Latest / Becker’s Healthcare -- Pediatric Leadership Podcast / Meysam Kebriaei and Collin Torok on Building Pediatric Neurointerventional Care at Children’s Minnesota

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Meysam Kebriaei and Collin Torok on Building Pediatric Neurointerventional Care at Children’s Minnesota · Becker’s Healthcare -- Pediatric Leadership Podcast

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  Welcome to Becker's Healthcare podcast. I'm Chris Sosa,
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  your host. And I thought we'll be joined
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  today by doctor Mason Kebriae,
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  medical director of neurosurgery and neurosciences at Children's
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  Minnesota, and doctor Colin Torok,
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  medical director of neurointerventional surgery at the health
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  system. Mason and Stalin, thank you for joining
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  us today.
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  Thanks for having
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  me. Wonderful. So you're both on to tell
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  us about this, wonderful new program you have
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  at Children's Minnesota.
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  It's free sweet. But before we get into
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  that, could you both please introduce yourselves and
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  some bit about your backgrounds.
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  My name is Colin Torok. I'm an inter
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  neurodivergental surgeon in Minneapolis Saint Paul. Provide neurovascular
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  care to adult pediatric patients throughout the region.
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  I trained in radiology and neuroradiology at Johns
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  Hopkins and subsequently in neurointerventional surgery at Massachusetts
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  General Hospital.
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  I was actually originally inspired to pursue a
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  career in this field by, pediatric neurointerventional leaders,
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  including doctors Gayut and Pearl at Johns Hopkins
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  and, continue to develop my interest and experience
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  with doctor Darren Orbach at Boston Children's Hospital,
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  during my time at Mass General. Currently, serve
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  as assistant co director of neurodivergental surgery at
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  Alina Health, medical director of the same at
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  Children's Minnesota,
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  and I hold an adjunct appointment in the
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  department of neurosurgery at the University of Minnesota.
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  Yeah. Mason Khebri. I am a pediatric and
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  adult neurosurgeon.
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  I, did my residency at University of Nebraska
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  Medical Center
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  and a pediatric fellowship
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  at Emory.
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  I did wonderful mentors there. I've been at
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  Children's Minnesota for fourteen years. I'm the medical
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  director of neurosurgery and neurosciences like you mentioned.
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  And,
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  Colin and I have had the pleasure of,
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  working together, and being friends for for a
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  long time, and on the adult side where
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  we have a joint,
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  similar joint venture in, cerebrovascular
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  neurosurgery. So we work together quite a bit.
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  Wonderful. Thank you guys for sharing it with
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  our audience just what has brought you to
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  this moment in time, at which point
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  back to what we originally said we were
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  gonna talk about. That's the neuroangiography
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  suite at Children's Minnesota. This has gotta be
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  a very exciting development,
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  no doubt, and one that's taken a while
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  to,
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  come to fruition.
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  So can you take us back to the
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  beginning and what led to the creation of
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  the suite?
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  Yeah. Absolutely. We at Children's Minnesota, we're one
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  of the largest stand alone children's hospitals. And
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  what that means for our patients in the
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  region is that we are made up of,
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  specialists that are have dedicated our careers and
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  our training, have self specialized training in pediatrics
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  specifically.
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  And so we have a lot of and
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  especially in neuroscience program, we've got a lot
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  of multidisciplinary programs like our neuro oncology program
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  where it's neurosurgeons, neuroradiologists,
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  neuro oncologists, and other other team members, our
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  fetal program. So really our goal is to
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  become a regional referral center, not just for
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  the people in the community and the Twin
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  Cities and the surrounding area, but for the
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  surrounding states to be able to, offer our,
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  kids and families a high level of care,
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  that they really where they wouldn't have to
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  travel far. And so
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  in in that talking about that, we with
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  the neurovascular
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  care, with aneurysms, AVMs, for example, there are
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  a lot of centers that do a great
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  job,
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  us included, where you have neurosurgeons that do
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  the the neurosurgical portion, and then you you
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  transform,
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  for example, for us to to our partners
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  at Allina, which is an adult hospital.
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  They do a great job, but then they
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  they do their intervention or neuroradiology
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  there, and then the patient gets shipped back,
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  transferred back to Children's.
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  And so it's somewhat siloed care, not, not
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  a truly comprehensive program. And then, unfortunately, because,
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  of the sort of limitation that we'll probably
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  get into for pediatric programs, it's really hard
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  to get,
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  a comprehensive program. One of the really, the
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  benchmark for a comprehensive,
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  pediatric cerebrovascular
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  program is, Boston.
