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Bringing the Patient-Centered Specialty Practice Model to Multiple Sclerosis Patients

November 16, 2016

A study published in the September issue of Neurology Today launched by Georgetown University is looking to cement an idea for a pilot “Multiple Sclerosis Home”.

The medical home model is not new to neurology. For years, neurologists say, they have had to manage comorbidities of patients with chronic conditions such as epilepsy and multiple sclerosis, coordinating preventive services and acute and end-of-life care — and communicating all aspects of patient regimens between hospitals and nursing homes or other specialists and primary care physicians.

Neurology Today did the leg work to find out how many neurologists had embraced this model and they came away finding that not many did.

To clearly explain this model: each player on the treatment team would be paid separately, but the primary care physicians would receive reimbursement so they'd have more time to invest in face-to-face visits, telephone and e-mail consultations with patients, and discussions with others who are involved in a patient's care.
Carmelo Tornatore, MD and Chair of the dept. of Neurosurgery at Georgetown University, has secured the private funding to launch the very first MS-focused patient medical home.

The medical home is being planned as a clinical trial: 500 of the center's 3,000 MS patients will be recruited into the three-year study. They will be followed for a year under the standard care model, before being transitioned into the patient-centered specialty practice model.

“Maybe they need more social services. Maybe their disease-modifying agent is incorrect, maybe they need physical therapy. Maybe they are underinsured and we need to look at their insurance,” said Dr. Tornatore. “We will focus on identifying those at-risk patients and take a multidisciplinary approach to intervention.”

Days will be set aside for patient education. This time will be much more available as clinicians can do much more with telemedicine and other methods rather than being subjected to what Dr. Tornatore calls the “tyranny of the office visit.”

“Our schedules shouldn't be jam-packed because we're taking care of things in other ways, so the patients who need to come in truly are acute,” he said.