Best Practices
The Multiple Sclerosis Centers of Excellence: A Model of Excellence in the VA
The MS Centers of Excellence at the VA improves the consistency and quality of care for veterans with MS.
Mitchell Wallin is the Director of the VA Multiple Sclerosis Center of Excellence (MSCoE)-East and Associate Professor of Neurology, George Washington University School of Medicine in Washington, DC. Ruth Whitham is Professor Emeritus of Neurology at Oregon Health and Science University in Portland. Heidi Maloni is the Clinical Director of the VA MSCoE-East in Washington, DC. Shan Jin is a Statistician and Data Analyst at VA MSCoE-East in Baltimore, Maryland. Jonathan Duckart is a Health System Specialist at the VA Office of Inspector General in Portland. Jodie Haselkorn is the Director of the VA MSCoE-West and a Professor of Physical Medicine and Rehabilitation at the University of Washington School of Medicine and Public Health in Seattle. William Culpepper is the Director of the Veterans Health Administration Epidemiology Program and Director of Epidemiology and Informatics at VA MSCoE-East and an Adjunct Associate Professor of Neurology at the University of Maryland School of Medicine in Baltimore.
Correspondence: Mitchell Wallin (mitchell.wallin@va.gov)
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the US Government, or any of its agencies.
To achieve greater numbers across populations, there has been efforts in Europe to combine registries into a common European Register for MS. A recent survey found that although many European registries were heterogeneous, it would be possible to have a minimum common data set for limited epidemiologic studies.20 Still many registries do not have environmental or genetic data to evaluate etiologic questions.21 Additionally, most registries are not set up to evaluate cost or quality of care within a health care system.
Recommendations for maximizing the impact of existing MS registries were recently released by a panel of MS clinicians and researchers.22 The first recommendation was to create a broad network of registries that would communicate and collaborate. This group of MS registries would have strategic oversight and direction that would greatly streamline and leverage existing and future efforts. Second, registries should standardize data collection and management thereby enhancing the ability to share data and perform meta-analyses with aggregated data. Third, the collection of physician- and patient-reported outcomes should be encouraged to provide a more complete picture of MS. Finally, registries should prioritize research questions and utilize new technologies for data collection. These recommendations would help to coordinate existing registries and accelerate knowledge discovery.
The MSSR will contribute to the growing registry network of data. The MSSR can address questions about clinical outcomes, cost, quality with a growing data repository and linked biobank. Based on the CR platform, the MSSR allows for integration with other VA clinical registries, including registries for traumatic brain injuries, oncology, HIV, hepatitis C virus, and eye injuries. Identifying case outcomes related to other registries is optimized with the CR common structure.
The MSSR has been a useful tool for clinicians managing individual patients and their regional referral populations with real-time access to clinical and utilization data. It will also be a useful research tool in tracking epidemiological trends for the military population. The MSSR has enhanced clinical management of MS and serves as a national source for clinical outcomes.
The MS Centers of Excellence at the VA improves the consistency and quality of care for veterans with MS.
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