Back pain is in the top 5 most common reasons people seek emergency care. However, healthcare systems often rely on opioids, hospital admissions, and ambulance transport due to a lack of effective alternative care. Our program directly aligns with Value-Based Health Care by improving back pain management through evidence-based, patient-centred care pathways that enhance health outcomes, patient experience, and system efficiency.
Our SHaPED trial implemented a new back pain model of care in emergency departments (ED), resulting in a shift from opioids to safer, more effective treatments. We worked with 270 ED clinicians and included 4,625 patients across 4 hospitals, prioritising evidence-based management strategies. Australia has one of the world’s highest admission rates, with 1 in 3 patients admitted from ED. Ambulance services are also heavily used, with nearly all back pain patients transported to hospital. By implementing alternative pathways like our Back@Home virtual hospital, we are providing high-value, evidence-based alternatives that improve outcomes while reducing system burden.
Back@Home is Australia’s first virtual hospital for back pain, which accepts referrals from both ED and ambulance services. More than 300 patients have already benefitted from this model of care in the Sydney Local Health District (LHD). To improve efficiency of ED care for patients with musculoskeletal pain, our RESHAP-ED trial is testing a physiotherapy-led service within EDs with over 1,370 patients already involved. Using a learning health system approach, we have developed a real-time dashboard surveillance system in Sydney LHD to monitor and improve the quality and safety of care.
