The Mississauga Halton LHIN in partnership with Trillium Health Partners and Halton Healthcare launched Central Intake and Rapid Access Clinics for patients with Low Back Pain in 2019. The low back pain pathway is part of the Rapid Access Clinic for MSK care and stems from the Interprofessional Spine Assessment and Education Clinics (ISAEC). More information on ISAEC.
The Rapid Access Clinic (RAC) provides patients with an assessment by an Advanced Practice Provider within 4 weeks of when the completed referral is received by the Central Intake Program. An Advanced Practice Provider (APP) is a Regulated Healthcare Professional such as a Physiotherapist and/or Chiropractor with additional training in orthopaedic care.
The objectives of the program include:
- Improved outcomes 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
- Improved access to specialist care
The program has resulted in:
- 99% patient satisfaction
- 97% Primary Care Satisfaction
- 96% of patients referred for surgical consult by an APP were surgically appropriate
- Reduced Chronicity Risk especially amongst patients at moderate risk of chronicity
Referral Process
Primary Care Providers must register and complete an online module to obtain referral privileges.
How to get started:
- Register here to receive a link for training
- Complete the online training module
- Use the referral to refer your patients to the Low Back Pain Rapid Access Clinic (LBP RAC)
Once the Central Intake Program receives the completed referral, it will be routed to the community based RAC closest to the patient’s residence.
| Inclusion Criteria | Exclusion Criteria |
|---|---|
| Patients must be 18 years of age or older | Initial low back related symptoms <6 weeks post onset |
| Persistent lower back pain and/or related symptoms (e.g. sciatica, neurogenic claudication) 6 weeks to 12 months from onset; OR | Constant/persistent LBP-related symptoms >12 months post onset |
| Recurrent episodic unmanageable lower back pain and/or related symptoms of less than 12 months post-recurrence | Unmanaged established chronic multisite pain disorder and/or narcotic dependency |
| Active LBP related: WSIB claim, motor vehicle accident claim, legal claim | |
| Pregnant/post-partum patients (<1 year) | |
| Patients with red flags including possible Cauda Equina Syndrome, progressive neurologic deficit or significant trauma. |
Mandatory Information
All mandatory information is indicated on the referral form with an asterisk (*)
- Patient Information (Name, Date of Birth, Address, Phone Number, Health Card Number)
- Back Specific History (Red Flags, Previous History, Previous Investigations treatment or surgery)
- Referring Provider Information (Name, Address, Fax Number, Billing #)