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Resources for evaluating vertigo


The “Stop the Spinning: Evaluating Vertigo” Clinical Collaboration Series event last month gave LHP adult primary care, urgent care and emergency medicine providers an opportunity to hear from network ENT and neurology specialists on how to evaluate vertigo symptoms, including tests to perform and recommendations for imaging, to make an accurate diagnosis and the best referral.

Todd Berinstein, M.D., from ENTOffice.org, presented “The 5 Minute Dizziness Evaluation,” an overview of the differential diagnosis of vestibular causes of dizziness. Richard Rosenbaum, M.D., from Legacy Medical Group–Neurology, focused on the “Neurological Evaluation of Dizziness and Vertigo” and presented an evidence-based approach to the relevant physical exam findings for the evaluation of the dizzy patient. The presentation slides are available on the LHP team site.

Twenty-eight providers from both Legacy Medical Group and independent practices were in attendance. They found the topic to be interesting and relevant and thought the presenters did a great job of explaining causes of vertigo and correlating them with signs and symptoms, which is information they can use directly in their practices. In addition to the clinical content, providers appreciated the opportunity to meet other network providers and reconnect with people they don’t get to see regularly.

A draft guide on vertigo evaluation for your input

The LHP Clinical Collaboration Guide on vertigo evaluation is now in the open comment period and available here. The LHP Clinical Collaboration and Performance Improvement subcommittee, which oversees the collaboration events and guidelines, chose vertigo as a topic because imaging is one of the significant cost drivers in our value-based contracts, and MRIs done for the diagnosis of vertigo are a large portion of the imaging volume. In speaking with some of our specialists, a good physical and clinical evaluation can often preclude the need for costly imaging.

The purpose of the guide is to provide a resource for the clinical evaluation of vertigo, and to establish a consistent, cost-effective approach throughout the LHP network. We welcome any feedback on the guide during the open comment period, so please review it and submit your comments directly to LHP Medical Director Nick Kashey, M.D., at nkashey@lhs.org by July 18. The guide will be finalized this summer after the open comment period is over.

Future Clinical Collaboration Series events

These evening educational meetings are an opportunity for PCPs and specialists to learn from and talk with one another about best practices for patient co-management between primary care and specialty. Topics for the series focus on clinical areas where we have an opportunity to decrease unnecessary variation, control the cost of care or improve clinical quality. Mark your calendars for Thursday, Oct. 3 when LHP will host another Clinical Collaboration Series event on chronic pain.


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