Standout Insights From the First 30 Episodes

Thirty episodes in, and this is a special one. Over the first 30 episodes of A Dose of Optimism, host Omkar Kulkarni has sat down with physicians, founders, researchers, and change makers working at the edges of what's possible in pediatric healthcare. In this episode, he revisits some of the moments that stayed with him the longest, ideas that challenged conventional thinking, insights that sparked optimism, and reflections that encouraged deeper thinking about the future of children's health.

Featuring standout moments from:

Dr. Bimal Desai on  how digital check-ins are supporting medically complex children at home.

Dr. Solfrid Raknes on how children in conflict zones describe a digital mental health game as "a school break, a break from the war."

Andrew Post on the measurable impact of school-based health services: up to 11 fewer days of absenteeism, and nearly $2,800 in reduced annual healthcare costs per child served.

Dr. Sucheta Joshi on the coming era of gene therapy for epilepsy, and the shift from treating symptoms to treating disease at the cellular level.

John Brownstein on where AI is heading in healthcare: beyond documentation and into patient-facing equity, access, and a future where physicians can't imagine going back.

Carla Small on why AI tutoring may be the most important application of AI for children, and why 98% of kids who need high-dose reading support aren't getting it.

Dr. Jonathan Santoro on preventive neurology: using genetics and family risk scores to stop neurological disease before it starts.

David Feinberg on why he is, by his own admission, wildly optimistic about the future of healthcare, and why that might just be a character flaw.

Episode Resources:

From Minecraft to Remote Monitoring: Innovating the Patient Experience

Trauma, Grief and Resilience

Schools: A Hub for Children's Healthcare

Pediatrics, Everywhere: Telehealth for Rural Kids and the Future of Epilepsy Care

Public Health: Policy, Trust, and Emerging Technology

Season 2 Premiere: Return of the Parentrepreneurs!

Closing the Gap in Pediatric Care

Oracle Health: David Feinberg, MD

→ For more episode resources, please check out our blog

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Children's Hospital L.A. Website

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Children's Hospital L.A. LinkedIn

Transcript

SPEAKER_08 0:01

Welcome to the Dose of Optimism, where I talk to the optimists in healthcare. My name is Omkar Kulkarni, and I work at one of the world's best children's hospitals where I lead innovation. I started Kids X, which is a premier international startup accelerator for pediatric innovation, and over the years I've met thousands of startups, investors, and innovators. Every one of them has a story, and every one of them is optimistic about the problems they're solving. On this podcast, you'll meet amazing people who will share their stories and what makes them optimistic about the future of healthcare. Alright, let's get started. Welcome to a special episode of A Dose of Optimism. If you've been listening since the beginning, thank you for being part of this journey. Over our first 30 episodes, we've had a chance to sit down with remarkable leaders, innovators, physicians, founders, and change makers who were helping shape the future of healthcare and innovation. While every conversation has brought tremendous value and intriguing perspectives, there have been a few moments that especially stayed with me. Ideas that challenged conventional thinking, insights that sparked optimism, reflections and encouraged me and many of you to think more deeply about the work we do and how new perspectives can support innovation and meaningful progress. In this episode, we're revisiting some of those standout insights from our first 30 episodes. My hope is that these moments leave you inspired, thoughtful, and perhaps even seeing new possibilities for the future ahead. Thank you for listening and for continuing to be part of the Dose of Optimism community. Zephyr, what makes you optimistic about the future?

SPEAKER_07 2:06

I think working in a pediatric organization is probably the easiest job I've had, and I've done it a few times in pediatric organizations, because every day you wake up, you don't have to think about why you do the job. Our job is to protect kids, get them healthy, take care of the holistic child. So I think the optimism for me is no matter what happens in the world, we have to look to our kids for the future. And if we take care of our kids, we educate our kids, we give them good values, they will lead the world forwards, probably in a better way than I could. And that's my hope for the future.

