"Healthcare and health outcomes must become more accessible and equitable for everyone, regardless of their backgrounds."

Q. Tell us a bit about your background, how you got into the Lucile Packard Children’s Health Foundation and its affiliation to Stanford Medicine.

Cynthia: I work with the Palo Alto-based Lucile Packard Foundation for Children’s Health. We exist solely for the purpose of unlocking philanthropy, to transform health for kids and moms, starting in the Bay Area community, and then, reaching out to kids, moms, and families around the world.

We do that by supporting Stanford Children’s Health’s (Stanford University School of Medicine) endeavours related to maternal and child health and the Lucile Packard Children’s Hospital, which is part of the Stanford Medicine enterprise. We’re here today, to support their work and bring so many resources to be on that great mission.

Q. How did you get involved with the Foundation?

Cynthia: I feel really lucky. This is my first time as a CEO, and it was a chance to bring together this huge passion I have for philanthropy with health care and then, use the ability to have Science help Humanity. So, how do we use the power, for example, of Stanford Science to improve care and eventually get to the cures for kids and moms? This is, I feel, like my life’s work and I’m lucky to be doing this with our team at Stanford Children’s Health.

Q. Many of us don’t think of philanthropy as a business, but it is, and it’s undergoing changes, too. Having been part of that world, can you talk about the business of philanthropy and what it looks like for your mission at the Foundation?

Cynthia: Let me say that philanthropy is really a big picture. We talk about people giving — making philanthropic gifts to things they really care about and the impact they want to have in the world. A lot of people also give their time and expertise as well as their financial resources. All of that is what we mean when we talk about philanthropy.

Now the business of philanthropy, like so many professions, has become more specialized over time. At this point, within my organization there are maybe six or seven different revenue teams all running a different kind of business model. So, for example, we have a program that works with corporations who want to make gifts and whose employees are donating time and expertise to our mission. We have another program where people make gifts through their estates, so they’re thinking really long-term about the impact they want to have during their lifetimes and even after they pass. Then, we have incredible programs where people in the community come together and maybe have a lemonade stand for their child’s birthday. So, there’s just so many different ways to participate.

And it’s our business to figure out how to do that better and more efficiently, and to help make the connection between people who want to make a difference and where, in our mission, we need that. So I would say, one of the things I’m specifically very passionate about, is the partnership that those of us who are doing this work have with folks in the organization in health care.

So, our faculty, physicians, the administrative leadership try to figure out how we can do this better and how philanthropy can be an even more powerful lever for what we want to accomplish. And then, we create really strong business plans. When I go to a donor who’s thinking about making a really significant gift, I can tell them about where this money will go, how it will be used and what impact it will have. I assure them about how we will partner with them over time and bring them closer to what their gift is accomplishing. It’s a really interesting time for our work and a time of huge potential.

Q. You were the recipient of a fairly large gift earlier in the year. Could you talk a little bit about that?

Cynthia: We received a gift from Elizabeth and Bruce Dunlevie. Elizabeth is Board Chair at the Foundation and has also been on the Board at the Children’s Hospital for a long time. Bruce is a long-term volunteer and leader at Stanford University, and they’re incredibly passionate about this work. They’ve developed a great relationship with one of our physician leaders, Dr. Yasser EI-Sayed, who leads our Maternal-Fetal Medicine Program — high-risk Ob – so they know what the hospital is trying to accomplish. One of the things is, changing our facilities to keep up with the level of care we can provide while serving as a platform for research and innovation. That will not only help our patients and their families, but also, many others. Elizabeth and Bruce gave us a chance to present an integrated opportunity that supported the transformation of our physical building, specifically, labor and delivery and the antepartum part of maternity Rooms.

There’s also a research program led by Dr. EI-Sayed, which will totally change what kind of healthcare we’re able to deliver, not just here but everywhere, for high-risk moms with high-risk pregnancies. This excited Elizabeth and Bruce so I think they accelerated their gift. They had planned to do things over a longer period of time and that’s how the gift of $80 million for this facility and the research program came about. It’s totally transformative for what we can do for moms and so very inspiring.

