Accessing Care from Anywhere - Arthritis Society
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Accessing Care from Anywhere
Dr. Brent Ohata, Rheumatologist
Clinical Assistant Professor, UBC
Jocelyne Murdoch
Occupational Therapist, Advanced Clinician Practitioner in Arthritis Care
Moderated by Dr Siân Bevan
Chief Science Officer, Arthritis Society
April 22, 2021
1
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question 2
Overview
[1] [2] [3]
Obtaining an Making the most of The future of arthritis
arthritis diagnosis your medical care
appointments
3
With thanks to our partners
Diamond Sponsor
Gold Sponsors
Bronze Sponsors
Friend Sponsor
4
I suspect I have arthritis but I’m having challenges with
getting diagnosed. What should I do?
5
Challenges Obtaining Arthritis Diagnosis
Difficult Diagnosis Barriers to Appropriate Care
6
Arthritis = Joint Pain
Osteoarthritis Viral Arthritis
Reactive Arthritis Rheumatoid Arthritis
Lupus
Ankylosing Spondylitis
Gout Psoriatic Arthritis
Sarcoidosis Hemochromatosis
Sjögren syndrome Calcium Pyrophosphate Disease
7
Physician Supply in Canada
Canadian Institute for Health Information. Physicians in
Canada, 2019. Ottawa, ON: CIHI; 2020. 8
Distribution of Rheumatologists in Canada
Optimal
Rheumatologist to
Population Ratio:
1:75,000
Most
Rheumatologists in
Urban South
Barber CEH et al. Stand up and be counted: measuring and mapping
the rheumatology workforce in Canada. J Rheumatol 2017;44:248–57
9
Social Determinants of Health
Social, economic, cultural and political inequities that
impact the health of individuals and communities
Income and Social Status Healthy Child Development
Social Support Networks Biology and Genetic
Education and Literacy Endowment
Employment/Working Health Services
Conditions Gender
Social Environments Culture
Physical Environments Racism
Personal Health Practices and Social Exclusion
Coping Skills
10
Courtesy of C. BarnabeCanadian Rheumatology Access: Neither Equal Nor Equitable
Interaction Institute for Social Change. Artist: Angus Maguire.
https://interactioninstitute.org/illustrating-equality-vs-equity/ 11How can I prepare for my virtual rheumatology
appointments?
12How to prepare for a virtual visit
13Tips and tricks for virtual visits
Test Turn off Choose Wear Sit away Wear Have Email
Test your Turn off all Choose a Wear a Sit away Wear a Have these Email photos
internet, devices that headset or from available: a of rash,
quiet and earphones
tank top
device and use wifi, windows helper, m swollen
other than private with a and loose edication joints or nail
ability to location microphone to ensure pants to
the device list, tape changes that
connect to and to improve even allow a
you are measure, are hard to
the video using. the audio lighting pad and see, or
platform
position quality
good
your physical pen. Keep documents
ahead of On your Sit an
device, close the original that you
time device so arm's exam virtual visit want to
all apps, and that it is length
ensure your email handy share ahead
device is stable. away from in case you of time
fully the device get dis-
charged. and place connected.
it at eye
height.
15Preparing for in-person appointments
Before your appointment After your appointment
During your appointment
Prepare yourself Take notes on your appointment
Give the full story
Track your symptoms Note any follow ups, referrals, and tests
Bring a trusted friend or family member
Take advantage of available resources Utilize self-management strategies when possible
Ask if travel assistance funding is available in Don’t be afraid to speak up, and make sure you understand
your area Partner with your treatment team Don’t be afraid to follow up
Plan your appointment day carefully allowing Ask what is the best way to communicate between visits
for travel and rest
16I feel like I’m pulled in many different directions when it comes to
my arthritis care, and I don’t know how to navigate it all. What
should I do?
Learning to advocate for yourself and your needs can be one of the most powerful
things you can do
17What can I do to manage my arthritis at home, while
waiting for care?
18We will get through this
togetherAre there things I can do to self-manage my arthritis?
Practice good
self-care
20Are there things that I can do online to help manage my
arthritis?
21Register to receive the Arthritis Society’s
flourish e-newsletter
22Where can I find reliable information?
23What’s being done across the country to improve
arthritis care?
24Current Rheumatology Model of Care
You
Rheumatologists
25Current Rheumatology Model of Care
You
Bears,
Wolves,
Snow!
Rheumatologists
26Telemedicine = Virtual Health
Patient alone Scheduled
appt.
Patient +
Arthritis family
doctor Or on-
Patient + demand,
RN/PT/OT real-time
service
Patient + GP
27BC RheumVision
Improving access to
care for indigenous,
rural and inner-city
patients
Instant rheumatology
access at the click of a
button
Yukon rheumatology
initiative coming soon!
28How are allied health providers being used across the
country to improve arthritis care?
29ACPAC
ACPAC= Advanced Clinician
Practitioner in Arthritis Care
10-month post-licensure
interprofessional certificate
program for physiotherapists,
occupational therapists, nurses and
chiropractors
100 graduates across Canada
Designed to increase access to
arthritis care and promote an
interprofessional approach to care
30Ideal MOC in Northern Ontario for Rheumatology?
Sudbury
Elliot Espanola
Lake
HUB
SITE with
Local
ACPAC
Therapist
Sturgeon
Mindemoya Falls
Hub-Spoke Virtual Care model with an ACPAC-
Rheumatologist
Recruited 4 new rheumatologists to help in Sudbury starting Courtesy of Sahil Koppekar, University of Toronto 31
July 2021Comprehensive model for Timmins, Ontario
December January
Traditional in-person clinics in Timmins
Half-day OTN ‘Direct-to-Home’ Virtual Consults Annual Capacity of this System
E-consults from GPs and NPs (2 rheumatologists, 1 ACPAC)
Virtual Case Conference and Educational Rounds ~300-350 patients in person clinics
144 patients in virtual clinics
Drs. Koppikar and Soowamber 30-40 Case discussions
Variable E-Consults 32
ACPAC – Lynn RichardsPediatric Rheumatology in Ontario – Bensen Models of Care Project
Improve efficiency by partnering
Pediatrician (local) with AHP (ACPAC) colleagues
Evaluate key drivers of optimal care:
• No show rates
ACPAC and • Referral volumes from under resourced
Patient areas
• Best practices metrics
(remote) • Disease outcome measures
Increase knowledge and skills of
ACPAC and PCPs via pediatric-
focused education at distant sites
Telemedicine Link Collect evidence that sustained
Rheum public funding can lead to cost
savings by supporting high quality
(tertiary site) care delivered locally
33
Courtesy of Deborah Levy, University of TorontoAny final thoughts or recommendations?
34How can I help make arthritis a priority?
Ask and advocate for similar endeavours in your
What YOU province
can do Advocate for ongoing telemedicine support
with your local government
35Questions
36Tell us what you think…
37May is Leave a Legacy Month
Help us create a future free from arthritis.
Much of our funding comes from people who leave a gift in their Will. Legacy gifts help
ensure the continuation of our education, programs and services to support Canadians
living with arthritis.
There’s never been a better time to learn more about planning your legacy.
For more info, visit
www.arthritis.ca/plannedgiving
38Upcoming Events
May Arthritis Talks:
Eat Smart for Arthritis
19 Lalitha Taylor, Registered Dietitian, Alberta
6 p.m. ET
• Why is having a balanced diet so important for people living with arthritis?
Learn about: • Are there any recommended diets to follow?
• What small changes can people make to make a difference to their overall
arthritis management?
Register at: Visit arthritis.ca/arthritistalks or click the link in your email inbox
39You can also read
