MD – Baylor College of Medicine, Houston, TX
Residency – Adult Neurology, UCLA David Geffen School of Medicine, Los Angeles, CA

Biography: Dr. Andrew Wilson, neurologist, is interested in analyzing the performance of Accountable Care Organizations to restructure healthcare delivery systems both locally and nationally. In addition, he is interested in incorporating telehealth into his practice to improve cost, quality, and access of neurologic care.   

Dr. Wilson’s main project was a community based participation research collaboration entitled “Implementing and Evaluating a Teleneurology Network in the VA.”  His mentor team included Drs. Michael Ong, Moira Inkelas, Debra Saliba, and Eric Cheng.  Dr. Wilson collaborated with community partners including Dr. Sewnet Mamo, telemedicine coordinator for GLA, Maria Luisa Suarez, telepresenter at Bakersfield, and Manpreet Jhandi, pharmacist at Bakersfield.  As an early adopter of telemedicine to serve the veterans located throughout the United States (U.S.), the Veterans Health Administration (VA) has redoubled efforts to use telemedicine to improve access to care.  Telemedicine is a means of providing clinical services remotely and has been increasingly utilized to improve access to healthcare.  The Greater Los Angeles (GLA) VA Neurology service line explored telemedicine clinics to improve access to neurologic care.  With a community-partnered participatory research (CPPR) framework, this study aimed to: 1) Implement a teleneurology clinic that is appropriate for the GLA VA community; 2) Evaluate the quality of care provided in the teleneurology clinic compared to an in-face clinic; and 3) Provide a cost-benefit analysis of the teleneurology clinic. Based on a needs assessment performed in the GLA area, the team and leadership implemented the telemedicine neurology clinic at the Bakersfield community-based outpatient centers (CBOC).  The tele-polyneuropathy clinic opened in January 2017, continued stakeholder meetings were conducted, and data was collected related to the various satisfaction, quality, utilization, compliance, and cost metrics.  Dr. Wilson presented this work at the RWJF Clinical Scholars Program Annual National Meeting in November 2017. A report of the results of this work was submitted to a peer-reviewed journal for publication. 

Dr. Wilson worked on several additional projects during fellowship.  He worked with mentors Drs. Jose Escarce and Ioana Popescu on a policy paper entitled “Factors that affect attribution stability in MSSP ACOs.” Using secondary data analysis of existing Medicare data, this study sought to investigate the idea that patient loyalty/continuity as measured by attribution stability is associated with improved MSSP ACO performance.  This study also looked to address what patient and ACO factors lead to attribution stability (or conversely, which factors lead to attribution instability) in the MSSP ACO cohort.  Elucidating these relationships should encourage MSSP ACOs subject to the retrospective attribution methodology to develop targeted strategies to improve their attribution stability.  In addition, analysis of this work may encourage CMS and MSSP ACOs to consider alternatives to the current retrospective attribution methodology as a means of better incentivizing and capturing the work ACOs do.  Data analysis is complete and a manuscript was submitted to a peer-reviewed publication.  Dr. Wilson also worked with Drs. Eric Cheng and Susan Ettner on the following projects: 1) “Trends in Out of Pocket Costs in Healthcare” for which the first draft of a manuscript for submission to a peer-reviewed journal is completed; and 2) “Trends in Out of Pocket Costs in Multiple Sclerosis” for which report writing is in progress.   

During his fellowship, Dr. Wilson also served in various roles for the American Academy of Neurology (AAN) including: 1) the AAN Axon Registry Subcommittee (for neurology disease registry), 2) as the chair of the AAN Axon Registry Annual Report workgroup; and 3) participated in AAN advocacy activities. Dr. Wilson also served weekly at the Veteran’s Affairs General Neurology Clinic during the NCSP fellowship and at the VA Tele-Polyneuropathy Clinic weekly and he earned a Master of Science in Health Policy Management in summer 2017.  

Dr. Wilson is Assistant Professor-in-Residence in the Department of Neurology at UCLA and the VA Greater Los Angeles Healthcare System, where his research continues to focus on evaluating innovative care models for ambulatory neurology and improving population health for those with neurologic disorders.  Current projects include developing real-time disease management dashboards for Parkinson’s Disease and implementing and evaluating teleneurology clinics.  Dr. Wilson is also an attending neurologist at the Ronald Reagan UCLA Hospital, the West Los Angeles VA Hospital, and the Greater Los Angeles VA neurology clinics (in-person and via telemedicine).