Innovation in Children’s Healthcare:

Challenges and Opportunities

This is kicking off a multi-part development on the future of children’s healthcare and pediatric digital health. 2023 holds a unique set of challenges and opportunities for innovation in children’s healthcare, and we’ll explore both in part one of this series.

Key challenges facing children’s health

Even before the COVID-19 pandemic, the children’s healthcare field faced several major challenges. Research points to a growing pediatric mental health crisis, with the number of children diagnosed with mental health conditions growing considerably between 2016 and 2020. COVID-19 was akin to pouring gasoline on the behavioral health fire. Suicide rates in youth rose — especially for young females. Additionally, several chronic health conditions have become more prevalent among children, including asthma, obesity, and diabetes. Not only has the pandemic exacerbated many of these previously-existing issues, it has created brand new health concerns for children as well.

C.S. Mott Children’s Hospital (affiliated with the University of Michigan) released its National Poll on Children’s Health which found the pandemic led to heightened concern for several key health issues:

• Excessive screen time (72%)
• Bullying/cyberbullying (62%)
• Unhealthy eating (59%)
• Depression/suicide (54%)

While we’ve seen signs of normalcy post-pandemic, data on kids’ and teens’ physical and mental health continue to show negative trends.

Barriers to innovation

The healthcare industry is complex, and innovation and scale for helathcare solutions remain a huge challenge. That said, if we want to address many of the aforementioned pediatric health issues, we need to embrace innovation and develop new solutions.

First, we will break down the key barriers to innovation for children’s health which are centered around population size, consumers, regulatory and reimbursement hurdles, and research funding, to name a few.

For children’s health, one example and primal barrier to innovation is population size. Since there are fewer children than adults, fewer people ultimately get served for specific health needs (think: fewer kids have skin cancer than adults, both on average and a total volume basis). When companies look at investments in new and innovative health solutions, the smaller population sizes make it difficult to justify long-term investments since only a few hundred (or few thousand kids) are impacted. Because of this, it can be quite expensive to fund innovative solutions for so-few kids — a sobering thought. Second, these small patient populations are heavily fragmented across the country, so even when there are solutions to combat illness or unmet needs, these solutions are often harder to scale.

Another challenge is the consumer. Healthcare, and digital health solutions in particular, are often seen as a two-part sale. Not only are companies trying to partner with providers, payers, employers, or pharmaceutical companies, but they are also selling their solution to the end-consumer (the patient). For children’s health, the latter is exacerbated through an additional end-user: the parent or caregiver. As companies expand on their offerings, it becomes even more important to consider the child’s siblings, family status, or immediate family, often an afterthought when incubating new ideas. When it comes to children’s health and end-users, you aren’t just building and selling solutions to the child or parent, but to the entire family, which is a challenge in and of itself.

Another challenge is the regulatory and reimbursement landscape associated with Medicaid and the Children’s Health Insurance Program (“CHIP”). Medicaid is the nation’s public health insurance program for people with low income, covering roughly 1 in 5 Americans, and CHIP is the insurance program aimed at providing low-cost health coverage to children in families that earn too much money to qualify for Medicaid but not enough to buy private insurance. Both play a critical role in serving lower-income families but often struggle with state bureaucracy and funding. The two programs differ in many regards, which can impact eligibility and access to basic healthcare needs. For example, government officials often struggle to come to an agreement regarding even basic primary care.

Lastly, research remains another key challenge to adoption and innovation. While other industries allow for incremental improvements in new solutions, grant funding is lacking for children’s health and private capital is difficult to come by (for many of the reasons mentioned above). Children’s healthcare will need to develop new solutions that appeal to investors to secure the proper private funding, otherwise, companies will need to seek grant funding or financial support from their institutions.

Innovation: key initiatives today

Thankfully, despite these setbacks, we’re still seeing several key innovation players step up to the challenge.

Children’s hospitals are beginning to build upon their innovation efforts. For example, Boston Children’s Hospital’s Innovation and Digital Health Accelerator (“IDHA”) and the hospital’s efforts to build out a continuum of care to support children with mental health issues are leading the way for many organizations. Children’s National Hospital’s Bear Institute Pediatric Accelerator Challenge for Kids (“PACK”), which supports pediatric digital health startups looking to bring new solutions to market, is another great example of a lare organization supporting these innovative efforts.

Boston Children’s and Children’s National are not the only ones tackling healthcare issues through incubation: Redesign Health and KidsX (affiliated with Children’s Hospital of Los Angeles) recently announced a partnership, which includes the launch of a program designed to bolster pediatric digital health companies. Countless others (not covered here) are continuing to innovate on health initiatives internally and externally through strategic partnerships.

Separately, emerging technologies that are being built for adults are also applicable for children in many cases but don’t get implemented because of the issues above. However, there is still a need to reduce pediatric clinicians’ administrative burden, better integrate systems and data into the clinical decision-making process, and address patient and provider experience for children’s health.

One clear opportunity lies in technologies or platforms that help bridge the gap between children’s chronic issues and adulthood. It is clear that preventative measures that are taken to avoid chronic disease early on, create better outcomes and provide health systems with more cost savings. As we think about children’s healthcare, there is an opportunity to bridge the gap between children’s chronic disease (e.g., obesity), and the prevention and cost savings associated with reduced chronic disease in adults.

Children’s healthcare has progressed exponentially in recent decades, but many issues still exist that prevent our nation’s youth from getting the care they need. Organizations are eager to step up to the challenge, and through collaboration, we can make healthcare more equitable and improve the health and well-being of future generations.

If you enjoyed reading about the challenges and initiatives associated with pediatric digital health, stay tuned / follow for upcoming posts where I’ll be breaking down the history of children’s health, CHIP, recent innovations in the US, key startups in the space, and trends in the years ahead.