The Multiple Sclerosis Center of Atlanta provides specialized care for people living with multiple sclerosis (MS) through neurological care, diagnostic studies, social services, and general medical care. The Center aims to improve health and hope for MS patients through advocacy, education, state-of-the-art treatment, and research. While originally focusing on in-person care in Atlanta, the Center now utilizes telehealth to extend specialized MS care to rural Georgians living over 100 miles from metro Atlanta, addressing barriers to care in remote areas. Going forward, the Center views telehealth as key to navigating challenges and furthering its mission of serving medically underserved populations with MS across Georgia.
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
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.
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
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