DHMC to study multiple sclerosis care

by Berit Svenson | 4/20/18 2:25am

A national study featuring multiple medical centers by Dartmouth-Hitchcock Medical Center aims to improve the quality of care that multiple sclerosis patients receive. Examining several MS comprehensive care centers, the study will look at the care provided by each of the centers and the patients’ experiences across three years. The study, called Multiple Sclerosis Continuous Quality Improvement, is the first of its kind to be conducted in the United States for MS, according to co-research investigator and health care consultant Randy Messier.

Although there have been efforts made to improve the quality of MS patient care, no work has been done to redesign how the healthcare system works to better suit patients’ needs, according to the study’s principal investigator Brant Oliver, who is a DHMC nurse practitioner and a professor at The Dartmouth Institute for Health Policy and Clinical Practice and the Geisel School of Medicine.

The collaborative study uses a different kind of approach than what is typical in the healthcare field and is new to MS in particular, Oliver said. As the first systems level continuous quality improvement collaborative for MS, the study aims to conduct benchmarking analyses.

“This multi-center research program ... is both innovative and timely in that it will bring quality improvement to the MS field, including a rigorous study of geographic variation in care quality and a randomized study of different improvement interventions to optimize outcomes,” DHMC chief nursing executive Susan Reeves said in a recent press release.

According to Oliver, the study is unique because of its randomized design. The study will expose three of the four participating centers to a healthcare quality improvement intervention during the three-year period.

“We’re randomly assigning sites to different quality improvement dimensions,” Oliver said. “Then, we’ll be comparing which ones work best to see if they do better than the control groups with usual care.”

The study will add an additional four centers by the summer for a total of eight centers, which will double the study in less than a year, Oliver said. He added that in addition to providing data from its health records, each center will distribute patient questionnaires to assess their experiences. Researchers will then aggregate the data to help identify the high performing centers from which others can learn.

“The idea behind [this method] is that it accelerates everyone’s learning and then we can push outcomes further faster,” Oliver said.

One of the primary goals of the study is to ensure that patients are receiving the care that they want, Messier said.

The program takes into consideration the patients’ input by collecting their responses to the questionnaires.

Oliver said that the rapid growth in interest has been encouraging and “a bit surprising.”

“There’s been less resistance than I was expecting,” he said. “We’re seeing that the reason we’re growing is because of the interest that has been intrinsically generated from the study, simply by word of mouth going around in professional conferences.”

Similar collaborative studies that have focused on different medical conditions, such as cardiac surgery, cystic fibrosis and inflammatory bowel disease, have produced effective results and seen significant expansion across the country, according to Oliver. He noted that his dream for the MS study is to see it grow in a similar manner to these programs.

If the study endures past its initial three years, it has the potential to effect great change, Messier said.

Some national organizations, like the Centers for Medicare and Medicaid Services, have expressed interest in the study, Oliver added.

“People are watching,” Oliver said. “It will be interesting to see what we find. We’ve got our fingers crossed.”