Innovative Approaches in Academic Neurology Workflows

Leaders in academic neurology gathered at an Institute for Value-Based Medicine^® event held October 14, 2025, in Aurora, Colorado, to share the latest breakthroughs in multiple sclerosis (MS) and Alzheimer disease (AD) care, with an emphasis on new therapies, multidisciplinary teamwork, and strategies to overcome persistent patient access and treatment challenges.

The discussion at the event, held by The American Journal of Managed Care^® in partnership with the University of Colorado (CU) Anschutz Medical Campus, included real-world workflow insights, payer perspectives, and ideas to shape the future of neurological care.

Global Impact of Neurological Diseases

The World Health Organization (WHO) Global status report on neurology acknowledges a growing burden of neurological disease,¹ underscoring an increasing prevalence and societal impact, according to Kavita V. Nair, PhD, FAAN, professor of neurology and clinical pharmacy, CU Anschutz Medical Campus, who chaired the discussion. She noted WHO’s recent inclusion of MS medications on its essential list as a major step forward in improving global access to care. Reflecting the pace of innovation, Nair pointed out that 261 neurology drugs were in development as of 2021, including a substantial number targeting AD. She also emphasized that early diagnosis, along with the continued advancement of novel therapies, remains critical to improving outcomes and transforming the future of neurological care.

“Most excitingly, we are seeing diagnostics—and the ability to diagnose—happen sooner and become more sophisticated, in some ways more exciting, in Alzheimer disease,” said Nair. “Just yesterday, we had the second blood-based biomarker approved,² which means that for a disease this prevalent in Colorado—we have about 90,000, potentially, and that may be an underestimate—patients or individuals who could be eligible for a dementia diagnosis can be reached through outreach, and you could probably get diagnosed, maybe even at your primary care [clinic]. Early diagnosis, sooner diagnosis, novel therapies—it’s kind of an exciting time.”

Innovations in Clinical Operations, Patient Referral Systems

Samantha K. Holden, MD, MS, FAAN, associate professor and vice chair of clinical practice, CU Anschutz Medical Campus, outlined how the department has transformed its clinical operations and referral management systems to meet rising patient demand, challenges that have only intensified since the COVID-19 pandemic. With patient volumes doubling since 2020 and limited neurologist capacity, CU Neurology implemented a series of strategic reforms, including adding general neurology clinics, piloting direct referral web portals for specific conditions such as amyotrophic lateral sclerosis, and revising triage and intake processes to reduce delays and misrouted cases.

Holden emphasized the inefficiencies of traditional referral systems and advocated clear, specialty-specific referral pathways supported by standardized intake forms.

“There has been no standardized referral intake form required for neurology to get patients to the right places, and UCH [University of Colorado Hospital] says it’s too burdensome to ask people to fill out a form just to route patients correctly,” explained Holden. “There have been some murmurings about using AI [artificial intelligence] to review a chart, pull out the relevant information, and get the patient to the right place.”

Holden then described the department’s use of data-driven tools—such as clinical full-time equivalent models, productivity tracking, and flexible work menus—to measure workload and value nonbillable clinical duties more accurately. To expand access, CU Neurology introduced patient “graduation” procedures, e-consults, and improved coordination between generalists and subspecialists, all aimed at optimizing resources and ensuring timely, high-quality neurological care.

Advanced Practice Providers in Comprehensive MS Care

Grace Worland, NP, MSN, AGNP-C, nurse practitioner, Rocky Mountain MS Center, shared the advanced practice provider (APP) perspective on delivering comprehensive, patient-centered care for individuals with MS. She highlighted the essential role APPs play in symptom management, patient education, and care coordination, often serving as the primary point of contact for follow-ups, medication management, and portal communications. Emphasizing a multidisciplinary approach, Worland described how the center supports patients’ mental health, disability needs, and access to therapy and social services. Despite these strengths, she noted persistent challenges, including limited staffing, rising patient volumes, and barriers to access and insurance.

