Outcomes Data, Multidisciplinary Teams, and Upstream Interventions Improve Spine and Neurological Care

Physician leaders talk benefits of cross-functional work and transparency in latest Intermountain Podcast.

Conditions like back pain and head and spinal cord injuries are treated at Intermountain Healthcare using a team-based approach. Experts from many disciplines work together to provide the most appropriate care and treatment for each patient. Experts across specialties, like: Robert Hoesch, MD, Medical Director for Intermountain’s Neurosciences Clinical Program and for the Intermountain Neurosciences Institute at Intermountain Medical Center—and Stephen Warner, MD, Medical Director for the Intermountain Spine Development Team and for the Intermountain Spine Institute at The Orthopedic Specialty Hospital (TOSH)—collaborate to better understand and implement what’s working best for our patients.

In January 2018, Mark Briesacher, MD Chief Physician Executive and President of the Medical Group, spoke with Dr. Hoesch and Dr. Warner to see why 2017 was a foundational year for the Neurosciences Clinical Program and its Spine Development Team and how its services and clinicians are working together to improve patient care.

According to Steve, “A primary success we made in 2017 was our sign-on with NeuroPoint Alliance’s Quality Outcomes Database. With this participation, we’re able to benchmark safety, cost, and patient-reported outcomes data to see how we’re improving lives.” This partnership allows Intermountain to compare ourselves internally and to other facilities locally and nationally where spine and cranial procedures are performed, in real-time.

“We’re starting to get that data back,” says Steve, “on parameters like surgical volume, length of stay, infection, etc., and variations in treatments and devices used, variations in cost, and impact on the patient. This allows us to standardize procedures to improve outcomes and lower costs to improve safety, quality, and keep care affordable.”

“Since using this database, our spine team has transitioned from just a stewardship team to one focused on safety, quality, experience, and access,” says Bob. “It’s a huge step forward, bringing in the patient voice to highlight how the things we’re doing are making a difference. Doctors and patients are all contributing to this information to make better and better decisions about spine care.”

Teams have also worked to improve access to multispecialty spine and neurological treatments. “Key to spine care and treating painful spine disease is to get upstream of episodes of illness, before back pain becomes serious,” says Bob. “Our multidisciplinary Spine Centers of Excellence include physical therapy, which means quick and easy access to physical therapy early in the process, as well as programs to make payment easy, psychological support, and interventional and non-interventional pain management” to treat issues before they become progressive and more complicated.

Plans for the Neurosciences Clinical Program and its Spine Development Team in 2018 and beyond include increasing participation in the NeuroPoint registry and use of its data, engaging in other research, expanding our Spine Centers of Excellence, and enhancing development of best practices and decreasing variation.

“Your Clinical Program is really looking at spine and neurological issues holistically, finding ways we can provide the safest, right interventions early, and procedures at the right time,” says Mark.