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GPs referring for MRI scans to reduce high tech imaging treatment wait times


Training GPs to assess and directly refer patients for MRI scans has been shown to significantly reduce potential unnecessary specialist appointments and treatment waiting times.

This exciting initiative, led by Ventures and in collaboration with ACC, offers GPs the opportunity to make the best use of their clinical time and offer patients an expedited pathway to the right intervention for specific musculoskeletal injuries.

Ventures have worked with ACC over the past 12 months to get a contract in place to support the entire Midlands region. Other PHOs will not be able to access this until late 2019 at the earliest. Ventures have also been able to support e-integration with indici, using a direct API (application programming interface) they built with ACC, a New Zealand first!

This initiative leverages off a successful, but contained, urban pilot conducted with an Auckland-based PHO, ACC and Mercy Radiology. The pilot developed and successfully trialled four pathways (neck, lower back, shoulders and knees) over an 18 month period. Not only was GP interest great, but the benefit to the patient in getting to the right place of treatment was clear.

GPs were supported by expert training and electronic referral processes that contribute to better-quality specialist referrals for pa­tients who needed them. During the trial 95 per cent of MRI referrals were deemed appropriate. 

"The programme gives general practice direct access to high tech imaging for certain musculoskeletal conditions by using defined pathways and integration with radiology and specialist providers. Obvious benefits to patients include efficient access to rehabilitation, and specialist assessment and treatment referrals," says Tim Norman, Ventures project manager.

"Clear primary care orientated guidelines and training have been developed to help GPs identify patients who would benefit from an MRI, meaning GPs can re­fer patients with certain in­juries directly, rather than via a specialist. Patients not requiring high tech imaging or orthopaedic surgeon review will have extended pathway, prehab and rehab options.

"Most parties see that the calibre of the patient needing an MRI is appropriate. GPs having high tech imagery treatment training will mean a better chance that patients being referred to specialists are in need of specialist review," says Tim.

Until recently, the pathway has involved a lengthy process including potentially unnecessary specialist appointment. The previous pathway took an average of 28 days, the new pathway has been reduced to an average of six days in the Auckland region.

What's happening currently?

More than one third of Pinnacle Incorporated GPs have expressed interest in the programme which is a fantastic response to a new initiative. 

Regional clinical leads have been appointed alongside physio support. (We are still looking for a clinical lead in Gisborne.)

Waikato

  • Dr Graham Currie (clinical lead)
  • Lisa Hansen (physiotherapist)
  • Dennis Shepherd (physiotherapist)
  • Ronen Buser(physiotherapist)
  • Dan Moore (physiotherapist)

Lakes

  • Dr Natalie Clarke (clinical lead)
  • Colin Hancock (physiotherapist)

Taranaki

  • Dr Steve Smith (clinical lead)
  • Lydia Radich (physiotherapist)

Gisborne

  • Clinical lead not yet appointed - looking for interested parties.
  • Jo Chivers (physiotherapist)

What's next?

Clinical leads and physio teams will attend training in August with sports medicine doctor Stephen Kara. Clinical leads will then deliver training within their regions which will be a combination of an e-learning package to complete prior to attending a face to face session, keep an eye out for the upcoming CME opportunity.

Stakeholder engagement with radiology providers and orthopaedic surgeons is also currently taking place. 

All Pinnacle regions will be 'live' with the new pathways before the end of year. 

This project signals a change in the way primary care can work with ACC. Funding and access will be via primary options and we hope to include other services in the future. 

If you haven't yet expressed interest and would like to, or you'd like to express interest in the clinical lead role in Gisborne, please contact Ventures executive assistant Liz Patterson or project manager Tim Norman.

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