Leading Better Value Care
Local vignette – Hunter New England LHD

Osteoarthritis Chronic Care Program

Condition-specific clinic and telehealth – a clinician's perspective

By Elizabeth Wellard

28 Apr 2021 Reading time approximately

What is important to know about your service?

Patients at more remote sites are able to access the Osteoarthritis Chronic Care Program (OACCP) knee group at their local hospital. The physiotherapist based at the Inverell Hospital facilitates the exercise program and links in for education using telehealth. The program is coordinated by the larger OACCP at Armidale Rural Referral Hospital.

What organisational model do you use?

Condition-specific clinic and telehealth.

Whole-of-person assessment
leads to
Coordination of conservative care
leads to
Regular review
leads to
Shared decision-making about surgery

What is special about the way care is delivered that is valuable for others to know?

Patients who have been reviewed by the orthopaedic surgeon in Armidale are able to access the OACCP exercise and education sessions at the Inverell Hospital. Other patients with osteoarthritis of the knee are also able to access this service through a referral from their general practitioner.

Patients who are waiting for total knee replacement are initially assessed at Armidale and then offered access to the program at their local facility. The group exercise sessions are held with the local physiotherapist in Inverell and Glen Innes.

The patient is then linked to the larger OACCP site through telehealth for a shared education session. This is facilitated by the main presenter. Participants ask relevant questions and discussion is held between the onsite therapists at the three sites of Armidale, Inverell and Glen Innes.

For example, this may include a dietician talking about weight loss and healthy eating; a pharmacist discussing how medications are used to manage symptoms; or the physiotherapist discussing the disease, use of walking aides or what happens with total knee replacement surgery.

A companion document describes options of organisational models for the management of diabetes in the inpatient setting. One option is access to a senior physician and an interdisciplinary team with expertise in diabetes management – this vignette describes the model from a local perspective.

How does it make a difference?

As a sole therapist, I am able to link to the OACCP team in a larger site to assist with ensuring best practice using telehealth. This allows patient education from the multidisciplinary team that may not be available locally and allows clients to access this service locally, eliminating travel.

What tips do you have for others?

  • The therapist is involved in group exercise at this site.
  • It is essential that a local therapist sits in with local clients when connecting with a larger site via telehealth. This helps to assist with discussion on key topics.

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