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Integrated Neurology in Medical Home Cuts Health Care Use

Neurologist integrated and co-located in primary care can reduce unnecessary testing, tertiary consults


FRIDAY, Dec. 16, 2016 (HealthDay News) -- A model of a neurologist integrated and co-located in primary care, leveraging curbside, electronic, and traditional consultations, can reduce unnecessary health care use, according to a study published online Dec. 12 in the Journal of Evaluation in Clinical Practice.

Nathan P. Young, D.O., from the Mayo Clinic in Rochester, Minn., and colleagues developed a model of a neurologist integrated and co-located in primary care to examine the impact on health care resource use. During the 3.5 month pilot study, 359 unique patients generated 429 consultations (179 curbsides, 68 electronic consultations, and 182 face-to-face visits).

The researchers found that 78 face-to-face tertiary neurology consultations, 39 brain magnetic resonance imaging, 50 electromyograms, and 53 other advanced imaging studies were avoided with the integrated model. In 22 percent of patients, earlier curbside consultation may have prevented unnecessary testing or face-to-face tertiary neurology consultation. In 17 percent of patients, earlier face-to-face consultation may have avoided expensive testing. None of the cases met the criteria for an adverse outcome. There was a 64 percent decline in the number of referrals to tertiary neurology and a 25 percent decrease in the total number of face-to-face visits per month.

"Co-located neurology in a primary care medical home offers a promising intervention to deliver high-value care," the authors write.

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