Redesigning the Care of Musculoskeletal Conditions With Lifestyle Medicine

Kristi E. Artz MD , Timothy D. Phillips PT, DPT , Janine M. Moore PT, MS, OCS , Kara E. Tibbe MBA
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Abstract

Value-based health care has been accelerated by alternative payment models and has catalyzed the redesign of care delivery across the nation. Lifestyle medicine (LM) is one of the fastest growing medical specialties and has emerged as a high-value solution for root cause treatment of chronic disease. This review detailed a large integrated health care delivery system’s value transformation efforts in the nonoperative treatment of musculoskeletal (MSK) conditions by placing patient-centric, team-based, lifestyle-focused care at the foundation. With an economic and treatment imperative to reimagine care, recognizing more intervention is not always better, a collaborative approach was designed, which placed functional improvement of the patient at the center. This article described the process of implementing LM into an MSK model of care. The change management process impacted clinical, operational, and benefit plan design to facilitate an integrated care model. A new understanding of patients’ co-occurring physical impairments, medical comorbidities, and behavioral health needs was necessary for clinicians to make the shift from a pathoanatomic, transactional model of care to a biopsychosocial, longitudinal model of care. The authors explored the novel intersection of the implementation of a biopsychosocial model of care using LM principles to achieve greater value for the MSK patient population.

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用生活方式医学重新设计肌肉骨骼疾病的治疗方法
以价值为基础的医疗保健因替代支付模式而加速发展,并推动了全国范围内医疗服务的重新设计。生活方式医学(LM)是发展最快的医学专科之一,已成为从根本上治疗慢性疾病的高价值解决方案。本综述详细介绍了一家大型综合医疗保健服务系统在肌肉骨骼(MSK)疾病的非手术治疗方面进行的价值转型,其方法是将以患者为中心、以团队为基础、以生活方式为重点的护理作为基础。由于经济和治疗方面的原因,必须对护理进行重新规划,认识到更多的干预并不总是更好,因此设计了一种协作方法,将患者的功能改善放在中心位置。本文介绍了将 LM 纳入 MSK 医疗模式的过程。变革管理过程影响了临床、运营和福利计划的设计,促进了综合护理模式的发展。临床医生必须对患者同时存在的身体损伤、医疗合并症和行为健康需求有新的认识,才能从病理解剖学、事务性护理模式转变为生物心理社会学、纵向护理模式。作者探讨了利用 LM 原则实施生物心理社会护理模式的新交叉点,以实现 MSK 患者群体的更大价值。
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来源期刊
Mayo Clinic proceedings. Innovations, quality & outcomes
Mayo Clinic proceedings. Innovations, quality & outcomes Surgery, Critical Care and Intensive Care Medicine, Public Health and Health Policy
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审稿时长
49 days
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