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  And so Colin and I have worked together
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  for a long time. He's a fantastic
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  neuromerangiologist
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  and a and an even better guy. And,
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  you know, we thought, well, we you know,
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  there are a lot of adult programs like
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  the ones that we actually work, together. And,
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  we we offer really comprehensive care to these
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  patients that come in with an aneurysm,
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  with AVM, with other,
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  pathologies that require both the neurosurgeon, neurologist,
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  neuroradiologist,
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  and interventional neuroradiologist
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  so they can get the best care.
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  What can we do so we can provide
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  that to, to children? And and, really, we
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  put a lot of, work together. We came
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  up with a plan. We,
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  work closely with our colleagues on the administrative
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  side at the Children's as well,
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  and we're able to,
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  get approval and and and take this program
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  off the ground.
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  About how long does that process take, Mason?
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  You said there you mentioned a lot of
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  moving parts, which, of course, is gonna be
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  with any sort of endeavor like this.
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  So about
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  when you started to this point in time,
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  what are what are we talk?
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  I would say and you correct me, Colin,
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  if if, if I'm off on this. But,
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  I mean, I would say probably five, six
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  years ago is where we had the we
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  we talked about this vision
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  that we both shared of building a program
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  like this, for for the kids and their
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  families in our in our community.
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  And so from there, it was kinda coming
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  up with a plan and and, of course,
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  COVID hit and that, you know, reset everything
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  and then really reinventing that, planting the seas,
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  talking to different people, trying to see what
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  obstacles there are. And,
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  one of the issues is there's a lot
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  of there there's there are two challenges, two
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  big challenges to this program is, one, is
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  having the pediatric expertise,
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  in Colin,
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  and then, myself and the rest of our
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  team. And we're lucky that we have that
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  in our community. So that's one. We thought,
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  okay. Well, we have that handled. The next
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  thing is this big capital expenditure investment in
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  the
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  biplane suite, this neuroimmunity suite in a stand
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  alone children's hospital. We we don't have the
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  big
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  dollars of of, the larger adult hospital systems
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  that are sometimes,
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  tied and and partnered up with the pediatric
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  programs. And so, you know, hospitals in general
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  run on a shoestring budget, but pediatric hospitals
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  more so. And so so it was really
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  partnering with our cardiologists, interventional cardiologists, and say,
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  hey. We don't if we're not using this
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  suite, you know, is this something
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  that we can partner with you guys and
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  your team and have you guys use it.
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  So there there's, you you know, so there's
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  some scale and there's usability so that the
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  performer works out. We have a we have
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  a great, colleague and colleagues in a body
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  IR department as well too that we so
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  a lot of stakeholders when you say, well,
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  how can we make this happen? So it's
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  not just feasible,
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  to for build up, but financially feasible so
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  we can get approval so that it makes
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  sense for hospital systems so we don't, you
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  know,
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  cut cut cut the crash financially for them
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  and put them in a in a a
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  tough position. And so really, it took a
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  lot lot of talking to different stakeholders to
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  bring this together.
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  Mason, thanks for taking us through all the
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  the mechanisms that it takes to get a
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  project like this off the ground.
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  So, Colin, how would you say Children's Minnesota
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  is gonna measure the success of this program?
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  Yeah. We'll measure the success of the program
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  in multiple dimensions.
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  Certainly, clinical excellence is first and foremost.
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  So we'll be participating in various international academic
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  organizations,
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  such as the International Pediatric Stroke Organization,
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  Society of Neurotiverventional Surgery Pediatric Section, and have
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  a a distinct presence in in academic conferences
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  and publications. So taking all these dimensions together,
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  we're we're really planning to, be a leader
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  in the field.
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  Thanks so much, Colin. So
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  when we think about
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  where this program is headed,
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  what is important for health systems to know
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  about treating children with these types of disorders
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  and conditions?
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  And there's an end of that question. So
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  I know it's a lot, but take one
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  thing at a time. So along those lines,
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  what advice would you give other health systems
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  that are considering creating their own angiography suite?
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  Well, I think maybe I'll start with that
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  one,
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  Chris and Colin. You know, I think the
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  first thing you have to look at is
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  is what are the needs of what what
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  are the goals of your your hospital system,
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  health care system, and what are the needs
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  of your community? I mean, there there are
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  certainly
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  infinite demands and infinite needs out there and
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  limited resources both in in people and in
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  finances. And so
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  we we look at our department at neuroscience
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  at Children's Minnesota and and ask ourselves, what
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  is it that we wanna do? You know,
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  do do and our our goal really is
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  to be a quaternary system
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  and and to be a to be a
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  regional referral center center for our patients and
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  and families in the community. And what that
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  means isn't that we're just here to help
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  out the the patients and their families, but
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  also our our partners in from other health
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  care systems, from other referring providers,
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  and also and and and that we we
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  have the capability and the fact that we've
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  got the subspecialist. That that in itself, having
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  the pediatric subspecialist subspecialist that also
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  further subspecialize
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  in cerebrovascular
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  neurosurgery
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  and neurointerventional radiology,
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  That's a rare feat, but we have that
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  under one umbrella. And then to be able
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  to
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  make it financially make sense as well too
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  as a hospital system and be able to
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  build out this neuro IR suite,
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  neuroangiography
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  suite, that is tough too was was a
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  big challenge that we overcame. So now we
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  have this together, and really we can partner
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  with with our communities and be able to
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  bring those bring those patients here. Give them
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  the the best outcome, the best care, which
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  will will measure the way, that Colin had
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  mentioned earlier.
