Not every shoulder injury requires surgery or a visit to a physician. Read More
’The clinical question is, can a physician make a diagnosis online?’
Advertisement 1
‘The clinical question is, can a physician make a diagnosis online?’
Article content
Not every shoulder injury requires surgery or a visit to a physician.
Article content
Article content
That’s what Dr. Nick Mohtadi, co-medical director of the Sports Medicine Centre at the University of Calgary, intends to test in his newly launched research clinic, diagnosing and treating patients with shoulder conditions.
Article content
“The whole idea is to provide patients with direct access so they don’t have to go through a physician or another practitioner,” he said.
Article content
Story continues below
Article content
The Shoulder Care Access Project (SCAP) Clinic bases its model on an online self-referral tool — a web questionnaire that patients can fill out online that specialists can use to make a diagnosis. The idea is to see how often the diagnosis made remotely matches up to that concluded from an in-person examination.
Article content
Noon News Roundup
Article content
“The clinical question is, can a physician make a diagnosis online?” Mohtadi said.
Article content
If successful, this could be the boon people living in remote Alberta, who don’t have easy access to a health-care system, are looking for.
Article content
“We could access their information, we could contact them remotely and say, here’s what we think your problem is and this is what we think you should do about it, which would be a very simple way of delivering care,” he said.
Article content
The research
Article content
The clinic is a research clinic, Mohtadi emphasized, which means that it collects and analyzes patient data to make an informed, evidence-based conclusion on whether the model works or not.
Article content
Story continues below
Article content
But it’s not the first time Mohtadi has tested a similar model.
Article content
Stories You May Like
-
‘Promising’ psychedelic therapy aims to help cancer patients
-
U of C researchers aim to fill the gap with new study on menopause, among largest in Canada
-
Advertisement embed-more-topic
Story continues below
Article content
Fifteen years ago, he established the Acute Knee Injury Clinic (AKIC), which also uses a web-screening questionnaire to diagnose patients. Since its launch in 2010, the clinic has seen more than 25,000 patients, fewer than a third of whom required a referral to a surgeon. Approximately 85 per cent of the patients were diagnosed using only web-based information.
Article content
SCAP also tests how necessary it is for the patient to see a surgeon, which Mohtadi says is often not the case, as attributable to a clinical trial done two decades ago.
Article content
Article content
The trial compared different techniques to repair the rotator cuff muscles and contacted people who were already on the waitlist for surgery. Noticing that most people on the waitlist didn’t want surgery and had also not had any treatment done prior to going on the waitlist, he and his team decided to create a non-surgical pathway of treatment and tested its efficacy. After going through the program, patients would see a surgeon who would examine whether they required surgery.
Advertisement 1
Advertisement 2
Advertisement
Article content
“Our preconceived notion was that 75 per cent of these people were going to need surgery. Turned out it was the exact opposite,” Mohtadi said, adding that most patients who are diagnosed at his clinic come with rotator cuff injuries.
Article content
“So everything in this clinic started with that project and the evidence that told us that we actually shouldn’t be sending people to surgeons,” he said.
Article content
Changing the system
Article content
If Alex McEwen, 35, had access to a model like this when he was suffering from a ripped tendon in his shoulder, it may have made getting treatment a lot easier for him.
Article content
“It was challenging,” he said of his own experience. Two years ago, he had injured himself in the gym, wherein the major tendon connecting his pectoralis muscle to his right shoulder had torn completely away from the bone.
Article content
“The system is set up with the best intention,” he said. “But most people whom you’re going to interact with in an emergency room or maybe in a family doctor clinic, they’re not specialists with regards to the shoulder or other joints . . . getting an accurate or timely diagnosis can be quite challenging.”
Article content
Story continues below
Article content
Patients are often left to handle the system on their own and may be asked to take the wrong, and sometimes expensive exams, that are unnecessary for diagnosis. In McEwen’s case, he was asked to get an ultrasound, “but it wasn’t going to provide the conclusive evidence that there was a ruptured tendon,” he said.
Article content
In his case, he would have required an MRI scan, but those could take months to get in the public system, which leads to some patients opting for the private route.
Article content
“You’ll be paying out-of-pocket for that,” he said.
Article content
Article content
With the help of connections and hours spent on the phone for days, talking to specialists, McEwen was able to get an appointment with a surgeon within three weeks.
Article content
But with the new model, the pressure to navigate the system would be lifted off him, according to Mohtadi.
Article content
“Alex would have received care by accessing the website, putting the information in and we would have a good idea of what the problem is,” he said. “We would be able to see him in a timely fashion, get a publicly-funded MRI on an urgent basis and we could be connected to surgeons to be able to get the case he needed. In other words, we’re facilitating everything he had to do on his own.”
Article content
Story continues below
Article content
McEwen described the model as an “order of magnitude improvement over” what he has heard and experienced.
Article content
“It’s the fact that you can get some degree of answer with a high accuracy or confidence, within 15 minutes or 20 minutes, versus waiting months or years to get some sort of direction.”
Article content
The clinic
Article content
The clinic has already been operational for months, starting in late August 2024 and collecting data since January of this year, after it secured a funding grant from the Alberta Bone and Joint Health Institute and additional philanthropy.
Article content
It’s already at full capacity, Mohtadi said, with staff seeing 15 new patients a week, alongside follow-up visits. The team includes orthopaedic surgeons, a sport medicine physician, a physiotherapist, an athletic therapist, a patient researcher, a research coordinator and a health-care administrator.
Article content
The clinic will run for another year, Mohtadi said, after which data will be evaluated.
Article content
“If we demonstrate we’re improving care at less cost, I would hope that Alberta Health or the new acute care organization would look at this favorably and consider funding it long term and expanding it elsewhere,” he said.
Article content
It’s one of the many logical routes to improve health care at a low cost, with evidence-based research. “We have to facilitate that and we have to trust it and that’s why we’re doing the research.”
Article content
Discover more from World Byte News
Subscribe to get the latest posts sent to your email.