As Executive Vice President, Enterprise Physician-in-Chief, and Chief Scientific Officer for Nemours Children’s Health, Dr. Matthew Davis oversees all clinical and research activities across Nemours Children’s and works to ensure that education, training, and community engagement are fully integrated into clinical and research efforts. It’s a position of great import and impact, but one where he plans to rally teams within Nemours Children’s and community relationships outside the enterprise to move toward wellness for children across the nation and the world.
Recorded live at the Pediatric Academic Societies (PAS) Meeting 2024 in Toronto, Canada, on May 3, 2024.
Watch on YouTube.
Guests:
Matthew M. Davis, MD, MAPP, Executive Vice-President, Enterprise Physician-in-Chief and Chief Scientific Officer, Nemours Children’s Health
Host: Carol Vassar
Producers: Carol Vassar, Joe Gillespie and Sebastian Riella
TRANSCRIPT
Carol Vassar, podcast host/producer:
Welcome to Well Beyond Medicine, the Nemours Children’s Health podcast. Each week we’ll explore anything and everything related to the 80% of child health impacts that occur outside the doctor’s office. I’m your host, Carol Vassar, and now that you’re here, let’s go. (singing)
And we are live at the Pediatric Academic Societies Meeting 2024 PAS. And joining me right now is Executive Vice President, Enterprise Physician-in-Chief, and Chief Scientific Officer for Nemours Children’s Health, Dr. Matthew Davis. Dr. Davis, thank you so much for joining us.
Dr. Matthew Davis, Nemours Children’s Health:
It’s such a pleasure.
Carol Vassar, podcast host/producer:
We are so glad to have you here. I met you at another conference right before you started last year, and I said, “This man is personality plus. We have to have him on the podcast.” You’ve been with Nemours since last November, and you have this immense role. You oversee all clinical and research activities across the entire enterprise of Nemours. And you work to ensure that education, training, and community engagement are fully integrated within clinical and research efforts. That’s huge. What are you doing and how are you approaching a job that is so immense and of such great import?
Dr. Matthew Davis, Nemours Children’s Health:
It’s really all about the team, and the teams at Nemours are in our regions. The regions of Delaware Valley and North Florida, based in Jacksonville and Pensacola, and Central Florida, based in Orlando, are all outstanding in their own ways based on the needs of the regions. So yes, I do have responsibilities for clinical care, especially quality and safety and improving our ability to be consistent in all the care we provide. And also, I’m responsible for research and all of those efforts are going to be much better if we have the right teams in place.
I’m also very pleased to be working with Jane Mericle, who’s our chief nurse executive at the enterprise level, with Kara Walker, who’s our chief population health officer, and with Mark Mumford, who’s our chief operating officer. And the four of us together are really responsible for this combination of clinical work and community outreach that helps us go well beyond medicine. And then they, in turn, are looking to me and the research team to help advance children’s healthcare and health through advancing science.
Carol Vassar, podcast host/producer:
Which ultimately goes well beyond Delaware and Florida and impacts children here in the US and worldwide. But a lot of it starts in the community, and as I was reading your bio, community came up again and again. It’s something Nemours does really well now, though it sounds like you are poised to bring us to the next level. How do you intend to do that?
Dr. Matthew Davis, Nemours Children’s Health:
For me, community is such a natural setting for us to work in because I’m a primary care pediatrician and so my patients are mostly living in their communities all the time. So, we better make sure that Nemours Children’s Health is the best partner we can be with communities if our goal is to help create the healthiest generations of children.
So when we work with communities to try to prevent asthma or try to improve birth outcomes, or help children do better in school and have less school absenteeism, we are working with communities to achieve the goal of better health for every child, as best as health as they can have.
That community work is hard because communities are often under-resourced to solve their own problems. And Nemours Children’s Health can bring its expertise and, most importantly, its compassion for families and neighborhoods to work on the priorities that communities have because if we follow their lead, we’re likely to be able to solve their problems with them.
Carol Vassar, podcast host/producer:
You were talking about teams earlier in the team that surrounds you, Dr. Kara Odom Walker, Jane Mericle, and Mark Mumford, but teaming up with the community is really important and impactful. Give me some examples of how that is happening right now and where you’d like to see it go.
