Clinical Centers of Excellence: Seizure Disorders

This month's Clinical Centers of Excellence series features facilities offering comprehensive seizure disorder diagnosis andtreatment augmented by active research protocols.

Although each center treats a variety of seizure disorders, all of the centers we highlight this month have been designatedas Level 4 centers by the National Association of Epilepsy Centers and as such, offer complex neurodiagnostic monitoring andgenerally provide a broad range of surgical treatment options. Lifestyle management also plays an important role whentreating these patients because epilepsy and other chronic seizure disorders can be debilitating and in some cases, confinethem to their homes. The centers profiled involve patients in research aimed toward developing improved diagnostic devicesand drug delivery systems, as well as clinical trials for new antiepileptics that hopefully have fewer side effects thancurrently available agents.

The seizure disorder centers were chosen based on a survey of neurologists and neurosurgeons. Each center was asked toprovide patient statistics, research protocols and funding information, areas of concentration, and information on otherpertinent services. These profiles provide primary care physicians with a valuable tool when considering where to referpatients whether for first seizure workup, surgery, detailed diagnostics, or ongoing management.

We do not rank the centers relative to each other, but highlight what makes each one unique. We could not profile them all,but have included a list of the other Clinical Centers of Excellence identified by our survey (see list, below).

Medical Economics editors have also gathered management and referral tips from the experts associated with thefeatured centers that may be useful when managing patients with seizure disorders in the primary care setting.

For a state-by-state listing of all National Association of Epilepsy Centers Level 4 facilities visit the association's website.

Clinical Centers of Excellence

• Barrow Neurological Institute, St. Joseph's Hospital, Phoenix, Arizona
• Cleveland Clinic Epilepsy Center, Cleveland, Ohio
• Henry Ford Comprehensive Epilepsy Center, Detroit, Michigan
• Johns Hopkins Epilepsy Center, Baltimore, Maryland
• Mayo Clinic Epilepsy Center, Rochester, Minnesota
• Massachusetts General Hospital Epilepsy Service, Boston, Massachusetts
• New York University Comprehensive Epilepsy Center, New York, New York
• UCLA Seizure Disorder Center, Los Angeles, California
• University of California, San Francisco Epilepsy Center, San Francisco, California
• University of Pittsburgh Epilepsy Center, Pittsburgh, Pennsylvania
• University of Washington Regional Epilepsy Center, Seattle, Washington

Advanstar Clinical Centers of Excellence

Institutions under consideration to be named Clinical Centers of Excellence are asked to self-report data, which is checkedagainst publicly available information. Depending on the specialty, these criteria may include:

• Quality-improvement initiatives under way
• Community outreach
• National awards and recognition
• Participation in national therapeutic initiatives (e.g., the National Cancer Consortium, Children's Oncology Group,etc.)
• Number of referrals for the particular specialty area
• Number of international referrals
• Number of patients treated/procedures performed per year
• Number of research protocols engaged in annually
• Number of medication/surgical errors
• Systems in place to prevent errors
• Outcomes data (e.g., mortality/morbidity rates, unnecessary readmission rates, etc.)
• Level of technological equipment on site
• EHR processes and level of development
• Participation in regional systems integration initiatives
• Follow-up care programs (e.g., enforcement of secondary prevention/medication compliance)
• Patient education efforts
• Patient satisfaction survey results
• Infectious disease prevention efforts
• Availability of comprehensive care programs (e.g., preventive cardiology)
• Evidence of incorporating research and clinical care
• High ranking by NCQA
• KOL publishing records
• Medical Nobel Laureates on faculty
• JCAHO certification/accreditation