Overview of PainTracker Progress to-date at UW Medicine & Progress to-date at UW Medicine Brian Theodore, PhD Mark Sullivan, MD, PhD David Tauben, MD
What is PainTracker? The UW PainTracker is a web-based tool to assess and graph core patient-reported outcomes of chronic pain management over time. Its purpose is to provide a brief visual display of the relationship between chronic pain treatments and these outcomes, such as pain, function, mood, sleep, and treatment satisfaction. Computerized Patient Reported Outcomes (cPRO) platform and web application developed by the UW Center for Informatics Research Group and UW Division of Pain Medicine.
Who is Using PainTracker? Clinical Services Date of Adoption Early-Adopters UW Neighborhood Clinics July 2011* UW TelePain July 2012** Sports Medicine at Husky Stadium April 2014 Center for Pain Relief July 2014 HMC Pain Relief Service Q4 2014 – Q1 2015 (est.) Planned Expansions (Planned rollout 2015 – 2016) Bone & Joint Surgery Center/Rheumatology Neurology & Headache Clinic Pelvic Pain Clinic Other internal & external partners * Not web-based. EPIC SmartSet and Note Template. ** Started paper-forms, migrated to web-based in Q4 2013.
Common Core, Multiple Versions Common web application designed to support multiple modalities and uses: UW PainTracker initially supported primary care content and workflow, and also TelePain Content added to support sports medicine and ortho needs and rebranded “UW ActionTracker” Content added to support chronic pain at CPR
Core Measures Pain location PEG – Pain Intensity, Interference with Enjoyment of Life and Interference with General Activity Pain interference with sleep initiation and maintenance Pain interference with patient-defined “Most Important Activity” PHQ 4 – Mood screener for depression & anxiety Opioid Risk Tool Medication tracking Prescription opioid dose (MED) and utilization Satisfaction with Pain Treatment
Service-Specific Measures PainTracker – Sports Medicine “Action Tracker” PainTracker CPR Function Oswestry Disability Index Other location-specific measures (e.g., NDI, FADI, QuickDASH) Alcohol Screener AUDIT-C Treatment Tracking PT, Injections, Surgeries, Behavioral Medicine Mood Screeners PHQ-9 GAD-7 PC-PTSD Additional Opioid Use Screener PODS Sleep Apnea STOP-BANG Global Quality of Life PROMIS Global Health
User Interface
Clinical Report PainTracker
Clinical Report PainTracker Content in table below graphs: Days per month excess meds Important activity selected Prior treatment history Item responses to selected questionnaires
Challenges Integration with Epic Labor intensive Completion rates Access to dataset
Workflow Analysis In collaboration with UW Department of Human Centered Design & Engineering
Progress with Integration Epic Scheduling Pain Tracker Daily Activity Report PSS/Outcomes Coordinator Reminder Calls
Progress with Completion Rates Baseline: 131 patients observed over 7 weeks at CPR Followup: 163 patients observed over 7 weeks at CPR
Progress with Completion Rates
Progress with Completion Rates (single clinic champion) 128 patients observed over 8 weeks at CPR
Progress with Data Access Current development of flat file with raw and summary scores (Est. Dec 2014/Jan 2015) On-demand download into Excel file Available on-demand for QI Available for research with IRB approval
Questions?