Current Research and Scholarly Interests
The major emphasis of my early work was understanding the role of cytokines and cytokine inhibitors in immune and autoimmune diseases. In the past 2 decades 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 academic subspecialists. Since 2012, my scope has expanded to include improving care for children with medical complexity and how to improve the resilience, well-being and sense of purpose in work for the clinical care team.
In the area of pediatric rheumatology, I am a founder of the pediatric rheumatology research network (Childhood Arthritis and Rheumatology Research Alliance -CARRA) in 2002. CARRA now includes the vast majority of practicing pediatric rheumatologists and trainees in the US and Canada with over 500 members and 110 sites. The network supports a broad variety of clinical, epidemiologic, translational research, biospecimen repository and clinical trials, with multiple funding sources from NIH, Arthritis Foundation, not-for-for profit foundations and biopharma. Through CARRA I have been the PI and/or co-PI of 2 major NIAMS funded innovative (Atherosclerosis Prevention in Pediatric Lupus Erythematosus--APPLE and Randomized Placebo Phase of Rilonacept Treatment in systemic JIA (RAPPORT)) and PI (multi) on a large ARRA Grant to develop a registry for pediatric rheumatic diseases. This Registry has grown into the largest registry for pediatric rheumatic diseases and is the platform for multiple pragmatic clinical trials, phase 4 clinical studies, linked biospecimens for translational research, and multiple epidemiologic studies. The Arthritis Foundation has been a generous supporter of the Registry for the past several years. I am currently Chair of the Board of Directors of CARRA Inc.
Since 2008, in addition to work with the research network, I have focused my scholarly work on the intersection between patient and family-centered care and related areas of faculty and trainee career development and mentoring, and wellness and professional fulfillment for physicians and the entire clinical team. 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. In the past 5-6 years I have participated in physician wellness projects and the Stanford WellMD Center. My interest in resilience, wellbeing and professional fulfilment for non physician staff at LPCH has led to a collaboration with Human Resources, on developing a resilient and engaged workforce as one of the 5 core goals for LPCH. To expand and enhance our ability to provide the safest, highest quality care with the best outcomes and experience, we must both partner with patients and families and ensure the highest well-being, resilience and professional fulfillment in our workforce. To help lead this effort, I was appointed the Stanford Children's Health Chief Experience Officer in 2019