The USC Epilepsy Care Consortium represents a “living laboratory” created to understand the systems-level barriers that greatly limit access to critically needed services across our healthcare ecosystem, and to develop creative patient-centered solutions to epilepsy care across our highly siloed healthcare ecosystem. It is the culmination of the combined efforts of a large number of individuals dedicated to the concept that all epilepsy patients across the socio-economic and age spectra deserve access to excellent care.
The Consortium was created facilitate the establishment and sustainability of comprehensive epilepsy centers, including in critically underserved areas, by allowing unprecedented resources sharing, with three key missions:
• Education: Improve education, awareness, and advocacy
• Patient Care: Maximize equity and inclusion in healthcare services in diverse communities. Integrate effective resources to provide necessary treatment within the patient’s community.
• Research: Equitable access to advanced research protocols and clinical trials across the region.
The lessons learned by this work will inform a broader effort across the United States and world-wide to design solutions to the biggest challenges in taking care of epilepsy patients.
Epilepsy is one of the most common neurological disorders worldwide. Latest estimates from 2015 indicate that epilepsy affects approximately 1.2% of all Americans, including approximately 3 million adults and 1/2 million children, and this number is increasing. The human impact on patients and family, as well as economic impact is tremendous. Approximately 2/3 of all epilepsy patients are adequately managed on medications alone. For the remaining “medication-resistant” patients, the American Academy of Neurology recommends that they be referred to an epilepsy center, and epilepsy surgery is offered to those that meet established criteria.
Millions of patients who live in California have very limited access to epilepsy care. While there have been considerable advances in the diagnostic and therapeutic dimensions of epilepsy care, the highly siloed nature of the American healthcare ecosystem represents a tremendous challenge for many patients from differing socioeconomic circumstances, resulting in glaring disparities in care and a general failure to address the public health dimensions of epilepsy. Pediatric epilepsy patients have the additional challenge of transitioning care as they reach adulthood.
To address these issues, a group of dedicated epilepsy specialists associated with the University of Southern California Keck School of Medicine have worked to create a patient-centered ecosystem made up of independent but collaborating epilepsy centers linked together in a care partnership. The initial concept for a care partnership began with the expansion of adult and pediatric services provided at the USC Comprehensive Epilepsy Center based at Keck Hospital and LA County-USC Medical Center. Within a few years, another epilepsy center was established at Rancho Los Amigos National Rehabilitation Center to serve as a resource for all patients served by the Los Angeles County Department of Health Services, the first such center in a safety-net hospital network. The partnership was then expanded to include the newly invigorated epilepsy center of Children’s Hospital of Los Angeles to more broadly cover the pediatric dimensions of the epilepsy. In 2014, key members of the USC team moved to Orange County to re-invigorate the epilepsy center at Hoag Hospital, a highly resourced community hospital in Newport Beach. In 2017, the USC team partnered with local physicians at Kern Medical in Bakersfield to establish the only epilepsy center to serve adult patients in the Central Valley; the first adult admission to an EMU in the Central Valley took place on January 2018. Additionally in 2018 Valley Children's Hospital, home to the first and only epilepsy center for pediatric patients in the Central Valley joined the Consortium. Together with the adult center at Kern Medical this completes the continuum of care for Central California patients across the age spectrum.