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  And then and then really let those patients
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  go back in their community and seek care
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  for everything else there. One of the worries
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  that I think one of the challenges in
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  getting referrals from other health care centers is
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  that there's there's
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  this thought of this the siloed mentality in
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  general in health care of this competition. But
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  in reality, you have to look at, well,
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  what is our goal here? Our goal is
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  here to make our community healthier and be
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  a good partner to our chart the our
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  patients in our community, and we do that
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  by
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  doing from providing care that other health care
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  systems are limited in and providing the best
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  care and then having those patients go back
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  to their community for the care that they
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  need.
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  Excellent. So and as to what other
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  health systems
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  what is it important for them to know
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  about treating children with these or disorders and
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  conditions?
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  I would say the,
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  you know, the the more you look at
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  outcomes and patient experience, that's really what patients
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  are looking for is patient experience and also
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  outcomes.
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  And multidisciplinary
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  and there's more and more data coming out
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  that multidisciplinary programs, patients have a better outcome
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  than programs that are siloed. And, unfortunately, in
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  health care, it's just our
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  for whatever reason, intuitively, there's a lot of
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  siloed care. It's great care individually, but it's
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  very, very siloed. So the more his the
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  health care system starts thinking of of what
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  can we do in,
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  multidisciplinary
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  care,
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  that they'll be able to sort of organically
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  come up with ideas of what they can
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  provide given the the capabilities that they have.
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  And I think they should focus on that.
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  And then the other challenges, especially in a
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  pediatric setting is I mean, finances
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  is are are challenging and with the just
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  ever changing regulations in health care and reimbursement
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  as well too, it's not gonna look better
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  and better. So you have to get creative
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  and say, well, we're gonna you know, we
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  know we need this biplane suite, but it
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  costs so much money. How can we, partner
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  up with other, subspecialists like we did with
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  our cardiology sub specialist, somebody IR subspecialist
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  to to use this enough, utilize enough so
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  that it'll financially make sense as well too.
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  I think that's another you really have to
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  get creative and work closely in partnership with,
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  with other team members. So I guess my
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  my big
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  word would be,
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  you know, I think the key is just
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  partnership, you know, both in multidisciplinary groups and
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  and partnership with other groups and and, solving
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  these problems to be able to provide,
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  super vascular care and other are they types
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  of care that are more challenging
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  and resource limited at at health care systems?
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  Yeah. I was gonna add too. I think
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  it's worth pointing out that we're in a
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  very unique situation.
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  You really have to start with a a
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  critical mass. And,
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  Children's Minnesota, I think it has,
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  the health care system is of, adequate size
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  and reach that we have a referral base
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  that can actually,
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  lead to a viable program, and then on
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  top of that division to invest in a
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  dedicated neuron geography suite in a freestanding center.
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  So these are very unique conditions. And, obviously,
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  on top of that, we have a a
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  wonderful collaborative team with a lot of experience
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  in in taking care of children. So,
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  we're we're very lucky, but I think if
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  if you're missing any of those single components,
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  very difficult to to pull this off. And
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  I think that's why it's it's taken us,
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  years of of planning and execution to get
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  here.
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  Mason, thank you so much for sharing all
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  those details on what it takes to put
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  this program together.
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  My last question for you is when will
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  it officially be rolling at Children's Minnesota? Any
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  other details you wanna share with us?
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  Yes. I'll take that. So we're we're proud
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  to announce that this is, again, going to
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  be the region's first dedicated pediatric neurointerventional angiography
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  suite, and we we hope to launch, in
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  February.
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  So,
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  we'll have dramatically expanded capabilities to, treat all
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  variety of complex conditions on on-site.
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  And, again, it's taken a while to get
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  here, but we're we're very excited to to
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  finally,
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  get to work.
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  Perfect. Colin, Mason, thank you so much for
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  sharing everything involved with this wonderful program you
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  guys have at Children's Minnesota. I know it's
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  take taken a lot of work and a
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  lot of time, and I'm sure, you know,
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  part of it is just paying off now,
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  and the rest will pay off well into
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  the future. Thank you both so much for
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  your time, and, you know, we look forward
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  the next time we speak to you or
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  anyone at Children's Minnesota.
• 12:55
  Thank you so much. Nice talking to you.