I am Terry Smith, CEO of the Multiple Sclerosis Center of Atlanta.In considering the use of telehealth to deliver care long term care to a medically underserved population three points should be considered:The nature and impact of Multiple SclerosisThe challenge for rural residents to have available long term care options for an incurable diseaseChallenges for a Center like ours and other MS focused care facilities to expand using traditional hub and stoke modelsTelehealth model that incorporates local physicians and remote specialists.
Let me first state, I am not a clinician, but rather I am a spouse of someone who was as having MS in 1997, a 12 year Board member of the MS Center and the CEO for the past four years, so much of specifics and technical side around the treatment of the disease I will leave for the physicians, but here are the key aspects of the disease:MS is an incurable disease of the central nervous systemThere are approximately 450,000 people in the US with MS and approx. 14,000 in Georgia. In GA. Approximately 6,000 live outside the Atlanta MSA2 to 1 Women to men, avg. age when diagnosed is in the late 30’s to early 40’s.Depending on the location of where the disease attacks the central nervous system, the manifestations of the disease will vary.Most in not all treatments revolve around disease modifying agents that include treatment either in a facility or at home
MSCAFounded in 2001 as a not for profit out patient treatment facility devoted to comprehensive MS CareOne of MS center of Excellence in GeorgiaTwo full time neurologist , seven part time neurologist, five internist and two nurse practitionersOffer a one stop shop for the treatment of MS, neurology, internist, MRI, lab, treatment research, phone
3.3 2013 ga telehealth final 3 7-terry smith
Multiple Sclerosis Center of AtlantaHelping people and families live with MS
What is Multiple Sclerosis? Multiple Sclerosis is an incurable disease of the nervous system in which the body mistakenly attacks and damages the cells that produce the myelin sheath that encases a nerve fiber. MS can attack any area of the brain, optic nerve or spinal cord causing nerves to lose their ability to transmit signals• Estimates are that 450,000 • In 2002 it was determined people in the United States that a person with MS can have MS. The risk of MS expect to live seven years is approximately 1 in 800. less than the average life expectancy• There are approximately 14,000 Georgians that are • The manifestations of MS can afflicted with MS. More vary in scope and intensity. than 6,000 live outside the Persons afflicted with MS may Atlanta MSA exhibit physical and cognitive stability for years or they may• MS affects women more have an immediate, rapid degradation of mobility and frequently than men by a ratio of about 2:1 cognitive functions
The Beginnings of MS • First record of a person with symptoms typical of MS – 14th century in Holland • MS was initially described as a disease in 1868 by Jean Martin Charcot who connected the symptoms with the “plaques in the brain.”Jean Martin Charcot
Timeline of MS treatments•Treatments in the 1800’s •Strychnine •Gold and Silver injections• 1993 - First FDA approved therapy for MS: Interferon Beta• 2010 – First oral therapy for MS – Fingolimod• 2013 – 8 approved therapies for MS, and 2 therapies currently submitted to the FDA for approval
The Multiple Sclerosis Center of Atlanta Founded in 2001, The Multiple Sclerosis Center of Atlanta was established as a 501(c)(3) outpatient center devoted to providing healthcare to the medically-underserved population afflicted with Multiple Sclerosis.The Center’s Mission Statement:“The MS Center exists to improvethe health and hope of MS patientsthrough advocacy, education, stateof the art treatment and researchleading to a more promising future.” MS Center Programs Successful MS Include: Treatment Protocols Neurological Care Social Services Diagnostic Studies General Medical Care
Georgians from 118 of our state’s 159 counties receive life-changing outpatienttreatment at the MS Center of Atlanta.
The Barriers Faced by Rural Residents with MS• Those in rural areas tend to be diagnosed 1.5 years later than urban residents. Lack of early treatment can lead to a more rapid and greater degree of disability.• Residents of more remote • Living in a rural area reduces rural areas are more likely to the likelihood of having a have a primary care physician neurologist as the MS care providing the majority of their provider by 46%. MS focused care. • An urban resident on average will drive 26 miles to receive MS-focused care, while a rural resident has to travel an average of 103 miles.
Challenges In Extending MS Care Outside MetroAtlanta… Original MSCA Plan for Expanding MS Care : • Develop brick and mortar sites that would be staffed by local neurologists and primary care physicians Hurdles to expansion of long-term care at satellite location • Costly, ongoing operational expenses that would limit the number of satellite facilities • Because of extensive federal regulations, rigid professional services agreements are necessary between the local physician and the MS Center. These PSA’s limit availability of local physicians and restrict changes that reflect patient volume. • Limited number of neurologists that have available time for lengthy and reoccurring MS office visits • Patient apprehension to a new physician for their long-term care Current Satellite Location: • Weekly Office and Infusion presence in Villa Rica on the Tanner Medical Campus
Telehealth….. For the MS Patient: • Local physician versus a physician office that is an extended distance away • More available locations for ongoing MS care • Continued long term-care with the neurologist that developed their MS treatment program • Real time evaluation by a MS specialist when disease relapses or flare-ups occur. • Elimination of travel expense and time as a barrier to ongoing care For the Rural Physician: • Greater flexibility in the use of staff and resources for administering long-term MS care • Limited investment and reoccurring costs in the treatment of patients with MS • MS specialist available to assist in the comprehensive treatment of the MS patient For the MS Center: • Greater flexibility in the use of staff and resources for administering long-term MS care • Limited investment and reoccurring costs in the treatment of patients with MS • A solution that aligns with the MS Center’s mission to extend long-term, ongoing care to a medically under-served population.
We view MS care delivered via Georgia Telehealth like navigating a whitewater river…….. there is a direction we are attempting to go……. we expect obstacles that we must steer around……..…………and anticipaterapid changes as wecontinue to move forward
Multiple Sclerosis Center of Atlanta For additional information contact: R. Terry Smith CEO Multiple Sclerosis Center of Atlanta 3200 Downwood Circle Suite 550 Atlanta, GA 30327 404-856-4801 firstname.lastname@example.org