Dr. Lidia Moura

Moura, Lidia M. V. R., MD, MPH - NeuroValue Health Services Research Lab

We use established health services research methods to identify and compare alternative delivery models for achieving desired outcomes. We have a particular interest in strategies for reducing costs while improving the quality of care. The ultimate mission of our group is to design and implement coordinated care models for neurological care of high value.

Overview

Our group recognizes the economic burden associated with neurological conditions and the inefficiency associated with payment for units of service rather than quality and health outcomes. In response, the MGH Neuro Value lab was created to increase the value of healthcare in neurology – a ratio of the quality and/or outcomes to cost.

The critical points in this effort are to understand the following: Neuro-psychiatric epidemiology, access to neurological care, appropriateness of care, measures of the processes of care, risk-stratification in chronic neurological conditions, health resources utilization and payment models, impact of new technologies and educational programs, how to systematically gauge outcomes or impact.

These studies should have a positive impact on the health of patients with neurological conditions.

Group Members

Principal Investigator

Lidia M. V. R. Moura, MD, MPH
Instructor in Neurology, Harvard Medical School
Assistant in Neurology, MGH
Director, MGH NeuroValue Laboratory

Research Lab Members

We are a proud, multicultural team deeply inspired to improve outcomes by revolutionizing health care in neurology. Our research group includes scientists in the areas of neurology, healthcare policy and health services research.

The current list of Lab members is found at: http://neurovalue.mgh.harvard.edu/meet-our-team/

 

Research Projects

Adherence to Quality Measures: As we begin to move away from this fee-for-service payment method towards a system where the quality of care given is stressed, measures of quality are becoming increasingly important. We are trying to look at how we provide care to patients with chronic neurological conditions and how to better evaluate physicians’ performance.

Disparities in neurology care: Our goal is to assess the differences in the quality of care experienced by individuals who have private medical coverage to the individuals who receive public medical coverage. This project stems from the concern that although the Medicaid expansion has increased access to care, there is still a lack of research investigating whether or not the people receiving this new affordable care are improving in health.

Associations between Quality and Outcomes: Some examples of quality measures in epilepsy are: checking the number of seizures and the amount of issues because of medications. It is expected that the adherence to these quality measures leads to benefits to patients with epilepsy. This project looks at whether or not these quality measures lead to benefits that matter to patients such as fewer convulsions and a better quality of life.

Patient-reported Outcomes in the Neurology Outpatient Setting: Outcomes directly reported by patients are the most efficient, reliable, and valid assessment of health and delivered care. We aim to develop feasible ways to collect and characterize self-reported patient outcomes in the general neurology clinic population. Examples of the measures include socio-demographic information, current medication list and active mental and physical problems.

The Epilepsy Severity index: This index reflects the clinical complexity of patients with epilepsy and has provided critical information for analysis that requires risk adjustment (severity of illness).  It has been helpful in our concurrent work on quality of care and the impact on outcomes.

Quality of neurological care in the Intensive Care Unit: In the Neuro-ICU, utilization of continuous EEG has significantly expanded over the past several years. We aim to understand the application, utilization and safety of continuous EEG monitoring in the Neuro ICU.

Other projects: In several ways, we work in collaboration with other laboratories. Our rich ongoing academic partnerships nourish our aims to integrate medical education, clinical care and research.

Research Positions

Our goal is to enhance research power in health services research field by fostering the career of young investigators that will become international leaders and collaborators.

Apply to current positions at: http://neurovalue.mgh.harvard.edu/research-positions-2/

Publications

We have selected some publications from our lab that are relevant to the topic of health services and outcomes research. The list is not intended to be comprehensive and updated, as our members’ productivity is extremely dynamic.

  1. Abreu, CG; Parente, M; Rocha, LMV; Brasil, LM; Silva, APB. Tridimensional Modeling to Support the Mastology Field. In: 21º Congresso Brasileiro de Engenharia Biomédica (CBEB2008), 2008, Salvador. 21º Congresso Brasileiro de Engenharia Biomédica (CBEB2008). Rio de Janeiro, Brazil: SBEB, 2008. p. 173.
  2. Abreu, CG; Parente, MR; Pinho, RHL; Brasil, LM; Silva, APB; Souza, GD; Rocha, LMV. Medical Simulation Platform: Teaching Virtual System Applied to Mastology. In: 5o. Congresso de Iniciacao Cientifica do Distrito Federal, 2008, Brasília. 5o. Congresso de Iniciacao Cientifica do Distrito Federal. Brasília, Brazil : UnB, 2008.
  3. Martinelli, GG; Teles, G; Ferneda, E; Rocha, LMV; Brasil, LM. Medical Simulation Platform: Mastology Domain Modeling. In: 5o. Congresso de Iniciacao Cientifica do Distrito Federal, 2008, Brasilia. 5o. Congresso de Iniciacao Cientifica do Distrito Federal. Brasilia, Brazil: UnB, 2008.
  4. Moura, LMVR; Fleming, NRP. Migraine During Pregnancy: a Diagnostic and Therapeutic Challenge. In: Âmbito Hospitalar Magazine, São Paulo-SP (Brazil), 2011.
  5. Moura, LMVR; Bezerra, JMF; Fleming, NRP. Management of Hemicrania Continua - Case Series and Literature Review. Rev Bras Anestesiol. 2012 Mar-Apr;62(2):173-87.
  6. Westover, MB; Shafi, MM; Bianchi, MT; Moura, LMVR; O’Rourke, D; Rosenthal, ES; Chu, CJ; Donovan, S; Hoch, DB; Kilbride, RD; Cole, AJ; Cash, SS. The probability of seizures during EEG monitoring in critically ill adults. Clinical Neurophysiology. 2015 Mar;126(3):463-71.
  7. Moura, LMVR; Shafi, MM; Ng, M; Pati, S; Rosenthal, ES; Cash, SS; Cole, AJ; Hoch, DB; Westover, MB. Spectrogram screening of adult EEGs is sensitive and efficient. Neurology. 2014 Jul 1;83(1):56-64.
  8. Moura, LMVR; Mendez, DY; De Jesus, J; Andrade, R; Hoch, DB. Quality care in epilepsy: Women's counseling and its association with folic acid prescription or recommendation. Epilepsy & Behavior. 2015 Feb 20;44C:151-154.
  9. Moura, LM; Mendez, DY; Jesus, JD; Andrade, RA; Weissman, JS; Vickrey, BG; Hoch, DB. Association of adherence to epilepsy quality standards with seizure control. Epilepsy Res. 2015 Nov; 117:35-41.

Please visit http://neurovalue.mgh.harvard.edu/results/ for an updated list of publications.

Contact

For more information call: 617-726-3311 

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