Elgin Primary Care Alliance
The Provincial Musculoskeletal (MSK) Rapid Access Clinics Program offers pathways for hip and knee arthritis as well as low back pain management. The program aims to integrate proven pathways for managing MSK conditions efficiently. Primary care specialists and advanced practice providers play key roles in patient care within this program. Learn about the status update, process changes, onboarding requirements, and launch dates in this presentation.
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Presentation Transcript
Elgin Primary Care Alliance Co-Chairs: Dr. Kellie Scott & Dr. Melissa Tenbergen Mar 20, 2019
Welcome & Introductions 1. A few quick reminders/FYIs 2. MSK Rapid Access Clinics for the South West LHIN - Shirley Koch, Flo Cassar, Ravi Rastoga, Rhonda Butler, Dr. Tatiana Jevremovic 3. COPD Follow Up 4. Post Partum Mood Disorders Dr. Heidi Haensel, Lindsay Pettit (CMHA) Kate Andrews & Wai Ling (Southwestern Public Health) Sponsored by Lundbeck 5. System Transformation News/Sub-Region Integration Table Update
For Your Information/Reminders St. Thomas Elgin Medical Association (STEMA) Dinner April 13 for Physicians. RSVP to stemamd@gmail.com Recruitment Survey for Physicians from Dr. Kellie Scott is in your inbox or trash, please take 5 minutes to complete if you haven t already (Thanks to 22 of you who already did!) South West LHIN Digital Coalition has recently released new CT, MRI forms (and soon the hip/knee referral form). We are working on a letter that you can send back if you are having forms rejected or requests to use a new form which has not gone through this process yet. Download new forms here in PDF, Telus PS Suite EMR and Accuro EMR formats.
South West MSK Rapid Access Clinics Primary Care Alliance March 2019
Objectives of todays presentation 1. Status update: Process changes Onboarding requirements Launch dates 2. Answer your questions Register for Webinar if interested in more information https://www.surveymonkey.com/r/VTRNY2X 3. Discuss our asks See the Appendices if you would like a refresher on the MSK Program.
The Provincial Musculoskeletal (MSK) Rapid Access Clinics Program
The first two pathways to be implemented are: 1. Hip and knee arthritis pathway: For patients: 1) presenting with moderate to severe arthritis, 2) needing a second opinion on prior arthroplasty Excludes: urgent cases, ligamentous injuries and meniscal pathology Low back pain pathway: For patients presenting with: 1) persistent Low Back Pain and/or related symptoms (e.g., sciatica, claudication) 6 weeks to 12 months post onset; 2) unmanaged, recurrent episodic low back pain symptoms (LBPS). Excludes: established pain disorder and/ or narcotic dependency, WSIB, MVA, pregnancy of <12 months post partum, <18 years of age 40% of patients do not require a consultation with a surgeon PRIMARY CARE SPECIALIST 2. ADVANCED PRACTICE PROVIDERS Only 7% of people referred to the low back pain management pathway need surgery Over time, proven pathways for managing other MSK conditions will be integrated into the Rapid Access Clinics
Location of Assessors: Regional MSK Team: 2 Advanced Practice Leads 1 Low Back Pain (ISAEC) 1 Hip/Knee 8 Advanced Practice Providers (APPs): o 5 Hip/knee APPs (population based allocation) o London o Owen Sound o Stratford o Strathroy o St. Thomas o Woodstock o 3 Low Back Pain APPS (population based allocation) o London o St. Thomas o Wingham o Woodstock Hip and Knee Advanced Practice Provider Low Back Pain (ISAEC) Advanced Practice Provider Advanced Practice Leaders *APLs provide additional assessment supports across the region where needed*
Location of Assessors ** Advanced Practice Leads provide additional assessment supports across the region where needed
Process Changes: Current Practice Activity Future Practice Comments 1. Submit Referral Forms for patients with Low Back Pain or Osteoarthritis Primary Care sends to surgeon offices Central Intake 2. Notify patient of appointment with RAC N/A Central Intake Primary Care will be notified of the appointment date, FYI. 3. Completion of patient assessment Surgeon Office APP/APL An Outcome Summary and Recommendations will be sent to Primary Care and will include shared care self- management plan for the patient. 4. Referral to Surgeon Primary Care Central Intake/ APP/APL Primary Care will be notified. 5. Notify patient of consultation with Surgeon. Primary Care Hip/Knee: Primary Care Low Back Pain APL will have access to surgeon schedules and will book appointment at same time as his assessment. Low Back Pain: APL Hip & Knee program will follow current practice. APL = Advanced Practice Leader APP = Advanced Practice Provider * Refer to each program s exceptions where Primary Care continues to send referrals direct to surgeon offices
Onboard Requirements: Hip and Knee: 1. Receive notification from Partnering For Quality to download referral forms to your EMR. Low Back Pain: 1. Complete the registration: [Link to be provided post March 8] for ISAEC online learning. This is a prerequisite to receiving the Low Back Pain referral form. 2. Upon completion of the registration, you will have access to an online video and quiz. Duration is approx. 20 minutes. 3. Upon successful completion of the quiz, you will receive notification to download the Low Back Pain Referral form via the ISAEC Operations staff.
