive
procedures.
This article made me more understanding of the different means by which
technology can be used in medicine. I was aware of what telemedicine was but I was
unaware of the different forms of telemedicine, especially that it could be/was
transmitted directly from hospitals. This one example of telemedicine shows what
an extensive effect technology has on advancing patient care and how it strengthens
the rapport between parents, the child, and the physician.
It was stated in the article that the UC Davis Medical Center was trying to
bridge gaps between rural need for sub-specialized care. This point stood out to me
as it exemplified that access to pediatric specializations was insufficient when
compared to need for the same specializations. Furthermore, the article also noted a
5.3 percent increase in visits to the pediatric sub-specialty clinic which signifies the
increased necessity for pediatric sub-specialized care. This new advancement at UC
Davis tries to compensate for this lack of access that rural families face and will
hopefully succeed.
In addition to learning about the technological improvements implemented
by UC Davis Medical Center, I also learned about in-utero invasive and non-invasive
procedures. Essentially, in-utero procedures allow the child’s heart to normalize
quicker as their heart is still developing. These procedures would allow their heart to
mature with theses newly made corrections. The increasing number of these
procedures in addition to early detection of congenital heart disease could greatly
affect the quality and efficiency of patient care as they would decrease the amount
of recovery time for the child and lessen complications in the future.

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MLA Citation:
Alvarez, Felicia. “‘Facetime for Preemies,' in-Utero Therapies Part of UC Davis’
Pediatric Expansion.” Sacramento Business Journal, Sacramento Business
Journal, 25 Sept. 2018,
www.bizjournals.com/sacramento/news/2018/09/25/facetimefor-preemies-in-
utero-therapies-part-of.html.

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(see next page for annotations)

Article Annotations:

‘Facetime for preemies,' in-utero

therapies part of UC Davis’
pediatric expansion
By Felicia Alvarez
See Correction/Clarification at end of article

Between a $40 million surgery unit and a stream of new physicians,

UC Davis Medical Center is doubling down on its pediatric
services(1).

The number of physicians within the department has surged over the
last year, with 20 new specialists(2) brought on board, bringing the
total number of pediatricians to more than 120.

Some of those physicians will staff the new children’s surgery unit at
the medical center, which is set to debut Nov. 13. The 20,000-square-
foot facility was relocated to the medical center’s main building and
will cost $40 million to build out. The American College of Surgeons
has given the new surgery center a Level 1 designation.

With the expansion of its pediatric services, UC Davis Medical Center

is trying to position itself to fill a gap in access to care for children
with complex medical issues in both rural and urban areas(3) in a
large swath of Northern California, said Dr. Satyan
Lakshminrusimha, chair of the Department of Pediatrics.

“There is a huge catchment area from up to the Oregon border and

down to Stockton,” Lakshminrusimha said.

Trends that the expanded pediatrics unit hopes to address include

childhood obesity and premature births, he said. Over the last year,
visits to the pediatric sub-specialty clinic increased 5.3 percent(4),
according to data from UC Davis Health.

The expanded pediatrics department hopes to serve both locally

based patients and those farther away through telemedicine(5). The
department recently debuted new "FaceTime"-like camera devices
for premature babies in the Neonatal Intensive Care Unit(6), to help
parents see and communicate with their babies who could be
hospitalized for weeks or months.

The cameras provide video sharing through Cisco's Jabber app. With
internet access, parents can connect with their child via laptop,
desktop, smartphone or tablet(7)

The medical center spent $3,643 to launch the program, which was
funded by a grant from the Children’s Miracle Network.

Among the recent additions to pediatric team is Dr. Frank Ing, a

pediatric cardiologist recruited from Children’s Hospital Los Angeles.
He was named the new chief of pediatric cardiology at UC Davis
Medical Center in February.

Ing is renowned for his ability to perform heart procedures on fetuses

as young as 20 weeks(8) and less invasive heart procedures for
premature babies.

The procedures are made possible by a thin heart catheter device(9)

that has existed for more than a decade. Ing, however, is one of the
few cardiologists in Northern California known to be able to perform
the procedures in-utero(10) and on premature babies as small as 2.2
pounds.

The in-utero procedure directs a thin needle into the fetus’s chest to
open up valves and improve the flow of oxygen, while another
procedure for premature babies closes defective arteries(11).

“Over the years I’ve developed a reputation of opening things that

people say can’t be opened,” Ing said.

Ing is on the cusp of bringing the in-utero procedure to the UC Davis

Medical Center(12), he said.

“If you can fix something before it's fully developed, you can actually
make the heart more normal over time(13),” Ing said.

He has performed the procedures at other hospitals and is currently

waiting for the right patient to come along before pursuing it at UC
Davis Medical Center.
To train, Ing's team will set up in a dark room with a vat of jello. A
small grape placed inside the gelatin will simulate the mother's
womb, Ing said, where the physicians can practice inserting the
millimeters-thin cardiac device into the grape.

Correction/Clarification
This article has been corrected to note that one procedure is performed to open fetal heart
pathways, and another procedure is done to close defective arteries in premature babies.

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(1) UC Davis Medical Center new advancements in pediatric center

(2) more pediatric specialists including Dr. Ing
(3) care for complex medical issues rural/urban
(4) massive increase in number of children coming to sub-specializations
(5) the use of telecommunication and information technology to provide clinical
health care from a distance
(6) new advancement(telemedicine); camera for parents to observe their child
in NICU
(7) accessible via smart devices
(8) specialization of Dr. Ing
(9) catheterization for babies
(10) catheterizations in the womb
(11) results of catheterizations
(12) in-utero procedure has not yet been conducted at UC Davis Medical Center
(13) in-utero procedures allow normalization of heart pre-birth