Why Advance Online
Since 1995 we have been successfully supporting Victorian patients with chronic pain to lead happier and more productive lives. Our results speak for themselves with industry leading outcomes on improving function, reducing opioids, facilitating return to work and promoting independent self management. That is why Advance Healthcare has developed Advance Online - bringing benchmark leading (1) medical, psychology, physiotherapy and dietitian services to the whole of Australia via telehealth and innovative tech solutions. Advance Online offers multi-disciplinary Pain Management to people with chronic pain and psychology services for people with mental health issues across Australia.
Electronic Persistent Pain Outcomes Collaboration 2020/2021 reports. University of Wollongong, Australia
What makes us different?
Experience
Our clinical programs have been developed and refined over decades by our expert team of practitioners led by Associate Professor Jon Ford (Managing Director, PhD, Musculoskeletal and Pain Physiotherapist), Dr Aston Wan, (Medical Director, Specialist Pain Physician) and Charles Ruddock (Clinical Director of Psychology, Clinical Psychologist). A full listing of our practitioners can be found here.
Track record
We are one of the largest and most established providers for people with chronic health issues in Australia with 6 practices, 50+ practitioners and over 30 years’ clinical and research experience.
Over the past 5 years we have collected program results from over 2000 patients. In 2020/2021 our results showed 90% of patients completing our program report significant greater improvements compared to other pain management programs around Australia (see figure below). The quality of our program, training and clinical quality assurance approaches is particularly evident when you consider the large number of practitioners in our group, and that these outcomes were achieved across 6 different clinics and a telehealth consultation rate of 40% during the COVID pandemic.
A true commitment to evidence-based practice
Our Pain Management program is based on the latest research evidence including a systematic review of a large number of clinical trials (Kamper et al 2015). Our approach is also supported by our world-leading clinical research team who have published over 50 peer-reviewed papers on the management of chronic health issues. You can rest assured that our Advance Online treatment program has been developed around scientifically supported approaches that adhere to the best practice guidelines. One highly relevant paper from our group shows that the Advance approach to managing chronic low back pain results in a $3000 saving per patient due to reduced sick leave. The paper also showed an incremental cost effectiveness ratio (ICER) of $422 per quality-adjusted life year gained which is highly favourable compared to most other treatments for chronic health problems.
Driven by data
All our patients are monitored by the Electronic Persistent Outcome Collaboration (ePPOC) and our Managing Director is a member of the ePPOC Clinical Management Advisory Committee. We are able to provide reports every 6 months on a range of outcomes including medication, treatment utilisation, return to work, program costs and duration as well as a series of validated outcome measures including the Brief Pain Inventory, the Depression Anxiety Stress Scale, the Pain Catastrophising Scale and the Pain Self Efficacy Questionnaire. Over the past 5 years these data have had a major impact on review and improvement in our programs as demonstrated on the following graph showing improvement on opioid use after major program restructure. We own our outcomes.
Figure 1 - % of patients who reduce their opioid use by at least 50% at 6 months post pain management. Red line is industry benchmark. Based on 194 patients from AHC (Advance Healthcare) and 1617 patients from other pain management providers across Australia
This graph further demonstrates our commitment to clinical quality assurance and continuous improvement. In 2016-2018, the ePPOC results showed a significant decrease in the percentage of patients achieving a “clinically important” reduction in opioids at 6-months post program. As a result, we reviewed our clinical protocols and pain management approaches in a systematic evidence-based manner, resulting in a dramatic turnaround over the past 3 years. In 2021 over 70% of all patients taking opioids at the beginning of our pain management programs had reduced their intake by over 50% at 6 months post program.
Given the costs and harms of opioid overuse these results are an outstanding endorsement of the effectiveness of our pain management programs and our ability to respond to outcome data.
Currently we are undertaking a major randomised controlled trial to improve self efficacy in our patients. In the compensable environment this metric can be challenging to shift and we wish to improve from average (compared to most providers who see less complex private pain patients) to well above average.
How does our online Pain Management program work?
Multi-disciplinary Pain Management is the gold standard treatment for people with chronic pain. Our online Pain Management program runs for 8-10 weeks and includes telehealth sessions at least weekly. Our online Pain Portal provides patients with important information on their pain problem and interactive tools to support the telehealth sessions. This means patients get the best treatment supported by our Pain Portal whenever and wherever they need it. A critical component of the pain portal is live tracking of scheduled activity and exercise and progress towards collaboratively negotiated long term goals (including return to work). An example goal sheet is displayed below.
You can find out more about the Advance Healthcare Pain Management program here. An example of the Pain Portal content can be also seen here.
Our programs are individualised based on the patient presentation but a typical structure would involve
One on one physiotherapy working on gradual and safe increases in exercise and daily activities (based on important life goals such as recreation/hobbies, relationships, work, housework). Typically 2 sessions a week for 10 weeks
One on one medical (if required) to assist with the diagnosis and medication regime. Up to 5 sessions over 10 weeks
One on one psychology (if required) to assist in establishing meaningful goals, understanding pain, developing coping strategies and dealing with feelings/emotions around chronic pain. Only if related to the compensable injury and up to 10 x 1 hour sessions over 10 weeks
Group psychology (if required) to learn from other patients about the nature of chronic pain and how to deal with it more effectively in a supportive group environment. Only if related to the compensable injury and up to 20 x 1 hour sessions over 10 weeks
Patients not responding or complying with the program structure are discharged early with a report outlining the issues and recommendations to facilitate greater change. Over the past 5 years our early discharge rates are 15% ensuring funding is not spent on patients where a positive outcome is unlikely.
All stakeholders receive a detailed initial, mid program, end of program and 6 month follow up report including ePPOC measures and return to work planning. An example initial assessment report can be found here.
Our telehealth and activity/exercise tracking services are supported by the secure platform of Microsoft Teams. We have used this platform successfully for thousands of patients over the last 2 years. Our online Pain Portal is password protected and accessible via computer, tablet or smartphone browsers. This simple and foolproof system enables ongoing updating and improvements to the portal and a user friendly patient interface.
Example goal sheet that helps drive return to work and daily activities
Who pays and what does it cost?
The Advance Online Pain Management program is available to private payers with a Medicare referral or through private health insurance, however there are out of pocket costs. Our best results have been achieved in complex chronic compensable pain where a more intensive program provides the best results. We utilise the fee schedule relevant to the state jurisdiction and invoice based on service data.
We can alternatively negotiate fixed cost services with guaranteed service outcomes.
In Victoria the Network Pain Management Program model has been developed which enables Worksafe and TAC to closely monitor providers (who are approved by application) for outcomes. If you wish to speak to a Worksafe representative about the Advance Healthcare Pain Management program please contact our Managing Director for the key contact.
What if I want further information?
Please contact Rodney McMeeken (Manager of Advance Online) to discuss how we can help your compensable patients on the road to recovery. On enquiry we can provide access to our online Pain Portal to view the extensive range of patient resources that optimise their recovery. If you already have a password to the Pain Portal click on the button below to gain access.
