We helped the Bone and Joint Health Strategic Clinical Network towards a solution for the increasing demand for rheumatologists in Alberta.
Rheumatoid arthritis is the most common inflammatory joint condition. While it affects all age groups, more than one half of all new cases occur between the ages of 40 to 70 years. RA affected an estimated 0.9% of the Canadian population. Within ten years of the onset of the disease, up to 50% of people living with RA are work disabled if not treated. For those living with RA, related inflammation in the arteries result in an increased risk of mortality. In Alberta, in 2010, there were 1,691 new cases and this number was expected to rise to an estimated 2,405 by 2040. We worked with the Bone and Joint Health Strategic Clinical Network and provincial partners on a new model of care to enable Alberta’s rheumatologists – numbering just 40 – to meet growing demand as the rate of rheumatoid arthritis and other dangerous inflammatory joint diseases increased in the population.
With the assistance of ABJHI, a group of rheumatologists, family physicians, therapists, and pharmacists designed a model of care to optimize diagnosing and managing rheumatoid arthritis. Three clinics initiatied between 2015-2016 served varying patient populations (e.g. disease types, patient age). The model was designed with flexibility to not limit application at sites across the province. The model introduced alternative care practitioners specializing in rheumatoid arthritis. Medical professionals, such as nurses, general practitioners, pharmacists and therapists, were trained to perform routine monitoring and provide maintenance-level care of rheumatoid arthritis patients. Communication was a crucial component. The alternative care practitioners kept the rheumatologist informed of the patient’s condition and consulted with the rheumatologist if any changes were observed. We worked with the three clinics to establish an assessment of quality and areas for improvement with the aim of informing health funders about sustainability of the model.
The model gives rheumatologists more time for diagnosing patients, getting new patients into treatment before joint damage occurs, and managing existing patients who experience a painful disease flare-up. The model increases the capacity of rheumatologists to diagnose and treat the growing numbers of rheumatoid arthritis patients and reduce the service disparity that exists between urban and rural areas of Alberta.