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Multiple Sclerosis Center of Atlanta




Helping people and families live with MS
What is Multiple
    Sclerosis?
                                  Multiple Sclerosis is an
                                  incurable disease of the
                                  nervous system in which the
                                  body mistakenly attacks and
                                  damages the cells that
                                  produce the myelin sheath that
                                  encases a nerve fiber. MS can
                                  attack any area of the brain,
                                  optic nerve or spinal cord
                                  causing nerves to lose their
                                  ability to transmit signals



•   Estimates are that 450,000                                     •   In 2002 it was determined
    people in the United States                                        that a person with MS can
    have MS. The risk of MS                                            expect to live seven years
    is approximately 1 in 800.                                         less than the average life
                                                                       expectancy
•   There are approximately
    14,000 Georgians that are                                      •   The manifestations of MS can
    afflicted with MS. More                                            vary in scope and intensity.
    than 6,000 live outside the                                        Persons afflicted with MS may
    Atlanta MSA                                                        exhibit physical and cognitive
                                                                       stability for years or they may
•   MS affects women more                                              have an immediate, rapid
                                                                       degradation of mobility and
    frequently than men by a
    ratio of about 2:1                                                 cognitive functions
The Beginnings of MS

                      • First record of a person
                        with symptoms typical of
                        MS – 14th century in
                        Holland

                      • MS was initially
                        described as a disease in
                        1868 by Jean Martin
                        Charcot who connected
                        the symptoms with the
                        “plaques in the brain.”
Jean Martin Charcot
Timeline of MS treatments


•Treatments in the 1800’s
    •Strychnine
    •Gold and Silver injections
•   1993 - First FDA approved therapy for
    MS: Interferon Beta

•   2010 – First oral therapy for MS –
    Fingolimod


•   2013 – 8 approved therapies for
    MS, and 2 therapies currently
    submitted to the FDA for approval
The Multiple Sclerosis Center of Atlanta
 Founded in 2001, The Multiple
 Sclerosis Center of Atlanta was
 established as a 501(c)(3)
 outpatient center devoted to
 providing healthcare to the
 medically-underserved population
 afflicted with Multiple Sclerosis.


The Center’s Mission Statement:

“The MS Center exists to improve
the health and hope of MS patients
through advocacy, education, state
of the art treatment and research
leading to a more promising future.”

                                       MS Center Programs     Successful MS
                                       Include:              Treatment Protocols
                                       Neurological Care    Social Services
                                       Diagnostic Studies   General Medical Care
3.3 2013 ga telehealth final 3 7-terry smith
Georgians from 118
   of our state’s 159
    counties receive
       life-changing
           outpatient
treatment at the MS
  Center of Atlanta.
The Barriers Faced by Rural Residents with MS

• Those in rural areas tend to be
  diagnosed 1.5 years later than
  urban residents. Lack of early
  treatment can lead to a more
  rapid and greater degree of
  disability.

• Residents of more remote          • Living in a rural area reduces
  rural areas are more likely to      the likelihood of having a
  have a primary care physician       neurologist as the MS care
  providing the majority of their     provider by 46%.
  MS focused care.
                                    • An urban resident on average
                                      will drive 26 miles to receive
                                      MS-focused care, while a rural
                                      resident has to travel an
                                      average of 103 miles.
Challenges In Extending MS Care Outside Metro
Atlanta…
                    Original MSCA Plan for Expanding MS Care :
                      •   Develop brick and mortar sites that would be staffed by local
                          neurologists and primary care physicians



                    Hurdles to expansion of long-term care at satellite location
                           •       Costly, ongoing operational expenses that would limit the
                                   number of satellite facilities
                               •      Because of extensive federal regulations, rigid
                                      professional services agreements are necessary
                                      between the local physician and the MS Center. These
                                      PSA’s limit availability of local physicians and restrict
                                      changes that reflect patient volume.
                                        •   Limited number of neurologists that have
                                            available time for lengthy and reoccurring MS
                                            office visits

