Current Research and Scholarly Interests
The major emphasis of my work in the past decade has been focused on the future of academic pediatrics and pediatric rheumatology through providing training, research opportunities and environments to nurture and challenge future pediatric rheumatologists and subspecialists, and has now expanded to encompass design of new models of care for children with complex chronic illness
In the area of pediatric rheumatology, I am a founder of the pediatric research rheumatology
research network (Childhood Arthritis and Rheumatology Research Alliance -CARRA) which now includes the vast majority of practicing pediatric rheumatologists and trainees in the US and Canada with over 270 members and 91 sites. The network supports 15-20 studies and trials and currently has 4 major NIH clinical trials, and 2 ARRA funded projects (one RC1 in Clinical Effectiveness Research, and one RC2 to develop a pediatric rheumatic disease registry). The clinical trials include Atherosclerosis Prevention in Pediatric Lupus Erythematosus--APPLE, Trial of Early Agressive Treatment of polyarticular JIA--TREAT JIA, Randomized Placebo Phase of Rilonacept Treatment in systemic JIA (RAPPORT), and Rituximab in Myositis (RIM).
At Stanford, I have focused my scholarly work on developing programs to enhance career development of faculty and trainees. Through my role as co-director of the pediatric portion of Stanford's CTSA, Spectrum Child Health, we have developed programs for mentoring, career development, and clinical research personnel support. for child health clinical and translational research investigators. In addition, Hannah Valantine MD, Senior Associate Dean of Diversity and Leadership, and I are collaborating on new approaches to improving the academic success and retention of women and young family-oriented faculty, through a variety of programs and research on stereotype threat, flexibilty in careers, and the role of clinical excellence in our faculty lines.
Since early 2011, I have expanded my interest to encompass health care delivery, extending my interest in children with rheumatic chronic illness to broadly study the most complex and highest cost children across all diagnoses. . LPCH, a high quality tertiary and quaternary institution, provides an outstanding venue to study and test innovative models of care with an emphasis on the most complex and chronically ill children, with very high costs of care. The rich collaboration between pediatric faculty and researchers--Lee Sanders, John Mark, David Bergman, Ken Cox and others, with LPCH leaders, Alexandria Combs, Karen Wayman, Doug Cameron and many others, and a hybrid strategy firm Jump Associates, has led to the design of the Children's Complex Care Model, which is currently in pilot testing. The basic premis of the model is to cxreate true partnerships between patients and families, providers --both subspecialty and primary care providers, and the community to improve the quality and outcomes while decreasing costs across the entire continuum of care.