Overview of the care pathway

The low back pain pathway is an integrated care pathway during which GPs and specialists collaboratively treat patients based on the Belgian KCE guideline for treatment of aspecific low back pain:

It supports caregivers by providing:

• The relevant guideline recommendations at the right time
• A holistic overview of the patient journey at any time
• Access to patient data (both specialist and GP have access)

The care pathway is started by GPs but can continue in the hospital, GP’s office or patient’s home.

Start of the care pathway

Start-up of the care pathway occurs the moment a patient with low back pain presents to the GP for the first time. This event can thus be seen as the "first consultation". GP will then decide to start up the patient in the digital care pathway "low back pain".

For information:
At this initial consultation, the primary care physician will enroll/start the patient in the low back pain care pathway. Next, the patient will have to fill out the first questionnaires at home. Based on the duration of the complaints the intake into the care pathway will be determined:

• Duration of complaints can be an exact date;
• Duration of the complaints can be an estimate in number of weeks;
• Based on exact date or estimate, the care pathway determines where the patient should start: 1-2w, 3-5w or 6-11w;
  

Screening for red flags

The 'baseline information' form reminds the GP to check for the presence of red flags:
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"The sensitivity and specificity of red flags are limited, especially when applied individually. Clinicians should focus on clusters of red flags that indicate specific severe pathology. Click here to view an overview of red flags. The KCE guideline strongly advises against prescribing imaging or other additional tests if no red flags are present in patients with nonspecific low back pain. Explain to your patient that this does not make any sense for him/her at this time."

If red flags are present, the care pathway is closed using the following steps:

• GP receives following instruction: "We recommend that the patient be urgently referred to the second line. The digital care path is then closed."
• Push message to EMR: "During screening, red flags were detected. It was recommended that patient be urgently referred to second line."

Acute follow-up

If the patient has no red flags, they will be followed up acutely for the next 8 weeks by the GP and the Awell system. If the symptoms have not improved after 8 weeks, the GP can include the patient in the chronic pain care pathway.

Integrations

From your EMR to scheduling or billing, Awell easily connects with your systems so you can create powerful care pathways that tie disjointed systems together.

Benefits

The low back care pathway offers numerous benefits that will increase efficiency on the one hand and improve the quality of care for both patient and provider on the other.

• Based on pre-test / post-test result, we see that the care pathway managed to reduce the consultation time by 10 minutes (33% consultation time reduction)
• Capacity increase by 30%
• Automatic scoring calculations
• Integrated with your systems (Electronic Medical Record, scheduling, medical billing, online pharmacy & fulfilment, e-prescribing, insurance eligibility....)
• Decreased administrative burden for the care team
• Automatic alerts to the care team if patients reports alarming Patient-reported-outcomes
• Dynamic advice for caregivers to treat patients based on the Belgian KCE guideline for asymptomatic low back pain