Patient-Centered Management for Chronic Disease—A Model Applied to Parkinson Disease Care in Southern California


Jason Cheves, MSBA; Steve Cedrone, MBA;
Todd Sachs, MD; Kathy Kigerl, RN, MN

Abstracts from the Kaiser Permanente 2019 National Quality Conference

From Northern California and Southern California

Background: Recent research indicates specialized physical, occupational, and speech therapy can help delay the progression of Parkinson disease (PD) and can help patients manage disease symptoms. Furthermore, evidence from ParkinsonNet in the Netherlands suggests specialized therapy correlates to reduced fracture rates and Emergency Department (ED) visits. Additionally, our “Voice of the Customer” work has shown patients and caregivers want relevant and abundant information about their disease, along with inclusion in the decision-making process of their care.
Methods: There are currently more than 11,000 Kaiser Permanente patients with PD in Southern California. Intervention includes disease-specific training for select ancillary practitioners; refinement of existing workflows to ensure patient referrals to these experts for care; creation of multidisciplinary expert teams to prioritize and coordinate care; a Web site platform designed to provide information to patients, caregivers, and practitioners; and involvement and sponsorship of community events. Patients also complete questionnaires to inform the physician as to their current emotional and physical state and to provide an overall patient perspective of the level of care and service they are receiving. All data are collected, analyzed, and reported monthly.
Results: Parkinson’s Care was implemented regionwide between 2014 and 2015. Since its inception, more than 125 Southern California ancillary practitioners have received PD-specific training. Data suggest patients are receiving more frequent ancillary therapies, and referrals and visits for therapy have approximately doubled regionwide. Approximately 67% of therapist visits are with PD-trained therapists, higher than the rates observed by ParkinsonNet at Radboud University (Nijmegen, The Netherlands). ED visits and inpatient admissions have decreased approximately 22% and 17%, respectively, and fracture rates have decreased approximately 56% for this population. Patient and caregiver feedback has been positive regarding improved access to care, patient-centered and collaborative visits, and information received. These successful results have garnered Kaiser Permanente-authored article publications and submissions in leading global public health journals.
Discussion: Parkinson’s Care has demonstrated successfully that a patient-centered model, with input from patients, caregivers, and specialized care, coupled with relevant and abundant information, can improve quality of care, patient safety, and member satisfaction in dealing with chronic diseases. Key components of this approach include: 1) a Web site platform, used for collaborative communication, information, and support; 2) specially disease-trained ancillary practitioners; 3) patient-centered care to collaboratively treat the “whole person,” not just one symptom; and 4) and community involvement. Given these compelling results, we believe the Parkinson’s Care model could be implemented and spread to other Regions and conditions.

Abstracts from the Kaiser Permanente 2019 National Quality Conference


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