Important Information Primary Care Offices will be notified of all: o invitations to waitlisted patients to receive an assessment prior to a call being made to your patient; o patient appointment dates; o Patient assessment outcomes, including referrals to surgeons. Wait-listed, low back pain and osteoarthritis patients within inclusion criteria will be offered assessments prior to new referrals. The four week turnaround from time of referral to assessment will not be met until waitlisted patients are assessed. Please let your new referrals know. Rapid Access Clinics in London, St. Thomas, Woodstock and Listowel (Low Back Pain) will be ready by launch date. The Hip and Knee Rapid Access Clinics in: o Owen Sound, will be live by April 30, 2019. o Stratford and Strathroy will be live by June 30, 2019 Initially, as Low Back Pain patients on waitlists are seen, it is anticipated that the assessments will be conducted in London to streamline the patient s visit with a Spine surgeon.
Key Dates: February 28, 2019: Referral forms will be available through a) ISAEC Operations, once the ISAEC (Low Back Pain) module is completed and b) the Hip and Knee referral form will be available online at http://www.swpca.ca/ under the EMR resources tab. March 29, 2019: App. 50 wait listed patients experiencing low back pain or osteoarthritis will have been assessed. Monday, April 15, 2019: 1. All Primary Care Providers use new referral forms and submit to Central Intake. 2. Surgeon Offices may return referrals to Primary Care that should be redirected to Central Intake. June 30, 2019: Target date for completion of 20 minute, ISAEC learning module by Primary Care Providers.
Whats Next For You, Our Primary Care Partners? Go to http://www.isaec.org/isaec-registration.html to submit your ISAEC registration and complete the 20 minute, online training module so you can be eligible to refer your low back pain patients through this model using the new form. Referrals will only be accepted from providers who have completed this module and registered. 1. 2. On April 15, download the Hip and Knee referral form from http://www.swpca.ca/EMRResource/ and start using the form for those being referred for assessment of hip or knee replacement anywhere in the South West LHIN or in other LHINs. 3. Advise your patients that waitlisted patients are being assessed prior to new referrals. The South West Rapid Access Clinics will advise when all waitlisted patients have been seen and the standard, four-week turnaround for assessments will be met 4. Register for the Webinar if you, your colleagues, or staff need to review this information about Rapid Access Clinics and the new process presented today: https://www.surveymonkey.com/r/VTRNY2X 5. Provide feedback on your experiences with the onboarding process and the program to: Your Primary Care Alliance Co-Chairs: MSK Primary Care Champion: Advanced Practice Leaders: Central Intake: kellie.scott@lhins.on.ca mtenbergen@elmdalefho.ca Tatiana.Jevremovic@lhsc.on.ca Rhonda.Butler@lhsc.oa (Hip/Knee) Ravi.Rastogi@lhsc.on.ca (Spine) MSKCentralIntake@lhsc.on.ca
COPD Management in Elgin Best Care COPD Program PREVENT (IDEAS Project)
Post-Partum Mood Disorders Dr. Heidi Haensel (LHSC Child & Adolescent Psychiatry) Kate Andrews & Wai (SW Public Health) Lindsay Pettit (CMHA Elgin)
SRIT Update 1. Status of work on the 2 identified priorities, moving ahead 1. Discussions about System Transformation plans from MOHLTC
Visit the South West Primary Care Alliance Website for resources for you and for patients www.swpca.ca Elgin Primary Care Alliance also has a Facebook Page https://www.facebook.com/groups/3099935 22704420/
Next Meeting Wednesday, April 17, 2019 Diabetes Dr. Stewart Harris Quality Improvement in Your Office Dr. Vineet Nair **AT SW LHIN OFFICE, NOT HERE!**
