Blog Post August 23, 2019 Neuroscience Service Line Development Authors ECG Management Consultants Neuroscience service lines are among the most complex to define and manage, in part due to their need to be organized around a constellation of clinical conditions, many of which have unique and distinct patient, physician, programmatic, and planning implications. It is because of this that neuroscience programs require health systems to thoughtfully plan their services into more coordinated, contemporary, and long-term financially sustainable clinical programs. As organizations focus on this specialty clinical program area, three industry imperatives consistently surface as prominent topics to understand and emphasize in program planning efforts: prioritized and integrated care, performance improvement, and patient experience and access. Prioritized and Integrated Care Few health systems have the resources—staff, capital, or even time—to invest in every subspecialty in the neuroscience domain, and therefore they prioritize those with the highest potential impact on and alignment with the organization and communities they serve. Once the array of subspecialties is assessed and high-priority programs are identified for development, it is paramount to ensure that comprehensive services exist across those prioritized areas. The care settings for these services have also been evolving, as systems shift from a hospital-centric model to one that has both ambulatory and acute care components. A service line’s success depends on clearly sequenced development goals, adequate funding, and accountability for implementation across the full care continuum. Performance ImprovementHealth systems must continually refine their approach to performance improvement within neuroscience service lines. For our neuroscience clients across the country, a constant focus on direct cost reductions in areas like implant and device pricing, workforce optimization, length-of-stay reductions, transitions of care, and telehealth integration is recommended. Of equal significance is how successful neuroscience service lines are developing consistent, evidence-based care standards in partnership with their aligned physicians and prioritized programs. From a broader perspective, many neuroscience service lines are now managed and governed from an enterprise-level viewpoint within multisite systems and across an expanded geography; performance improvement efforts must also apply regional planning parameters to prudently use capital and operating resources to maintain the financial health of the service line and sustain long-term success. Figure 1: Neuroscience Service Line Wheel Constellation of ConditionsPatient Experience and AccessThe continued shift toward patient-centered care has had a dramatic effect on how health systems focus on the patient experience. While still developing and offering subspecialty neurology programs (e.g., epilepsy, neuromuscular, Alzheimer’s/dementia), neuroscience programs also now focus on expanding general neurology access to address growing backlogged patient needs and providing those services through convenient local community and digital access. Though these access points have been well utilized in oncology programs for quite some time, neuroscience programs are investing in dedicated patient navigation staff and access lines to optimize referrals and strengthen network integrity. Neuroscience Patient Population Themes Developing a contemporary organizational design is a critical component in the creation of a successful neuroscience service line model, but without a clear understanding of varying neuroscience patient populations, that success cannot be sustained. Health systems must pay constant attention to the current themes of their respective patient populations to ensure their service lines continually achieve their goals. The diversity of neuroscience patient populations can be viewed through different lenses, each with important considerations to weigh regarding organizational planning, development, investment, and community need. More than ever, the demand for services is steadily growing because of the aging baby boomer generation and the general population’s increasing life expectancy, so providers must be attentive to their respective communities’ needs and their ability to serve them. While not inclusive of all neuroscience patient populations, figure 2 shows three growing segments that have significantly different care needs, entry points and locations where they receive care, and economic structures. Figure 2: Three Growing Populations of Neuroscience PatientsBroad organizational strategic initiatives and unique market dynamics are important to remain attentive to when planning for neuroscience service line needs. Programs that are able to take a disciplined approach to prioritizing and integrating subspecialty care options, pursuing a performance improvement agenda, and elevating the patient experience and access to care will be the market leaders.