In celebration of World Spine Day 2020 today, always on October 16, Corazon wants to support the mission of calling attention to the importance of spinal health, along with the need for effective programmatic organization and management of spine care.  Spine is a core specialty for many hospitals, and continues to offer the potential to be a high-revenue/high-demand service in many markets across the country…


And since patients seeking care for back and neck pain are ever on the rise, it’s unfortunate that many report a lengthy and often frustrating process of getting relief, mainly due to the process by which hospitals manage these patients from the initial call-in, to referrals, to physician visits, to treatment, and finally, eventual relief.


Many patients with spine pain will have been referred to a specialist by a primary care physician (PCP). However, one of the challenges for PCPs is making a referral to the most clinically-appropriate specialist. With exhausting caseloads and with the advent of hospitalists, many PCPs rarely encounter spine specialists. This disconnection can result in PCPs not being current with technology and treatment options, whether surgical or non-surgical, which can unfortunately compromise the patient’s care path.


In nearly every community, current systems of intake reside exclusively in the respective spine specialist offices and are frequently dysfunctional and inefficient. Each has their own protocols for accepting and treating referrals from medical professionals and self-referred patients. Referring physicians often characterize the coordination of access, evaluation, and treatment as “haphazard” and poorly-coordinated. It is encouraging however that many medical staff and spine specialists recognize the need to improve service to medical professionals and self-referred patients. Corazon believes that opportunities for spine program improvements can begin here – before the patient even walks into the office.


Access to spine care has long been a challenge for both the self-referred patient and professional referral source. Frequently, the first referral is made to a surgeon for consultation. It is not uncommon that scheduling an initial consult will require a wait between 4 – 8 weeks. With greater than 85% of patients needing non-surgical care, patients and consulting surgeons are frequently frustrated that the patient is re-referred for non-surgical care and must endure another wait for a specialist. This is particularly acute in geographies where patients must wait for extended periods and make long drives for initial specialist consults only to be told that they are not a surgical candidate.


Further challenges for hospitals and physician practices associated with access and care include:

    • Patients enduring long waits, ill-defined paths of care, successive dissatisfying experiences, and continued pain and disability
    • High levels of patient non-compliance and appointment no-shows
    • Inappropriate utilization of spine resources (i.e., non-operative patients being evaluated and managed by the surgeon)
    • Lack of coordinated care once patient is in treatment
    • Poor communication about current and prospective interventions
    • Patients and PCPs will follow the path of fast access (even if not the most clinically-appropriate or effective)
    • Spine out-migration / leakage from the hospital system


As the most effective antidote to these challenges, Corazon believes that one of the most effective approaches to address these common barriers is to develop and deploy a comprehensive intake, triage, and navigation (ITN) care management system. Indeed, the greatest value in care coordination lies in improving the level of access to the most clinically-appropriate spine specialist in an expedited timeframe, communicating treatment paths to the patient and referring professional, and providing a truly remarkable patient experience.


A patient-centered model of ITN ensures patients are quickly directed to the most effective care modalities, and to spine specialists most qualified to treat their unique symptoms. The goal of an effective ITN program is to bring hospital and spine specialist ownership and sequential management of a typically inefficient, fragmented, or non-existent system of intake.


An operational ITN system supports and promotes the patient experience, spine specialists, referring physicians, and professional referral sources (Worker’s Compensation, Employer, and Payors.) Specifically, an effective ITN process:

    • Places a priority on customer service to the patient and referring professional
    • Provides expedited evaluation and treatment by the most clinically-appropriate spine specialist
    • Maximizes quality of face-to-face time with spine specialists
    • Results in better clinical outcomes
    • Positions the hospital to capture incremental ancillary services


ITN also provides a care coordination function, ensuring thorough communication to referring and treating physician or to the patient. Any specific marketing and educational initiative for spine programming or services should be accompanied by a well-conceived centralized system of ITN, characterized by rapid access to staff that can readily engage callers into a defined process and link them to services that match their needs. A vanity phone number (i.e., 1 800-BACK PAIN) can add an element of increased identity and will be easily remembered.


While the benefits are great, especially in terms of the patient experience, implementing an ITN program can happen with relatively minimal financial investment.  Most challenges occur in the logistics of first defining and then establishing each step in the process.


To learn more about how Corazon can help with this effort and perhaps establish your organization as a destination for patient-centered spine care, call 412-364-8200.  And if you have programmatic interest or needs within the spine specialty, sign-up for next week’s webinar: