PENN STATE HERSHEY NEUROLOGY. Outpatient Services

Transcription

1 PENN STATE HERSHEY NEUROLOGY Outpatient Services

2 TYPES OF SERVICES PROVIDED All services are multidisciplinary, partnering with other relevant specialties, as needed. Comprehensive stroke and vascular neurology (for individuals who have experienced a stroke, cerebrovascular disease, vascular dementia, or stroke-like spells). Penn State Hershey Stroke Center is designated a Comprehensive Stroke Center, the highest level possible, by The Joint Commission. Penn State Hershey provides stroke telemedicine services to central Pennsylvania hospitals, and operates a comprehensive brain attack system for acute stroke management (for those who present within minutes to hours of stroke onset). Inpatient and outpatient multidisciplinary specialty care for prevention, management, and rehabilitation of stroke. Comprehensive seizure and epilepsy care (for individuals who have or are currently experiencing seizures). Penn State Hershey is designated a Comprehensive Level 4 Epilepsy Center by the National Association of Epilepsy Centers (naec-epilepsy.org). We provide outpatient and inpatient multidisciplinary care, EEG (routine, ambulatory, and continuous), diagnostic and surgical video- EEG monitoring (including use of intracranial electrodes), cortical brain mapping, neuropsychological evaluation, medical and surgical management of epilepsy, and vagus nerve stimulation. Penn State Hershey Neuroscience Institute provides neurology, neurophysiology, neuropsychology, and neurosurgery outpatient services. This brochure focuses primarily on neurology and neurophysiology. It provides key information to help you know what to expect when visiting. Our goal is to provide the right care at the right time for our patients. Located on the Penn State Hershey Medical Center s East Health campus, 30 Hope Drive (Building B) in Hershey, Pennsylvania, we are open Monday through Friday from 8:00 a.m. to 4:30 p.m. Movement disorder care (for individuals with Parkinson s disease, Huntington s disease, tremors, torticollis, restless leg syndrome, and involuntary movements). Medical management, botulinum toxin injections, and deep brain stimulation services are offered to these patients. Multiple sclerosis and neuroimmunology care (for individuals with multiple sclerosis or autoimmune illness). Penn State Hershey provides infusion therapy, medical management, and outpatient and inpatient care. Nerve and muscle disease care (for individuals with Myasthenia gravis, Guillaine-barre syndrome, neuropathy, myopathy, muscular dystrophy, and other nerve or muscle diseases). We provide EMG, NCV, botulinum toxin injection, muscle or nerve biopsy, and medical management. 1 2

3 ALS care (for individuals with ALS amyotrophic amyotrophic lateral sclerosis, or Lou Gehrig s disease). Penn State Hershey is designated an ALS Association Center, and provides comprehensive multi-disciplinary care. General neurology care (for individuals with migraines, headaches, dizziness, memory dysfunction, weakness, or any neurological question). Penn State Hershey provides a general neurology access team for prompt evaluation of any neurological concern. Neuropsychology (for individuals with memory or cognitive dysfunction). We provide in-depth neuropsychological testing and cognitive counseling. Neurophysiology (for individuals needing neurological testing). Penn State Hershey provides EEG (brain wave test), EMG and NCV (nerve and muscle test), evoked potential testing (spinal cord and brain electrical test), autonomic function testing (for small fiber neuropathy or dizziness), spinal tap, and botulinum toxin injection (for torticollis, dystonia, spasticity, migraine, and sialorrhea). WHAT TO EXPECT DURING YOUR VISIT Step 1: Check-in Penn State Hershey Neuroscience Institute staff verifies your personal information (name, address, health insurance and primary care doctor). If your insurance requires, copay may be collected. This step may take five to ten minutes. Step 2: Nurse Encounter Nursing staff guides you to a room where your vital signs are assessed. Here you are asked to verify your medical conditions, medications, and allergies. Bring an updated list to every visit. This step may take ten to fifteen minutes. Step 3: Provider Encounter A neurology provider meets with you to address the reason for your visit. During this encounter, the provider gains a better understanding of your symptoms, performs a physical neurological or neuropsychological examination, and presents a summary of findings and recommended plan. This step may take fifteen minutes to one hour. Step 4: Check-out Clerical staff provides you with a printed visit summary. If diagnostic tests, consultations, or if follow-up appointment have been ordered by the provider, staff will assist in coordinating these steps. This step may take five to twenty minutes. Arrival time Please arrive thirty (30) minutes before your scheduled visit to provide enough time for any unexpected delays, bathroom needs, and the check-in process. This location has adequate parking including handicapped-accessible parking. There are several restrooms for patients all compatible with the needs of patients with wheelchairs. 4 5

