Good evening. We have a full complement up here now, and we're going to start. And thank you for your interest in this topic, which Dr. Das and I came to think about last year at AES with the recognition that the care of people with epilepsy does not respect the boundaries of neurologic training, that we as neurologists don't provide or can't provide all that the patients with epilepsy require. And increasingly, we see the expansion of clinical programs to involve other disciplines, but then also increasingly is some uncertainty as to where the boundaries of those disciplines. And so the thought was to have a program that level sets across the disciplines as to what to expect from each individual, what the training provides, and how there's contribution to the total care of the patient through that. So I'm John Stern. I'm from UCLA, and Dr. Das is at the end of the table there. He's the co-chair for this session. We have a panel across not the full breadth of what's available, but a large amount of it in a way that's hopefully meaningful to all of you. Here are my disclosures. And our objectives are to analyze situations and then use that analysis and think about what are the appropriate services, care interventions that are available for our patients, and then to think about how that can be addressed in having teams that provide multidisciplinary care for the patients. And ultimately, what makes a team is the integration of the individuals. So how do we create pockets of care that overlap and have understanding of one another, maybe like gears and a clock, instead of independent silos separated by terrain? So a point of background, and maybe to justify why we're here for this, is some published attention to the matter. The American Academy of Neurology has a position statement about the integration of advanced practice providers to form care teams and help create models of care toward that. And it's necessary to recognize the scope or scopes across disciplines of practice, and then to allow those individuals to practice to the full extent of their license, because to do otherwise is to limit what care can be provided for our patients. And so thinking about license and training and personal experience and abilities as being the fundamentals for understanding the individuals. Aside from a position statement, the National Association of Epilepsy Centers recognizes in its accreditation process that medical, neuropsychological, and psychological services are expected for Level 3 and 4 centers. The NAC historically has been geared toward surgical epilepsy, but over recent years has been paying attention to the broader level of care necessary for true epilepsy care allowed. And so this mentions three elements of care, but I wonder as time goes forward that the NAC will be broadening its considerations. Then there's the Institute of Medicine report for the United States, which recognizes in the report 36 different health professions that all have contributions to the care of people with epilepsy. And some of these health professions are more technologically oriented. You're thinking about EEG technologists, and so we don't have an EEG technologist as part of this panel, so we're thinking more about the outpatient care than the inpatient. But it's still a large number of disciplines that are necessary, that come into action for the care of patients. And so the quote I placed here, which obviously is skipping over some words, so I don't think the message is altered, is that important elements of epilepsy care include co-management of patients that may cross boundaries. And may is soft-pedaling it. It does cross boundaries. And coordination is important, involving a team to cross these boundaries in order to provide that. So we have a series of lectures as listed here from these individuals. One lecture is prerecorded, so we'll get to that in a few minutes. And so we're thinking about advanced practice providers in the form of nurse specialists, nurse practitioners, and physician's assistants as being a very rapidly growing aspect of epilepsy care. Diet and dietary therapies, pharmacists, especially a subspecialty-trained pharmacist for neurology and epilepsy, clinical psychologist, and here we're going to be expanding beyond epileptic seizures to include non-epileptic seizures, or functional seizures as the term has become. And then psychiatric interventions, thinking about the well-established relationship between especially affective disorders and epilepsy, but going beyond that as well. And social work, because obviously patients living with epilepsy live with epilepsy outside the clinic. And understanding the needs in the real world is something that social work can bring to this. And then Dr. Das will be bringing us home with summarizing this and opening up for some panel discussion and back and forth with all of you. So final requisite slide is the impact on clinical care. What are we hoping to do with this session? We hope to help frame in your minds a sense of optimal care delivery, and that requires a team, and teams require teamwork. It's not a matter of having an assembly of people who aren't recognizing each other. And this is based upon communication, distribution of responsibilities, and then reintegration of that. And maybe one part of this, which maybe is a problem we want to have, is for the patient to recognize so many people involved in their care, but the problem we don't want as part of that is for the patient to feel like it's fragmented because of that. And that brings us to the idea of unification. So thank you for your interest in this topic.

multidisciplinary care

epilepsy management

healthcare integration

patient-centered care

coordinated teamwork