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This is Chris Sosa with the Becker's Healthcare
podcast. I'm thrilled to be joined by Dan
Fields, senior vice president and chief strategy officer
at Children's Hospital of Philadelphia. Dan, thank you
for joining us today. Thanks, Chris, for having
me. I really appreciate it.
Dan, for our listeners who are not familiar
with you and your work, could you please
introduce yourself and give us a bit about
your background?
Sure. I'm happy to. So as you said,
Dan Fields. I'm chief strategy officer at Children's
Hospital of Philadelphia,
which we often refer to as CHOP.
My responsibilities and my team's responsibilities,
focus on a couple of broad areas.
The first is we focus on our enterprise
strategy, which includes
clinical strategy, operational strategies.
We also partner with our colleagues to think
about our research and innovation strategy.
I joined CHOP about 7 years ago,
having spent my career prior to this in
health care consulting where I was at McKinsey.
I'm actually a lawyer by training, though never
by practice. So if you ask me if
I ever thought
I'd, have gone from law school to consulting
to children's hospital, I probably wouldn't have said
I would have, but, I'm really glad I'm
here.
Briefly about
CHOP. So CHOP is the 1st hospital in
the US dedicated exclusively to pediatrics. We're one
of the largest and most well regarded hospitals
in the country,
got more than 6 80 beds, 50 outpatient
sites, 1,500,000
outpatient visits per year, we train 100 of
residents and fellows every year.
It's a pretty amazing institution with a long
standing commitment to innovation, which is what drew
me to join SHOP.
You mentioned that you're a lawyer by training,
Dan. So could you let me know it
does sound very interesting that you've gone from
that
training to health care. What led you in
that direction?
Yeah. I actually,
I think for the early part of my
career, I may have tried to tried to
avoid
working in health care. I'm from a family
that focuses on health care. My dad's a
doctor. My mom's a nurse. I'm married to
a doctor. My sister's a doctor.
Now I wanted to do other things.
But in law school, I got really fascinated
with
the innovation that was happening
in healthcare, and I decided I wanted to
focus on that for my career.
And so
I rejoined McKinsey after law school and really
made that a focus of my
work and really enjoyed doing that. And so
when I was leaving McKinsey and looking,
for other opportunities,
I wanted to find an institution that was
really committed to innovation in health care, and
CHOP is a good illustration and embodiment of
that.
And no doubt CHOP is very happy to
have you, I'm sure. So you mentioned the
innovation.
On those along those lines, could you tell
us what your top priorities are today, whether
it's innovation
or any other aspects of your job?
Yeah. Absolutely.
An interesting question, you know, because there's really
so much going on in health care
right now and certainly in pediatrics. And so,
when I think about my
broad priorities, they kinda fall into 2 general
themes.
So the first is about
impact and how we maximize the impact we
can have,
and the second is around sustainability.
And I'll tell you a little bit more
about
each. So from an impact perspective,
for us, impact is often and frequently grounded
in innovation. We're an organization with
so much potential,
a legacy of improving child health through innovation
for a very long time.
Now we're the 1st formal medical training in
pediatrics. We were part of developing multiple of
the first vaccines
for cell therapy for cancer, for gene therapy
for blindness. You know, we have expanded care
across the whole care continuum,
so we can provide extraordinary care
in our community, around the country, around the
world.
We focus a lot on investing in our
community,
and, we have an extensive global health program.
We've got
1,000
principal investigators
that
are supported by nearly $400,000,000
in external funding to advance new ideas.
And I tell you all that that's partially
it's because it's interesting, but mostly because when
you've got a foundation like that, you have
just a tremendous
ability
to make a difference in improving child health.
And
pediatrics, as you know, is different. Right? We
only represent 10% of health care expenditures,
far fewer organizations that are focused
on improving the state of health care for
pediatrics for children.
There are a lot of children who are
depending on it. And so
this big theme for me is
really asking the question, you know, how can
we maximize the impact we can have
through innovation? How do we create an environment
where new ideas and discoveries can flourish, can
advance quickly and can do so at scale?
This theme of quickly is something that really
matters to me. I think there's just a
lot
of urgency for us to bring new ideas
forward as quickly and safely as we
can,
because as much advancement that there's been in
pediatrics and there has been a lot,
If your child has a condition where
we haven't made as much progress as an
industry, and it doesn't matter how much other
progress has been made. It only matters whether
we have the idea that will make a
difference for your child. And so this idea
of advancing ideas in an environment that can
advance ideas
and bring them to scale quickly is really
important.
I'll maybe give you an example of
how we think about this because one of
the things we're really good at here is
turning innovation into tangible results.
And one of the ways we do that
is through
what we call some of our accelerator programs.
