Grant: Team Grant: THINC Impl. Science Team Grants - Rural, Remote/Northern Communities

Rural Albertans have less access to health services such as specialist care and advanced diagnostic imaging. As such, rural patients with shoulder pain frequently visit their local family physician or emergency department for immediate care, usually for pain management. Many are referred onto specialist care and must travel long distances, often in winter driving conditions while incurring substantial out-of-pocket costs. Alberta has created Shoulder Rapid Assessment Clinics (RACs) in Edmonton and Lethbridge that utilize shoulder specialist teams to assess patients and personalize treatment plans. While RACs are effective, ~25-45% of referred patients reside in rural areas. Also, ~75% of rural patients are not surgical and, after traveling long distances to RACs, are referred for non-operative care. Many rural communities however, lack rehabilitation services. Telehealth can help to eliminate barriers for rural patients, while effectively improving high value care. We will use TeleRehab 2.0 (TR2.0), an advanced virtual assessment technology that mimics real-time patient and provider interaction equivalent to in-person assessments. Our TR2.0 model of care will virtually connect 8 rural spoke sites in 4 Alberta rural health zones (NORTH, CENTRAL, CALGARY RURAL HEATH, SOUTH) with 2 urban clinics (Edmonton, Lethbridge) serving as hub sites to provide integrated appointments for >2500 rural patients. This will transform access to specialist care provincially for rural shoulder pain patients and create a community of practice for rural providers. Non-operative care can now be delivered back in rural communities or at home with counseling, education, and training. If successful, the shoulder TR2.0/RAC integrated care model can expand to other bone and joint conditions to deliver equitable high-quality care in rural primary care settings with minimal added fixed system costs, providing the right service in the right place at the right time.