measured approach at helping us to "think outside the box", while building consensus and developing actionable solutions
Back Pain Collaborative Did you know that low back pain is the most costly of medical conditions for employers? The direct cost of care and the cost of absence from work for this condition are immense. With a large national employer, Virginia Mason conducted a Back Pain Collaborative that analyzed the care for patients seeking treatment of back pain. A key finding was that overutilization of MRIs for back pain treatment accounted for a substantial proportion of unnecessary costs for employers — at about $1,000 per test. Interestingly, medical evidence indicates that an MRI of the spine is generally indicated for a short list of conditions, including trauma, weakness, onset of bowel or bladder dysfunction, evidence of systemic illness or unremitting pain. With none of these conditions present, an MRI is unlikely to help. In the Back Pain Collaborative, what was identified as medically helpful to patients is same-day physical therapy. A model was designed that provided same-day access for a combined appointment with both a physical therapist and a physical medicine physician. Those patients who do require emergency or complex care have prompt access to advanced imaging, neurosurgery consultation, rehabilitation and pain specialists. Unnecessary MRIs were avoided by designing a system that required evidence-based indicators to schedule the test. Results of the Collaborative included: ▪ Elimination of 23 percent of all MRIs of the lower back ▪ Increase in same-day access with patients seen promptly and returning to work quickly ▪ Very high patient satisfaction scores ▪ Greater reduction in pain, greater improvement in function and greater perceived improvement — with fewer MRIs and less physical therapy ▪ Reduced cost to purchasers for uncomplicated back pain
“"I found the 3P event to be very engaging and informative. I really liked your measured approach at helping us to "think outside the box", while building consensus and developing actionable solutions.– Gerard G., Shepley Bulfinch
