For Children in Puerto Rico, Elevating the Standard of Care

When a child in Puerto Rico needs a specific medical procedure, their primary care physician contacts Dr. Carlos Llorens. The chief of interventional radiology at the University Children’s Hospital (HOPU) of Puerto Rico, he is the only pediatric specialist of his kind on the island.

It may sound like an obscure subspecialty, but interventional radiology is the standard of care in many settings. Compared to traditional surgeries, these minimally invasive procedures, guided by medical imaging, are faster and less painful for the patient. They are also less expensive for health care in general.

Interventional radiologists diagnose and treat kidney disease and heart defects, obtain tissue biopsies, insert needles and catheters, and treat blocked blood vessels. However, these procedures require specialized equipment such as ultrasound, X-ray fluoroscopy, computed tomography, and magnetic resonance.

And while interventional radiology for children is widely practiced, there are currently no procedural suites dedicated to their care in Puerto Rico. That means a child who needs one of these procedures will have to be transferred to an adult hospital or travel to the U.S. mainland. Both options are financially costly – and endanger the safety of these young patients.

A much-needed resource

Llorens trained at UPMC’s Children’s Hospital of Pittsburgh, with the intention of eventually returning home to Puerto Rico. “When [the hospital] recruited me, I informed them that I am interested in developing a pediatric interventional radiology service” in Puerto Rico, he said.

Today, when it is determined that a child is a candidate for a procedure, Llorens must first ensure that he has the correct equipment and that the intervention room in the adult hospital is available. These hurdles often mean delays in diagnosis and treatment.

Direct Relief provided a $1.6 million grant to the Pediatric Hospital Foundation to build a pediatric interventional radiology unit. It will be the first in Puerto Rico – and the Caribbean.

The new unit “will elevate patient care to national standards,” Llorens said.

dr. Carlos Llorens. (Photo by Wanda Liz for instant help)

HOPU, the only public children’s hospital on the island, will be home to the unit. The hospital serves 8,500 patients annually, from babies to 21 years. Most patients come from low-income households and are eligible for Medicaid. Being the only medical facility on the island to provide 24/7 subspecialty care and having a pediatric dialysis center, it receives patient referrals from all over Puerto Rico.

Treating pediatric patients in a unit dedicated to their care will dramatically reduce the stressors that children and their families experience while receiving care in an adult hospital setting, such as being surrounded by strangers or needing nurses trained in pediatric care.

New chances

Puerto Rico has no shortage of interventional radiologists. But none of them specialized in pediatrics before Lloren arrived. Now a unit dedicated to caring for children is a necessity.

“Offering this service provides added value to the health of pediatric patients in Puerto Rico,” said Dr. Francisco Arraiza, an interventional radiologist and board member of the Pediatric Hospital Foundation.” He explained that the unit would mean faster recovery time for patients — and lower costs because children don’t have to stay in the hospital as long.

Rebeca Quiñones, executive director of the Pediatric Hospital Foundation, said the new pediatric interventional radiology unit would position the hospital as a state-of-the-art medical facility with “world-class advanced medical technology.”

There is more reason to be hopeful. HOPU serves as the pediatric teaching hospital for the University of Puerto Rico School of Medicine and trains physicians in a variety of disciplines. Doctors are optimistic that the new unit will call on other pediatric interventional radiologists who may be practicing or training on the mainland but interested in returning home.

The unit can also help Puerto Rico prevent more doctors and other health workers from leaving the island, as has happened in large numbers in recent years.

Arraiza also thinks the state-of-the-art new addition could boost medical tourism in Puerto Rico, providing an economic boost. Due to the geographic location of the island, “we can become a medical center and treat the neighboring islands in the Caribbean,” he said. “If you build it, they will come.”

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