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Better Coordinated Care, Better Outcome

Better Coordinated Care, Better Outcome

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[brainlinemilitary - A service of] [Anand Veeravagu, MD - Neurosurgeon, Stanford University, White House Fellow, Dept. of Defense] Service members coming back from the war have experiences that most of us will never comprehend. They have had either emotional experiences, physical experiences, anxiety and stress levels that civilian populations couldn't fathom. And so when they come back to a hospital and they're being treated for PTS or traumatic brain injury or an amputation, it is extraordinarily important that the care be coordinated because we're trying to heal the patient as a whole and we're not trying to heal their amputation, their TBI, or their PTS individually. And really, that I think is at the center of the way the VA has delivered care. I know where I practice I've been able to coordinate with physical medicine and rehabilitation doctors to make sure that we optimize the rehabilitation plan. Coordinated care is extraordinarily important for the patient, and making sure that all the physicians and healthcare practitioners are on the same page has really been shown to improve the outcome of patients, no matter what they're suffering. I personally think for traumatic brain injury this is especially true because if you're able to have the rehabilitation team—and that includes physical/occupational therapists, the social worker, and the physical medicine and rehabilitation doctors— in conjunction with the surgeons, the neurologist, the psychiatrist, all working together towards a common goal, the patient is going to experience a much higher level of care. And the other important component of this is that we are moving towards a patient-centered care option, which really gives the patient the ability to communicate their wishes, their goals, and provide feedback on how the rehabilitation or the care experience has been. And that's really important because it helps maintain the level of hope that patients have, it helps maintain their level of engagement and involvement. And if they believe in the therapies that they're receiving, whether it's aqua therapy or if it's a type of medication, they're more likely to be compliant with taking the medications and also probably going to participate at a much higher level than they would have if they didn't really think that this was working for them. Part of the issue with having a number of physicians and a big clinical care team is that if there isn't communication, then patients can be on a number of different medications and maybe even in some cases repetitive medications. And I think one of the most important aspects of the integrated electronic health record is to eliminate that, to make sure that all physicians, all health practitioners are drawing from the same database and see the same medication list and so the pharmacies are aware. And really, I think the implementation of an integrated electronic health record with increased coordination among physicians will help eliminate some of those issues where patients are taking medications that they may no longer need to be on or that they're taking too many medications. And hopefully technology will partially help solve that issue. At the same time, coordinated care will definitely make a big impact.

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Dr. Anand Veeravagu talks about the efficacy of coordinated care among a patient's entire medical care staff and how it ties into patient-centered care and successful outcome.

See more video clips with Dr. Anand Veeravagu.


Produced by Christian Lindstrom and Justin Rhodes, BrainLine.

Anand Veeravagu, MDAnand Veeravagu, MD is a neurosurgeon in training at Stanford University School of Medicine. He is a former White House fellow and special assistant to Secretary of Defense Chuck Hagel. He previously served as chief neurosurgery resident at the Palo Alto Veterans Affairs Hospital.

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