Ontario Expands Access to Rapid Assessment Clinics to Help People with Hip, Knee and Low Back Pain

The need to address access to care for people with MSK conditions is growing. 1 in 3 adults are affected by musculoskeletal diseases (e.g. arthritis, repetitive strain injuries) and these numbers are expected to grow. Timely access to appropriate MSK services reduces the incidence of unnecessary opioid prescriptions. 37% of MRIs ordered in the province are ordered for MSK conditions resulting in a significant cost factor for this group of conditions. MSK surgeries lag in meeting access to service targets and wait lists to see surgeons continue to grow.

The Ministry of Health and Long-Term Care articulates a vision for MSK Care that provides for:

  • proven models of care
  • a team approach, shared care
  • improved value
  • patient choice
  • selective referral to surgeons
  • integration through community resources and linkages
  • provides for e-tracking and referral management
Rapid Access Clinics
This model of care has been piloted in various sites across the province with positive results.  The new clinics will help people with pain in their muscles or bones get the treatment and specialized care they need by reducing unnecessary medical procedures, including imaging and surgery. The clinics will also improve wait times through a coordinated intake and triage process, with patients better able to access the right education and treatment options faster, which could include referrals to proven alternatives to surgery and pain medication like physiotherapy or chiropractic treatment.

Patients will be referred by family physicians to Rapid Access Clinics if they are considering an opioid prescription, an imaging referral or specialist referral.  In the clinic, clients will be seen within four weeks and given an assessment by a specially trained interprofessional MSK provider who will work with them to determine the appropriate care pathway.  Patients that are not surgical candidates will be provided with an evidence-based self-management plan and directed to local services if needed.

The Ministry of Health and Long-term Care is investing $37 million over the next 3 years to support expansion of this access model.  View Ministry news release.  In fiscal 2018/19 all hip and knee patients within a LHIN should be referred via a centralized intake, assessment and management.

Learn more about MSK Rapid Access Clinics here.

Implications for Occupational Therapists
Occupational therapists working with MSK clients will wish to be familiar with this new service access model for hip and knee arthritis and low back pain.  While most clinic IP Assessors may be physiotherapists or chiropractors, occupational therapists with advanced practice training can be valued interprofessional assessors.  Further, occupational therapists have considerable contributions to the non-surgical management of osteoarthritis, low back pain, psychosocial impacts of pain, maintenance of function, work and participation levels, etc.

Mechanisms to engage advanced practice OT assessors need to be advanced.  Access to OT services within the community that support patient needs on a group, individualized or telehealth basis need to be promoted.

Do you work with MSK clients?  Interested to link with OSOT regarding this initiative?  Contact Christie Brenchley.