Dr. Andrea Andrade, ECHO Epilepsy "In My Words: Meet the Leads"

In My Words: Meet the Leads – Dr. Andrea Andrade | Paediatric Neurologist and Epileptologist

Dr. Andrea Andrade quote care: "My main interest is epilepsy surgery..., we have tools right now that make help us to remove the area that causes a seizure and help them to to be seizure free once and for all."

Dr. Andrea Andrade is a paediatric epileptologist and Director of the Paediatric Epilepsy Program at Children’s Hospital London Health Sciences Centre (CHWO). She is passionate about the ECHO Epilepsy “all teach-all learn” program, its community of practice, and its effectiveness in helping primary care providers to care for paediatric epilepsy patients in their practice – combatting key challenges like the specialist “wait list”.

Dr. Andrade is Medical Lead of the Epilepsy in Children and Youth: Foundational and Advanced ECHO Programs lead by the CHWO hub team.

Three Key Points
A few key points that Dr. Andrade raises throughout the interview:

  • There are life-changing benefits to identifying epilepsy surgery candidates early on in life
  • Epilepsy surgery is effective and needs broader awareness amongst providers
  • Epilepsy is a chronic condition that affects many areas of development in a childs’ life and needs a comprehensive, holistic approach like ECHO Epilepsy’s case-based, interprofessional learning model, helps to provide.

Why did you choose to specialize in the care of children and youth with epilepsy?

(Length: 1 min.)

Epilepsy is such a broad neurological condition that affects not only one aspect of patient’s life, it’s not just about the seizures. And especially in pediatrics, my main field, epilepsy affects many areas of development in pediatrics. It affects how the child will behave later on in life; their opportunities in the future; it may affect their social life.

To me it is way more than just treating the seizures, to me it is treating a patient who is going to endure his or her life with this situation throughout and helping them to cope with that, and to adjust, and to make sure they can live an independent life moving forward.

Why is epilepsy surgery your main clinical and research interest?

(Length: 1:45 min.)

My main interest is epilepsy surgery and epilepsy candidacy for surgery. The reason is because those patients go through a journey where their seizures become really hard to treat with the medications. And we have tools right now that help us to remove the area that causes a seizure and help them to be seizure free once and for all.

Identifying these patients early on in life is quite important because the impact of seizures. [The impact of] many medications, what we call polypharmacy, in the developing brain is not great. So finding those patients and offering definite therapy is quite important. So that’s why I focus on epilepsy surgery.

The other area that I’m very passionate about is to educate and share about epilepsy to all [healthcare professionals], whether they are in the neurology field or outside the neurology field. I think we all should be familiar with the condition. We should be familiar with the therapies, because it’s a chronic condition, just like diabetes. People should understand it better so that those patients can integrate into our society in a much better fashion.

How does ECHO Epilepsy differ from great e-health services like eConsult, eReferral or Telemed?

ECHO not only provides the opportunity to bring one of your personal cases and share the discussion with an expert. It’s a group of experts usually as a whole team. So it’s not just me as a colleague  helping them in a telephone consultation. It’s myself, my point of view as a physician, but I also have my team, which I’m incredibly grateful for, and they give their own perspective in terms of nursing care, in terms of community advocacy care and education, social workers, neuropsychology.

So there are all of these nuances about epilepsy; and physicians are not the only sole provider, it is comprehensive care that is provided to the family doctors, pediatricians, community neurologists. So it’s a much more comprehensive, holistic approach that we provide through ECHO.

How has ECHO Epilepsy intersected with your clinical practice?

(Length: 1 min.)

It has helped enormously to not only create strong ties with my colleagues, epileptologists out there in Ontario, but also with colleagues that are non neurologists, health care professionals, nursing, EEG technologists, community educators and to spread the word way better.

Also among my own community here in southwestern Ontario, it has allowed us to really have stronger ties with some of our providers that have become champions in Project ECHO and epilepsy care.

So I think it is one of those incredibly positive things that has helped us to integrate our care and spread the word of what we do and share our knowledge with our community providers.

What inspires you about teaching in this ECHO Epilepsy Ontario education model?

