Roberta G. Williams, MD developed an interest in congenital heart disease as a research assistant in medical school and selected residency training in Medicine-Pediatrics, followed by pediatric cardiology fellowship at Boston Children’s Hospital that included 9 months of training in adult cardiology at Massachusetts General Hospital. During the next 9 years on the faculty at Children’s Hospital, her work with the early development of echocardiography led her to the diagnosis and management of children and adults as well as fetuses with congenital heart disease. She served as the medical director of the cardiac surgical intensive care unit at Boston Children’s Hospital and had the opportunity to observe the interface between perioperative imaging and surgical outcome. This experience strengthened her commitment to the concept of coordinated, comprehensive and proactive care of chronic disease throughout the lifecycle.
Subsequently, while Chief of Pediatric Cardiology at UCLA, Dr. Williams participated in the Ahmanson Adult Congenital Heart Program and became active in the Council on Sections of the American Academy of Pediatrics, collaborating with leaders from other subspecialty sections on issues related to continuity care delivery, workforce and reimbursement. She pursued this interest as Chair of Pediatrics and member of the Sheps Center for Health Services Research at the University of North Carolina, Chapel Hill. She was later attracted to the position of Chair of Pediatrics at the University of Southern California and Vice-President for Pediatrics and Academic Affairs at Children’s Hospital Los Angeles because the large population of underserved patients with chronic childhood diseases could serve as a base for developing systems of care at two critical periods where hand-offs of care represent challenges – fetal to neonatal and adolescence to young adulthood. Having established a successful maternal-fetal medicine program, the same multidisciplinary model has been applied to their adolescent to young adult transition program, which consists of core preparation and quality assessment programs, a life-management clinic for patients at special medical or social risk, alliances with multiple adult general and subspecialty providers and a forum in which best practices can be shared. They are now engaged in expanding this program to a standard of care that can be applied to all patients in a standardized and sustainable format.
Over the past 25 years, She has served on the Advisory Council for NHLBI and other NIH review panels, AHA scientific review committees, the Pediatric Scientist Development Committee, NASA research panels and other committees that relate to translational research directed toward child health or cardiovascular disease, Since stepping down from the chairmanship of the department, she has engaged in the study of the economic costs and value of life-long care of patients with chronic disease originating in childhood, combining the economic issues with the interrelated issues of patient preparation, access to care and systems of care. She has concentrated on issues of neurocognitive effects of chronic childhood illness and strategies for functional improvement through early assessment, patient and family education and skills enhancement. It is her belief, which must be tested, that improvements in lifetime health and cost outcomes will result from efforts to improve health literacy, life-management skills, and continuity of care from fetal to late adult life.
- Review regional factors that affect patient access to appropriate adult care
- Explain how models of transition have adapted to regional resources and needs
- Discuss how we move forward together to improve systems of care for adults with rare conditions originating in childhood
- Roberta G. Williams, MD
This seminar was delivered as a Pediatric Grand Rounds Lecture at Children’s Hospital of Philadelphia, on May 4, 2022.
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