The integrated pathway upon which the Care New England Spine Care Program is founded has been implemented in various environments since 2009 by a team that includes our medical director, Donald R. Murphy, DC, FRCC. These environments include hospital spine centers and a community-wide program associated with a major insurer.
The programs have proven successful and popular for patients, providers and the community. Founded upon bringing greater efficiency, effectiveness and patient-centered focus to spine care, our program responds to the Triple Aim of improved outcomes for patients, improved patient experience and lower per capita costs. It does this by taking an integrated team approach, with the Primary Spine Practitioner guiding the patient along the path to recovery.
What is more, the program is founded on early identification of risk factors for chronicity, so early invention can be undergone for the patient at risk of developing chronic back or neck pain. This intervention is typically focused on self-care strategies, exercise and manual therapies that are physical in nature, but whose application is informed by the principles of Cognitive-Behavioral Therapy and mindfulness. Other services, such as behavioral health, injections, surgery, opioid dependence management or acupuncture, are utilized when needed.
Data from the programs that have incorporated our spine care pathway demonstrate its value:
With regard to outcome and patient satisfaction:
- Mean improvement in pain of 4.2 points.
- Mean improvement in disability of 62%.
- Patient satisfaction of >95%.
- Clinically meaningful improvement in pain in 69% of patients.
- Clinically meaningful improvement in disability in 71% of patients.
- 33% of patients identified as “High Risk” of chronicity drop to “Moderate Risk”.
- 53% of patients identified as “High Risk” of chronicity drop to “Low Risk”.
- 85% of patients report being “very confident” in their ability to self-manage the condition.
With regard to efficiency:
- In one Family Medicine practice with a shared savings contract, the doctors who utilized our integrated spine pathway experienced 28% reduction in spine costs ($756,000 in savings) in the first year. The doctors in the practice who did not use the pathway experienced an 8% increase in spine costs.
- Emergency Department (ED) compliance with the pathway rose from 65% in 2012 to 93% in 2013.
- Amongst patients with low back pain who attended the ED, of those who saw a Primary Spine Practitioner (PSP), only 6% made a return visit to the ED, whereas 23% of patients who did not see a PSP made a return visit.
- In the 4th year of implementation at one hospital, 100% of patients referred to the primary spine care facility were offered a visit within 48 hours.
- Prior to implementation of the pathway, 132 patients attending the ED who were identified as DRG 552 (low back pain without medical complications) were admitted to the hospital. Four years after implementation of the pathway, only 31 were admitted.
Looking for our spine care services?Whatever the problem is and whichever services you may need, we are happy to guide you toward a quick and lasting recovery.
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