Dr Alla Melman1,2, A/Prof Kerrie Evans1,3, Prof Trudy Rebbeck1,2
1Faculty of Medicine and Health, University of Sydney, Camperdown, Australia, 2NSLHD, Sydney, Australia, 3Healthia Limited, Bowen Hills, Australia
Biography:
Dr Alla Melman is an APA titled Pain Physiotherapist and Post-Doctoral Research Fellow at the University of Sydney. She combines clinical practice, teaching and research roles. Her research focus is in implementing new models of care to improve health equity, outcomes and healthcare efficiency. She recently completed a PhD in the development and evaluation of a virtual hospital care model for low back pain.
Abstract:
Background/Problem:
Musculoskeletal (MSK) conditions represent Australia’s highest disease burden, with 25% higher burden in rural regions. Access to appropriate care in these regions can be limited, leading to costly and unnecessary medical services (e.g., imaging, injections).
Purpose:
This presentation describes a care pathway aimed at improving access to care for people with MSK conditions living in regional, rural and remote Australia (PACE-RURAL).
Methods: We followed a clinical translation framework to develop, adapt and scale a PAthway of CarE to be suitable for implementation in rural Australia. Key stakeholders (allied-health clinicians, patients, researchers and 15+ partner organisations) codesigned implementation strategies. We conceptualised PACE-RURAL in three steps.
Step1: Identify care needs using risk assessment at the point of care. We established that the Short Form Örebro Musculoskeletal Pain Screening Questionnaire accurately identified people at risk of poor outcome.
Step 2: Provide people at low-risk access to guideline-based e-resources. We collaboratively designed a “one-stop shop” (www.mypainhub.com) for evidence-based resources for common MSK conditions (low back, neck, knee and hip pain), customised for patients and clinicians.
Step 3: Provide collaborative care with allied-health specialists for people at risk of poor outcome using telehealth. Allied-health specialists (e.g., specialist physiotherapists) provide collaborative care with primary health clinicians (as an alternative to medical referral). Building on positive feedback from implementation in urban regions, we will adapt PACE to include telehealth.
Outcome/conclusion:
A comprehensive, robust pathway, with implementation strategies codesigned with key stakeholders, will now be tested in an Australia-wide hybrid type II effectiveness-implementation trial.