Objective: To determine whether an interdisciplinary one-stop care model improves (1) patient engagement and (2) patient outcomes for people with Parkinson’s disease (PwP).

Background: PwP require complex care coordination across health professions, including medicine, nursing, pharmacy, social work, and rehabilitation therapies (physical, occupational, and speech therapy). A hub-and-spoke care model in the Netherlands improved outcomes and lowered cost [1] but developing a similar network is challenging in the United States, where geographic distance and competing hospital networks may fragment care. We developed a single-day comprehensive care clinic for PwP, to reduce care fragmentation, increase patient engagement, and improve outcomes.

Method: We identified a core implementation team consisting of fellowship-trained movement disorders specialists (MDS), physical therapists, occupational therapists, speech therapists, social workers, a physician’s assistant, pharmacy and nursing. During the morning clinic session, patients rotate through each non-MDS station and receive a standardized battery of assessments, which are reviewed in an interdisciplinary meeting at noon. In the afternoon, the patient and their care partner meet with their MDS to review assessments and devise a follow-up plan for any ongoing needs.

Results: 80 individuals (31 female, 39%) participated in the interdisciplinary clinic between July 2019 and January 2020. On a 5 item Likert scale completed by 25 participants, overall satisfaction was rated “excellent” by 91.3% of respondents (n=23) and interdisciplinary teamwork was rated “excellent” by 95.6% of respondents (n=23). Ongoing data collection will assess measures of self-efficacy and care engagement, treatment adherence, and exercise, along with objective measures of fall rate, hospitalizations, medication interactions, and cost of care in a 1:1 randomized comparison of interdisciplinary one-stop care versus standard care at our movement disorders specialty center.

Conclusion: A comprehensive care model is feasible for PwP and may improve patient engagement. Ongoing analysis will determine the impact of a benchmark clinic on objective metrics and health care costs.

References: [1] Bloem et al. ParkinsonNet: A Low-Cost Health Care Innovation With A Systems Approach From The Netherlands. Health Affairs 2017 Nov;36(11):1987-1996

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