Healthcare Delivery for Children with Medical Complexity : The State of the Art and Future Directions

This book describes the state of the art of pediatric complex care, sharing the authors' decades of experience in an academic health center to illustrate points. The authors are pediatric generalist and subspecialist providers, among others, who care for children with medical complexity in a Pediatric Complex Care program. 

Children with medical complexity (CMC) are a small yet impactful pediatric population, a subset of children with special healthcare needs that include multi-system, non-categorical, chronic conditions, high resource and technology dependencies, medical fragility, and functional impairments. CMC do not fit into traditional systems of care. They require the continuous collaboration of pediatric subspecialists, community and public health partners, and family caregivers. 

The field of Pediatric Complex Care is rapidly evolving, yet lacks a well-prepared workforce built on clear educational competencies and clinical guidelines. In this compact volume, the authors review models of care for CMC, and how these models intersect with larger public health systems, dependent on collaborative networks of community-based and family partnerships. They explore ethical considerations, including implications for policy and practice. Among the topics covered are:

• The Specialty and Scope of Complex Care Pediatrics
• Ethical Considerations in the Care of Children with Medical Complexity
• Implications for Policy and Practice

Healthcare Delivery for Children with Medical Complexity: The State of the Art and Future Directions is an essential resource for all medical professionals who care for CMC, public policy makers, medical educators, healthcare leaders, and community partners and stakeholders.

Nancy Murphy, MD, FAAP, FAAPMR is a Professor of Pediatrics, Adjunct Professor of Physical Medicine & Rehabilitation, and Chief of the Division of Pediatric Complex Care at the University of Utah. She also serves as Vice Chair of Faculty Engagement and Director of Women in Pediatrics in the Department of Pediatrics. She blends her expertise as a pediatrician, pediatric physiatrist, and academic health leader to connect people and processes in team-based, interdependent systems.

Justin C. Alvey, MD, FAAP received his medical degree from Washington University School of Medicine in St. Louis, Missouri and completed his pediatric residency at the University of Utah School of Medicine/Primary Children’s Hospital. He is a Professor of Pediatrics and serves as Chief of the Division of General Pediatrics at the University of Utah. Clinical interests include providing primary care for children with medical complexity, ADHD, and genetic disorders.

Jennifer Brinton, MD, FAAP received her medical degree and completed her pediatric residency at the University of Utah School of Medicine where she is a faculty member in the Division of Pediatric Complex Care. She serves as a general pediatrician at skilled nursing facilities at South Davis Community Hospital and NeuroRestorative Utah and as a hospitalist at Primary Children’s Hospital.

Natalie Heyrend Darro, DO, FAAP is an Assistant Professor of Pediatrics at the University of Utah in the Division of Pediatric Complex Care. She earned her medical degree from Touro University Nevada College of Osteopathic Medicine, completed her pediatric residency at University of Nevada School of Medicine in Las Vegas, and her fellowship in pediatric critical care at University of California San Diego/Rady Children’s Hospital.

Jason Fox, MPA/MHA is the Director of Clinical Revenue Integrity & Primary Care Operations for the Department of Pediatrics at the University of Utah. He also serves as the Division Manager for Adolescent Medicine, Complex Care, and General Pediatrics. Jason graduated from the University of Utah with master’s degrees in public administration and healthcare administration.

E. Avery Hill, DO, FAAP attended medical school at Rocky Vista University College of Osteopathic Medicine in Parker, Colorado and completed her pediatric residency at Blank Children's Hospital in Des Moines, Iowa, then became the inaugural fellow of Complex Care Pediatrics at the University of Utah. Her passions include advocacy and partnering with families to provide the best care possible to children with medical complexity.

Kathleen Irby, MD, FAAP is an Assistant Professor of Internal Medicine and Pediatrics at the University of Utah. After graduating from medical school at Nebraska Medicine, she completed an internal medicine-pediatrics residency at the University of Utah followed by fellowships in adult developmental medicine at Baylor College of Medicine and hospice and palliative medicine at the University of Utah. She splits her clinical time between the Divisions of Pediatric Complex Care and Palliative Medicine.

Andrew Robertson, PA-C earned a degree in Exercise and Sports Science from the University of Utah and received his Master of Medical Science in Physician Assistant Studies from Midwestern University in Glendale, Arizona. He enjoys working on the Comprehensive Care team where he is able to collaborate with many providers in caring for children with medical complexity.

Laura Smals-Murphy, MD, FAAP is an Associate Professor of Pediatrics at the University of Utah in the Division of Pediatric Complex Care. Previously, she cared for children with medical complexity for over 20 years in two primary care medical homes that she helped create at St. Christopher’s Hospital for Children in Philadelphia and Penn State Children’s Hospital in Hershey, Pennsylvania.