New Physiotherapy Program

Filling gaps for eligible patients without coverage, financial means (no cost to patients).

Physiotherapy was one of the top-three-requested additional PCN supports — based on the survey asking for ideas for the lump-sum funding — and our Physiotherapy Program is focusing the available, limited resources on motivated patients:

• With general (non-acute), MSK conditions of the shoulder or osteoarthritis (OA) of the hip or knee
• Without coverage by other health payers, financial means, or access to AHS-funded services

Patient eligibility was physician-informed, and the full inclusion-exclusion criteria is listed on the referral form for reference along with a link to a patient handout (bit.ly/physio-handout).

The eligible shoulder, hip, and knee conditions were determined by physician feedback and program capacity. (Please review this FAQ document for more details on the program’s development.)

For ineligible patients, we have compiled a concise summary of alternative services.

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Full inclusion-exclusion criteria for the program

Inclusion criteria:

• The patient:
  • Requires physical rehabilitation and/or pain management and can actively participate in physiotherapy to achieve a positive outcome
  • Is motivated and willing to participate in either one-on-one or group exercise settings and perform a home exercise program
• And meets one of the following criteria:
  • Rotator cuff-related shoulder pain that limits activity and participation in the community.
  • Joint-related degenerative hip and/or knee pain due to osteoarthritis that limits activity participation in the community.
• And you have reviewed the exclusion criteria (below and page 2 on the referral form) and confirmed eligibility.

Exclusion criteria:

• Patients eligible for coverage or currently receiving care from the AHS Outpatient and Community Physiotherapy Services (if so, refer to Rehab Advice Line at 1.833.379.0563 for AHS physio program).
• Patients eligible for coverage from Workers Compensation Board, Automobile Accident Insurance Benefits, or unused extended health benefits.
• Patients with the financial resources to pay out of pocket.
• Patients receiving physiotherapy or have received physiotherapy within the last year through an AHS-funded program for the same diagnosis.
• Patients who previously received treatment through the CWC PCN’s Physiotherapy Program for the same diagnosis.
• Patients receiving or eligible for services for specialized complex and chronic pediatric conditions through AHS programs or AHS contracts.
• Acute (within the last three months) rotator cuff tear
• History of shoulder instability (e.g., subluxation, dislocation)
• Ligamentous knee injury (e.g., ACL tear)
• Soft tissue hip pathology, including greater trochanteric pain and myofascial hip pain
• Patients diagnosed with a pain syndrome, including complex pain syndrome, myofascial pain syndrome, or fibromyalgia.
• Radicular signs or radiculopathy

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Physiotherapy Program overview

Eligible patients referred to the program are booked an appointment with one of our Physiotherapists (30-minute virtual appointment or call) who will use their expertise to assess and determine the appropriate type of care.

Patients are then connected to the appropriate type of care:

• Physiotherapy Program: In-person, one-on-one physiotherapy appointments (up to six appointments, including a one-hour initial assessment appointment; follow-up appointments are 30 minutes and based on the plan of care developed with the patient in the first appointment)
• Physiotherapy Program: In-person GLA:D Hip and Knee Osteoarthritis program (two education sessions about OA and self-management and 12 group exercise sessions over seven weeks to build strength through functional exercises and learn to apply the exercises to everyday activities)
• Physiotherapy Program: Exercise-based rehabilitation plan developed by our Physiotherapists with the patient for self-management (our Physiotherapists will then follow up with the patient virtually)
• External services: Referred to an AHS or community-based program (e.g., Alberta Healthy Living Program, etc.) — please follow up with your patients referred outside of our Physiotherapy Program

The contracted service providers for the one-on-one appointments and GLA:D program offer:

• Numerous locations in Calgary
• Appointments during the day and evening throughout the workweek and morning and afternoon appointments on Saturdays

View the locations and hours on the program’s web page.

Program monitoring and evaluation will be ongoing — along with evaluation of contracted service providers for quality assurance — so we can identify expansion opportunities for eligible conditions based on capacity and resources.

Please ensure you are only referring eligible, motivated patients who would benefit from our limited resources for physiotherapy (focused on improving quality of life and leading to a virtuous cycle of improvement of other health conditions).

To refer:

• Please download the referral form and upload it to your EMR.
• To save time, our Health Information Coordinators will add it to clinic EMRs, where possible, and members can contact their Physician Liaison if they need additional information to add the form.
• Please remember to review the inclusion-exclusion criteria on the form before referring.

Download the form

Faxed updates back to referring members:

• Notification of the outcome of the initial call (connected with one-on-one physiotherapy appointments, GLA:D Hip and Knee Osteoarthritis program, self-management, or an AHS or community-based program) or if the patient could not be contacted or declined
• Plan of care after the assessment appointment with a contracted provider for patients who are connected to one-on-one physiotherapy appointments
• Discharge summary after the completion of the one-on-one physiotherapy appointments or GLA:D Hip and Knee Osteoarthritis program
• Summary of patient activity and progress made within the self-management option

Thank you to the many physician members who provided feedback or shared their expertise in interviews and the working group so we could bring this program to our membership.

Questions? Contact your Physician Liaison for answers and information about our PCN.