Review of Patient Outcomes After Referral to OT Embedded Within a Primary Care Practice

Context: Interprofessional teams can reduce workload of primary care providers (PCP). Currently, there is no standardization regarding which professionals should be on the team. We completed a 2 year pilot imbedding an occupational therapist (OT) within a family medicine team. Our initial findings showed significant satisfaction among PCPs. This current study further analyses the outcomes from this pilot.

Objective: To examine the treatment plans and corresponding outcomes for all patients that were seen by an OT in order to assess the impact on patients of integrating OT into a primary care setting.

Study Design: We performed a retrospective chart review of all adult patients that were referred to OT during an office visit over a period of 23 months.

Setting: Department of Family Medicine, Mayo Clinic AZ.

Population: Consecutive patients 18 yrs or older referred to OT by a PCP within the designated family medicine clinic between 01/02/2020 and 11/30/2021.

Intervention: A novel pilot program imbedding OT within a family medicine team was initiated in January 2020. Patients are referred to an embedded OT during an office visit with their PCP. Whenever possible, a warm hand-off was performed to facilitate the referral.

Results: Total of 776 patients were referred to OT. 64.1% were female. Mean age 62.9 years.

Insurance: 46% Medicare, 46.4% commercial. 7.2% both.

Mean encounter duration: 35.17 minutes. Patients were referred for a variety of diagnoses including balance and movement disorders, musculoskeletal pain, dizziness /vertigo and neuropathy. A majority of patients, 84.21%, reported either partial (30.24%) or complete (54%) improvement. Only 2.9% did not improve, while 12.9% were lost to follow up. 59.7% of patients required a one time treatment, 40.1% were referred for further treatment outside the department (OT or PT).

Conclusions: Imbedding OT within a primary care team resulted in partial or complete improvement of symptoms in 84.21% of patients with a variety of diagnoses. A majority of patients required only 1 treatment. Both Medicare and commercial insurance plans were successfully billed for OT services.

Learning Objectives: OT imbedded within a primary care team can result in efficient and successful treatment of a wide variety of patient complaints. OT services embedded within a primary care team are reimbursable by Medicare and commercial insurance plans.

Research Category: Original research

Study Design: Retrospective chart review