Abstracts

Increasing Epilepsy Self-management Access by Embracing a HUB and SPOKE Model: The HOBSCOTCH Institute Translational Network (HITN)

Abstract number : 3.154
Submission category : 17. Public Health
Year : 2024
Submission ID : 576
Source : www.aesnet.org
Presentation date : 12/9/2024 12:00:00 AM
Published date :

Authors :
Presenting Author: Elaine Kiriakopoulos, MD, MPH, MSc – Dartmouth-Hitchcock Medical Center

Barbara Jobst, MD, PhD – Dartmouth-Hitchcock Medical Center
Eva Alden, Ph.D, LP – Mayo MN
Danielle Carns, PsyD – University of Pittsburgh
Felicia Chu, MD – UMass Chan Medical School
Jonathan Kleen, MD, PhD – University of California, San Francisco
Karen Secore, NP – Santa Barbara Cottage Hospital
Laura Flashman, Ph.D, ABPP – Wake Forest University
Cormac O'Donovan, MD – Wake Forest University
Megan Selvitelli, MD – Maine Medical Center
William Tatum, MD – Mayo Clinic Florida
Dan Weber, DO – St. Louis University School of Medicine
Christopher Benjamin, PhD – UCSD
Dona Locke, Ph.D – Mayo Clinic
Fadi Tayim, Ph.D – Premier Health Ohio
Anna Graefe, PhD – Dartmouth-Hitchcock Medical Center
Lisa Sackett, Ph.D – Dartmouth-Hitchcock Medical Center
Maureen Quigley, APRN – Dartmouth-Hitchcock Medical Center
Krzysztof Bujarski, MD – Dartmouth-Hitchcock Medical Center
Kaarkuzhali Krishnamurthy, MD, MBE – Beth Israel Deaconess Medical Center
Hamada Altalib, DO, MPH – Yale University School of Medicine
Sana Ali, MD – Yale School of Medicine
Johanna Messerly, PsyD – University of Texas Health
Mouhsin Shafi, MD, Ph.D – Beth Israel Deaconess Medical Center
Sarah Kaden, BA – Dartmouth-Hitchcock Medical Center
Jill Stuart, Ph.D – Duke University School of Medicine
Trina Dawson, BA, CHW – Dartmouth-Hitchcock Medical Center
Laura De Muro, MS, CHW – Dartmouth-Hitchcock Medical Center
Suzanne Lenz, MA, CCRP – Dartmouth-Hitchcock Medical Center
Laura Bernstein, PhD – Dartmouth College
Sharon O'Connor, MBA, MS – Dartmouth College

Rationale: Rationale Evidence based epilepsy self-management (ESM) has been challenging to bring to clinical centers and there is need for infrastructure that supports real world access and delivery. Without infrastructure, ESM programs will continue to be underutilized, accessibility will remain limited and the needs of people with epilepsy (PWE) will continue to be unmet. Measurable progress has been made with the establishment of a centralized support for telehealth deliverable HOBSCOTCH (HOme Based Self-Management and COgnitive Training CHanges Lives) program. Dartmouth’s HOBSCOTCH Institute (HI) was founded to cross barriers and facilitate adoption and referral to ESM. This project utilizes a hub and spoke model to bring together clinicians at 18 US epilepsy centers serving diverse communities to increase healthcare system capacity to provide equitable access to ESM for PWE.


Methods: Methods Champions were identified at 18 epilepsy centers (Fig 1) to fuel a leaderful approach to constructing a translational network. A calendar for HITN meetings and establishment of communication pathways between hub and spoke sites were intentionally developed. A baseline survey of epilepsy center clinicians was distributed to gauge awareness of HOBSCOTCH and perceptions of ESM need, interest and value. Individual planning meetings between HI hub team and SPOKE sites were held to consider contextual factors determining readiness for centers to adopt a referral, hybrid or onsite delivery process to ESM. Clinician education and EHR referral were prioritized for ease of clinician engagement.


Results: Results Baseline surveys (n=87) revealed 80% of providers felt standardized ESM has significant value for PWE and 76% were familiar with HOBSCOTCH. In the first 6 months (12/2023–5/2024) of the network being established, 231 patients from 23 states (Fig 2) were referred to HITN Coaches and 26 SPOKE clinicians have participated in HOBSCOTCH Coach training. 152 referrals were received by the HOBSCOTCH Institute hub team over the first six months of the project; with an additional 79 referrals connected to a HOBSCOTCH Cognitive Coach at their respective HITN epilepsy center spoke site. Referrals came from diverse multidisciplinary epilepsy providers, including MDs/DOs (n=60), APPs (n=7), RN (n=1), neuropsychologists (n=13), and LICSW (n=3).


Conclusions: Conclusion The majority of epilepsy providers at 18 epilepsy centers within a specialized network support self-learning via telehealth to provide an infrastructure that enables real world access. Survey data and the high rate of referrals indicates that epilepsy clinicians are committed to sharing the HOBSCOTCH resource with patients. Patient access will be further facilitated through streamlined mechanisms for provider engagement, Coach training, implementation support, EHR decision support and patient self-referral portals, all standard patient materials, advanced delivery systems and training accreditation and certification from the HI hub.


Funding: Funding Source: Centers for Disease Control and Prevention 1NU58DP007541-01-00



Public Health