(Length: 50 sec.)

So part of what I mentioned before,  spreading the word about epilepsy, teaching my colleagues about how important it is to identify those patients early on, and to tell them of all the options that we have right now.

So basically bring epilepsy out of the darkness and put it out there for everybody [healthcare professionals] to understand it, to integrate it in their lives and to know what to do.

And because we are fortunate enough to live in a country that has those programs and has these initiatives but we are a minority in the world.

How has the ECHO Epilepsy community of practice impacted your practice?

(Length: 1:42 min.)

At Southwestern Ontario and our LHIN, our catchment area is incredibly large, geographically speaking. So we take care of children and families living with epilepsy across the board, in the north west region and also all the way to the southwest region.

So it’s incredibly large, geographically speaking.

So it’s really key for us to have those connections with folks, for instance, up north like Dr. George Derbyshire, who has been a champion in ECHO sessions and epilepsy care and who is our community neurologist in Thunder Bay and not only facilitates care and people stay at home to receive their epilepsy care, but we communicate we faster and way easier for those patients that need fast-tracked epilepsy surgical candidacy or gene diagnosis or ketogenic diet and so on and so forth.

So he has been a champion and again, accessing or providing care also for communities that are and in certain disadvantages or our folks from

Indigenous communities as well.

So that’s quite important to bring everybody into the same page.

Who was an influential teacher and what did you learn from them?

(Length: 3:28 min.)

That’s a fantastic question.

And I have to say, one of my greatest mentors is Dr. Carter Sneed.
And he has been an inspiration to me just sitting and having a small conversation with him; how he’s a forward thinker and how he thinks outside the box and brings ideas that can be implemented in different settings to me was an eye opener, that we can use if frameworks and different ways to approach epilepsy care in a way larger environment, as opposed to just limited to our typical traditional clinic model that I’m not saying it’s bad, but is it’s the way more when we’re encountering chronic conditions.

So he’s one of my main inspirations and teacher in regards of epilepsy.

What lessons has your work life taught you?

You grow and mature with your job as you become older and a more seasoned Epileptologist.

One of the main lessons I have learned about these this job and especially working here in this community, is the responsibility that leaders in any area or field have in terms to promote good messages out there to the community, to be role models.

And that’s something that I have been privileged to be here in London; to have that close relationship with my community, with my patients, with the families I care for, with my community agency, and the educators over there. With families who have moved from being the patient, coming to the clinic to being fundraising out there for epilepsy care.

So all of those things are really, really important and inspiring for us and make us humbled and privileged to be part of something way bigger than us or was bigger than one individual.

Epilepsy care is again, as I mentioned to you, it’s not for one person job.

And the approach that other professionals bring to the team is as important as the physician’s point of view.

So I have never had any problem to have my nurse practitioners and nursing staff, social workers to come and give me their perspective and listen to them because their views have been transformative.

Integrating Care: An Interprofessional Community of Healthcare Providers

Dr. Andrade spoke extensively about how the ECHO Epilepsy in Children and Youth program has helped to “integrate our care” by building strong ties with paediatric epileptologists, neurologists, nursing, EEG technologists, social workers, neuropsychologist, community educators and others across the Southwestern Ontario catchment and beyond. Below are a few voices representing the interprofessional team of the Chidren’s Hospital London Health Sciences – Host Site and the ECHO Epilepsy community of practice, including Dr. George Derbyshire, a paediatric neurologist in Thunder Bay whom Dr. Andrade spoke of.

Other Interprofessional Team Members

Holly O’Neill is a member of the Children’s Hospital LHSC Host Site Team and a registered social worker and Director of Client Services at Epilepsy Southwestern Ontario.

Quote from Holly O'Neill, Social Worker at Epilepsy Southwestern Ontario: I was inspired to go into social work to be able to make more of a systemic change and to help families find the supports that they need.

The Role of a Social Worker in Epilepsy Care | Holly O’Neill, Social Worker at Epilepsy Southwestern Ontario

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In My Words: Our Community of Practice

Testimonials from Healthcare Providers who have participated in and benefitted from ECHO Epilepsy programs

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