A clinician-led AI triage layer for ACC’s musculoskeletal reform

SECTOR UPDATE - Dr Stuart Armstrong, sports and exercise physician, founder of Ara Health

ACC is reshaping how musculoskeletal injuries reach secondary care. Instead of a GP or physiotherapist referring directly to a surgeon or specialist, referrals will run through a triage process that confirms the referral is complete, appropriate for ACC cover, and headed to the right place. With around 160,000 secondary-care referrals a year, that process has to be digitally enabled — it simply can’t be done by hand at that volume.

I’m a sports and exercise physician, and for the past six months I’ve been running an AI history-taking platform in my own practice. When ACC signalled the change, I adapted it into a dedicated triage platform, Ara Health.

Here’s how it works. A referral arrives from a GP, physiotherapist or other allied health provider. Ara first screens it — checking the ACC claim, the date of injury, that an examination is recorded, that the body site matches the cover. It sends the patient a history-taking form, pulls relevant past imaging from radiology, and collates everything into one place. From there it drafts a decision across five outcomes: decline (not an ACC injury), decline with a redirect (wrong coding, or too early to refer on), more information needed (an MRI before re-review, for example), specialist care, or ongoing management within an ICP musculoskeletal service.

The part that matters most to me: a registered clinician reviews and approves every single decision. The AI makes suggestions and does the paperwork — the GP letter, a patient letter written in plain language, the ACC read-code update, the return-to-work request to the employer — but a clinician signs off every call. And when something isn’t right for ACC, the patient isn’t simply turned away. The seventy-year-old with arthritis is told it isn’t an ACC injury and given the exercises that will actually help.

I think ACC’s direction is the right one. But it has to be done well, or we risk creating bottlenecks where there shouldn’t be any — the obvious rotator-cuff tear that sits in a loop for weeks instead of reaching the surgeon who can fix it. Preventing that is the whole point.

I’m now working with established ICP musculoskeletal providers toward combined bids for the new pathway. If you’re thinking about the same problem, I’d be glad to compare notes.

Source: Dr Stuart Armstrong, sports and exercise physician, founder of Ara Health media release

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