MDNews - South Central Pennsylvania

Powerful Partnerships THE SPECIA LISTS OF WellSpan Pediatric Neurology know their most effective allies in caring for children with neu - rological conditions are primary care physicians (PCPs). "We don't think of patients as mine or yours — they're ours," says Todd Barron, MD, Medical Director of WellSpan Neurosciences. "We've created an environment where our pediatric neurologists are accessible to PCPs, and we want clinicians in the community to view us as resources for both patient care and information. We have a true dialogue with PCPs. If, for example, we see a patient who isn't growing appropriately, we'll notify the PCP that short stature is a concern. The PCP is the patient's medical home, and now pediatric neurology is part of the neighborhood." No effort better illustrates the collaboration between pediatric neurologists and PCPs than WellSpan Pediatric Neurology's approach to concussion management. "We want to ensure concussion patients always receive the most appropriate level of care, and for less complicated cases, it's seeing their PCP or a provider at WellSpan Urgent Orthopedics," says Lori Clark, Vice President of Neurosciences. "Our pediatric neurologists have trained PCPs in management of concussions. If symptoms don't resolve, PCPs can refer their patients for a higher level of care with pediatric neurologists or sports medicine clinicians, as well as rehabilitation therapists. We have a truly integrated approach to caring for children with concussion." LEVERAGING TELEMEDICINE TO BENEFIT MORE PATIENTS WellSpan Pediatric Neurolog y conducts tele-epilepsy follow-up visits with children from two patient-centered medical homes in Central Pennsylvania. Each exam features collaboration among many providers. The process begins at the loca l practice, where a medica l assistant takes the patient's vita l signs and transmits them to a WellSpan Pediatric Neurolog y clinica l assistant. A WellSpan pediatric neurologist then conducts the exam with the patient and family, with a representative from the Epilepsy Foundation of Western/ Central Pennsylvania present on the call. The pediatric neurologist provides a clinica l summary to the loca l practice at the end of the appointment. "During a recent exam, a parent raised concerns about the inability of the child's school to handle his or her seizures," Dr. Barron says. "The representative from the foundation volunteered to go to the school or send someone to help train the nurse in seizure management. It was a nice, synchronous approach to the parent's concern. "I think telemedicine will be increasingly integrated into hea lth ca re moving forward," Dr. Barron continues. "Certain patients will a lways want or need a hands-on clinica l experience, but for those who live, say, two hours away and have a lways had norma l exams, it may be more va luable to have a conversation via telemedicine. In adult neurolog y, we have successfully implemented telemedicine services with four partnering hospita ls for acute stroke eva luations and care." POINTING THE WAY TOWARD THE FUTURE WellSpan Pediatric Neurolog y provides another model for multispecia lty neurologica l care in the form of its neurodevelopmenta l clinic in York. Held one Friday per month — a nd likely to expa nd to two days a month in the future — the clinic is a one-stop, early-intervention destination for families with children discharged from the Neonata l Intensive Care Unit (NICU). "These children, particularly those born around 25 or 26 weeks of gestation, are at greater risk for intellectua l disability and may have developmenta l cha l lenges," Dr. Ba rron says. " We involve nutritionists, rehabi litation therapists, early-inter vention providers and NICU nurses to ensure these patients receive the ser vices they need to thrive. The clinic a lso provides depression screenings for parents. We follow most children through age 3, unless they have longer-term needs." WellSpan plans to institute approaches to stroke, migraine and movement disorder care based on the neurodevelopmenta l clinic's multidisciplinar y model. These changes will be incorporated as part of expected grow th of WellSpan's neurologica l services in the next few years. "Expanding telemedicine and multidisciplinary services are two important areas of focus for us," Clark says. "One of our strategic goa ls is to provide access to care throughout the region we serve, and we're well on our way to doing this." To refer a patient or learn more about services, call WellSpan Neurosurgery at 717-812-5400. ■ M D N E W S . C O M /// M D N E W S S O U T H C E N T R A L P E N N S Y LVA N I A ■ 2 016 1 9

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