Expanding our horizon: Delivering world-class care close to home is the goal of Children’s of Mississippi, both in Jackson and at specialty clinics in Grenada, Tupelo, Hattiesburg and on the Gulf Coast.

If your elementary schooler is knock-kneed, or your toddler's gait seems strange, just how concerned should you be - and is it worth driving for hours to consult a specialist?

For children living in or near Grenada, there's no need to seek that care far from home. A University of Mississippi Medical Center pediatrician trained
 in children's orthopedics can treat them at the children's specialty clinic located within UMMC Grenada, formerly known as Grenada Lakes Medical Center. 

"There are no other pediatric orthopedic fellowship trained physicians in that part of the state," said Dr. Catie Carlyle Zimmerman, an assistant professor of pediatrics in the Department of Pediatrics' Division of Orthopedics and Rehabilitation. "Many of these families can't afford to drive to Jackson. They don't have transportation, or they might miss a day of work."

Delivering world-class care to the state's children and making it easier to access services close to home is the mission of Children's of Mississippi, a part of UMMC that encompasses all pediatric services available at UMMC and at specialty clinics in Grenada, Tupelo, Hattiesburg and on the Gulf Coast.

Children's of Mississippi staffs the clinics either full time, with pediatric specialists living in that community; or part time, with specialists commuting from Batson Children's Hospital to staff clinics certain days of the month. They operate in partnership with their local medical community to fill gaps in available specialty care.

Zimmerman can see about a dozen patients during her day-long clinic at UMMC Grenada held the second Thursday of the month. Patients come not just from that city, but from as far away as Greenwood in the Delta to Oxford in north Mississippi.

"Unique services is what Children's of Mississippi can offer in these communities," said Dr. John Purvis, associate professor of pediatric orthopedics and medical co-director of pediatric ambulatory services, who is overseeing development of the outreach clinics. "Many of the specialties offered by Children's aren't available any other place in the state."

And, patients seen in the clinics can be referred to Batson Children's Hospital for surgeries or other complex care not available in their own communities.

Accompanied by his mom, Modesta Carroll, Levi Washington of Vancleave visits with Dr. John Purvis at UMMC’s children’s specialty clinic in Biloxi. Levi copes with physical and mental impairments stemming from an extremely rare chromosome abnormality.

The Gulf Coast clinic's patients include 6-year-old Levi Washington, son of Modesta Carroll and Michael Washington. Carroll drives about 30 minutes from her home in Jackson County's Vancleave to the Children's Gulf Coast clinic in the Cedar Lake neighborhood of Biloxi.

Levi was born with an extremely rare chromosome abnormality and copes with physical and mental impairments, including cerebral palsy, seizures and scoliosis. "At one time, we were told he'd never smile or hold up his head, and he does," Carroll said. Purvis and multiple UMMC pediatric specialists treat Levi for his gastrointestinal, neurological, genetic, orthopedic and rehabilitation challenges.

"We travel for Levi's care. We've gone to Ochsner's in New Orleans, but we are trying to move toward just Mississippi doctors," Carroll said.

Levi's in-state care now includes visits to pediatric gastroenterologist Dr. Michael Nowicki at the Batson Specialty Clinic. Carroll took Levi out of state for pediatric neurological care before their current specialist, Dr. Mark Lee, began practicing with Singing River Health System in Ocean Springs. Lee is also on staff at UMMC. 

"It's nice to have care for all of his needs in one location," Carroll said. "We're moving in that direction. More areas of specialization at the Biloxi clinic would be wonderful."

A new arrangement is specialty clinic pediatricians living in the communities they serve, rather than commuting from Jackson. That's the model at the five-day-a-week clinic in Tupelo staffed by pediatric endocrinologist Dr. Jessica Sparks Lilley and pediatric cardiologist Dr. Salwa Gendi. UMMC pediatric hospitalist Dr. Jana Sperka cares for children in the pediatrics unit at North Mississippi Medical Center.

"Another UMMC cardiologist and hospitalist will start there in July, and we'd like to hire a neurologist," said Dr. Rick Barr, the Suzan B. Thames Professor and Chair of Pediatrics. "It's all focused on putting specialists there, as opposed to rotating them from the Medical Center."

