Vermont Business Magazine Dartmouth-Hitchcock hopes to improve the quality of care for people living with multiple sclerosis (MS), an incurable and debilitating disease of the central nervous system, through a three-year, national multicenter study of 5,000 people with MS. “MS is a progressive, disabling, costly and incurable disease that can cause a variety of physical and emotional challenges, including fatigue, pain and depression,” says Brant Oliver, PhD, MPH, APRN-BC, the principal investigator of the new Multiple Sclerosis Continuous Quality Improvement (MSCQI) Collaborative. “We are attempting an innovative approach using quality improvement methods to optimize evidence-based care for people with MS at system and population levels.”
Oliver, a Dartmouth-Hitchcock nurse practitioner and assistant professor at The Dartmouth Institute for Health Policy and Clinical Practice and the Geisel School of Medicine, says the program is in the first year of the study to investigate system-level health care performance variation and improvement across participating MS centers. The goal is to accelerate the rate of improvement in MS care by sharing aggregated data across MS health centers to inform improvement efforts. It is among the first U.S. quality improvement research collaborative studying MS.
Dartmouth-Hitchcock is conducting the study in collaboration with Biogen, a leader in the research and development of treatments for people living with MS. Participating MS centers include Massachusetts General Hospital’s Multiple Sclerosis Center, in Boston; the University of Vermont Multiple Sclerosis Center, in Burlington; the Multiple Sclerosis Center of Greater Orlando, in Maitland, FL; and the Concord Hospital Multiple Sclerosis Specialty Care Program in Concord, NH. Four additional sites are expected to join MSCQI this year, increasing the total study size to greater than 10,000 people with MS.
“In his role as a Dartmouth-Hitchcock nurse scientist, Dr. Oliver will lead the work of this improvement science research collaborative which aims to improve the quality and value of care for individuals with MS,” says Dr. Susan Reeves, Chief Nursing Executive at Dartmouth-Hitchcock. “This multicenter research program, which is the first of its kind in the United States for MS, 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.”
“We hope that through research programs like the MSCQI Collaborative we can meaningfully improve the care of people living with MS,” said Terrie Livingston, senior director, U.S. Medical at Biogen. “By sharing data across centers, we hope to identify effective strategies to improve MS care.”
The MSCQI study will evaluate geographic variations in MS care and test the effect of two different system-level quality improvement interventions. System level interventions and analyses are performed at higher levels than individual clinicians and patients but at a lower level than population epidemiological studies. Other national quality improvement collaboratives for chronic disease conditions include cystic fibrosis, cardiac surgery, and inflammatory bowel disease.
In the first year of this prospective study, participants will be followed to establish baseline performance data. Beginning in the second year of the study, participating centers will then be randomly selected to engage in quality improvement interventions for at least two additional years. Investigators will then study the impact of quality improvement interventions on a range of patient care and healthcare resource measures, including FDA-approved MS disease-modifying therapy and magnetic resonance imaging (MRI) utilization. They also will study clinical processes and outcomes such as relapse rate, quality of life, and patient experience
About the Collaborative
MSCQI is a collaborative alliance. Participants are Dartmouth-Hitchcock; Biogen, a biotechnology company that has specialized in MS research and development for more than 25 years; DeltaQuest Foundation, Inc, an independent data analytics group; and participating MS centers including Massachusetts General Hospital (MGH) Multiple Sclerosis Center, University of Vermont Multiple Sclerosis Center, the Multiple Sclerosis Center of Greater Orlando and Concord Hospital’s MS Specialty Care Program.
Dr. Brant Oliver oversees the MSCQI Collaborative via a research team based at the Collaboratory for Implementation Science, a regional “collaborative laboratory” directed by Stephen Bartels, MD, MS. The Collaboratory is dedicated to rapidly developing, testing, and implementing innovative approaches to health care delivery and novel uses of technology. The Collaboratory, a component of the Dartmouth Institute; the Dartmouth Hitchcock Research Program; and Dartmouth’s SYNERGY Clinical Translational Science Institute, aims to develop the next generation of clinician researchers equipped to solve the most difficult problems in health care delivery.
Funding for MSCQI is provided by Biogen. MSCQI is also advised by a research and improvement advisory committee composed of people with MS, researchers, quality improvement experts, and MS clinicians that meets twice annually.
Source: DHMC Lebanon, NH