Bringing the pediatrics perspective to emergency medicine: Weil Institute interviews incoming EM chair
The Weil Institute sat down with Dr. Mahajan to talk more about his work as a specialist in pediatric critical care, his ongoing research at Weil and what he envisions for the future of emergency medicine for patients of all ages.
Contact:
Katelyn Murphy
Marketing Communications Specialist, Weil Institute
mukately@med.umich.edu
ANN ARBOR, MI – Earlier this summer, the University of Michigan Board of Regents approved the appointment of Dr. Prashant Mahajan to incoming chair of the Department of Emergency Medicine. Among other accolades within Michigan Medicine, Dr. Mahajan is a member of the University’s Max Harry Weil Institute for Critical Care Research and Innovation and sits on the oversight committee for the Kahn Pediatric Critical Care Grand Challenge.
The Weil Institute sat down with Dr. Mahajan to talk more about his work as a specialist in pediatric critical care, his ongoing research at Weil and what he envisions for the future of emergency medicine for patients of all ages.
Thank you for your time, Dr. Mahajan! To begin, could you tell us a little bit about what your role as department chair will involve and what are you looking forward to most?
Prashant Mahajan, MD, MPH, MBA
Thank you for this opportunity to discuss my role as the chair for the department of emergency medicine at the University of Michigan. The typical expectation of an academic department chair is to oversee the tripartite missions of clinical care education and research. In this role I fully intend to impact emergency care delivery at the local and at the global level. Furthermore, I want to ensure that high quality emergency care is delivered to critically ill and injured individuals and populations. I believe that the Emergency Department at the University of Michigan is the global leader in clinical care, research, and education, and I am looking forward to sustaining this culture in the department.
What potential collaborations do you see in the future between the Department of Emergency Medicine and the Weil Institute?
The Weil Institute’s impact on emergency critical care continues to be substantial. The unique model advanced by the Weil institute that includes multidisciplinary approach with a strong focus on translational research and impact assessment of implementation of outcomes of research is truly paradigm shifting and impactful. The department of emergency medicine at University of Michigan is known for its highly collaborative approach to research education and clinical care delivery and thus I see substantial opportunities to collaborate with Weil institute in all aspects of acute and critical emergency care delivery from the field to the emergency department and even after patient discharge.
Can you tell us about some of the research you are currently doing with the Weil Institute and our core units?
I have multiple projects with the Weil Institute but I would like to highlight two of them. The first one is a $2.5 million dollar NIH funded study on pediatric sepsis where we are creating a complex signature using a combination of the host immune response, host cytokine response, and host physiologic response to determine early sepsis as well as predict outcomes including ICU admission and organ failure. I believe we will be able to determine future therapeutic targets for precise and personalized approach for sepsis management. My second project is a startup called HealthIntel which is using state-of-the-art artificial intelligence and machine learning algorithms to predict patients need for emergency care and subsequent hospitalizations as well as patient diagnosis.
The Weil Institute’s Kahn Pediatric Critical Care Grand Challenge program supports high-risk research addressing the unique needs of critically ill and injured children. Can you tell us a little about your role as a member of the program’s oversight committee?
I'm very excited in my role of the Khan Pediatric Critical Care Grand Challenge program because I get to see highly innovative projects which are essentially multidisciplinary and have a line of sight towards commercialization thus very likely to be successful. In this role I get to work with a large cohort of highly motivated and trained individuals across multiple disciplines to come toward a common goal of improving patient care through innovation. It is particularly exciting to me when I get to interact with clinicians including nurses and non-clinicians, biomechanical engineers, computer scientists as well as designers.
You’ve reviewed dozens of Kahn Grand Challenge proposals since the program’s beginning. What can you tell us about the projects you have seen so far? About the research ecosystem at Weil and the University?