                                              •    Patient apprehension to a new physician
                                                   for their long-term care



                                                   Current Satellite Location:
                                                   • Weekly Office and Infusion presence in
                                                     Villa Rica on the Tanner Medical Campus
Telehealth…..
                For the MS Patient:
                 •   Local physician versus a physician office that is an
                     extended distance away
                 •   More available locations for ongoing MS care
                 •   Continued long term-care with the neurologist that
                     developed their MS treatment program
                 •   Real time evaluation by a MS specialist when disease
                     relapses or flare-ups occur.
                 •   Elimination of travel expense and time as a barrier to
                     ongoing care


                              For the Rural Physician:
                                 • Greater flexibility in the use of staff and
                                   resources for administering long-term MS care
                                 • Limited investment and reoccurring costs in the
                                   treatment of patients with MS
                                 • MS specialist available to assist in the
                                   comprehensive treatment of the MS patient


                              For the MS Center:
                                 • Greater flexibility in the use of staff and
                                   resources for administering long-term MS
                                   care
                                 • Limited investment and reoccurring costs
                                   in the treatment of patients with MS
                                 • A solution that aligns with the MS Center’s
                                   mission to extend long-term, ongoing care
                                   to a medically under-served population.
We view MS care delivered via Georgia Telehealth
                                   like navigating a
                                   whitewater river……..
 there is a direction we are attempting to go…….




            we expect obstacles that we must steer around……..

…………and anticipate
rapid changes as we
continue to move forward
Multiple Sclerosis Center of Atlanta




         For additional information contact:
                    R. Terry Smith
                         CEO
         Multiple Sclerosis Center of Atlanta
               3200 Downwood Circle
                       Suite 550
                  Atlanta, GA 30327
                    404-856-4801
                  tsmith@mscatl.org

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3.3 2013 ga telehealth final 3 7-terry smith

