Year: 2012
Type: article
Abstract: Many patients and families may need to travel long distances to receive specialty consultation for management of dementia and other cognitive disorders. To increase access of patients and their families to the expertise of dementia specialists and guide their primary care providers (PCPs) in caring for them we developed an electronic consult (E-Consult) system. We developed a multidisciplinary collaborative cognitive disorders and dementia program to serve veterans based at the Veterans Affairs Medical Center in Portland, Oregon. Specialists in geriatric neurology, geriatric medicine, geropsychiatry, clinical informatics, neuropsychology and social work developed a dementia care process integrating caregiver education and support and advance planning. We created templated notes and resources and a mechanism for E-consults in the electronic medical record (EMR) to improve access of outlying primary care clinics to specialty dementia consultation and resources to provide ongoing management. Specialist input based on EMR review provides diagnostic and/or management recommendations. Menus can also direct clinicians to community resources, patient and family education and caregiver support. To promote adoption of this new system by PCPs, we conducted continuing medical education incorporating basic information about dementia, behavior management and advance planning in 8 different clinic sites. In the first 8 weeks 18 E-consult requests from 9 different clinic locations resulted in substantive changes in assessment. Two E-consults were changed to face-to-face consults due to complexity and two consults initially requested as face-to-face consults were completed as E-consults. The rate of uptake suggests that over 50 E-Consults will be conducted during the next 4 months providing a rich dataset for assessing the efficacy of remote dementia consultation. A multidisciplinary E-consult process can provide an effective and efficient means of providing access to needed specialty dementia consultation. Success of such programs is facilitated by early engagement of the needed multidisciplinary team and timely training of the end users through relevant CME programs.
Source: Alzheimer s & Dementia
Authors: Kathryn Wild, Craig Tanner, Jeffrey Kaye, Lisa Silbert, David Mansoor, Linda Boise, David Douglas, Cathy Potts, Sarah Goodlin
Institutions: Oregon Health & Science University, Veterans Affairs Canada
Language: English
Domain: Social Sciences
Open Access status: bronze
OpenAlex ID: W2018288283