Q. Tell us about the Foundation’s work and the different aspects of children’s health that you focus on – in Bay Area and globally.

Cynthia: It does start here in our community, and though people think of Silicon Valley as comprising people with a lot of wealth and doing really well in technology – it’s true – but simultaneously, it’s also true that this community is very diverse – ethnically and socioeconomically in terms of background where people came from, to be here.

Our patient population at Packard Children’s Hospital is equally diverse and a good microcosm for what we’re trying to accomplish on a bigger scale. The things that we try out, for instance, a pilot here, then, can possibly help people beyond the Bay Area and beyond Silicon Valley. The example I really want to talk about is not so much global, but it’s California, and it’s something I hope will scale-up across the nation and around the world. It has that potential. But right now, there’s a care collaborative, in fact, two care collaboratives of hospitals across California – one, that’s about maternal health and the other, about perinatal health. These are called, the CMU-UCC and the CP-UCC and they’re led by people at Stanford Health. It’s all about real-time data coming in from 200 hospitals and 100 different NICUs across California and using that data on outcomes — Who had a premature birth? What happened? What were some of the causes? What happened for the baby and the mother? Using the kind of data at scale to then develop tools for, for example, workwith moms who have hypertension when they come into late-term pregnancy and/or developing and testing some of those tools here and then producing kits and training back for the 200 hospitals and the 100 different NICUs to be able to implement them.

Maternal mortality in the U.S. is on the rise as are premature births and that’s really shocking – globally, 15 million babies are born too early, and a million, die every year. In California, we’ve been able to reduce maternal mortality 65% over the last 15 years through this collaborative model across many health care institutions. That’s where I see the potential. It’s California now but I’m hoping that with some philanthropy and other resources, we will be able to scale this up and other parts in the U.S. and the world can replicate these kinds of data-driven interventions to improve maternal and pre-natal care and premature births.

Q. It’s interesting that you’re in Silicon Valley, the land of great wealth but it seems there’s another side to it too, a population there that does need help. Did I pick up an underlying theme of you trying to bring in some degree of equity through the Foundation and the Children’s Hospital?

Cynthia: We’re very passionate about and quite committed to making excellent health care and health outcomes accessible and more equitable for kids and moms. We’ve seen through the pandemic terrible disparities in health outcomes so, we’re committed to not allowing that to continue. I think, it’s a shared commitment from us at the Foundation and everyone in our health care system and then, far beyond into our community.

One of the things at our Hospital, and typical of children’s hospitals, is that we accept all patients, regardless of their insurance status or their ability to pay. We have, for instance, about 40% of our patients who are uninsured or on public insurance – something that doesn’t fully cover the cost of their care. That’s not unusual for children’s hospitals. So, it’s this very mission-driven approach of seeing that this great health care that we provide here at Packard Children’s Hospitals and other children’s hospitals is available to every mom and every child, regardless of their backgrounds is a powerful message and mission. I hope people get really inspired about children’s health and what a great place it is for the mission of health care in terms of equity.

Q. What does the Foundation do for special needs kids? I’m curious to understand this for a personal reason — my daughter works in that field.

Cynthia: You must be so proud! This is such a special commitment. At the Foundation, we have a small endowment and grant-making program. Over the past decade plus, we have chosen to commit all of those resources to helping kids who have special health care needs and specifically, to making system-level change for kids with special health care needs. I would really frame that in terms of access and equity.

Different kids have different needs and we’re trying to lift-up those who have special needs. One of the organizations we work with is Family Voices, one of our Grantees. With them, we’re really taking on this question of how do families become more engaged in care for their kids who have special health care needs? How do we change the systems and standards of care for insurers, for state agencies, for our health care systems? We’re really looking across the system to say, how do we make this more equitable for kids who do have different needs than other kids? But it’s a huge population of around 1% of all kids who have that kind of medical complexity.

