The Role of Advanced Practice Providers in Multidisciplinary Teams

Many epilepsy centers have enriched the care they deliver to patients and their families by creating a multidisciplinary team of providers, establishing a team-centered approach to healthcare.

One area of growth has been the addition and expansion of Advanced Practice Providers (APPs) within the multidisciplinary team. The term APP is an umbrella term that includes Advanced Practice Registered Nurses (APRN) and Certified Physician Assistants (PA-C). The APRN profession can be further broken down into different certifications, with those applicable to the epilepsy practice including the Certified Nurse Specialist (CNP) and Certified Nurse Practitioner (CNP). Each provider type (CNS, CNP, and PA-C) has nuances to the certification and scope of practice they can provide. It is important to highlight that with each degree practicing and prescribing laws vary from state to state. APPs can bill for both inpatient and outpatient services, and Medicare pays 85% of the physician fee schedule.  

When an APP works at the top of their scope there are many opportunities to elevate patient access and quality care. In the outpatient setting, APPs can have autonomous clinic, paired, or shared medical appointments, specialty clinics (such as pregnancy or neuromodulation), and assist with ambulatory needs such as telephone calls, electronic messages, medication refills, and letters. In the inpatient setting, APPs can provide care in the epilepsy monitoring unit through H&Ps, discharge paperwork, patient education, procedures, acute seizure management, and consult patient care. 

When considering expanding the patient care team with an APP, it is important to review your specific needs to guide the best fit for your practice; this can include the age of patients you treat, APP degree and specialty, previous experience and interest, coverage needs, amount of collaboration available, state laws, salary, and continuing education requirements.

Overall, collaboration with APPs within a multidisciplinary team is a means to increase patient access, optimize workload, and elevate the epilepsy care provided.