As a pediatric endocrinologist at Johns Hopkins Children’s Center, Risa Wolf treats many young patients with diabetes and knows that some are at risk of developing diabetic retinopathy, an eye disease that can damage the blood vessels in the retina and lead to blindness if left untreated. Eye screening is crucial for these patients, but too many children miss out, particularly those from marginalized communities, primarily because screening requires making an extra appointment with an eye specialist or optometrist.
Intent on utilizing new technology to make eye screening easier and more accessible, Wolf in 2018 applied for an Innovation Grant — a program supported by funds raised from the annual MIX 106.5 Radiothon benefiting Johns Hopkins Children’s Center, the hospital’s largest annual fundraiser. Since 2017, about $450,000 from this event has been used each year to award Innovation Grants of up to $50,000 to Children’s Center faculty and staff members to support innovative ideas in pediatric care, education or research.
Funded projects have run the gamut — from research on new treatments for lethal liver disease to new ways to stem brain bleeds in premature infants. Some faculty members, including Wolf, have used insights gained through Innovation Grant funding to apply for larger grants that allow them to further their work.
Awarded with a $36,000 grant, Wolf purchased a non-mydriatic fundus camera that can capture high-resolution images of the retina with autonomous artificial intelligence (AI) software that can interpret those images within 30 seconds. She then led a study to determine the effectiveness of using the AI software to offer diabetic retinopathy screenings for young people — important work because the Food and Drug Administration had only approved this software to be used for patients ages 22 and older at the time.
Among her 310 study participants, Wolf found that the AI software had the ability to provide a diagnosis in 97% of diabetic retinopathy screenings. Family adherence to screening guidelines also improved from 49% to 95% when using this new technology during regular diabetes care visits at the Children’s Center.
Wolf’s research led to Johns Hopkins Children’s Center becoming the first medical institution in the country to use AI software for diabetic eye screenings in pediatrics.
“The Innovation Grants focus on innovative ideas that can impact our local community, make health care easier for patients, and ultimately improve clinical care, and they have been instrumental in positioning us as a program at the forefront of diabetes care,” says Wolf, who went on to secure a nearly $2 million grant from the National Institutes of Health for a randomized controlled trial that allowed her to take the next important step in her research: investigating whether using AI technology for diabetic eye exams improves screening rates among young people.
Innovation Grants have also been used to jumpstart many research programs. Rebecca Seltzer, an assistant professor of pediatrics at the Johns Hopkins University School of Medicine, received a $40,000 Innovation Grant this year to pilot test CAPABLE Kids with five families. This program — an adapted version of the CAPABLE program, an initiative from the Johns Hopkins University School of Nursing that helps older adults age in place — focuses on optimizing the home environment for children with medical complexity and their families. Seltzer’s prior research interviewing families in Maryland has shown that the home environment is often inadequate to promote safety, independence and quality of life, yet families struggle to access home modification resources.
Through CAPABLE Kids, the five families will work with an occupational therapist and a nurse through Johns Hopkins Pediatrics at Home to develop child- and caregiver-centered goals, as well as a handyperson or contractor to make low-cost repairs to their homes, all with the aim of improving the function and independence of the child and the quality of life for the family. For example, a contractor might build a custom height-adjustable table so a child who uses a wheelchair can have a comfortable place to sit and play with her Legos.
“We’ve also had caregivers talk about how adding a removable showerhead in the bath makes all the difference in avoiding back pain because they no longer have to bend up and down to wash their child,” Seltzer says.
After the pilot is complete with the initial families, Seltzer will use a $250,000 grant from the National Institute on Disability, Independent Living, and Rehabilitation Research to expand the reach of the program to more families in order to better understand the impact of CAPABLE Kids.
“The Innovation Grants program is a great mechanism for investigators to be able to access funds that allow us to do this type of pilot work and then expand on that,” says Seltzer. “My hope is that one day, CAPABLE Kids will be able to promote improved function, quality of life and safety in the homes of families of children with medical complexity across the country, and this is a great start.”