Q. Now that we’re now coming up on the two-year anniversary of the pandemic, how this has changed the way you focus or approach the Foundation’s mission? What are your priorities for 2022?

Cynthia: The new year is a great time to think about what kind of difference we’re making in the world. In that context, our priorities for 2022 are very related to how the pandemic has changed what we do. Some of the needs that have emerged through the pandemic — child and adolescent mental health, for example—are huge issues and they’re something we’d like to direct attention to.

I’ve learned a lot about this from listening to some of your episodes on the delivery of different care, whether it’s mental health or other areas of concern. For us, it’s all about “how do we marry these?” How do we keep them going beyond this pandemic and retain the benefits that we’ve all seen from doing things more, through telehealth and digital health? The example I want to cite here, is that of the Stanford Parenting Center. It’s got some great faculty who’ve asked, “how do we scale-up interventions for mental health and how do we have a longer, more durable impact?” Let’s coach and train parents who spend much more time with their kids than the kids spend with a therapist, for example, or a social worker, and see if we can figure out how to deliver this kind of curriculum in a pandemic situation. You could call this a program for parents through digital means.

Q. The digital means and modalities for delivering care and health care related services is very mainstream, today. But some of your programs though, are not actually being delivered through a digital modality. That’s interesting. Tell us a little bit more.

Cynthia: That has been such a transformation for all of health care. This could have taken 10 years, instead, it took a couple of months for us to be up and running. Programs like the Stanford Parenting Center’s pilot program about Type 1 Diabetes, require so much ongoing monitoring that they make us think of how to enable parents and families to do that remotely and maintain a much higher level of contact with the care providers from Endocrinology that they see. We’re trying to find things like this to pilot from a philanthropic point of view, too, while answering questions such as, “how do we think about what should be scaled-up” now, and even as we enter, the post-pandemic/late pandemic/chronic pandemic period of time.

Some kind of new normal. So, we can’t let go of what we’ve learned and what’s made it more equitable, more accessible to reach out to other families and kids with some of these health care interventions.

Cynthia, you’ve had a remarkable career. And there are some personal aspects of your life that have had a big role to play in your success. You’re a member of the LGBTQ community. How has that impacted career progress from a personal and a leadership development standpoint?

Cynthia: Thank you for the opportunity to talk about that. And I encourage all of us in this field, in health care, to just really embrace those parts of our backgrounds that make us better at this work, and more able to transform health care and health, especially, for kids and families.

For me, identifying as LGBTQ has meant that I have been an outsider. I’ve experienced that many people have from different parts of their identities, and it gives you so much empathy, which is an important part of leadership. That and being able to see, experience, and listen for other people and try to understand their experiences and then, to be an advocate, an ally, to step up and be powerful for that; that’s a huge part of my background and a big part of my leadership. I’m really proud of that.

Q. I personally want to thank you for sharing your thoughts and experience, today. This is an important moment, and we must recognize and embrace all the diversity in our community and population. In these times, when human social interaction is more virtual than face-to-face, there’s a lot that will change. We can only be optimistic and hopeful about the future. If our listeners want to get involved in the Foundation’s work, what should they do?

Cynthia: That’s the best question ever, and I would encourage everyone to see themselves as philanthropists. You are doing great work trying to make health better, more accessible for many more people, so I hope you will take the next step and think about that in terms of what you can give back financially, or of your time and expertise. Our Foundation is a great place to do that. Our website is just the acronym for Lucile Packard Foundation for Children’s Health — LPFCH. And there’s a Giving Page where we’d love for you to come and give.

I also want to make the case for you to reach out to the Children’s Health Hospital in your community. There are so many amazing children’s health organizations and hospitals around the country doing great work. We share so many things in terms of how we want to transform health. And I encourage you all to step up and find the place where you can make a difference. Thank you.

We hope you enjoyed this podcast. Subscribe to our podcast series at  www.thebigunlock.com and write to us at  info@thebigunlock.com

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity.