The 2014 update to the Centers for Medicare & Medicaid Services’ (CMS) Epilepsy Quality Measures focuses on seven guidelines that have a greater emphasis on recording and intervention than the previous 2009 measures, according to medical experts in “Adhering to the Epilepsy Quality Measurement Set Update,” a CME video presentation for the virtual education summit NeuroSeriesLive.
Dr. Nathan Fountain, MD, Professor of Neurology and Director of the Comprehensive Epilepsy Program at the University of Virginia, and Dr. Elizabeth Waterhouse, MD, Professor of Neurology at the Virginia Commonwealth University School of Medicine discuss the new epilepsy quality measures and their implementation along with the gaps in epilepsy care that led to these updates.
The following quality measures are not only associated with a better standard of care for epilepsy patients, they’re also closely tied with federal insurance reimbursements. Throughout the video, Drs. Fountain and Waterhouse discuss ways to incorporate and document these measures as easily as possible.
2014 Quality Measures Add Seizure Intervention and Mental Health Assessment
The 2014 quality measures update institutes portion 1B, which is seizure intervention. According to the presenters, many patients are pleased when their seizure number is stable from month to month. However, the goal for quality measure 1B is to intervene in such a manner that a patient has zero seizures.
“The intervention as you mentioned doesn’t always have to be a major intervention, sometimes it can be just a tweaking,” Dr. Waterhouse says. “If they’re having other types of side effects at certain times of the day, you may switch them to a long-acting formulation from an immediate-release formulation.”
Additionally, mental health is now addressed due to the availability of research showing that depression, anxiety, and even suicidal ideation are all common in both adults and children with epilepsy.
In the video, Drs. Fountain and Waterhouse provide an in-depth discussion of each measure and recommend ways to incorporate each into a physician’s practice. The doctors agree, many physicians may be surprised to find they are already doing many of these interventions – but they may not be documenting them.
Know When to Refer for Refractory Epilepsy
More than two hundred National Association of Epilepsy Centers exist across the United States, and the new guidelines make recommendations on when to refer a patient to these centers for treatment.
Dr. Fountain explains that refractory or pharmacoresistant epilepsy refers to patients who continue to have seizures despite trials of two appropriate antiepileptic drugs at appropriate dosages. When a patient experiences refractory epilepsy, there are many ways an epilepsy center can help a patient, including surgery, drug trials, and/or re-evaluation of medications.
The major lesson from the new guidelines is to keep trying to find interventions to help patients, according to Dr. Fountain.
“Our theme as epileptologists, epileptic specialists, is never give up. Never give up, we’re not going to be satisfied,” Dr. Fountain explains. “We don’t want to harm anyone, of course, but never give up on trying to make them better.”
To watch Drs. Fountain and Waterhouse review patient case studies related to quality measure applications, watch “Adhering to Epilepsy Quality Measurement Set Update” for CME credit on NeuroSeries Live.
Disclaimer: All PlatformQ Health articles, reports, summaries, and recaps of events are for informational purposes. The quotes and opinions of the speakers covered are not to be taken as direct advice for individual patients. Patients should always seek care from qualified, properly accredited healthcare professionals.