Improving Patient Care Through Multidisciplinary Clinics
Author: Alan Bonder, MD
Citation: Bonder A. Improving patient care through multidisciplinary clinics. The Interdisciplinary Autoimmune Network. https://www.consultant360.com/exclusive/ian/improving-patient-care-through-multidisciplinary-clinics. Published online February 2, 2019.
The complexity of autoimmune liver conditions and other autoimmune diseases requires multiple perspectives to ensure adequate treatment and improve patients’ quality of life. Vilas R. Patwardhan, MD, and I started the Autoimmune and Cholestatic Liver Disease Program at Beth Israel Deaconess Medical Center in Boston, MA, to address the needs of our growing autoimmune liver disease patient population.
The Clinic
The clinic was started in January 2018 and treats patients with a variety of liver-related autoimmune diseases, including autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, inflammatory bowel disease-related liver disease, sarcoid-related liver disease, and liver-related complications of autoimmune pancreatitis. Our Autoimmune Liver Clinic brings together clinical care, research (led by Maria Serena Longhi, MD, PhD), and pharmacy expertise (Sam Lam, PharmD) to give our patients the most comprehensive care.
We also work closely with the Center for Advance Endoscopy, Transplant Institute, Inflammatory Bowel Disease Program, the Liver Tumor Program, and are working to expand our clinic to include clinicians from rheumatology, allergy, immunology, and other fields that treat patients with autoimmune diseases.
As a part of our Autoimmune Liver Program, we give patients the opportunity enroll into an Autoimmune and Cholestatic Liver Disease registry and biorepository. This registry combines clinical and biochemical data, which we hope will allow us to better optimize treatment, identify new potential therapeutic targets, and enhance overall patient quality of life.
In addition, we have several investigator-initiated and industry-sponsored clinical trials underway, which are open for patient recruitment.
Value in Multidisciplinary Care
As hepatologists, Dr Patwardhan and I have expertise in one aspect of a patient’s condition. By incorporating the knowledge of providers from other fields, we are able to better appreciate the patient’s entire condition and develop a more comprehensive treatment plan.
Our goal is to improve communication between providers and, thus, improve patient care at our clinic. We do this by discussing cases at a regular multidisciplinary conference and communicating with referring physicians and our patients’ local care providers. At the end of the visit, patients are given a detailed summary of their clinical encounter and future plan of care, which they themselves can also share with their doctors. Along with improving communication, having multiple providers working with the same patient at our clinic ensures continuity of care and that all aspects of their disease are taken into account.
In addition, the multidisciplinary clinic increases the possibilities of creating registries and opportunities for leading investigations into potential therapies. This improves research across the fields by allowing us to access and review registries, databases, studies, and trials by our colleagues in hepatology and other discipline, as well as determine areas for further exploration. This is especially important for patients with inadequately controlled diseases or difficult-to-treat conditions with few therapeutic options.
Conclusion
Autoimmune diseases require a multispecialty approach to improve patients’ symptoms and quality of life. Our clinic seeks to create a complex and thorough treatment strategy for all of our patients and improve communication between specialties. In doing so, we ensure that our patients receive the best care available and are able to enroll in current and future studies that would continue to advance our understanding and treatment of autoimmune diseases.
For more information about our clinic, please visit: https://www.bidmc.org/centers-and-departments/digestive-disease-center/services-and-programs/liver-center/programs-and-services/autoimmune-and-cholestatic-liver-disease.
For updates on clinical trials, you can follow Dr Patwardhan and I on twitter:
https://twitter.com/bonderalan
Dr Bonder is an assistant professor of medicine, medical co-director of Liver Transplantation, and associate program director of the Liver Transplant fellowship with the division of GI and hepatology at Beth Israel Deaconess Medical Center in Boston, MA.
