Abstracts

Rationale: Care managers may help coordinate care for children with epilepsy. Their role is understudied. Methods: We conducted nine semi-structured interviews and one focus group with care managers at a pediatric accountable care organization in Ohio, in order to understand their potential value in care delivery for children with epilepsy. We analyzed transcripts using grounded theory. Results: We identified three core themes: relationship, communication, and service. Relationship. Care managers build rapport with families, physicians, and other providers. These connections improve trust and adherence to treatment plans. Communication. Care managers facilitate communication among families and providers. This helps physicians fully understand health issues, reinforces care plans and epilepsy education with families, and helps disseminate care plans among multiple providers. Service. Care managers provide an extended list of concrete social-work services to families (housing, transportation, scheduling, liaison with community resources, etc.). Success stories included improved use of rescue medications and reduction of ED use, as well as triumphs of education, advocacy, routine social work, and community outreach. Perceived barriers to effective care management included epilepsy-specific factors (inadequate or incorrect clinician advice, high comorbidity burden, stigma), as well as family, community, organizational, child, and transitions-of-care factors. Perceived facilitators included multiple modes of communication, EHRs, checklists, co-location of care management with physician offices, and engaged physician leadership. Conclusions: Care managers are a potentially valuable addition to a pediatric epilepsy care team. Further research is required to understand the effect of care management on costs, use of health services, seizure control, and quality of life for children with epilepsy. Funding: This work was funded by Pediatric Epilepsy Research Foundation (PERF).