Dr. Matthew Davis, Nemours Children’s Health:
Absolutely. Well, we’re very fortunate to have support from the Ginsburg Institute in Orlando. The Ginsburg Foundation has supported our Ginsburg Institute, which is all focused on improving health equity in everything that we do. And in doing so, what we’re focusing on are what are often referred to as the social determinants of health based on community input that I’ve had over my career.
I like to call them social influencers of health because determinants sounds like it’s already done, but influencers sound like maybe we can work on this. And that’s the spirit of the Ginsburg Institute is that we can work on challenges such as hunger and homelessness and challenges that parents may have in getting jobs, et cetera.
And I’ve been really pleased to work with our team in Orlando, for example, think about how we can better support families whose children are about to be discharged from the hospital. How can we make sure that the home environment is safe and that they have food on the table when that child goes home? Because we want that child not only to be better from their illness but to get fully better after they leave our care in the hospital.
Carol Vassar, podcast host/producer:
It sounds a lot like you are looking at Nemours as a convener, a community convener, a leader in the healthcare sphere. Is there anyone who’s not at the table right now, and there are many people at the table including the folks from the Ginsburg Foundation, that you would like to see at the table?
Dr. Matthew Davis, Nemours Children’s Health:
We’re very fortunate today to have good channels of communication with the state and local authorities in Florida and in Delaware. Based on my experiences earlier in my career, I think there’s opportunity to build that even more because I often find that children’s healthcare institutions like Nemours Children’s Health and local and state governments are very well aligned in terms of the ultimate goal, which is to try to have children be as healthy as possible.
What those local and state officials are often not accustomed to is a healthcare partner who really wants to be a full partner with them. So, I know that Dr. Kara Odom Walker comes from the same philosophy that I do. Both of us previously worked in state government. So we know what’s possible, and the art of the possible is what we’re trying to accomplish with our initiatives such as the Ginsburg Institute.
Carol Vassar, podcast host/producer:
I, too, come from a background where I worked in government in the State of Connecticut. Let’s talk about public health a little bit. It really came to the fore during COVID-19. Is it as well funded and supported as you would like to see it, or would you like to see it a little bit more in the spotlight with a little bit more funding?
Dr. Matthew Davis, Nemours Children’s Health:
If I had a magic wand, of course, I’d like to have our local and state public health authorities have some more resources because I think that those authorities usually do a very good job in helping protect the population’s health. I’m also a realist, and I know that in the post-COVID timeframe, governments, whether they be state, local, or federal, have other priorities that they’re redirecting their funds toward that were previously directed toward COVID.
So what needs to happen in that situation is we as Nemours Children’s Health and other healthcare partners must be even better partners with local and state public health authorities because we want to be the best partners we can be when they’re going to have fewer resources that they can themselves bring to the table.
Carol Vassar, podcast host/producer:
What I’m hearing is that there’s maybe more education that needs to be done with state, local, and federal authorities on the importance of working on the social determinants of health.
Dr. Matthew Davis, Nemours Children’s Health:
I think that’s true. We need to recognize that for many departments of public health, it’s not in their job description to work on hunger or homelessness. That’s the job of other state agencies. So that’s also something I’m very excited about at Nemours is the opportunity to work with agencies in Delaware, in Pennsylvania and Florida, for example, to team up and figure out how can we work across state agencies to help address children’s needs and help support families because those types of approaches are going to help those kids thrive, do better in school, and ultimately have a better chance of having the best health that they can.
Carol Vassar, podcast host/producer:
I want to move into the research area or your responsibilities. You yourself are a researcher. Talk about some of the research you are doing right now.
Dr. Matthew Davis, Nemours Children’s Health:
Thanks. One of the projects that I’m working on right now is an example of going well beyond medicine. This is a multi-site national study called the ENRICH study. It’s supported by the National Heart, Lung and Blood Institute of the NIH. And the idea of ENRICH is that we want to try to understand can home visitors who are supporting mothers during pregnancy help those pregnant persons have healthier pregnancies and healthier babies from the point of view of their cardiovascular health. So things such as high blood pressure and stroke risk and heart disease, and for the children, obesity in the first couple years of life.
