Abstract Details

Title Neurology Access Clinic: A Study of Neurologist and Advanced Practice Provider Collaboration in a Tertiary Academic Setting

Topic Practice, Policy, and Ethics

Presentation(s) P5 - Poster Session 5 (8:00 AM-9:00 AM)

Poster/Presentation
Number 1-007

Objective NA

Background The global burden of neurological diseases continues to rise, contributing significantly to morbidity and mortality. As the population ages, healthcare systems face challenges in providing timely neurological care and reduce long wait times and overburdened urgent care settings. Neurology Access clinics have emerged as a partial solution to improve access. This study describes the operational framework and implementation features of the Mass General Brigham Neurology Access Team (NeAT) clinic through a multidisciplinary approach.

Design/Methods We conducted a retrospective review of all NeAT clinic visits from November 2023 to April 2024 at our institution. Clinic sessions were organized into one-week blocks, each consisting of eight four-hour sessions, accommodating four new patients per session. An advanced practice provider (APP) was available for follow-up referrals. Data collected included patient demographics, lag time to consultation, reason for referral, neurological diagnosis, time to follow-up, and disposition after the initial visit. Descriptive statistics summarized clinic operations, patient flow, and outcomes.

Results A total of 184 visits were scheduled, with 154 completed. The average time from referral to the first appointment was 81.4 days. Most referrals (70.1%) came from primary care clinicians, 21.4% from specialists, and 8.4% from emergency departments. Common complaints included headaches (27.7%), neuromuscular issues (24.5%), and cognitive problems (20%). Notably, 63% of patients did not require a second visit. Dispositions included return to primary care (23.7%), follow up with APP (16.7%), or a neurologist (37.2%), while 19.9% were referred to subspecialty care in neurology.

Conclusions This clinic model efficiently managed a variety of neurological cases in a single visit, highlighting its potential to optimize resource use and improve access to specialized care. However, long wait times and a high demand for neurology care remain a challenge, warranting further prospective and controlled interventions.

Authors/Disclosures
Bruna Leles Vieira de Souza, MD (Work) PRESENTER	Miss Leles Vieira de Souza has nothing to disclose.
Joao Vitor Mahler, MD	Dr. Mahler has received research support from The Sumaira Foundation.
Sergi Martinez-Ramirez, MD (Massachusetts General Hospital)	Dr. Martinez-Ramirez has nothing to disclose.
Andrea Thurler, NP (Massachusetts General Hospital)	Dr. Thurler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Focus Medical.
Sarbesh Chalise, NP (Massachusetts General Hospital)	Mr. Chalise has nothing to disclose.
Christina Maheras, MHA	Ms. Maheras has nothing to disclose.
Kasey O'Keefe, MBA (Massachusetts General Hospital)	Ms. O'Keefe has nothing to disclose.
Michael G. Erkkinen, MD (Brigham and Women's Hospital)	Dr. Erkkinen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen.
Bruce R. Kastin, MD	An immediate family member of Dr. Kastin has received personal compensation for serving as an employee of Eisai. An immediate family member of Dr. Kastin has received personal compensation for serving as an employee of Novartis.
Lidia Maria V. Moura, MD, PhD, MPH, FAAN (Massachusetts General Hospital)	Dr. Moura has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Moura has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer. The institution of Dr. Moura has received research support from Centers for Diseases Control and Prevention (CDC SIP20-007) . The institution of Dr. Moura has received research support from Epilepsy Foundation of America . The institution of Dr. Moura has received research support from NIH - NIA and NINDS. Dr. Moura has received personal compensation in the range of $50,000-$99,999 for serving as a Expert Advisor with Epilepsy Foundation .
Marcelo Matiello, MD, FAAN (Massachusetts General Hospital, Brigham, Harvard)	Dr. Matiello has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Matiello has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Matiello has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for WoltersKluwer.

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