Models of Care Update

Dr. Vandana Ahluwalia

I’m pleased to share with our members the accomplishments of the Models of Care Committee:

Access: Results of the Allied Health Care Provider Rheumatology Triage (AHRT) Study jointly led by ORA, The Arthritis Society and OBRI, now confirm that ACPAC-trained ERPs can effectively prioritize inflammatory arthritis patients for expedited rheumatology consultation in multiple settings across the province.

This study has shown significant reductions in wait-times to rheumatologist consultation (median 37 days which is substantially lower than the provincial median of 66 days).[1]

Based on these promising results, the ORA, The Arthritis Society and the ACPAC program are collaborating with the Arthritis Health Professions Association (AHPA) to facilitate and support the integration of ACPAC-trained ERPs in rheumatology practices within Ontario.

Knowledge: Educating rheumatologists about the principles and tools that are the foundation of the Models of Care (MOC) project is the final step in implementing the MOC across Ontario.

To this end, a knowledge translation program entitled “Rheumatology Care Redesigned – Created Nationally, Developed Provincially and Delivered Locally” was created and branded by the ORA models of Care committee.

We would like to thank our 10 rheumatology knowledge translation trainers who delivered sessions in their local regions during the last quarter of 2016 and early part of 2017!

At a recent debrief meeting in February, feedback from the facilitators and the participants indicated that the educational sessions were successful and positive.

Participants agreed that they learned new information about Models of Care, the available tools, and the role of ERPs, and were interested to learn more about the operational aspects of the MOC and how to integrate them into routine practice.

The debrief meeting also included a discussion about the need to develop an economic argument that may showcase the “costs and consequences” of implementing a patient centered shared care model for inflammatory arthritis.  The ORA and Arthritis Alliance of Canada (AAC) are currently in discussions to see how this work may be accomplished.

Completion of the Model of Care Work: Over the seven years since its inception, the ORA’s MOC Committee and Subcommittees have worked diligently to fully implement its vision and goals.

As it is wrapping up its work this year, the Committee will focus its efforts over the next few months towards communication and educational activities that continue to raise awareness and encourage implementation.

Efforts are underway to develop a paper, executive summaries, and social media presentations that will outline the key activities of the MOC committee, targeting rheumatologists and allied health professional audiences, as well as for other stakeholders such as administrators and government decision-makers.

The spring 2018 issue of the CRA Journal will showcase the MOC accomplishments from across Canada through collaboration of the ORA, the AAC and the CRA.

It has been my pleasure to have chaired this committee for the past 7 years.

I would like to commend the work of the subcommittees and their champions who continued to pursue our goals with unwavering effort. I would like to thank Sandra Couto, my project manager, whose strategic vision and support kept us all on the right path.

Although the MOC work will be completed in May 2017, this is only the beginning of using the work done by the committee to improve access, facilitate assessments, and monitor and improve outcomes for the benefit of our patients.

Dr. Vandana Ahluwalia
Director, Models of Care

1The Effect of Triage Assessments on Identifying Inflammatory Arthritis and Reducing Rheumatology Wait Times in Ontario: The ORA Allied Health Rheumatologist Triage (AHRT) Project. Brooks S, Bombardier C, Bell M, Cesta A, Fullerton L,  Karasik A, Kendzerska T, Sweezie R, Widdifield J, Ahluwalia V. Abstract #213. CRA  Ottawa, ON, Feb 2017 ( manuscript in press)