Stronger Houston: Inside UT Health’s High Risk Children’s Clinic

Inside the UT Physicians high risk children's clinic

HOUSTON – According to the University of Texas Health Science Center in Houston, less than 1% of children in the US are considered medically complex, but these children account for 40% of pediatric deaths and 54% of all pediatric hospital charges.

UT Physicians High-Risk Children’s Clinic is helping to change those numbers.

“We see children with medical complexity, those are children with chronic illnesses, children who require some type of technology to survive,” said Dr. Ricardo Mosquera. “Children who are in the hospital all the time, who are in the ICU, the emergency room, children who need to be seen by multiple specialists.”

Mosquera is a pediatric pulmonologist and director of the UTHealth High-Risk Children’s Program. The clinic has been operating for 12 years and currently serves 600 patients who have at least one chronic illness, have been hospitalized twice in the year prior to enrollment, along with admission to the ICU, and have a high risk of re-admission to the hospital.

“We are trying to avoid unnecessary ER visits and unnecessary ICU and hospital admissions,” said Mosquera.

KPRC 2 spoke with one mother whose son succumbed to SIDS at 6-weeks old but was revived after 20-minutes. Cheryl Lingenfelter said the lack of oxygen caused traumatic injury to Nathan’s brain.

“Nathan has epilepsy so he needs constant seizure medication. It’s intractable epilepsy, meaning his brain is always trying to seize,” said Lingenfelter.

Nathan also has a tracheostomy tube and a feeding tube. Lingenfelter said any type of ailment can potentially become life-threatening to Nathan.

“This clinic is paramount, it would be impossible for the level of care he needs for us to get it at a regular pediatrician’s office,” said Lingenfelter. “Before this, I was calling doctors all the time and trying to get in contact with them and it would take a week to get back to them.”

“How critical is a clinic like this to Nathan’s life?” asked KPRC 2′s Robert Arnold.

“Extremely. I can say this clinic has probably saved his life multiple times,” said Lingenfelter.

The clinic brings 11 pediatric specialists together under one roof so parents and their children don’t have to hop from office to office or hospital to hospital for specialized care.

“We can help them to navigate the system, we can help coordinate care with multiple specialists, with a social worker, with nutritionists,” said Mosquera. “Twenty percent of patients, their families don’t have high school diplomas. Thirty-five percent, they don’t speak English.”

The clinic also has a much smaller doctor-to-patient ratio than the average pediatrician’s office.

“A typical pediatrician in town sees 20 or 25 patients per day. Here in this clinic, a pediatrician here sees four or five only,” said Mosquera.

Mosquera said one of the keys to this type of care is having a robust telemedicine program and having doctors who are intimately knowledgeable about their patients’ needs available 24-hours a day seven days a week.

“Every patient’s family has our cell phones. We answer the phone for them anytime, after-hours, weekends, holidays,” said Mosquera. “With telemedicine, we can be more proactive with the patient. We are able to initiate treatment earlier.”

For Lingenfelter, this is a blessing since she lives close to two hours outside of Houston and transporting Nathan is a difficult task.

“It’s a lot just because I have to make sure I have everything we might need, we will need and everything we could possibly need. It’s a big undertaking,” said Lingenfelter.

Studies conducted by Mosquera and other physicians at UTHealth show this type of care can drastically reduce the amount of time a medically complex child spends in the hospital, which also cuts down on the amount of money needed for treatment. You can read about those studies here and here.


About the Author:

Award winning investigative journalist who joined KPRC 2 in July 2000. Husband and father of the Master of Disaster and Chaos Gremlin. “I don’t drink coffee to wake up, I wake up to drink coffee.”