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T - New Perspectives From E-Scan

A Lifetime of Care During the conduct of the E-scan, rehabilitation service providers repeatedly spoke about the importance of long-term follow up of individuals with SCI, over the course of their lifetime. Many described future rehab service models as “hubs of service”, rather than the current one-way streets. Many providers spoke passionately of many individuals’ need to re-access rehabilitation services. Long-term Follow Up is Intended to: • Address new rehabilitation goals as they emerge • Ensure optimization of functional outcome and maintenance of functional abilities, over time • Monitor neurologic impairment in order to detect late neurological deterioration (syrinx, disc, spondylolisthesis, hardware failure, peripheral neuropathy, etc.) • Provide primary and secondary prevention of SCI-related secondary health conditions • Enable access to new therapies and technologies • Assist with accommodation to aging with a disability, and • Enable living with multimorbidity after SCI (e.g., paraplegia, syrinx with myelopathy, neuropathic pain, diabetes, hyperlipidemia, elbow tenosynovitis, breast cancer and charcot spine). Ideally, this care should be provided in a multidisciplinary setting. Current outpatient service models either do not exist or are not adequately funded, nor are the variety of healthcare professionals or services available, to support interprofessional care. Further, the system of care is not designed to incorporate preventive approaches that aim to reduce ongoing morbidity, such as those that facilitate self-management skill development (see below) or promote the adoption of healthy lifestyle practices. Given the high frequency of inappropriate emergency department use, and frequency of physician visits observed in the chronic SCI population, development of interprofessional models to support lifetime care is a key priority that warrants rethinking, and would likely result in substantial system savings. NEW PERSPECTIVES FROM E-SCAN 203


T - New Perspectives From E-Scan
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