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  Details of the Roundtable Discussion with President Obama
July 20, 2009

President Barack Obama visited Children’s National Medical Center July 20 to learn more about the unique healthcare delivery challenges children’s hospitals and pediatric providers face. As the nation’s children’s hospital, Children’s National understands that when a child gets sick, it affects the whole family. At Children’s National, our focus is on the entire family.

Several members of Children’s National staff addressed the following issues:

Universal coverage does not translate to universal access. More than one in four children nationwide relies on Medicaid for health coverage. Because Medicaid reimburses an average of 20-30 percent less than Medicare, many providers significantly restrict the number of Medicaid patients they’ll see, if at all. This limits children’s access to the care they need. Delayed care is more expensive care; delayed care can be devastating to children.

Pediatric workforce challenges are different than adult medicine. Adult medicine faces a shortage of primary care physicians, but in pediatrics the shortage is in specialties. Pediatric specialty training includes as much as 7 years of extra training, and often pediatric specialists earn less than their adult specialty counterparts. Because Medicaid reimburses significantly less than Medicare, there is often less incentive to go into pediatric medicine. In addition, as an academic medical center, Children’s National is committed to training the next generation of pediatricians and specialists, but funding for pediatric graduate medical education (GME) lags behind adult GME funding.

Electronic Medical Records (EMR) and other technologies need to be customized for pediatrics. Standard EMRs are designed to meet the health care needs of the adult population. To ensure safety and cost effectiveness, EMR systems must be customized for pediatrics. Because most EMR vendors have focused on adult health care providers, systems have to be tailored - at great cost - to meet the needs of the pediatric population.

Children’s National is committed to meeting the primary care needs of children in our community, as well as the specialty care needs of children from across the country. As the single largest provider of pediatric services in the District of Columbia, Children’s National Medical Center touches the lives of more than 600,000 children annually. From serving as the medical home for the District’s children in foster care through our DC KIDS program to employing all the nurses in 163 District public and public charter schools, Children’s National is an integral part of the fabric of the District of Columbia.

Roundtable Participants

Regina Hartridge, RN, MSN, CPN, is a clinical nurse manager for the Children’s Health Project of the District of Columbia, a mobile health program based out of Children’s National Medical Center. She started at Children’s National in 2000. A lifelong resident of the metropolitan Washington area, Ms. Hartridge is passionate about helping the families in her community obtain the access to health care and other services they need.

Brian Jacobs, MD, is Vice President and Chief Medical Information Officer at Children's National. In addition, he is an attending physician in the Division of Critical Care Medicine. He plays an integral role in hospital informatics and spearheads Children's IQ Network. Dr. Jacobs enjoys skiing and sailing with his wife and four children.

Yewande J. Johnson, MD, is a pediatric anesthesiologist specializing in pain medicine. She cares for inpatients with complex illnesses to manage their pain. In 2006, Dr. Johnson was awarded an NIH-sponsored Mentored Specialized Clinical Investigator Development Award in Pediatric Pharmacology. Her research interests include studying the pharmacogenetics of opioid metabolism and sickle cell disease-related pain. In 2007, she was named to Washingtonian’s list of “40 Under Forty: Young Washingtonians to Watch.”

Michael Knapp, RN, is the Executive Director for the Emergency Medicine Trauma Services at Children’s National Medical Center. He joined the staff at Children’s in November 2008. Previously, he worked at the University of Maryland Shock Trauma Center. He has been a resident of the District of Columbia since 2000. He is passionate about providing the highest quality nursing care, and is currently pursuing additional certifications in emergency nursing and nursing administration.

Kathleen Quigley, PA-C, MSHS, is a physician assistant in the Division of Neurosurgery at Children’s National Medical Center. She has worked at Children’s for two years, and has been a resident of Arlington, Virginia for the last four years. She spends her free time hiking with her two dogs.

Joseph Wright, MD, MPH, is Senior Vice President of the Child Health Advocacy Institute at Children’s National Medical Center. He provides strategic leadership for the organization’s advocacy mission, public policy positions, and community partnership initiatives. He has served as attending faculty in the Division of Emergency Medicine at Children’s since 1993. Dr. Wright has devoted much of his academic energy to addressing the concerns of the underserved. He has been recognized for his efforts as a winner of the Shining Star award from the Los Angeles-based Starlight Foundation, and is an elected member of Delta Omega, the national public health honor society.