The health system and the physical therapy provider decided to develop a shoulder care pathway focusing on rotator cuff tears, as they represent the most common diagnosis that needs a surgical opinion and affects 50 to 80 percent of individuals over 60 years of age. The pathway offers an immediate treatment plan at the point of care.
If a patient’s history and initial physical examination suggests imaging is needed to confirm a rotator cuff tear, physicians use ultrasound to provide real-time diagnosis as opposed to waiting for an MRI. Then, a physical therapy or surgical treatment plan is discussed and presented to the patient. This allows patients to make an informed treatment choice, resulting in improved patient satisfaction.
Patients who require surgery and postoperative physical therapy can schedule their procedures in a timely manner. Patients indicated for conservative physical therapy treatment typically receive a shoulder injection and anti-inflammatory medications. These patients are then referred for an active rehabilitation program. According to the article, 70 percent of patients in the pilot program resolved their pain and disability in six to 12 weeks without the need for an MRI.
The clinically integrated pathway results in delivery of better care to a larger number of patients by using an appropriately skilled provider at the right time. It also utilizes ultrasound rather than MRI, which generates cost savings. Finally, patients receive the right care at the right time, which increases satisfaction. The model thereby helps healthcare organizations “flip the funnel” and improve physician efficiency and patient satisfaction.