Through telehealth and community education programs, APPs are working to close care gaps; however, ongoing support and resources are still needed. Worland underscored the critical role of APPs in the MS care team and called for broader policy and operational reforms to sustain comprehensive, equitable care.

“In terms of looking at medicine and the way that we practice medicine, [we’re] trying to remember exactly where we’re coming from and the patients we’re treating, and that all those individual characteristics that go into the care of each patient, and ultimately holding that as what drives us to resolve some of these issues is key,” Holden said. “And certainly, I think the underlying thing for most of all of this conversation is for everyone in this room to educate themselves on the current policies and what they can do with their votes and with their words to support the care of these patients.”

Pioneering Advanced Therapies for AD

Tara Carlisle, MD, PhD, assistant professor, CU Anschutz Medical Campus, discussed the launch and growth of the Advanced Therapy in Neurodegenerative Disorders (ATND) Clinic, which delivers cutting-edge antiamyloid therapies for patients with AD. She described the clinic’s multidisciplinary model, which integrates infusion centers, neuroradiology, nuclear medicine, and genetics, to ensure safe and effective care. The patient evaluation process includes biomarker testing, genetic analysis, and review by a multidisciplinary “brain board” before shared decision-making.

“We have kind of this really formalized candidacy workup that we have everyone go through once they’re seen in the ATND clinic, understanding there’s some things that come in that kind of throw a wrench into the whole system, and we have to rework things [and] think about the clinical setting and everything that we need to do to make sure that we’re providing personalized care to our patients,” said Carlisle.

Carlisle also highlighted challenges such as prior authorization delays, insurance barriers, data-sharing gaps, and the heavy educational and emotional demands on patients and caregivers. Looking ahead, she emphasized the need for improved cognitive screening, clearer referral pathways, additional support staff, and continued infrastructure expansion to meet rising demand for advanced neurodegenerative treatments.

High-Efficacy Therapies, Ongoing Challenges in MS

Andrew Wolf, MD, assistant professor of neurology, CU Anschutz Medical Campus, highlighted the evolving landscape of MS treatment, emphasizing the importance of early intervention with high-efficacy disease-modifying therapies (DMTs) to improve long-term outcomes.

“We want to treat patients really effectively as early as possible, because of the fear of these lesions that we have. When people get on drugs, especially modern therapies, which are incredibly effective at stopping lesions, we do not have as many lesions, and then patients do better over time,” said Wolf. “That is our goal.”

He explained that MS causes both relapses and underlying progression independent of relapses, and shared data showing that starting potent DMTs early leads to better patient outcomes than beginning with lower-efficacy therapies.

Wolf discussed the growing array of DMT options, including CD20-targeted therapies, and how efficacy, adverse effects, patient preference, and logistical factors guide selection. He also outlined key challenges, including high drug costs, insurance restrictions, provider shortages, and complexities in care coordination.

“I think all of these are also influenced by factors including patient features like gender, education, age, and then things like geography, access to subspecialty neurologists, [and] income levels,” said Wolf.

Innovations such as nurse navigators, AI-assisted prior authorizations, and community education—including rural outreach—are helping to address these barriers. Additionally, Wolf stressed the need for continued evidence-based practices, patient education, and system reforms to optimize MS care.

Author Information: Ms Steinzor is an employee of MJH Life Sciences^®, the parent company of the publisher of Population Health, Equity & Outcomes.

REFERENCES

1. WHO report finds neurological conditions now affect over one-third of the world’s population. World Federation of Neurology. October 17, 2025. Accessed November 6, 2025. https://wfneurology.org/activities/news-events/wfn-news/2025-10-17-wcn2025-who-report-1-in-3-neurological-conditions
2. Keenan J. Roche nabs FDA clearance for Alzheimer’s biomarker blood test. Fierce Biotech. October 14, 2025. Accessed November 6, 2025. https://www.fiercebiotech.com/medtech/roche-nabs-fda-clearance-alzheimers-biomarker-blood-test