Abstracts

Rationale: Public Law 110-S. 2162 mandated The Veterans Health Administration (VHA) to establish the Epilepsy Centers of Excellence (ECoE) program in 2008. In alignment with objectives, the ECOE is instituting a national system of standardized care for epilepsy patients. To meet above goal and for optimal data driven policies, ECoE is creating an epilepsy registry in the VHA. Methods: In the first phase, clinical templates incorporating American Academy of Neurology quality measures and National Institute of Health common data elements were created in the computerized patient record system (CPRS). After required approvals, 16 ECoE sites adopted national templates in 2013. Information is being stored at VHA Corporate Data Warehouse through structured "health factors." Results: To this date, data have been collected for more than 2,800 patients with over 5,000 visits. Detailed epilepsy related data about overall frequency of events, event type, living arrangements, aura, ictal semiology, employment, anti-epileptic drugs prescribed and mental health are available for more than 1,000 patient visits. Data related to quality of life survey (170 observations), education (300 observations), surgery and procedures (over 600 observations), driving (700 observations) are available. Approximately 300 comments are available for traumatic brain injury specific data. Statistics are available for patient education, plans for new medication and injuries regarding epilepsy. Of the 2,834 patients, approximately 10% were females. The average age was 57 years (standard deviation of 15 years). From available data levetiracetam was the most prescribed medication (47%) and traumatic brain injury was the top specific primary etiology (36%). About 26% patients had generalized tonic clonic seizures and 6% experienced non-epileptic seizures. Around 63% of patients were either unemployed and/or disabled; whereas 20% lived alone. Nearly 13% of visits constituted tele-health encounters. Conclusions: Clinical templates are currently under revision for implementation of improved versions nationally. In the second phase, templates will be instituted at ECoE sites as well as the consortium sites. The final objective is to implement the templates nationally throughout the VHA. There is great optimism that this project will lead to standardized quality epilepsy care across the VHA and allow clinicians to improve patient driven outcomes. Data will offer opportunities for advanced research and best policy making decisions. Funding: No funding was received.