As word spreads about the Tupelo clinic, Gendi said, patient numbers will increase. "People are very receptive," she said. "When patients have surgeries in Jackson, they don't need to follow up that far away. They follow up with us here. 

"Patients, doctors, everyone - they are glad that we are offering pediatric specialties here," she said. "They say, 'Oh! At last!' " 

Tupelo mom Tricia Edmonson said one of her twin sons, 12-year-old Drew, was rushed to the NMMC emergency room in June 2014. His family was surprised by his diagnosis of Type 1 diabetes. When they arrived, "there she was," Edmonson said of Lilley. "I had no idea we had a pediatric endocrinologist. I was so thrilled."

Julie Sparks, nurse coordinator at Children’s of Mississippi’s new Tupelo specialty clinic, leads a tour during the clinic’s January 21, 2015, opening and ribbon-cutting. It joins other pediatric specialty clinics across the state, including a Gulf Coast clinic that’s a partnership with Memorial Hospital.

Drew was airlifted to LeBonheur Children's Hospital in Memphis, but Lilley advised the family throughout Drew's ICU stay there, Edmonson said. His follow-up care began immediately at the Tupelo clinic, including instruction on how to use a pump and other treatment requirements. "Because they are there, we don't have to drive to Jackson," Edmonson said. "A lot of the children of our friends are seen at the University of Alabama at Birmingham. Driving all that way would be a real burden on our family."

In October 2014, Drew's twin Cooper also was diagnosed with Type 1 diabetes. "She was very good with contacting their schools about their needs," Edmonson said of Lilley. "It was so good to have her close by."

The main driver for establishing the four clinics, the first in Hattiesburg in 2012 and the most recent early this year in Tupelo, was the reformulation of the Children's of Mississippi mission, which is to improve the health of all children by providing world-class care, Barr said.

"We can't do that from Jackson, so we knew we needed to go out into the state, particularly in the north and on the Gulf Coast," Barr said. "We also realized we couldn't just go set up shop, so we spent a lot of time talking to pediatricians and
the health-care community and asked them how we could add value to what they were already doing."

The idea for outreach clinics also was borne in part from UMMC's longstanding relationship with the state Department of Health. Its clinics across Mississippi "were frequently staffed by UMMC physicians and other physicians throughout the state," Purvis said.

Conversations began about three years ago with the Hattiesburg medical community. "We polled pediatricians there about specialties they needed in their community to improve access and the level of care," Purvis said. At that time, he said, few pediatric specialists practiced in Hattiesburg.

"We did our research on the front end, and our Hattiesburg clinic was the first to open in 2012," Purvis said. "We have limited it to particular medical specialties at their request," he said of the local health-care community.

Children's likewise studied needs on the Gulf Coast before collaborating with Memorial Hospital to open the Biloxi clinic in early 2013, and possibly in the future, to provide full-time pediatric hospitalist coverage at Memorial.

Plans call for expanding all of the clinic staffs - and in Hattiesburg and on the Gulf Coast, leasing full time clinic space.  "We'd like to hire more hospitalists, and we'd love to put specialists in those communities," Barr said.

Barr said local health-care providers in cities with UMMC pediatric specialty clinics have been supportive of patients being referred to Batson for higher-level care. "We work very well together," he said. "There's not a lot of competition in Mississippi for high-end procedures. People know we're trying to ensure the care is much more efficient."

Some parents simply don't know they can stay in the state for world-class care, Purvis said. "Once the parent knows Batson is an option, they want to stay in Mississippi," he said.

"Any type complex intervention requires a whole health-care team, and that's best done in Jackson," Barr said. "But, the follow-up care can be done at their clinic at home."

As the clinic operations grow, Barr said, "we're starting to see growth at Batson due to that." And even if patients flowing in from around the state challenges Batson's clinic and inpatient capacity, Barr said, that's a good thing.

"If we are really fulfilling our mission of improving the health of every child in Mississippi, we're going to be stretched," he said.

Specialties in the Grenada area:
•  Orthopedics
•  General pediatrics/ primary care

Specialties in the Biloxi area: 
•  Hematology-oncology
•  Orthopedics
•  Child developmental/behavioral disorders

Specialties in the Hattiesburg area:
•  Gastroenterology
•  Hematology-oncology
•  Endocrinology
•  Cardiology

Specialties in the Tupelo area:
•  Endocrinology 
•  Cardiology