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Abstract Details

A novel practice model incorporating extended rooming and scribing assistance in an academic neurology practice
Practice, Policy, and Ethics
S50 - Practice, Policy, and Ethics (3:41 PM-3:52 PM)
002

Outpatient neurological care is time consuming limiting the patient volumes that can be seen. A novel clinical model, PT, has recently been implemented at the University of Colorado (UCHealth) in adult general practice. The ability to implement such a process in a specialty clinic is unknown.

To describe a practice transformation (PT) model that incorporates additional medical assistants (MAs) for extended rooming and scribing in an academic neurology practice.
Qualitative description of PT in neurology at UCHealth. PT includes having two MAs for each provider who do an in-depth rooming process with a scripted interview, presenting the interview findings to the physician, scribing for the physician, placing orders, scheduling follow up appointments, and ensuring the patients understands all elements in the after visit summary. 
Neurology is the first specialty group at the UCHealth to undergo PT. Multiple sclerosis and headache started PT in September of 2017. Compared to primary care, additional nursing care was included for the increased patient volumes. UCHealth developed an MA academy to help train MAs and based partly on our experience added additional training on scribing. Length of visits decreased: new patient visits from 60 to 40 minutes and return visits from 30 to 20 minutes. Patient visits increased from 8 (with new patients counting as two visits) to 10-11 visits per clinic. To effectively implement PT, standardization of note templates is required. Full implementation and training of MAs took 6 months. Visit volumes have increased >30% with stability in patient satisfaction and provider burnout scores (see accompanied abstract). Other sub-specialty neurology groups started to implement PT in 2018.  

We describe a novel model of clinical practice in an academic neurology clinic that resulted in increased patient volumes without worsened patient and physician satisfaction.

Authors/Disclosures
Enrique Alvarez, MD, PhD (University of Colorado)
PRESENTER
Dr. Alvarez has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Alvarez has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Alvarez has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene/BMS. The institution of an immediate family member of Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon.
Peter Smith, PhD (Univ of Kansas Medical Center) No disclosure on file
Kathy A. Deanda, RN, MSN (University of Colorado Hospital) No disclosure on file
No disclosure on file
Laura Palmer (University of Colorado) No disclosure on file
Jennifer Simpson, MD (University of Colorado Hospital) Dr. Simpson has nothing to disclose.
Drew S. Kern, MD, FAAN (University of Colorado) Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. The institution of Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. The institution of Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott. The institution of Dr. Kern has received research support from Boston Scientific. The institution of Dr. Kern has received research support from AbbVie Pharmaceticals. Dr. Kern has received research support from Medtronic.