RWD, RWE and Pain Big Data – What is the difference?

Real world data (RWD) involves data collected outside of clinical studies and their scientific constraints. It often comes from EHR,  EMR, registries, and claims data.  Yet, it is often been ignored over trial data. That is, until recently, when ‘big data’ became a household manta.

What is amazing about RWD is that it produces real world evidence (RWE) that is truly representative of live disease progression, patient cases, device or drug experience and patient impact.  It can tell stories at the patient level, practice level, life science level and more. RWE is incredibly actionable when powered by analytics, machine learning & artificial intelligence (AI). It provides insight beyond traditional time-delayed clinical trial data, making it possible to use RWD to support real-time care planning, disease hot-spotting and even post-market clinical reporting.

Moreover, there is the potential to link data from different sources; improve trial efficiency; identify new indications, and a real-world perspective of risks/benefits to make informed decisions beyond traditional clinical trials. RWE also has regulatory and market impact including the updated FDA guidelines requiring RWE use in regulatory decisions and how AI and information exchange can be securely managed. There are ethical and privacy concerns, recent big data consent guidelines and best practices for clinically integrating RWD in the form of data aggregation and more.  Watch for our Data Team to talk more about how RWD can morph into RWE for those in the pain community seeking real-time use of RWD, its evidence and ultimate data storytelling.

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The Pain Patient and the Value of Their Social Determinants

Pain severity and poverty level. Adverse pain outcomes and their association with unemployment and lower education.  

These ‘social determinants of health’ (SDoH) refer to the economic, environmental, and social conditions of individuals’ lives that impact the health outcomes of individuals. The amplification factor of  inequities in power, money, and resources is where the knowledge of a person’s SDoH can help pain care providers have an awareness that tailors their recovery plan to meet the patient in the middle of their social and clinical circumstances. There is a deep lack of understanding about how the social circumstances of individuals’ lives shape their pain care experiences. In a study involving interviews with 18 physicians, all described situations in which their clinical management decisions were influenced by their patient’s SES.1

What we need is to better understand the complex interconnection of factors involved in the delivery of high-quality pain care, its relationship to care outcomes, and patients’ care experiences. The perspectives of socially disadvantaged individuals, in particular, are likely to have important implications for understanding inequities in pain care and what to do about them.  At a minimum, a starting place is to create an awareness of SDoH for the pain provider. Here’s one path.

Step 1: Gather the patient’s social determinants. Do that through proven tools like PRAPARE or Health-Related Social Needs (HRSN) Screening Tool.

Step 2: Make sure you have the SDoH results in front of you when forming a care plan.

Step 3: Look at the SDoH across your entire practice so have a deeper understand of who your patients are. This helps your entire practice support them, such as your front office in appointment compliance and your back office in revenue cycle activities.  And finally,

Step 4, keep up a regular cadence of gathering SDoH to be sure you are alerted to a change in social circumstances.

Do you want to talk more about these steps or how to actualize them for you? Reach out to our data team here.

1 Bernheim SM Ross JS Krumholz HM Bradley EH. Influence of patients’ socioeconomic status on clinical management decisions: A qualitative study. Ann Family Med. 2008; 6: 53-59

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Pain Outcomes and MIPS Requirements…#182

Those that choose to voluntarily report do not receive a payment adjustment regardless of how well, or poorly, they score. However, those that opt-in are eligible to receive a payment incentive or penalty based on their performance. Opt-in eligible clinicians may also choose to voluntarily report instead.  Choosing to opt-in requires your EMR or outcomes/data technology partner to partner with you to gather the right data, in the right cadence and to reveal your results to you in a transparent manner.  Which MIPS measures did you choose?  Here is one of our favorites. Under the Quality category ( 30% of total score: Report 6 measures, including one Outcome or other High Priority measure for 12 months on at least 70% of eligible encounters to receive a score against 2022 National Benchmarks). #182: Functional Outcome Assessment.  

MIPS Measure #182: Functional Outcome Assessment. Percentage of visits for patients aged 18 years and older with documentation of a current functional outcome assessment using a standardized functional outcome assessment tool on the date of the encounter AND documentation of a care plan based on identified functional outcome deficiencies on the date of the identified deficiencies. A standardized tool is a tool that has been normed and validated. Examples of tools for functional outcome assessment include, but are not limited to: Oswestry Disability Index (ODI), Roland Morris Disability/Activity Questionnaire (RM), Neck Disability Index (NDI), Patient-Reported Outcomes Measurement Information System (PROMIS), Disabilities of the Arm, Shoulder and Hand (DASH), and Western Ontario and McMaster University Osteoarthritis Index Physical Function sub-scale (WOMAC-PF). Click here to hear more about how Celéri can help with gathering the assessment of your choice.  Note: A functional outcome assessment is multi-dimensional and quantifies pain and musculoskeletal/neuromusculoskeletal capacity; therefore the use of a standardized tool assessing pain alone, such as the visual analog scale (VAS), does not meet the criteria of a functional outcome assessment standardized tool.

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