The idea of working with home visitors rather than a healthcare model, but rather with a community health model is something rather unique for the NIH to be supporting. And I’m really proud that as a person at Nemours Children’s Health, I have the chance to work with colleagues at many other sites across the country to do this type of work.
We’re going to be at this for another five years or so, enrolling enough mothers, and then those mothers and babies, to really get the sense of how effective this outreach can be. But I’m excited about it because we’ve seen other examples where community health workers who may have nothing more than a high school education can make a huge difference in the health of people in their own homes by providing suggestions about connecting to social services, and by providing specific suggestions about how to take better care of their own health.
Carol Vassar, podcast host/producer:
We’ve seen this in other parts of the world. It is interesting that it is just now coming to the US.
Dr. Matthew Davis, Nemours Children’s Health:
Great point. You’re probably referring to the Promotora model, which started in Latin America. And absolutely as you’re saying, nations with fewer resources than the United States have had to figure out ways to have a big impact with fewer dollars to spend. So you have great examples like the Promotora model that now in the US we call the Community Health Worker model.
And what we’re doing now, it’s important, is we’re rigorously studying it because if we can help mothers have healthier pregnancies, then the babies end up healthier and everybody wins, and we can do it through a model that is more resource-efficient like community health workers.
Carol Vassar, podcast host/producer:
I want to ask one more question about this research project because I’m finding it fascinating. Does it get at the issue of some of the health disparities that we see amongst pregnant women? Talk about them.
Dr. Matthew Davis, Nemours Children’s Health:
Certainly. Nationally, we know that women of color tend to have worse pregnancy outcomes than their peers, and so the ENRICH project is designed to make sure that we reach women in low-resource settings who are typically women of color. They’re more often women of color in the United States. And in so doing, to make sure that when we are reaching out through this Community Health Worker model that we’re reaching everyone and doing so in a way that will help reduce the inequities that we currently have in maternal health and also in infant health outcomes.
Carol Vassar, podcast host/producer:
When it comes to research at Nemours, let’s move on to what’s happening across the enterprise. What do you see as exciting work right now in the research realm?
Dr. Matthew Davis, Nemours Children’s Health:
I’m super excited about so many of the projects and people we have active in research at Nemours. Let me highlight a couple of examples that are being presented here at the Pediatric Academic Societies annual meeting. One of them is from our research team in Central Florida in Orlando, led by Dr. Tammy Westmoreland and Dr. Joseph Mazar.
This team, along with other colleagues, has identified that some very difficult-to-treat pediatric tumors and pediatric cancers appear to be susceptible to treatment with the Zika virus. Now, Zika virus is a bad word in pediatrics because as we know, infection by Zika virus for women when they’re pregnant has led to children with neurologic limitations and very small heads. So, we don’t think of Zika virus as a good thing or really as a friend at all.
However, this team in Central Florida recognized that some of the pediatric cancers express or show particular receptors on their surface that are used by the Zika virus to get into the cells. And when Zika virus enters the cell, it does what Zika virus does, which is to kill the cell. Well, if we can channel that effect, which has been seen in mouse models so far, effectively to reduce or maybe even eliminate these tumors, we have a chance that we haven’t had before against some of these very difficult-to-treat childhood cancers.
Carol Vassar, podcast host/producer:
Some very exciting work. What else are you seeing that rises to the top for you?
Dr. Matthew Davis, Nemours Children’s Health:
I’m also seeing some very exciting work focused on digital tools to help children with chronic conditions like diabetes, manage their disease more effectively. We have some really exciting work led by our psychologists within the Center for Healthcare Delivery Science, which is in Delaware Valley, and Jacksonville and Orlando, who are working with the tools that teens know best.
That is to say their phones and working through apps that are designed to help the child recognize what’s going on in their body that they can appreciate. What can they monitor and manage with their own skills that they’ve developed? And how can they, therefore, end up taking better care of themselves when they have diseases such as diabetes? Of course, we need medications to treat something like diabetes, but when we can amplify the medication impact with self-monitoring and management, we’re winning the game in a totally new way.
