Objective: To present the initial outcomes following adoption of the Dutch ParkinsonNet model at Kaiser Permanente Southern California (KPSC).

Background: Parkinson’s disease (PD) is a common and disabling neurodegenerative disorder with a substantial impact on health-related quality of life.  There is increasing support for allied health treatments such as physiotherapy, occupational therapy, and speech-language therapy.  Unfortunately, allied health professionals often lack the specific expertise to treat patients with PD. ParkinsonNet was developed in the Netherlands and offers an innovative model: allied health interventions are delivered by specifically trained therapists who accumulate additional expertise by managing a high caseload of PD patients.  This approach has shown to significantly improve the quality of care in the Netherlands, reduce disease complications among patients with PD, and save costs.

Method: To adopt the ParkinsonNet model to KPSC, 57 physical therapists, 18 speech therapists and 20 occupational therapists in medical centers across SC were trained based on an evidence-based treatment guidelines.  Simultaneously, a project team built area networks, organized training, facilitated collaboration, and implemented supporting IT systems. Initial success of the program was based on the number of patients treated at least once by an expert professional.  Subsequently, complications related to PD have been monitored based on participation in the program.

Results: Before network initiation, only 29% of PD patients in the KPSC Region received specialized allied health treatment. By the second year of implementation, almost 67% of PD patients were treated by an expert therapy provider within the Region, which led to a total increase of 38%.  In addition, Program initiation was associated with a substantial reduction of preventable complications related to PD: hospital admissions reduced from 382.83/1000 patients to 289.50/1000 patients; fractures reduced from 26.35/1000 patients to 12.84/1000 patients; hip fractures reduced from 11.90/1000 patients to 4.09/1000 patients.

Conclusion: ParkinsonNet is an innovative healthcare program that can be successfully transferred between cultures and healthcare systems.  While direct causation cannot be proven, this comprehensive and expert program is accompanied by significantly improved outcomes for PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/network-based-healthcare-at-kaiser-permanente/