Background on MSK Implementation across the Central East LHIN

To improve access for patients with Musculoskeletal (MSK) concerns, the Ministry of Health developed a Comprehensive MSK Access to Care Program. Patient care is central to the implementation of the MSK initiative. Shorter wait times for an initial assessment for patients with hip or knee osteoarthritis and low back pain is essential to well-being and overall function. 

The Central East LHIN MSK pathway was designed in collaboration with patients, orthopaedic surgeons, primary care, and hospital leadership. MSK Care Steering Committee members come together on a monthly basis to provide support for planning and implementation of the MSK initiative. 

Hip and Knee Pathway Objectives

The Hip and Knee pathway is part of the provincial Rapid Access Clinic (RAC) program for MSK care. The objectives of the program include: 

  • Improved access to MSK specialist care; 
  • Streamlined MSK referral and treatment process for residents in the Central East LHIN;  
  • Provide patients with the choice of hospital, surgeon, or the shortest wait time;
  • Provide non-surgical patients with conservative management strategies; 
  • Improve communication with referral sources (i.e., primary care providers and specialists);
  • Improve the patient experience; and
  • Improve surgical wait times and referral practices.

Low Back Pain (LBP) / Inter-professional Spine Assessment and Education Clinic (ISAEC) Pathway Objectives 

The LBP pathway is part of the provincial RAC program for MSK care and stems from the ISAEC model of care – a successful pilot program for low back pain. The objectives of the program include: 

  • Improved outcomes and satisfaction for patients with persistent or unmanageable recurrent low back pain; 
  • Decreased prevalence of chronic unmanageable low back pain;
  • Reduced opioid initiation through early non-pharmacological management; 
  • Decreased utilization of lumbar spine imaging (e.g., MRIs);
  • Reduced unnecessary emergency room visits for low back pain;
  • Reduced unnecessary referrals to low back pain-related specialists; and
  • Improved access to specialty care.