You are correct, in my role as an oversight member of the Kahn Challenge, I have been fortunate to review multiple proposals, and the exciting part was the diversity of the concepts that suggest that there is a need for the work the Weil Institute is supporting. Furthermore, most projects have a requirement that shows a path towards commercialization and stepwise progression to incremental funding often using a multiple investigator approach which is exactly what is needed to solve complex healthcare related issues.
"The Weil Institute’s impact on emergency critical care continues to be substantial. The unique model advanced by the Weil institute that includes multidisciplinary approach with a strong focus on translational research and impact assessment of implementation of outcomes of research is truly paradigm shifting and impactful."
Prashant Mahajan, MD, MPH, MBA
Interim Chair, Emergency Medicine
Professor, Department of Emergency Medicine, Division of Pediatric Emergency Medicine
Professor, Department of Pediatrics
What’s the latest in pediatric critical care? Any new developments (research, discoveries, innovations, etc.) that you are particularly excited about?
I am most excited about the potential investigating the host-based immune system response to inciting etiologies which could be infective (bacterial or non-bacterial (viral, fungal etc) or inflammatory such as asthma, severe trauma, sickle cell disease with acute chest syndrome etc. to determine the patho-biology of illness, identify unique therapeutic targets and prognosticate outcomes. Using this approach in conjunction with advanced data science technologies including but not limited to machine learning, artificial generative intelligence etc. will help us advance care at an individual and at a population level. There are unique opportunities to leverage our Emergency Medicine Education and Research Network by Global Expert (www.emergenetwork.org) to exponentially expand the work and products from the Weil Institute at a global level.
A suggestion that innovators who are looking to break into the pediatric space may often hear is that pediatric patients shouldn’t be looked at as simply “small adults”. Could you expand on this, and do you have additional advice you would give?
That is often true because children have unique developmental and physiologic needs that are substantially different from adults. Unfortunately, there are substantial gaps in pediatric emergency and critical care research and indeed in pediatric research. There are various reasons including but not limited to underfunded NIH institutes that conduct pediatric research such as NICHD and a lack of a dedicated federal institute to emergency care. Consequently, most pediatric therapeutics and interventions are extrapolated from adult studies which is not applicable to children but in some instances, may lead to harm. This has been an ongoing issue in pediatric sepsis where it was documented that the aggressive volume expansion recommended for adults with isotonic solutions led to harm in children. On the flip side there are opportunities as well. We could leverage the Weil Institute to identify collaborators who could design pediatric trials and conduct discovery from bench to bedside using existing Weil assets such as the large animal lab and data scientists.
What is needed most in pediatric emergency medicine right now?
I believe the Department of Emergency Medicine is well poised to make substantial inroads into pediatric emergency and critical care. We have opportunities to recruit strategically and nurture early career investigators across the spectrum of research i.e. bench to bedside using a learning health systems approach. Indeed, expanding the research infrastructure to enhance emergency care research across all ages will be one of my primary goals in this job.
Finally, if you could have access to one critical care innovation—no matter how impossible—what would it be?
That's a great question. My overall area of research is to assist clinicians to make decision making in austere circumstances. Since sepsis is an extremely difficult condition to diagnose and thus manage in the emergency departments, I would love to see a point of care test to diagnose bacterial and non-bacterial infections with high accuracy which will allow clinicians to initiate appropriate antibiotics and discontinue them if the patient does not have a bacterial infection. This innovation is possible with robust collaboration with the Weil institute and I'm confident that its impact will be global.
About the Weil Institute
The team at the Max Harry Weil Institute for Critical Care Research and Innovation is dedicated to pushing the leading edge of research to develop new technologies and novel therapies for the most critically ill and injured patients. Through a unique formula of innovation, integration and entrepreneurship that was first imagined by Weil, their multi-disciplinary teams of health providers, basic scientists, engineers, data scientists, commercialization coaches, donors and industry partners are taking a boundless approach to re-imagining every aspect of critical care medicine. For more information, visit weilinstitute.med.umich.edu.