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For Children in Puerto Rico, Elevating the Standard of Care

A new state-of-the art pediatric interventional radiology unit is expected to reduce inpatient stays and allow for faster patient recovery.

Direct Relief Puerto Rico Advisor Ivonne Rodriguez-Wiewall, right, reviews plans for a new pediatric Interventional Radiology Unit with members of the Pediatric Hospital Foundation. (Photo courtesy of the Pediatric Hospital Foundation)
Direct Relief Puerto Rico Advisor Ivonne Rodriguez-Wiewall, right, reviews plans for a new pediatric Interventional Radiology Unit with members of the Pediatric Hospital Foundation. (Photo courtesy of the Pediatric Hospital Foundation)

When a child in Puerto Rico needs a specific kind of medical procedure, their primary care doctor contacts Dr. Carlos Llorens. The head of Interventional Radiology at Puerto Rico’s University Pediatric Hospital (HOPU), he’s the only pediatric specialist of his kind on the island.

It might sound like an obscure sub-specialty, but interventional radiology is actually the standard of care in many institutions. Compared to traditional surgeries, these minimally invasive procedures guided by medical imaging are faster and less painful for the patient. They’re also less expensive for the health care system overall.

Interventional radiologists diagnose and treat renal disease and cardiac malformations, obtain tissue biopsies, place needles and catheters, and treat blocked blood vessels. However, these procedures require specialized equipment such as an ultrasound, X-ray fluoroscopy, computed tomography, and magnetic resonance.

And while interventional radiology for children is widely practiced, there are currently no procedural suites dedicated to their care in Puerto Rico. That means that a child who needs one of these procedures must transfer to an adult hospital or travel to the U.S. mainland. Both options are financially costly – and compromise the safety of these young patients.

A much-needed resource

Llorens trained at the Children’s Hospital of Pittsburgh of UPMC, intending to return home to Puerto Rico eventually. “When [the hospital] recruited me, I let them know of my interest in developing a pediatric interventional radiology service” in Puerto Rico, he said.

Today, when a child is determined to be a candidate for a procedure, Llorens first has to make sure that he has the right equipment and that the interventional suite at the adult hospital is available. These hurdles often mean delays in diagnosis and treatment.

Direct Relief provided a $1.6 million grant to the Pediatric Hospital Foundation to construct a Pediatric Interventional Radiology Unit. It will be the first one in Puerto Rico – and the Caribbean.

The new unit “will elevate patient care to national standards,” Llorens said.

Dr. Carlos Llorens. (Courtesy photo)
Dr. Carlos Llorens. (Photo by Wanda Liz for Direct Relief)

HOPU, the only public children’s hospital on the island, will be home to the unit. The hospital serves 8,500 patients annually, from infancy to age 21. Most patients are from low-income households and qualify for Medicaid. Because it is the only medical institution on the island that can provide 24/7 sub-specialty care and houses a pediatric dialysis center, it receives patient referrals from all over Puerto Rico.

Treating pediatric patients in a unit dedicated to their care will dramatically reduce stressors that children and their families experience while receiving care in an adult hospital environment, such as being surrounded by strangers or needing nurses trained in pediatric care.

New opportunities

Puerto Rico doesn’t lack interventional radiologists. But none of them specialized in pediatrics before Lloren arrived. Now, a unit devoted to caring for children is a necessity.

“Being able to offer this service provides an added value to the health of pediatric patients in Puerto Rico,” said Dr. Francisco Arraiza, an interventional radiologist and board member of the Pediatric Hospital Foundation.” He explained that the unit would mean a faster recovery time for patients – and lower cost since children won’t have to stay as long in the hospital.

Rebeca Quiñones, executive director at the Pediatric Hospital Foundation, indicated that the new pediatric interventional radiology unit would position the hospital as a state-of-the-art medical facility with “world-class advanced medical technology.”

There’s more reason to be hopeful. HOPU serves as the pediatric teaching hospital for the University of Puerto Rico’s School of Medicine and trains physicians in several disciplines. Doctors are optimistic that the new unit will appeal to other pediatric interventional radiologists who might practice or train on the mainland but be interested in returning home.

The unit may also help Puerto Rico prevent more doctors and other health workers from leaving the island, as they have in significant numbers in recent years.

Arraiza also thinks the state-of-the-art new addition could elevate medical tourism in Puerto Rico, providing an economic boost. Due to the island’s geographical position, “we could become a medical hub, and provide treatment to neighboring islands” in the Caribbean, he said. “If you build it, they will come.”

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