So one of our marquee programs is called
the Frontier programs. It's actually
what brought me to CHOP in the first
place. So Frontier
takes
programs that have extraordinary clinical programs
and breakthrough research potential together,
and we really invest and support these programs
to
develop their ideas as quickly as possible in
both the clinical domain and the research domain
and really foster that bench to bedside,
translation that has so much promise in health
care.
When I got here, it was
it was just a couple of programs that
were making great progress. And now we've got
27 of these programs.
And then somewhere around a third of them
are actually working on curative therapies.
So when I think about impact,
that's the type of impact I hope we
can have. You know, we can bring ideas
forward faster, we can bring ideas forward
in a way that translates into care that
makes a meaningful difference for kids.
So that's a big
area of focus, is impact through innovation and
doing it quickly and at scale.
But the other side of the coin here
is the sustainability one and it's a really
important question. You know, even as I said,
even though pediatrics is different in many regards,
and one regard that we're not is,
being affected by the trends that are affecting
the healthcare sector generally.
Financial pressure, operational pressure, workforce pressure, disruption,
these are all affecting pediatrics generally and,
something we're really
focused on as we think about sustainability.
You know, at CHOP, we're kind of turning
the page, we're coming up on 170 years
into our
journey and we're fortunate to be able to
take the long view. But if you're taking
the long view and you're on that kind
of a journey and you face this kind
of pressure and disruption,
inability is really essential.
And there's really exciting things that are happening
from a sustainability perspective,
innovation and care delivery,
digital innovation, so there's a lot of really
good
work, and I think in order to have
the impact we wanna have, we have to
make sure we've got the sustainable foundation to
do it. So
those are 2 of the big themes that
are occupying a lot of my time right
now.
Dan, clearly, health care is anything but stagnant,
and you touched on a great deal of
the pressures and challenges that are facing health
care right now. You also mentioned Longview. But
for a second here, let's look at a
bit of a short term view. So over
the next 18 months,
what sort of things do you think will
evolve in the health care industry as far
as CHOP is concerned?
Yeah. And the the short view is really
important, but like you said like you said,
you know, such a dynamic time in health
care.
I think that some of the changes have
have already been happening, but I do think
there's a few that will continue and perhaps
accelerate. So,
one of them relates to the
the care continuum, you know. Children's hospitals have
this extraordinary responsibility,
especially children's hospitals like CHOP where we're involved
so deeply in our community and and across
the care continuum. So we focus on prevention,
education,
work with schools in our community,
primary care, all the way through the most
complex subspecialty,
outpatient and inpatient and diagnostic
care.
And when you're covering that much ground and
caring for kids that have needs across care
continuum, it's really important
to make sure that each part of the
care continuum
is robust and the children who need it
have access to the care that they need
across it. And so this has been part
of our focus for a long time, but
I think as
the world gets more complex and
clinical advances continue to move forward at an
astounding pace,
making sure that all parts of the care
continuum
are robust and well developed is something that
I think we're going to be spending a
much time thinking of or thinking about, excuse
me.
That's 1. The second, I touched on a
little bit,
but it's,
it's really the scheme about scale.
So, you know, health care, as you know
well, Chris,
loves to pilot an experiment and that has
a really important role in advancing new ideas
across the health care sector.
For us, I think one of the things
that we think a lot about is how
we bring these good ideas to scale at
a at a greater pace as I mentioned
earlier. And so I think thinking about scale
more deliberately, more systematically is going to be
really important.
And the last the last area is about
collaboration.
So we're we partner with many organizations today
in our region
in many different aspects of,
things like shared care, education, and others.
I expect partnership and collaboration to continue to
probably expand and diversify
the nature and types of partners and areas
that we
essentially collaborate with them.
So I think that's exciting to think about
it, there's a lot of promise there because
as much as we've done as an organization
individually,
opportunities that are available to us and
present
are presented to us with the innovation that
is coming require us as an industry to
be way more than the sum of our
parts, so collaboration is going to be pretty
essential.
There's so many exciting things happening right now
in health care. Dan, you just mentioned a
lot of them. But to switch gears a
little bit here, I do wanna get back
to what's exciting for you. But what's sort
of making you nervous on the horizon, whether
it be over the next year, 2 years,
even 5 years?
Yeah.
I appreciate the question, Chris. You know, I
think that,
you know, one of the things that gives
me pause that I think a lot about
is
the extent
of the sort of unmet need in pediatrics.
Now as much progress has been made, there's
still a lot more that needs to be
made and many of the indicators of child
health aren't moving in the right direction.
Perfect example of this is the child and
adolescent mental health crisis that
has been an area of focus for the
industry now, in particular for the last couple
of years.
