About
This service aims to:
- Reduce patient wait times
- Improve the quality of referrals
- Improve equity of access to treatment
- Reduce travel time, particularly for rural ACC patients.
Training Information
MRI clinical training
- Total of two hours over one evening.
- Delivered by a multi-disciplinary team.
- There is no payment for attendance.
- Available at a number of sites around South Island, including rural locations, with the exception of Otago.
- General practitioners can enrol via the 'Express Your Interest' form below.
To qualify for this service, GPs are required to complete a two hour clinical training module conducted by a multi-disciplinary team.
Pegasus invites all interested general practitioners from any PHO to express their interest by completing the form below.
All sessions will take place from 6:00pm – 8:00pm at Sports Central, 591 Colombo Street, Central Christchurch. Dinner and refreshments provided.
Please complete the form below.
Express your interest
Please fill the form below and select your choice of session. On submissions, your choice will be emailed to the Project Manager.
Please ensure you are logged in to Wā Kāinga to make a submission to this form.
Claims
ACC GP MRI-accredited providers can make the following claims via ACC GP MRI section of the Pegasus Claims Online:
Post MRI Claim:
- Only one claim can be made per body part. Where more than two MRIs are ordered for different body parts, two separate claims are required with the same ACC number.
- Date of injury will precede the post-MRI consult date
- Claimable only for GPs who have completed the ACC GP MRI training
The Unclaimed Scans Icon, if selected on the Claims Online platform, will display any MRI scans performed under the GP MRI service, for which a Post MRI Claim has not been claimed.
Clinical Guidelines
ACC GP MRI Training Session
Please make yourself familiar with the specific joint examinations below. It is acknowledged that these are not comprehensive examinations and professional experience may dictate alternative or additional tests. Clinical judgment should be used at all times.
(Click on the links below to access flowcharts and specific tests)
MRI is only available after following the clinical guidelines given in the flowcharts below:
Clinical Examinations
Knee
Assess for ACL/PCL or meniscal injury
- Extension
- Flexion
Watch a video on ACC High Tech Imaging MRI Training - Knee (vimeo.com)
Cervical Spine
Assess for radicular pain and/or radiculopathy
- Flexion
- Lateral rotation L&R
- Extension
- Spurling’s test (physio-pedia.com) (axial compression)
- Deltoid- (keep arms out at shoulders 90 degrees) C5
- Biceps C6
- Triceps (arms out 90 degrees at shoulders elbows bent- extend elbows) C7
- Curl fingers and grip C8
- Keep fingers spread T1
- Dermatomes
- Over deltoid C5
- Thenar eminence C6
- Middle finger C7
- Lateral border of hand C8
- Lateral border of forearm T1
- Reflexes
- Biceps C5/6
- Triceps C7/8
Watch a video on ACC High Tech Imaging MRI Training - Neck (vimeo.com)
Lumbar Spine
Assess for radicular pain and/or radiculopathy
- Assess gait – look for a shift, usually to contralateral side (worse prognosis if ipsilateral)
- Sit on chair (comfort level)
- Take shoes off (comfort level)
- Walk on heels L4
- Walk on tip toes S1
- Straight leg raising (<70 degrees is +ve)
- Reproduction of pain
- Sensation- dermatomes – compare opposite side
- Across upper thigh L2
- Inner aspect lower thigh /knee L3
- Inner aspect of heel L4
- Between big and next toe L5
- Sole S1
- Lie prone and palpate back – for patient satisfaction “actually examined my back”
Watch a video on ACC High Tech Imaging MRI Training - Back (vimeo.com)
Contact us
FAQs
Clients will pay a co-payment as usual for their first visit BUT their follow up visit to the GP to discuss the outcome of the scan and plan their rehabilitation will not have a co-payment at this stage. There is no co-payment for the HTI itself.
No, only MRI scans are included. CT scans are outside of the scope of this programme.
Clients will experience a more streamlined, coherent support from their GP when they present with injuries that are not resolving with usual care. It is our expectation that clients will have access to specialist care more quickly when they need to and will feel confident going to physio for active rehabilitation on the advice of their GP.
For uncertain diagnosis or consideration of surgical management specialists are certainly the appropriate choice. However, many injuries can be managed in primary care with the right resources and access to appropriate care. Pathways jointly developed by specialists and GPs in the programme support patient care.
This was an important issue to understand for the proof of concept but it seems that the pathway actually prevents some unnecessary referrals to specialists and probably contributes to “better value” specialist clinics. We have not seen the specialists inundated with clients worried about unexpected findings on their scan.
So far, GPs in conjunction with radiology colleagues have been managing the conversations about the results of the scan.
This was also an important issue to understand for the proof of concept (PoC). The PoC has shown that the ability to have results returned in a timely manner enables GPs to be able to make management decisions without having to reassess, re-confirm patient circumstances and spend significant time following up (as their patient assessment is still very recent). This is best for the patient journey and outcome and as such GP feedback from the PoC has been that the ability to utilise MRI has offset any additional time required.
The clinical pathway is not for acute injury, so usually there has had to be approval first. There has had to be an x-ray in the pathway first funded by ACC so this also usually is preceded by approval.
No, the claim has to be accepted prior to referral for MRI, usually the time period in the clinical pathways is enough to get the claim accepted. Currently, the patient has to inform the GP if the claim has been accepted.