Support My Spine ASAP. A Rural Tele-health care model for patients being managed with a Thoracic Lumbar Sacral Orthotic (TLSO).

Question: Does a Telehealth model of care facilitating treatment in rural hospitals for patients requiring a TLSO eliminate the need for transfer to a tertiary referral hospital? Design: Quantitative pre and post intervention design. Participants: Physiotherapists, nursing and medical staff at rural hospital pilot sites. Intervention: Pre and post intervention data collection provided patient demographics, and length of stay data around model of care implementation. Pre intervention staff surveys identified knowledge gaps informing educational packages which were provided with a mobile Telehealth link. Outcome measures: Primary: Number of patients managed under the new model of care. Secondary: Length of stay, travel distance eliminated and complications. Results: 30 patients fitted with TLSO’s and managed under this model of care to date. Length of stay has reduced from 9.14 days pre intervention to 3.8 days post intervention. Approximate savings of $6840 per patient have been identified, with over 6000kms of patient travel eliminated. No complications have occurred. Rural Physiotherapists have been successfully up skilled in managing patients requiring TLSO fitting. Conclusion: This intervention successfully created a model of care to facilitate local management of patients requiring TLSO fitting with Telehealth support from a tertiary referral hospital. Considerable savings have occurred from this model of care for patients and the health district. This model is currently being implemented district wide. Key Practice Points: Telehealth model of care can be successfully implemented to TLSO management Multidisciplinary team role is critical role in redesigning models of care Telehealth increase the efficiency of healthcare resource