Stanford’s Vasculitis Clinic Expanding Access to Care in Northern and Central California

Early in her medical training, Audra Horomanski, MD, saw several healthy young adults’ lives turned upside down by life-threatening vasculitis—and then saw the dramatic difference that could be made with appropriate treatment. Later in rheumatology training, she met many patients who had long delays in diagnosis because their symptoms came on slowly or they lived in an area without access to a rheumatologist. She realized these patients needed better access to care and competent providers to partner with along their journey.

Dr. Horomanski is hoping to change that in her new roles at California’s prestigious Stanford University. In July, she joined Stanford’s Division of Immunology and Rheumatology, Department of Medicine, as a Clinical Assistant Professor, following the completion of a fellowship there at the end of June. She is also the Director of the Stanford Vasculitis Clinic, where she manages rheumatological care of clinic patients and coordinates their multidisciplinary care.

The San Francisco Bay area is already home to many high-quality medical centers, said Dr. Horomanski. However, there are large areas of Northern and Central California with very limited access to rheumatologists. The clinic plans to expand access to vasculitis patients in those areas to reach a broader community by opening more days as demand grows.

“Our mission is to provide high-quality, comprehensive, rheumatologic care to patients with systemic vasculitis,” Dr. Horomanski said. “Part of the goal of our vasculitis clinic is to gather a set of specific physicians in associated specialties who we will partner with in the care of vasculitis patients.”

“An issue we have encountered with some specialty clinics is that when they fill up, it’s harder for new patients to be seen, and established patients go longer between visits,” she said. “This can significantly impact patient care and I’m hoping to avoid that by having the flexibility to expand the clinic as needed to accommodate demand.”

Dr. Horomanski and her team have already opened up more clinic days for vasculitis patients. This has given medical residents and fellows from rheumatology and overlapping disciplines the opportunity to join them and learn how to care for these patients.

“The accelerated adoption of telemedicine during the pandemic has allowed us to reach some of these more medically isolated communities,” she said. “For patients with financial constraints and caregiver responsibilities, the idea of taking a full day off work for a doctor’s appointment has been a real barrier.”

Patients referred to the clinic by their treating provider can expect to see rheumatologists who are experienced with all types of systemic vasculitis and have access to a network of multidisciplinary subspecialists and innovative imaging modalities for the monitoring of their disease.

While Stanford has an established history of basic science research in the field of vasculitis, Dr. Horomanski’s goal is to open up Stanford as a site for vasculitis clinical trials. “This will allow our patients access to the most cutting-edge research and broaden their options for treatment. Our department has several decades of experience with clinical trials in scleroderma, rheumatoid and psoriatic arthritis,” she said. “It’s time to add vasculitis to the list.”

Author: Nina Silberstein