  • 1. Multiple Sclerosis Center of Atlanta Helping people and families live with MS
  • 2. What is Multiple Sclerosis? Multiple Sclerosis is an incurable disease of the nervous system in which the body mistakenly attacks and damages the cells that produce the myelin sheath that encases a nerve fiber. MS can attack any area of the brain, optic nerve or spinal cord causing nerves to lose their ability to transmit signals • Estimates are that 450,000 • In 2002 it was determined people in the United States that a person with MS can have MS. The risk of MS expect to live seven years is approximately 1 in 800. less than the average life expectancy • There are approximately 14,000 Georgians that are • The manifestations of MS can afflicted with MS. More vary in scope and intensity. than 6,000 live outside the Persons afflicted with MS may Atlanta MSA exhibit physical and cognitive stability for years or they may • MS affects women more have an immediate, rapid degradation of mobility and frequently than men by a ratio of about 2:1 cognitive functions
  • 3. The Beginnings of MS • First record of a person with symptoms typical of MS – 14th century in Holland • MS was initially described as a disease in 1868 by Jean Martin Charcot who connected the symptoms with the “plaques in the brain.” Jean Martin Charcot
  • 4. Timeline of MS treatments •Treatments in the 1800’s •Strychnine •Gold and Silver injections • 1993 - First FDA approved therapy for MS: Interferon Beta • 2010 – First oral therapy for MS – Fingolimod • 2013 – 8 approved therapies for MS, and 2 therapies currently submitted to the FDA for approval
  • 5. The Multiple Sclerosis Center of Atlanta Founded in 2001, The Multiple Sclerosis Center of Atlanta was established as a 501(c)(3) outpatient center devoted to providing healthcare to the medically-underserved population afflicted with Multiple Sclerosis. The Center’s Mission Statement: “The MS Center exists to improve the health and hope of MS patients through advocacy, education, state of the art treatment and research leading to a more promising future.” MS Center Programs  Successful MS Include: Treatment Protocols Neurological Care Social Services Diagnostic Studies General Medical Care
  • 7. Georgians from 118 of our state’s 159 counties receive life-changing outpatient treatment at the MS Center of Atlanta.
  • 8. The Barriers Faced by Rural Residents with MS • Those in rural areas tend to be diagnosed 1.5 years later than urban residents. Lack of early treatment can lead to a more rapid and greater degree of disability. • Residents of more remote • Living in a rural area reduces rural areas are more likely to the likelihood of having a have a primary care physician neurologist as the MS care providing the majority of their provider by 46%. MS focused care. • An urban resident on average will drive 26 miles to receive MS-focused care, while a rural resident has to travel an average of 103 miles.
  • 9. Challenges In Extending MS Care Outside Metro Atlanta… Original MSCA Plan for Expanding MS Care : • Develop brick and mortar sites that would be staffed by local neurologists and primary care physicians Hurdles to expansion of long-term care at satellite location • Costly, ongoing operational expenses that would limit the number of satellite facilities • Because of extensive federal regulations, rigid professional services agreements are necessary between the local physician and the MS Center. These PSA’s limit availability of local physicians and restrict changes that reflect patient volume. • Limited number of neurologists that have available time for lengthy and reoccurring MS office visits • Patient apprehension to a new physician for their long-term care Current Satellite Location: • Weekly Office and Infusion presence in Villa Rica on the Tanner Medical Campus
  • 10. Telehealth….. For the MS Patient: • Local physician versus a physician office that is an extended distance away • More available locations for ongoing MS care • Continued long term-care with the neurologist that developed their MS treatment program • Real time evaluation by a MS specialist when disease relapses or flare-ups occur. • Elimination of travel expense and time as a barrier to ongoing care For the Rural Physician: • Greater flexibility in the use of staff and resources for administering long-term MS care • Limited investment and reoccurring costs in the treatment of patients with MS • MS specialist available to assist in the comprehensive treatment of the MS patient For the MS Center: • Greater flexibility in the use of staff and resources for administering long-term MS care • Limited investment and reoccurring costs in the treatment of patients with MS • A solution that aligns with the MS Center’s mission to extend long-term, ongoing care to a medically under-served population.
  • 11. We view MS care delivered via Georgia Telehealth like navigating a whitewater river…….. there is a direction we are attempting to go……. we expect obstacles that we must steer around…….. …………and anticipate rapid changes as we continue to move forward
  • 12. Multiple Sclerosis Center of Atlanta For additional information contact: R. Terry Smith CEO Multiple Sclerosis Center of Atlanta 3200 Downwood Circle Suite 550 Atlanta, GA 30327 404-856-4801 tsmith@mscatl.org

Editor's Notes

  1. I am Terry Smith, CEO of the Multiple Sclerosis Center of Atlanta.In considering the use of telehealth to deliver care long term care to a medically underserved population three points should be considered:The nature and impact of Multiple SclerosisThe challenge for rural residents to have available long term care options for an incurable diseaseChallenges for a Center like ours and other MS focused care facilities to expand using traditional hub and stoke modelsTelehealth model that incorporates local physicians and remote specialists.
  2. Let me first state, I am not a clinician, but rather I am a spouse of someone who was as having MS in 1997, a 12 year Board member of the MS Center and the CEO for the past four years, so much of specifics and technical side around the treatment of the disease I will leave for the physicians, but here are the key aspects of the disease:MS is an incurable disease of the central nervous systemThere are approximately 450,000 people in the US with MS and approx. 14,000 in Georgia. In GA. Approximately 6,000 live outside the Atlanta MSA2 to 1 Women to men, avg. age when diagnosed is in the late 30’s to early 40’s.Depending on the location of where the disease attacks the central nervous system, the manifestations of the disease will vary.Most in not all treatments revolve around disease modifying agents that include treatment either in a facility or at home
  3. MSCAFounded in 2001 as a not for profit out patient treatment facility devoted to comprehensive MS CareOne of MS center of Excellence in GeorgiaTwo full time neurologist , seven part time neurologist, five internist and two nurse practitionersOffer a one stop shop for the treatment of MS, neurology, internist, MRI, lab, treatment research, phone