Innovative Solutions for Neurological Health Populations

A number of health plans, hospitals, and community organizations have implemented new techniques to better manage their neurological health patient populations.

The Innovation Showcase is designed to illustrate a few key examples of these organizations that have implemented new population management techniques and improved patient outcomes throughout the process.

The following case study is provided for informational purposes only; the showcase does not represent a comprehensive list of all programs that have developed innovative programs in neurological health.

MINDSET Program: Epilepsy Self-Management Tool

The Management Information Decision Support Tool (MINDSET) was developed by Ross Shegog and Charles E. Begley at the University of Texas Health Science Center in Houston as a tablet-based clinical aid to improve communication between the patient and health care provider in order to promote self-management. MINDSET uses data entered by the patient during a clinic visit to create a patient profile to develop a tailored self-management action plan based on that patient's needs. This includes behavioral goals and strategies developed by the patient and provider together during the visit.1

Epilepsy Self-Management is defined as the “processes a person uses to optimize seizure control, to minimize the effects of having a seizure disorder, and to maximize quality of life in partnership with their health care provider.”2

Epilepsy-specific Self-Management encompasses:2

  • managing treatment – eg, adhering to anti-seizure medication and clinical visit schedules
  • managing seizures - eg, planning for, and responding to, seizure episodes
  • managing safety - eg, monitoring and avoiding environmental seizure triggers
  • managing co-morbid conditions - eg, anxiety, depression

Chronic care Self-Management encompasses:2

  • management of lifestyle issues - eg, adjusting typical behaviors to avoid seizures and/or to mitigate their adverse consequences
  • partnering actively with the health care team - eg, information sharing
  • pursuing independence - eg, invoking support, resources, and services when needed

Barriers to the adoption of Self-Management behaviors include poor communication between patient and HCP and/or differing perceptions about the patient’s attitudes and abilities for Self-Management of their epilepsy.2

The clinic-based Management Information Decision Support Epilepsy Tool (MINDSET) was designed to:2

  1. Engage adult patients with epilepsy (≥18 years) and their HCPs in managing therapy and lifestyle to prevent seizures and maximize quality of life
  2. Provide easily followed, goal-based action plans for patient decision support between clinic visits
  3. Document patient-centric quality indicators for epilepsy care

MINDSET was developed to increase awareness of epilepsy Self-Management behaviors by adult patients and their HCPs, facilitate communication between them during clinic visits that emphasizes Self-Management goals and strategies that are based on the patient’s needs, and to increase the patient’s ability to achieve those goals.2

Development of the MINDSET tool occurred in collaboration with three neurology clinics with different patient populations, payer-bases, epilepsy cases, and provider experiences: Kelsey–Seybold Neurology Clinic (KS clinic) and their associated Education and Research Program, the Smith Clinic at Harris Health, and the University of Texas Physicians-Neurology Clinic (UT clinic). The clinics allowed access to patients and neurologists for a Patient-Provider Advisory Group while giving ongoing input on MINDSET through each step of the development process and also provided a testing ground for formative assessment of the tool. These clinics were also the sites for the planned efficacy trial of MINDSET.2

Screening assessment and decision support consisted of computer-based prompts for the patient to input data and were designed to provide feedback to both the patient and provider on the patient’s profile on clinical and psychosocial variables; cues on discussion points during the clinic visit; and
Self-Management goals and post-clinic visit action plan. Below is a mock-up of the user interface for prioritizing Self-Management goals based on patient self-reporting using the MINDSET Tool.2

Data input occurred using items from previously validated surveys embedded in the MINDSET tool. Patient satisfaction with the user interface, ease of use, acceptability, credibility and applicability of the tool to their needs was evaluated with usability measures that had been previously validated, as well.2

To learn more about the MINDSET program, click below:
https://www.frontiersin.org/articles/10.3389/fpubh.2017.00256/full


 

References:

  1. Centers for Disease Control and Prevention website. Managing Epilepsy Well (MEW) Network. https://www.cdc.gov/epilepsy/research/MEW-network.htm. Accessed May 2, 2018.
  2. Shegog R, Begley CE. Clinic-based mobile health decisions support to enhance adult epilepsy self-management: An intervention mapping approach. Front Public Health. 2017;5:256.