HCPLive Network

A Patient-Centered Medical Home Model for Measuring Multiple Sclerosis Outcomes

At the 2013 Annual Meeting of the Consortium of Multiple Sclerosis Centers, Diana Logan, RN, of the Clinical Center for Multiple Sclerosis at the University of Texas Southwestern (UTSW) in Dallas described her multidisciplinary experiences working in a patient-centered medical home model for multiple sclerosis (MS)  in a talk titled, “Outcome Measures in the MS Setting-Can It Be Done?”
Logan started her talk with one profoundly simple statement. She said that we could completely revolutionize healthcare and save millions of dollars if we could just do three things: (1) bathe our patients, (2) offer them water to drink, and (3) take them for walks outdoors. However, she said that it is often easier or more convenient to prescribe a medication or other expensive intervention than to do some of these activities.
Logan argued that MS is too complex for a primary care physician to direct care, and that certainly the patient is not the best person to determine what kind of healthcare practitioner they should see next. She said that it is important for hospitals to have in place a coordinated plan for who should be in charge of organizing the management of a MS patient (she said that neurologists are best equipped to direct the care of MS patients).
Moreover, Logan stressed that effective treatment requires intervention by a multidisciplinary team, since there are so many different interdependent symptoms affecting MS pathogenesis. This team should include a neurologist, a nurse practitioner, a social worker, a physical therapist, a dietician, a pain management specialist, a pharmacist, and other therapists that may be needed such as speech or occupational therapists. Unfortunately, reimbursements are generally lacking for social workers and dieticians in most MS treatment center settings.

Further Reading
Treating patients with multiple sclerosis who opt to use only supplements and other complementary and alternative approaches requires a great deal of tact and education, and input and support from all members of the multidisciplinary treatment team.
To prepare for coming changes at the CMS driven by the Affordable care Act, multiple sclerosis care centers should begin to develop MS-specific electronic health record templates that record clinical outcome measures.
Comprehensive care for patients with MS starts with medical treatment of the symptoms of their disease, but must also include intervention by clinicians who can address the mental, physical, and social challenges experienced by many patients.
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