New Patient Triage for out of State Multiple Sclerosis Patients

Background: Patients with multiple sclerosis often have a variety of needs in addition to recommendations for disease modifying therapy.  A coordinated team approach is often the most efficient and effective way of addressing these complex needs but this approach is challenging to implement for patients who travel long distances for their care.  A new patient triage program incorporating a pre-travel consultation with an advanced practice nurse was established to facilitate care coordination for patients traveling from out of state.

Objectives: Describe a new model of care for multiple sclerosis patients referred from out-of-state for this MS care

Methods: Out-of-state patients who had never been seen at our institution were given the option of scheduling a phone consultation with an advanced practice nurse prior to making travel arrangements.  All patients electing to have this phone consultation were scheduled within seven days of their initial contact with the scheduling office. The date of the phone consultation, distance from the clinic, date of neurology consultation, recommendation for other services, and scheduling of other services were systematically tracked.  Patients were asked to complete a satisfaction survey retrospectively.

Results: In the 1-year pilot of this new patient triaging program 102 telephone consultations were completed.  Seventy-three patients completed their trips to our institution and 25 patients had visits coordinated with one or more services.  The most common coordinated visits included neurology, physiatry/rehabilitation, and physical therapy.  Patients came from an average of 529 miles from our facility with 37% traveling more than 500 miles. Collection of patient satisfaction scores is ongoing.

Conclusions: This pilot project demonstrated improved coordination of care for MS patients through a brief phone consultation with an experienced MS clinician prior to the initial visit.  This consultation identified patient expectations prior to the visit and facilitated access to other specialty care resources. Patient and health care provider perceptions and cost-effectiveness will be explored further.