It’s important to say, even though obviously I’m enthusiastic about these aspects of research, what we’re committed to at Nemours is taking the enthusiasm and combining it with rigor because that’s how we’re going create the interventions of the future that are going to be rigorous and reproducible and have the greatest impact that they can.
Carol Vassar, podcast host/producer:
You just completed your six months here at Nemours. What rises to the top for you outside of the research realm?
Dr. Matthew Davis, Nemours Children’s Health:
Outside of the research realm, I’m especially proud of our training programs, and what I mean by that are we’re responsible for training the next generation of children’s healthcare providers, recruiting in medical students who’ve decided that pediatrics or child psychiatry or neurology or pediatric surgery is going to be the track or the trail that they follow in their careers. And like other independent children’s health systems, we need to do that in outstanding ways so that we can protect the children of the future in terms of providing healthcare for them.
We have some superb leadership in pediatric medical education within Nemours that is doing a great job of bringing in more and more talented students, especially from the medical schools with which we collaborate closely. So, in the Delaware Valley, we work with Thomas Jefferson University. In Sidney Kimmel Medical College, we’re the official department of pediatrics for Thomas Jefferson. In Jacksonville, we are closely affiliated, and our faculty are appointed at the Mayo Clinic College of Medicine. And in Orlando, we are the official department of pediatrics for the University of Central Florida.
So all of those medical schools are now bringing their residents into our training programs and creating outstandingly or very well-trained pediatricians of the future who are then going to go on to perhaps further subspecialty training or directly into practice.
Carol Vassar, podcast host/producer:
What’s your long-term plan? Where would you like to be in a year with Nemours? Where would you like to bring Nemours in the next three to five years?
Dr. Matthew Davis, Nemours Children’s Health:
I spend a lot of my time thinking about that and planning it with my fellow team members. Here’s what I would say. Over the next three to five years, Nemours has substantial growth plans in each of its regions that are all dedicated to trying to serve the healthcare needs of the children in those regions. That’s going to mean focusing on challenges such as cancer and heart challenges and neurologic challenges, et cetera, to make sure that we have the staff and the clinical experts who kids need to take care of them. That’s number one.
Number two, we have so much growth potential in research. We’ve grown so much just over the last five years. Now we’re up to 13th ranked in the country. I believe we can get to the top 10 within the next couple of years here in terms of the amount of federal NIH funding we have for our research. And that’s a big goal for us because it’ll signal that the problems we are attacking are also high-priority problems for our peer group, who judge the quality of the work.
Number three, I want us to innovate to transform healthcare in ways that are obvious to the families, for example, through more virtual care options. And perhaps less obvious, behind the scenes in terms of how we think about bringing kids in, in a more timely way for their appointments and also reaching them in their home settings after they’ve left our hospital.
Carol Vassar, podcast host/producer:
I’m going to give you the last word. There is so much more to be done, but what would you like our viewers, our listeners, to know about you, about Nemours, and the future?
Dr. Matthew Davis, Nemours Children’s Health:
I believe that we’re going to have the greatest impact on children’s health if we listen to the priorities of the community members themselves. When we trust community members to tell us what they’re most concerned about, my experience has been they hit the nail right on the head in terms of where the greatest impact can be. I see it as a major responsibility of Nemours Children’s Health to respond to those priorities and build our teams accordingly.
I believe we can have the impact that those families and communities need, but we have to challenge ourselves to change the model because if what we are doing today was effective enough, we wouldn’t still have many of the challenges that we have. We need to think differently, act differently, and achieve differently in order for Nemours and other health systems to have the impact that children, families, and communities need from us.
Carol Vassar, podcast host/producer:
Dr. Matthew Davis, thank you so much for joining us. You are the executive vice president, enterprise physician-in-chief, and chief scientific officer for Nemours Children’s Health. And thank you for listening, thank you for watching. I’m Carol Vassar. We will be live again tomorrow at 3:30 PM approximately. We hope you join us then. And remember, we can change children’s health for good together, well beyond medicine. (singing)
