Advanced musculoskeletal physiotherapy and telehealth – improving access for patients following joint arthroplasty

Ms Stephanie Carroll1, Ms  Carolyn  Page1, Ms Belinda Cary1, Mr Colin Laurie1

1St Vincent’s Hospital, Victoria, Fitzroy, Australia

 

Aim:To scope, develop and implement a Telehealth service within the established orthopaedic post arthroplasty review (PAR) clinic, that  improves clinic efficiency and increases access to care.

Method: Phase 1: Scoping  – A literature review and benchmarking of Telehealth services in Victoria and survey of 100 patients attending the Elective Surgery Access Service (ESAS) to ascertain interest in utilising Telehealth and potential barriers. Patient eligibility criteria developed based on literature, consumer engagement and orthopaedic surgeon consultation.  Phase 2: Pilot  – Broad stakeholder engagement, telehealth clinic processes developed, technology interface established (Blue Jeans), online access to radiology secured for external sites, telehealth trialled on a small cohort of patients and processes modified following patient feedback. Phase 3: Integration  – Operational guidelines developed, patients triaged and invited to use Telehealth, evaluation of service, training of other Advanced Musculoskeletal Physiotherapists (AMPs) and orthopaedic surgeons to ensure sustainability of service and webinar education delivered to 10 public healthcare organisations across Victoria to share learnings.

Results: This patient focused service demonstrated high patient satisfaction and cost savings to individual patients and the organisation.  Telehealth also demonstrated improvements in clinic efficiency with quicker consultation times and fewer ‘Did Not Attends’ (DNAs). Telehealth was shown to be a safe and innovative service delivery model that can improve system capacity and offer patients greater choice in their care delivery.

Significance of the findings to allied health: Telehealth has wide applicability for Allied Health as an innovative model of service delivery that can increase access for patients and result in cost savings for patients and health services.