Clinical and engagement efficacy of a virtual musculoskeletal integrated practice unit in health system employees: aggregate and comparative results from two employers

虚拟肌肉骨骼综合实践单元在医疗系统员工中的临床和参与效果:来自两家雇主的汇总和比较结果

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Abstract

INTRODUCTION: Integrated Practice Units are whole-person models of care designed to deliver a comprehensive range of treatment strategies centered around a patient's preferences, values, and needs. The purpose of this study was to assess the efficacy of a virtual IPU (V-IPU) for employees of two large health systems experiencing back, neck or joint pain. Specifically, we evaluated improvements in pain interference, physical health, and user satisfaction/experience. METHODS: This was a prospective cohort study with a total of 167 employees from two health systems who were recruited through e-mail outreach and completed a brief health assessment, including patient reported outcome measures (PROMs) for physical, emotional, and pain health. Upon sign-up, employees began a 12-week multidisciplinary program consisting of musculoskeletal (MSK) physician telehealth treatment and oversight, supervised one-to-one physical therapy, registered dietitian counseling, health coaching, and platform to in-person specialty services when clinically appropriate. National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) scores for physical health, mental health, and pain interference were assessed at intake, 6-weeks, and 12-weeks after program initiation. Net promoter score (NPS) was measured to evaluate participant experience and satisfaction with the program. RESULTS: The average age was 50.56 years, and a large majority of responders were female (89.2%). There were clinically meaningful improvements for PROMIS measures of physical health, mental health and pain interference (5.6, 4.4 and 6.9 points, respectively). The Net Promoter Score was 85 for engaged individuals. Additionally, the V-IPU was successful in connecting employees to additional surgical-avoiding services offered by the employer and which complemented the digital participation of the V-IPU. CONCLUSION: The V-IPU improves health outcomes and care coordination for health system employees. These findings support the use of virtual multidisciplinary models to enhance access and outcomes in employer-based health initiatives.

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