SPEAKER_02 2:46

And there they use this magic missing game. The same as helping hand problem solving, like the situation here, like what's up. And here it's I have feelings like what do I feel? The red thoughts we call them like easier to remember when it's there, which are like the negative automatic thoughts if we are thinking CBT and the alternative thoughts here, and what can I do and who can help me? So they teach that. But in the magic mitten, it's for children eight to twelve, and then it's like a story, and they're telling the story, and then you come into the playground of the game and they're doing these games partly digitally and partly just uh analogue. What touches me the most from there now is that the children say, This is kind of a school break, a break from the war, like a little pause. And the small films I've seen and the children I've heard from more personally, they when it's so rough around you all the time and you are so scared, it's wonderful to have at least small little breaks. And that also is so healthy for the brain for developing children and adolescents. It makes a big difference.

SPEAKER_04 3:57

We have seen really great data out of places like Duval County in Florida, Paramount in LA County, Ferguson in Missouri, where we are reducing absenteeism by anywhere as much as 11 days of absences following services. A study out of Paramount in LA County showed that anywhere from 41 to 44% of the children that receive services from us about midway through the school year didn't miss a single other day the rest of the school year. And so when you talk about chronic absenteeism, our ability to impact that is really an important point. On the healthcare side, we also have a study with HealthNet actually in California that showed a really significant reduction in cost of care for that child across their higher acuity care and other related expense services to the tune of almost $2,800 per year per child that we served. And so we are expanding access. We're using that access to create meaningful engagement.

SPEAKER_01 5:02

I think gene therapy is here. We don't have FDA approved gene therapies for epilepsy yet, but they're at our doorstep. They're coming. And there are some clinical trials which are further along into the sort of the pathway to having these therapies approved. I think all along, up until now, we have thought about treating epilepsy as mainly treating the symptoms, which is making seizures better. As we have understood better and better the genetic underpinnings of epilepsy, we're able to think about not just targeting seizures, like treating the symptoms, but actually treating at a cellular, molecular, and biochemical level what is causing these epilepsies. Now, another thing to bear in mind is for some of these, not all, but for some of these, as we understand these genetic mechanisms better, some of the treatments that we had, including the genetically mediated treatments, not only impact seizures, but have the potential to actually be disease modifying. So they can have a much broader impact on these children's lives, development, and not just their seizures. So I think once these therapies are secured, they are going to be here to stay. And it's a very exciting time for pediatric epilepsy and pediatric neurology. We have moved from the era of we can diagnose conditions and we don't have definitive treatments to now we are looking at definitive treatments to borrow from my colleagues in the neuromuscular disorder space, gene therapy and genetically mediated treatments have really changed the face of how these children do in terms of their outcomes. And I think epilepsy is going to follow.

SPEAKER_03 7:11

But if you think about helping people prepare for their healthcare journeys and post-journey, the AI tools are going to be incredibly valuable and they will supercharge our ability to provide care and of course improve the experience that people have in interacting with our health systems. We've been slower on the patient side around improving and streamlining the patient experience, but that to me is where we should be pushing. And that's what families are looking for. They're looking to take more control over their data and their lives. You can't expect your provider to have every aspect of knowledge of every recent publication or every publication that's happened in the last century. Like I think that's an expectation that patients should have. I think that's especially true on primary care, where primary care physicians are spread so thin, have so limited amount of time to offer. And by the way, the adoption is showing that among our physicians that they recognize this too. So I think that it's a nice convergence. I think there's an expectation of patients, but I think physicians are seeing it across the board, seeing a life that they can't go back to.