4 FREQUENTLY ASKED QUESTIONS Do I need a physician referral to be seen in the neurology clinic? Yes. Penn State Hershey Neurology does not accept self-referral appointments at this point. Scheduling personnel from this clinic request the referring doctor mail or fax medical documents in advance. It is recommended that you contact your referring doctor s office to request these documents be forwarded to Penn State Hershey. What do I need to bring to my appointment? Please bring a complete list of all medications, dosages, and times taken (if possible, bring your medicine in the original box/bottle). Bring along any equipment that you use (e.g., walker, cane, wheelchair). If you are visiting us for the first time, bring copies of your previous medical records, including office visit notes, lab work, hospital stay summaries, and radiology reports. If you have had previous CT scans, MRIs, or other diagnostic tests, please obtain an electronic copy of these, so we can evaluate the images ourselves to better serve you. Please bring any videos along that highlight your condition. What is the purpose of a neurological examination? A neurological exam is an assessment of the brain, spinal cord, nerve, or muscle function. The evaluation may include assessment of orientation, language, cognition, strength, sensation, coordination, or walking. This assessment helps providers develop diagnoses and recommendations. What if I need to get in contact with my neurologist? Calls are answered by Penn State Hershey nurses. The nurses contact your neurologist, and return your call with answers/recommendations. Please allow twenty-four hours for return phone calls. Messages are checked every hour during regular business hours. If you are experiencing an emergency, please call 911 or contact your primary care provider. What questions should I be prepared to answer during the visit? Please come prepared to share details about your symptom onset for example: when and how did the symptoms begin, what part of the body was involved, any changes in symptoms over time, what helps or aggravates the symptoms, details of your own and your family history, medications that you have taken in the past and medications you currently take (including what times you take them). It is also common to be asked general cognitive questions (i.e., the date; the current president of United States; previous presidents; some recent events that may have taken place in your area; etc.). It is also not uncommon for a provider to ask the patient simple math questions or to ask details of the family that are not frequently used (e.g., middle name of family members). 6 7

5 What if I need disability/fmla or other forms to be completed? Please call the nurse line first to request completion of the form. If we are able to assist, we should have your forms completed within five working days of receipt. They can be mailed, faxed, or picked-up according to your preference. How do I request a refill of my medication? Requests can be sent through the patient portal, through your pharmacy, or by calling the nurse line. When you call for medication refills, a nurse sends an electronic request to your provider to sign. Please allow forty-eight to seventy-two hours. PLEASE INDICATE IF YOU NEED YOUR REFILL SOONER. We try to accommodate urgent requests, but cannot guarantee. How do you define provider? Penn State Hershey Neurology has a variety of providers including physicians, psychologists, and advanced practice clinicians (nurse-practitioners or physician assistants). Physicians undergo four years of undergraduate education, four years of medical school, four years of neurology residency, and variably one to two years of subspecialty fellowship training. Psychologists complete four years of undergraduate education, four years of postgraduate school, and one to two years of additional clinical training. Nurse-practitioners and physician assistants undergo four years of undergraduate education and two years of clinical training. Who else may be involved in my medical care? There are many support staff involved in the care of patients. In addition to the staff mentioned above, you may also be assisted by: Phone nurses: play a very important role in assisting you and your provider when you call with any question, concern, or medication refill needs. They process your call, send this electronically to your provider, and communicate recommendations back to you. This is automatically documented in your medical record. 8 9