It's definitely an example of an area where
the state of health for children is far
from where
it should be.
I'm proud as an organization that,
CHOP has invested quite significantly in this area
in building out our own capabilities and advocacy.
But when I think about that as a
microcosm of multiple areas where the indicators of
child health are far from where we'd want
them to be,
you know, that gives me pause. There's there's
a lot of work to do.
On the other side of that coin, Dan,
clearly, CHOP is doing a great many things
that I'm sure you find exciting. Can you
share some of those with us right now?
Yeah, absolutely. You know, I think that,
this is an amazing time, because we've got
this confluence of
scientific innovation,
clinical innovation,
digital innovation
with AI
and other modalities,
innovation and care delivery models, and so seeing
them come together
is really, really exciting.
One of the areas I'm particularly excited about
is the work that we have ongoing in
cell and gene therapy.
You know, when I got here in 2017,
it was late 2017 when I arrived at
CHOP and it was right around the time
that we had back to back approval of
that first gene therapy I talked to you
about and the first cell therapy, close succession,
it was remarkable.
I you know, I'm not even
remotely part of the history of it, but
I think when you talk to folks they
tell you that was years years years of
work coming to fruition
in that
couple of month period
there.
And so here we are now, six and
a half years later from that,
there are 38 FDA approved cell engine therapies
on the market.
A third of those are for pediatric indications
And the best I understand, there's something like
18
approvals that are anticipated to the end of
calendar year 2025,
the majority of which would be approved for
pediatric indications.
And so
what's exciting for me and what's exciting to
to watch unfold at CHOP is,
the progress for these disciplines, these fields to
really
breakthrough and flourish and thrive,
after years of investment that our faculty and
researchers have made in trying to advance this
technology. And so
watching that that sort of parallel of what's
happening in the industry unfold at CHOP, now
we have something like 80 principal investigators working
in cell and gene therapy, just at CHOP.
Type
of impact that can unfold in the years
ahead with that kind of momentum. Certainly, there's
work to do, and there's gonna be probably
a lot of evolution in the technology, but
it's just an illustration of the type of
thing that I find really exciting here.
No doubt. It's very gratifying to see all
that investment paying off. Lastly, Dan, I just
wanna ask you, you mentioned a little bit
about the mental health aspect and how it's
maybe not moving forward as quite as
quickly
as some would hope,
but is there any other
aspect of health care, especially pediatrics, you think
deserves a brighter spotlight?
Well, Chris, I appreciate the question.
I think there are a number, but one
theme that I'll highlight relates to the theme
of equitable access to care. And this is
a theme that's really important across the entire
care continuum, really, from prevention all the way
to access to the most
innovative
treatments and therapies.
Addressing
this theme really requires us to bring together
research innovation, clinical innovation, partnership with organizations across
the community, advocacy,
new capability development,
and more. You know, at CHOP, we've taken
a number of steps
to work on,
addressing and improving in this area, including establishing
new centers so we can really try to
make some progress here.
And maybe let me give you an example
of, what I mean in a little more
depth. So earlier in our discussion, we talked
about a lot of the exciting work related
to cell and gene therapy.
One area where there's been a lot of
progress and there's potentially curative therapies
coming to the market is in the area
of sickle cell disease.
And and
as the therapies progress, this theme of equitable
access to care is really important.
These therapies have the potential to benefit large
number of patients in a very transformative way.
But to really if we're gonna really meet
the needs of patients and families,
it's not enough just to contribute to the
scientific discovery,
not enough just to have one of the
largest clinical programs in the country.
So, you know, a place like CHOP, we're
really proud of both of those things, and
they're and they are really important.
But to really advance here, we have to
make sure that these resources are available quickly
and efficiently, and that requires us thinking about
overcoming barriers related to insurance coverage, travel,
housing,
and others. And we're trying to work to
remove as many of those barriers as possible,
but it's really critical that we, as an
organization, but really that the system
generally
gets as good as we can at doing
that.
And that will really let
the scientific innovation and clinical innovation that's coming
to bear
really be able to have a transformative effect
for as many kids as possible.
So it's an, you know, it's an example
really where some of the opportunities we've been
talking about and some of the challenges we've
been talking about actually come together.
And I think our shared
potential and opportunity and challenge for the time
ahead is we ought to simultaneously
lean into and capture the full promise of
the opportunities
and the innovation
while simultaneously
tackling these important challenges. And so that's some
of the important and hard work ahead.
Dan, thank you so much for sharing all
of your insights today. We absolutely cannot wait
to share them with our audience. And, of
course, we look forward to connecting with you
again soon.
Sounds great, Chris. Thanks so much for having
me. I really appreciated it.