Abstract Details

Title Embedding general neurology and tertiary care headache services in community health centers (CHCs) in Boston, MA: establishment and early experiences

Topic Health Care Disparities

Presentation(s) S28 - Health Care Disparities (2:48 PM-3:00 PM)

Poster/Presentation
Number 010

Background

Black, Latinx and American Indian/Alaskan Native patients in the United States are 30-40% less likely to have an outpatient neurology visit in the United States (Saadi et al, 2017). CHCs, which serve as the medical home for over 30 million Americans, are well equipped to address regional and population specific barriers to care.

Objective To describe the first year experience of embedding general neurology and tertiary care headache services in community health centers (CHC) in Boston

Design/Methods We describe the implementation and first-year experience of a general neurology clinic established within the internal medicine practice at Brigham and Women’s Hospital (BWH) Southern Jamaica Plain Health Center (SJP). The clinic provided consults and tertiary care hadache services for SJP and its sister CHC, Brookside.

Results SJP and Brookside are hospital licensed CHCs that serve communities of color (55% Latinx-American, 13% African American and 28% white) and the underserved (approximately half of patients are insured by Medicaid/Medicare). Population-specific needs are addressed through language-concordant staff, community resource specialists and integrated behavioral health, all consistent with a defined racial and social justice mission. Embedding a neurology clinic involved meetings with CHC directors, BWH Department of Neurology approval and cross-departmental administrative collaboration. In the first year of operation, there were over four-hundred patient visits, including new neurologic consultations and tertiary headache care services. Successes have included development of a shared care model with PCPs which includes education and establishment as a neurology resident continuity clinic site. Challenges have included utilization of staff resources for prior authorizations, operationalizing Botox and for some disorders, finding culturally sensitive Spanish language screeners and educational resources.

Conclusions Neurologic services embedded within primary care are a feasible model to offer care to communities of color and underserved populations in the CHC setting and to provide peer and trainee mentorship in neurology.

Authors/Disclosures
Angeliki Vgontzas, MD PRESENTER	Dr. Vgontzas has nothing to disclose.
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