Rebbeck T.1, Sterling M.2, Leaver A.1, Ritchie C.2, Bandong A.N.1,3, Kelly J.2, Basteris A.2, Mackey M.1
1University of Sydney, Faculty of Health Sciences, Sydney, Australia, 2Recover Injury Research Centre, NHMRC Centre of Clinical Research Excellence in Recovery Following Road Traffic Injuries, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia, 3University of the Philippines, Department of Physical Therapy, Manila, Philippines
Background: Whiplash-associated disorders (WAD) continue to be a worldwide health and economic burden. Current treatments fail to address the heterogeneity of WAD and often result in poor outcomes. A novel approach, using a clinical pathway of care, which involves providing matched guideline-based treatments based on risk of non-recovery, appears to be a promising strategy to address the burden of WAD. This new pathway of care is currently being tested in a randomised controlled trial (RCT). Prior to the commencement of the RCT, we commissioned website designers to develop an online tool to support the implementation of the clinical pathway of care. The various steps in the clinical pathway would be automated to provide patients and healthcare providers with: (1) risk classification and suggested management strategies; (2) schedule for review of progress; and (3) resources to assist in management.
Purpose: To develop an online tool to support a clinical pathway of care to improve recovery for people with WAD.
Methods: A process analysis describing the development of an online support package to assist with management of WAD. This is a collaborative project of the University of Sydney, Griffith University, NSW State Insurance Regulatory Authority and QLD Motor Accidents Insurance Commission. A tendering process was undertaken to select a suitable vendor to develop the website. Following contract execution, fortnightly work-in-progress meetings were held to discuss design concepts, content, features and functionality. The research team provided the content of the website whilst the website developers ensured that the materials were suitable for website use. Concurrently, a series of stakeholder surveys and focus group discussions were conducted among healthcare providers and patients to further inform website development. The development process involved collaboration, negotiation, trial and error, and extended time frame for delivery of the website.
Results: The primary outcome of the project was an interactive, user-friendly website, My Whiplash Navigator (www.mywhiplash.com.au) that included 3 sections. The first section involves an online version of a clinical prediction rule (CPR) that stratifies patients into low and medium/high risk of non-recovery. Upon completion of the CPR, feedback is provided and the patient is directed to resources that would assist recovery, with information targeted to their risk category. The second section includes guideline-based resources on assessment, prognosis and treatment for primary care practitioners. The third section provides specialist practitioners information about more complex assessments and resources to assist with management decisions. The website also links patients and their healthcare providers, which facilitates the process of referral of patients at medium/high risk of non-recovery to specialist practitioners.
Conclusion(s): The website provides access to evidence-based information and resources to assist patients and healthcare providers in optimising recovery after WAD.
Implications: The website has been launched and will be evaluated alongside the RCT. The end vision is for the website to be freely available to patients with WAD and healthcare providers who manage them. The website has the potential to facilitate improved patient outcomes and healthcare practice by providing access to evidence-based information and facilitating referral of patients at medium/high risk of non-recovery to appropriate care.
Funding acknowledgements: Funding was provided by the New South Wales State Insurance Regulatory Authority (SIRA) and Queensland Motor Accident Insurance Commission (MAIC).
Topic: Musculoskeletal: spine
Ethics approval: Approved by University of Sydney (2015/444) and Griffith University (2015/707) Human Research Ethics Committees.
All authors, affiliations and abstracts have been published as submitted.
