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Q&A with Dr. David Paydarfar: Rethinking Neurology

David Paydarfar, a leading innovator with a unique background in both physics and neurology, will be the inaugural Chair of Neurology at the Dell Medical School at The University of Texas at Austin.

What is it about the Dell Medical School that attracted your attention?
The creation of a new medical school at a top-tier research university was only the beginning; the vision of the Dean and other Dell Medical School leaders of building a truly transformative and innovative system for patient care, research and teaching made it clear that the school is uniquely positioned to make ground-breaking contributions to the health of people in Travis County and beyond.

How do you want to rethink neurology as the inaugural department Chair?
I would like to focus on addressing two critical challenges facing the future of our field. First is the deepening crisis in patient access to neurological care. I would like for us to attend especially to the complex needs of people with neurodevelopmental disabilities, the aged and those needing emergency services that demand timely recognition and intervention. For these individuals, initiating and centralizing their care at a medical center poses significant limitations in efficiency and effectiveness. We need to bring care to patients in their own communities in ways that enable rational triage and treatment decisions.

Second, we are managing disease in an antiquated way. We are attempting to predict the course of diseases in an unnatural and discontinuous fashion — that is, through brief encounters usually spaced apart as clinical visits. Instead, we need to design and implement rigorous, longitudinal, real-time analyses of what diseases are doing to individual patients where those patients live and work. Solving these challenges will help us anticipate the course of illnesses, setting the stage for early intervention before irreversible disabilities ensue.

How do you hope the community will see or experience a change in neurological care? How can technology and data change the way neurology is practiced?
I believe Dell Med’s Neurology Department is in the unique position to address the challenges described above. Breakthrough technologies and bio-informatics will play key roles.

I want to create a unique bioengineering/bioinformatics platform in collaboration with the Cockrell School of Engineering and the College of Natural Sciences to design, build and deploy technologies that will transform care on a wide scale. The scope of this effort will include the development and application of novel devices and user interfaces, biosensor networks, signal processing algorithms and computational tools. Enhanced teleneurology systems will help address our crisis in patient access and serve as part of a larger effort to track the course of diseases in our community, as well as the effects of interventions. Smart monitoring systems also will help physicians understand disease dynamics and give them unprecedented opportunities to forecast and avert adverse disease trajectories, while also helping test the impact of different strategies on health outcomes.

In this arena, Dell Med has the potential to be an international pioneer and leader. The effort is ambitious, requiring new technologies, new systems of care and new payment models, and it will require the expertise, participation and collaboration of partners across UT Austin and the community at large.

How will you integrate neurology into the school’s curriculum?
I would like to create an exceptional academic environment for medical students to learn and innovate in the field of clinically oriented neurosciences. The preclinical neurology course would emphasize the interpretation of neurological symptoms and signs, etiopathogenesis of disease and principles of management. The course would be designed to minimize lecturing and maximize interactive group learning. Students will be expected to come to class fully prepared to ask questions, solve problems and apply knowledge gained beforehand through reading and online materials.

The clinical clerkship would place students in both outpatient and inpatient settings throughout the community. Dell Med students would be mentored to gain mastery of the clinical method in patient-centered teaching sessions with dedicated Neurology teaching faculty. Advanced medical students interested in neurology research and scholarship would have the opportunity to participate in our neurology research or other neurosciences programs at UT Austin.

And in addition to the usual weekly Grand Rounds, I would like the department to initiate and host special campus-wide Rounds at least quarterly. These forums, each inspired by a clinical problem, would bring together relevant UT Austin communities for in-depth discussions at basic and applied levels, helping catalyze new ideas, interdisciplinary teams and projects.

Where does the community of existing physicians fit into your vision for the department?
I envision a neurology care platform that serves as a powerful interface between community-based physicians and university-based neurological specialists. Advanced teleneurology network systems will be used to triage, manage and monitor patients in new ways that greatly increase collaboration among physicians and other clinicians. In this, the Neurology Department will contribute to an integrated system with greater value and convenience, lower cost and improved access to neurological care.