SPEAKER_00 8:25

What's happening in our country today, there's $30 billion a year spent on tutoring. 2% of it is high quality, high-dose tutoring. So the reality is what happens when your child is in third grade, let's say, and that's a very typical time when parents actually identify and know that their kid has a reading issue because somebody, probably a teacher or a test, indicated to them that they aren't learning. And the problem is third grade is when they move from learning to read to reading to learn. And so you really want to, the earlier the better, but that's like a stop when parents can't ignore it. And so if you take a typical third grader, you tell a parent that your child's having trouble reading, they start looking into the tutoring options. They're expensive, right? To get good tutoring. In Boston, it's $150 an hour to get a Norton Gillingham tutor. So you can generally only afford maybe once a week. But kids who are that old with maybe one or two grade levels behind in reading, they need almost everyday instruction. And that's where I go back to that data point. 2% in the country are getting that high dose, high-quality tutoring. So this is a perfect application for AI. And why we're so excited about AI, because first of all, it's adaptive. The AI that we're building out is adaptive, right? So we're paying attention to the child's accuracy, their skills, their emotions as they're playing. Are they frustrated? And what's their attention span? We know little Tommy has a 22-minute attention span. We're not going to give him more instruction than that. And every response is adaptive according to the inputs from that information. And then it's highly personalized, right? Because even better than a tutor can remember, AI can collect information from the mom and from the child's experience and the progress monitoring. So we know that he loves the Red Sox, he hates the Yankees, and he's got a 22-minute attention span. So everything will be customized and very engaging, and we make it very game-like as well. And all of this is providing as a platform evidence-based instruction. And we are also quite good at working with kids with attention issues, and there's a high co-occurrence between dyslexia and ADHD. So it's quite handy. Many of the kids we're working with, they've tried so many other things and it's not working. They lose patience or they lose interest. And so the fact that we're adept at knowing how to keep these kids engaged is pretty important too.

SPEAKER_06 10:58

Two things I'm most excited about. So one is just a broad application of immunotherapy in people with not just down senior, but aero developmental disorders. So I think that there's a lot of diagnostic overshadowing that happens in that population. And so now bringing this whole new toolkit to this population is going to be the next big jump. And if we combine that with all of the gene therapies that are now in the pipeline for these conditions as well, I think that this is actually going to be a new age in terms of how we think about autism, Down syndrome, neurodevelopmental disorders like that. And I think that the second piece that I'm really excited about is how we can actually prevent disease. I think preventative neurology is going to be what we're really talking about in five years. Right now, a patient has a seizure and they come to me and I start them on an anticonvulsant and I say, you have epilepsy, and here's your new therapy. And that's the end of it, right? You still have epilepsy. I think in the future, in a combination with genetics, family risk scores, all of that sort of stuff, we're going to find ways to actually prevent the actual neurologic disease from happening. Some of that screening for it early and identifying. So if you have a stroke condition, we're piloting a study that uses transcranial Doppler. You just put an ultrasound up to the side of your head and you can identify stroke before it happens. We're doing genetic testing to say you are at risk or not at risk for these three diseases in the futures. So the idea of personalized medicine is right at our fingertips and we're starting to be able to use it more and more. And I think that how we will use that is to actually prevent the diseases from actually happening as opposed to selecting better therapies down the line. I think that's the shift that we're actually going to see over these next couple of years, where it's been more personalized, especially in oncology. We've got this very specific therapy for this very specific type of tumor. Now it's in the future, it's gonna be like you have to take this medicine for three years and you will never develop this tumor. You never develop this neurologic disease.

SPEAKER_05 13:01

I'm always optimistic. Um, I think that, you know, we've always talked about healthcare is too big of a percentage of GDP and we got to get it better. And I think there is uh movements now around people being healthier, around technology actually helping facilitate that. And I think we could get to a point where we're able to care for more people with higher quality and decrease the cost. So uh, and I hope we're part of that.

SPEAKER_08 13:29

All right, thank you for joining us for your dose of optimism. Make sure to check out our show notes to get more information about our guests and the work they're doing. Visit our podcast page on the Kids X website to join our podcast community and to learn more about pediatric innovation. Thank you to our sponsors and to our presenting partner, Kids X. Please subscribe wherever you get your podcasts, and remember, it takes a village to make sure our kids grow into healthy adults. So volunteer at your local library, help out at the community center, and if you're so inspired, donate to your local children's hospital. Alright, see you next time. The content, views, opinions, and information presented on this podcast do not reflect the views of Children's Hospital Los Angeles or of the sponsors of the podcast.