JENNIFER BOULDEN

Since the ribbon-cutting ceremony a year ago, the Centers for Children--ACH’s and UAMS’ largest regional pediatric facility--has grown exponentially.

In its first year, the Centers for Children in Lowell, Ark. has sprouted up like a weed.

The facility, a collaboration of Arkansas Children’s Hospital (ACH) and the University of Arkansas for Medical Sciences (UAMS) brings pediatric subspecialists to Northwest Arkansas on a regular schedule to treat area children and provides ancillary services such as pediatric labs to support their work. The center, located in a 40,000-square-foot, two-story building, houses the Schmieding Developmental Center and the Schmieding KIDS FIRST program (both previously located in Fayetteville and Springdale) and various regional subspecialty clinics.

Medical director Astryd Menendez, MD, said that the UAMS Department of Pediatrics has had a presence in the area for many years, but that the new center formalized their commitment and created a permanent, centralized space for the department’s physicians to care for the children in the growing metropolitan areas of Lowell, Fayetteville, Springdale, Rogers, Bentonville and surrounding communities. Since the 1970s, the UAMS Department of Pediatrics has been housed at Arkansas Children’s Hospital, so their joint commitment is an organic one, she said.

“It became apparent in treating patients and in the requests from area referring physicians that we needed to have a stronger presence here. We realized the need for more local services, so we set to finding ways to bring more pediatric subspecialty services to Northwest Arkansas,” Menendez explained.

UAMS and ACH also have other regional clinics around the state, including clinics in El Dorado, Fort Smith, Harrison, Helena, Jonesboro, Mountain View and Texarkana, but the Centers for Children in Lowell is by far the largest and most comprehensive regional pediatric facility they have created to date, said Hilary de Millo from ACH’s public relations office. The Centers for Children is part of a larger statewide collaborative between UAMS and ACH, approved in January 2007 by the ACH Board of Directors and the University of Arkansas Board of Trustees. That collaborative includes 24 existing clinics where physicians from UAMS or ACH treat patients.

Much research went into finding a permanent site for the Northwest Arkansas facility, Menendez said. She explained that Lowell was chosen for a number of reasons, but primarily because it is right in the middle of the area (linking Fayetteville, Springdale and Rogers) and because the site has direct visibility from Interstate 540 at exit 79.

“It really helps people know that we are here,” she said. “Even though we work mostly through physician referrals, people see us from the freeway and come by to see if we can treat their child, and that’s always a good thing.”

Parents especially appreciate not having to take off work for an entire day to take their children to see specialists in Little Rock, Menendez said. At the center’s grand opening in May 2007, ACH President and Chief Executive Officer John Bates, MD said, “With this new, shared outreach, thousands of families will not have to make the long trip to Little Rock for their child’s initial evaluation or clinic visits for follow-up medical attention.”

Recruiting pediatric subspecialists to set up residence in a given area is enormously difficult, Menendez said, because there are too few to go around. In her own specialty, pediatric pulmonology, she said there are only about 1,000 physicians in all 50 states combined. For that reason, while the hospital works in the long-term to recruit more subspecialists to work in Northwest Arkansas, in the short-term, available subspecialists from Little Rock fly weekly, monthly, or in some cases bi-monthly, into Northwest Arkansas to see patients.

The rotational arrangement at the permanent facility works well, Menendez said. Previously, when specialists from several pediatric disciplines, including pulmonology, cardiology and neurology would fly in from Little Rock once a month, they had difficulty with the logistics of treating patients, particularly with the dearth of ancillary pediatric services available.

Now physicians are able to draw on many more diagnostic services through the Centers for Children. On site is a full laboratory, staffed 40 hours a week. The Centers for Children has echocardiogram, electrocardiography, clinical radiology, EEG, and pulmonology lab facilities. She said there is an in-house radiology tech, and that through the partnership with ACH, they can ensure that a pediatric radiologist reads the results within 24 hours whether on site that day or not.

Videoconferencing, available at the center, is another boon, connecting local physicians to experts in Little Rock or elsewhere for consultations, meetings and continuing education.

She said having a private practice in the area was much more difficult for her before the availability of these diagnostic services. Building up the medical infrastructure as the Centers for Children has done should enable growth of pediatric services throughout the region by making it easier for physicians to reach the tools they need and fostering a community of pediatric experts.

To date, the only full-time subspecialists at the Centers for Children are Menendez and a newly recruited pediatric neurologist, Tonya Phillips, who started in July.

“As far as recruiting goes, we are concentrating our efforts on the areas of greatest need, although of course we would like to have all areas filled eventually,” Menendez said. “We very much needed a full-time neurologist here, so we are very, very happy to have Dr. Phillips at the facility.”

Although it held its grand opening in May 2007, patients started coming to the center in March 2007. Menendez said the available services started slowly, with only asthma, cardiology, neurology and rehabilitation medicine in the beginning. Within a short time, however, Menendez had set up her own pulmonolgy clinic at the Centers for Children and a number of other specialties have gotten on board.

“This past year, the center has been growing exponentially,” Menendez said. “Its quite exciting seeing what is now possible compared to what we had before.”

Some in-demand specialties, like cardiology, come every week. Others, such as endocrinology, see patients once a month, and the some such as rheumatology, are on-site every other month. The full list of disciplines now available at the center includes pulmonology, neurology, cardiology, adolescent medicine, asthma specialists, adolescent psychology, eating disorder specialists, endocrinology, neuromuscular pulmonary, gastroenterology, nephrology, immunology, rheumatology, hematology, growth and development, hemophilia, rehabilitative medicine, and pre- and post-op surgery.

The Schmieding Developmental Center provides medical and neuropsychological assessments for children with developmental disorders. Schmieding KIDS FIRST is a comprehensive, early-intervention program for infants and young children with medical conditions and developmental delays. UAMS operates 11 KIDS FIRST centers across the state.

The KIDS FIRST program is located on the first floor of the Centers for Children with the developmental center, and regional clinics are housed on the second floor.

Although end-of-year patient census numbers through June 30 were not yet available, Menendez said the numbers through the end of April 2008 were about 4,400 patients. Because of the diverse demographic make-up of the area, many of those patients are Hispanic, Marshallese or Vietnamese. “It truly is a multi-cultural area, and a multi-cultural service we provide here,” she said.

One of the center’s next goals is becoming licensed to provide immunizations for Northwest Arkansas’ many non-immunized children. “There’s a great need for that here, and it seems like a natural fit for us,” Menendez said, explaining that the licensure is currently in the works.

The Northwest Arkansas community has embraced the center with open arms, she said. “I think they recognize our goal is to provide our expertise and services to care for the children of this area and to blend with and enhance the services that are already here. Physicians are learning that we are only a phone call away. We’re here and eager to help,” Menendez said.

She said that while she is enormously proud of the center’s growth and expanding scope of services, the little things are what really tell her the center is doing good work.

“I am most proud of seeing the families that come in our doors for a child’s treatment afterwards leave looking much happier, relieved their child is getting such good care,” she said. “So many of the parents have expressed their appreciation for us being here. It makes a big difference in their lives. As their children grow, we will continue to expand our services and grow this medical community.”



August 2008