World Parkinson’s Day is April 11, marking the birthday of the late James Parkinson, MD, whose 1817 manuscript, An Essay on the Shaking Palsy, first identified the neurological disorder that would later be renamed Parkinson’s disease. Although scientists are still searching for a cure, Parkinson’s patients today have vastly better treatment options and support than ever before.
From specific therapy methods and medications to surgical procedures, team-based care and more, Parkinson’s patients are benefiting from the evidence-based medicine being developed by Kaiser Permanente and other leading health organizations throughout the world.
ParkinsonNet, a new care model for the delivery of best care and practices for Parkinson’s patients, has launched in Kaiser Permanente’s California service areas, adding to the consistently high-quality care the health plan provides to its approximately 15,000 members in California with Parkinson’s disease. The model’s roots, however, are found across the globe – at Radboud university medical center in Nijmegen, the Netherlands.
Lifting up best practices
“Part of Kaiser Permanente’s commitment to evidence-based medicine lies in scanning the world for best practices,” said Patrick Courneya, MD, executive vice president and chief medical officer for Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals. “When we partner with other learning organizations, as we did with Radboud university for ParkinsonNet, the health care advancements we achieve together ripple out through the larger communities we both serve.”
ParkinsonNet tackles the question of how health care systems can consistently provide expert care – nimbly and responsively – for a disease that manifests differently in every patient. The Dutch model successfully improved clinical outcomes for Parkinson’s patients by using a multidisciplinary team approach to care that emphasizes physical therapy in combination with medication, a network of specially trained providers, and patients and families playing an active role in co-designing care and leveraging social-media tools.
ParkinsonNet launches in the U.S.
Recognizing how closely Kaiser Permanente’s integrated system and patient-centric approach aligned with Radboud university’s model, the two organizations embarked on a learning partnership to advance the quality of Parkinson’s care at Kaiser Permanente and around the world.
In September 2014, Kaiser Permanente launched ParkinsonNet in Southern California. Todd Sachs, MD, medical director of operations, Southern California Permanente Medical Group, led the launch, working closely with ParkinsonNet’s Dutch colleagues. He and his team implemented the program using core components of the Dutch model:
- Training of providers – neurologists; movement disorder specialists; pharmacists; and physical, speech and occupational therapists – to help them develop expertise specific to Parkinson’s
- Connecting those providers as multidisciplinary, patient-centered teams
- Co-designing care plans with patients so they receive care how, when and where they want it
- Digital networking tools that connect providers for quicker patient diagnoses and referrals, and that enable the exchange of best practices and clinical insights
- Adherence to evidence-based clinical guidelines
The ParkinsonNet model soon spread north, championed by Suketu Khandhar, MD, a neurologist at Kaiser Permanente’s Sacramento Medical Center and medical director of the Movement Disorders Program for The Permanente Medical Group. Dr. Khandhar and his team partnered with their Southern California colleagues in applying components of the program to their own existing care model for Parkinson’s patients.
As the program has spread, Kaiser Permanente members across California have gained wider access to specially trained providers and therapists, as well as new exercise classes and educational resources based on best practices and evidence-based medicine. Kaiser Permanente member Justine Miller, whose husband Mike received treatment for his Parkinson’s symptoms, said Kaiser Permanente “[is] there with every possible resource available,” and that the organization “should be held up as a model for that.”
Lessons for the future
In the Netherlands, ParkinsonNet resulted in fewer hip fractures and hospitalizations, and more therapy visits. While Kaiser Permanente’s model is still too new to report clinical outcomes, program leaders are seeing early alignments with the Dutch results. Over time, Kaiser Permanente’s findings will add to those of Radboud university medical center in better understanding how the ParkinsonNet model can both improve the quality and care experience of Parkinson’s patients and serve as a template to improve care for patients with other chronic diseases.