6 Scheduling staff: receives referral information from your referring providers, assists with collection of prior medical records, and facilitates scheduling the most appropriate neurology visit for the patient. Clinic managers and supervisors: help supervise and manage all functions of the neurology clinic. They strive to create the best visit experience possible for you. You may contact them with any suggestions, questions, or complaints through the patient portal, by mail, at check-out, or by phone. Their contact information is available at the check-out desk. Do I need to bring anyone with me to the visit? If you or others believe that you have memory difficulties, then you must bring a loved one or a caregiver with you. If you are unable to bring such a person with you, please come prepared to provide a phone number for such an individual. You must have a driver with you if you are going to have a procedure performed (particularly if any sedation or calming medicine is taken before the procedure). Can I bring young children to the visit? Bringing children to your visit is not recommended. Young children do not understand the nature of a detailed neurological visit and may not have the patience to sit quietly during the exam. Moreover, some of the questions asked during a neurological visit may not be appropriate for young children. Young children are not permitted to stay with you during a procedure. May I leave young children in the waiting area? No, Penn State Hershey does not provide child care services or oversight of children left in waiting areas. Is research performed at this institution? Yes. Penn State Hershey Neuroscience Institute has a large variety of ongoing basic science, clinical, and translational research. If you are interested in participating or learning more, please notify your provider or visit our website at PennStateHershey.org/neurology. Will students be involved in my care? Penn State Hershey Medical Center is a teaching facility; therefore, there are learners at all levels completing rotations in neurology and neurophysiology at Penn State Hershey Neuroscience Institute. These learners may include fellows, residents, medical students, psychology students, nursing students, and high school students (enrolled in health care interest courses). All of our learners have completed privacy training

7 What follow-up is needed after the initial visit? At the end of your initial visit, your provider recommends the next step in your care. This could be with the same or alternate provider, with a community neurologist, or with your primary care physician. If you are uncertain about next steps, please ask your provider for further explanation. Where do I go for blood work? The nearest Penn State Hershey lab is located at 35 Hope Drive, a short distance from our outpatient location at 30 Hope Drive. Please call for hours of operation. They can be reached at What happens with my lab or test results? This varies depending on which test was done, where it was done, and why it was done. Please have a clear understanding with your provider during your visit as to what to expect. What happens if I need my provider but he or she is not available? You may contact Penn State Hershey Neuroscience Institute providers and staff by way of the patient portal or phone call to the nurse line. Penn State Hershey advises the rest of the team on outstanding questions and concerns for follow-up. Will my referring doctor receive information on my appointment and care? Yes. Referring providers receive typed consultation reports or letters from Penn State Hershey Neurology provider. Can I request copies of my medical documents? Yes. Please complete and sign an Authorization for Release of Medical Records form. You may request this from office staff or download from If I have questions prior to my visit, who should I call? Please call for assistance with your visit date, directions, or parking information. What if I need to cancel my appointment? Please contact us twenty-four hours prior to your scheduled visit and our staff will help you reschedule with your provider at the earliest available appointment. Please call (option 1 - neurology, then option 2 - scheduling), or toll-free (option 1, then option 3 - neurology). What if I miss my appointment? Please call scheduling at as soon as possible to reschedule your visit. Due to the high demand for neurology services, we must limit how many times we allow rescheduling for missed appointments to two. What if I need to be admitted to the hospital? If at any point during your outpatient appointment your provider thinks it necessary to admit you to the Medical Center as an inpatient, your provider and Penn State Hershey staff will coordinate arrangements with the admissions office

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9 CONTACT INFORMATION PHONE: (INCLUDES NURSE COMMUNICATIONS AND PRESCRIPTION REFILLS) FAX: TO SCHEDULE ADULT VISITS: TO SCHEDULE EMG, EEG, EVOKED POTENTIAL STUDY THROUGH THE NEUROPHYSIOLOGY LAB: PennStateHershey.org/neuroscience U.Ed. MED CNI