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Hospitals Bet on Neuroscience

 |  By jfellows@healthleadersmedia.com  
   February 04, 2016

Healthcare executives believe the neuroscience service line is primed for delivering better and more coordinated care. OSF HealthCare, Carilion Clinic, and Stanford Health are making big investments in patient-centric facilities and state-of-the-art equipment.

Neuroscience may be a clinical mainstay at hospitals and health systems, but new technologies are helping to reinvigorate the service line. So are the possibilities to improve care coordination for some of the most medically complex patients.

Funding for neuroscience initiatives got a big boost from the federal budget signed into law in December. Both the National Institutes of Health and the National Science Foundation will see more money for neuroscience research, but hospitals and health systems are also investing in neuroscience because of patients' needs.

For example, Peoria, IL-based OSF Saint Francis Medical Center, a 609-bed tertiary teaching center that is the largest of OSF HealthCare's 11 acute care facilities, and the Illinois Neurological Institute just unveiled a new intraoperative MRI (iMRI).


Frank Longo MD, PhD

It's only the second hospital in Illinois to have the technology, which lets surgeons better identify and see tumors as they are operating. And Carilion Clinic, a nonprofit integrated delivery health system in Roanoke-VA, recently opened a $32 million, 116,000-square-foot Institute for Orthopaedics and Neurosciences.

One of the most significant investments in neuroscience is in Palo Alto, CA at Stanford Health Care, the integrated health system that includes a highly regarded academic medical center. It built a five-story Neuroscience Health Center, which opened in January.

The center includes a full autonomic lab, which includes four EEG's, two EMG's, EKG, TCD, utlrasound, and two tilt rooms. It's the first and only such lab on the West Coast, according to Alison Kerr, vice president of operations for Stanford Health Care. "Most outpatient centers might do EEGs and EMGs, but they won't offer all," Kerr says. "We have the full complement of all the diagnostic testing, everything our patients need. We are really trying to accommodate them."

Now all outpatient services for neurology patients are under one roof. Instead of doubling back for a separate lab, rehab, or therapy appointment, patients can have multiple appointments on the same day, in the same building. Prior to the new center, the clinics were the only thing that were in one place for patients.

The central locality of rehab, infusion, and other services will make a huge difference to patients and their families, says Frank Longo MD, PhD, department chairman of neurology and neurological sciences, who was part of the center's planning team.

"These are scary diseases and frightening situations." Longo says. "When a person is in that situation, it is extremely important that they are confident they are getting the best [care] that exists. For doctors and nurses, they are also facing some very challenging clinical situations, and they need to feel they are in the most supportive environment they could be."


Gary Steinberg, MD, PhD

Planning for the center began five years ago with Kerr, who oversees the inpatient and outpatient side of Stanford's neurology service line, as well as Longo and Gary Steinberg, MD, PhD, neurosurgery chair and founder of the Stanford Stroke Center. "We really got everybody in the room to talk about clinical care, basic science, and research, because we have an advantage of being on the Stanford University campus," Kerr says.

"Neuroscience touches everything, especially as we look to the future of imaging."

When planning started, Kerr said she based neuroscience growth projections at 10%, but the reality is that neuroscience has experienced tremendous growth and Kerr expects appointments to get filled quickly. "I think physicians would say we are at the beginning of the bell curve," says Kerr about neuroscience.

Nurse practitioners take the complexity out of the process for patients, following them from discharge to outpatient. Once patients need outpatient services, NPs coordinate their visit by order tests and imaging in advance. "We've really designed this building around what our patients need," Kerr says.

What they needed, Kerr and other executives found, was assurance that every detail mattered—from flooring to lighting to seating. "As we were designing our space, we had a neuroscience patient advisory council," she says. "We had 12 people on our committee, and they were brutal at times, but they were our subject matter experts."

Kerry says patients showed them how narrow hallways, small exam rooms, and even carpet nap interfered with wheelchairs. Low seating in the waiting room wasn't comfortable for patients who had spinal rods, and dimmers were needed on the lights in infusion rooms for headache patients.

In addition to the more comfortable space that Stanford hopes will improve patients' experience, neurologists and the clinical care staff are also expecting that the space will improve care coordination.

Longo says he is excited to be able to "curbside" with colleagues when one of his patients has a tremor that isn't easily explained over the phone. Details or questions about testing can also be taken care of in a hallway conversation instead of a follow-up appointment that may be cumbersome for patients.

"The physicians providing the care will be in much better sync," Longo says.

Jacqueline Fellows is a contributing writer at HealthLeaders Media.

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