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