Abstract Details

Title Using Design Thinking to Create a Health System Wide Approach to Addressing Unmet Headache Access

Topic Headache

Presentation(s) P9 - Poster Session 9 (8:00 AM-9:00 AM)

Poster/Presentation
Number 12-010

Objective To improve access to headache care by designing a population health-based model for prospectively capturing and managing headache patients.

Background

Geisinger’s headache population far exceeds the bandwidth of our neurology department’s current access. A 12-month retrospective health plan survey identified 6987 poorly managed headaches patients defined as those over utilizing abortive medications (55%), neurology referrals with limited medication trials (24%) or having visited the ER twice within 6 months (22%). System-wide data showed that patients received a formal headache diagnosis, follow up visit or initiation of prescriptive medication less than half the time.

Design/Methods We partnered with headache patients, neurology, primary care, the ER, analytics, IT, pharmacy, insurance and administration for a human centered design thinking approach to expand our access. Using health system data and four 1-hour stakeholder empathy sessions, we developed a broader question, “How might we increase the access to headache knowledge in our system?” By balancing our population’s needs with already present health system resources, prototypes were developed and tested.

Results We developed a “Virtual Headache Hospital,” a novel space that combines technology and human capital to expand access and reduce barriers to headache care. We identify uncontrolled patients using EHR data. A multispecialty intake team assesses eligibility and facilitates transitions of care. PCP’s have real time, EHR-based fingertip access to diagnostic and therapeutic tools and a longitudinal headache specific report that provides a single screen summary of prior testing, consultation and treatments. Access to care was expanded by training 40 primary care embedded clinical pharmacists to manage headache, promoting electronic neurology consultations and implementing twenty-minute advanced practitioner neurology appointments.

Conclusions Using design thinking systemwide stakeholders developed opportunities for improved access for poorly managed headache patients. Next steps include iterative workflow improvements and developing clinical and resource utilization outcome dashboards.

Authors/Disclosures
Scott M. Friedenberg, MD, FAAN (Geisinger Medical Center) PRESENTER	The institution of Dr. Friedenberg has received research support from AMA. The institution of Dr. Friedenberg has received research support from Geisinger Medical Center.
Apoorva M. Pradhan, BAMS, MPH (Geisinger)	Dr. Pradhan has nothing to disclose.
Rachel M. Dragano, NP (Geisinger Medical Center)	The institution of Ms. Dragano has received research support from Geisinger Health Plan.
Peyton Latorre (Geisinger)	No disclosure on file
Mallory Sponenberg	No disclosure on file
Adriene Zook, PharmD (Geisinger)	Dr. Zook has nothing to disclose.
Henry Aftewicz (Geisinger)	No disclosure on file
Leonard Learn (Geisinger)	No disclosure on file
Michael Stoppie (Geisinger)	No disclosure on file
Sandra Herr (Geisinger Health Plan)	No disclosure on file
Jamie Kerestes (Geisinger)	No disclosure on file
Kim Mackes (Geisinger Medical Center)	No disclosure on file
Jimmie Hill (Geisinger Medical Center)	No disclosure on file
Raquel Martinez (Geisinger)	No disclosure on file
Jaime Silvagne	No disclosure on file
Leeann Webster (Geisinger Director, Ambulatory Clinical Pharmacy Programs)	No disclosure on file
Alyssa M. Callela, PA (Geisinger)	Miss Callela has nothing to disclose.
Justin Kosman	Mr. Kosman has nothing to disclose.
Eric Wright (Geisinger)	No disclosure on file

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