Using RWD In Everyday Pain Practice: An Overview

Our most innovative Celéri client providers use RWD from our Real World Outcomes Engine™ in their everyday practice to support care planning and population health.  Here are a few ways they do it:

Engagement.

We engage with your patient’s on your behalf over SMS or email or iPads provided in your office – or mobile.  Our digital engagement understands that patients need to know they are providing key information directly and securely to their provider. Our messages can look something like this: “Hello Susan, this is Dr. Smith. I am reaching out to understand more about how your pain is impacting your daily life.  I want to help.  These questions are essential to our custom plan for your pain recovery. Please take a moment to answer them with full candor and then we can discuss your answers when we see each other soon.”  Or, your choice of introductory wording. (English and Spanish, available, too)

New patients.

The majority of our provider clients ask us to gather PROMIS-29 to understand fatigue, pain intensity, pain interference, physical function, sleep disturbance, anxiety, depression, and ability to participate in social roles and responsibilities – as an outcomes baseline and a starting point for patient collaboration in their patient’s pain recovery. Additionally, our Body Map offers visuals for patients to indicate pain areas by primary, secondary and so on – for downstream assessment triggers by body area.  Body Map use also helps our provider patients understand our engagement questions are by pain area and not generalized pain – thereby mitigating a possible skewing of PRO results. Of course, ODI or NDI or other validated instruments can be initially gathered also.  Our provider clients customize the validated assessments they want and at what cadence. Set it and it works quietly in the background.  We deliver the new patient’s PROMIS-29 report (and others) directly to their appointment in your EHR/EMR for your reference before walking in the exam room and as a teaching tool (See Patient Education and Care Planning).

Pathways by intervention type.

As the patient moves on in their clinical pathway, we gather PRO assessments for our provider’s, based on the intervention in play.  At Celéri, it is all about the provider’s choice – based on their preferred PROs by intervention.  We have default pathways – or clients can customize their own. For example, many of our client’s SCS patients receive a Zurich Claudication Questionnaire (ZCQ) at -7 days, 7 days out, and 30 days out from trial.  Then, at Implant, a cadence of -7 days, 7 days out, 30 days out, 60 days out, 90 days out, 180 days out,  1 year,  2 years, etc. Assessment cadence stops if a known explant occurs, of course.  You can change that pathway to add PGIC or PROMIS-29 at any point,  if that is your preference.  Or, use the IMMPACT  recommended outcomes for SCS. For RF or SI Fusion, many of our providers receive ongoing ODIs at -7 days, 7 days out, 30 days out, 60 days out, 90 days out, 180 days out, 1 year, 2 years, etc. Medical management patients can receive our Schedule Substance Abuse Panel (PROMIS Pain Prescription Med Misuse, PROMIS Alcohol Use, PROMIS Appeal of Substance Use, PROMIS Severity of Substance Use) at first appointment and every six months – or Opioid Risk Tool or any of our other 20 validated assessments.  Once the intervention pathways are set, they run automatically – yet, can be stopped at any time or augmented to included an ad hoc gather of a GAD-7 or PHQ-4 for example.

Patient Education and Care Planning.

Our client providers use the individual PRO assessment result reports (pdfs) that are available in their EHR/EMR from us –  for education in the exam room and lean on them for medical decision making support. Please note that both time in education and MDM considerations may have E&M level implications and therefore revenue cycle implications.

Pain Command Center.

After gathering PROs and other custom data elements on patients to support in-clinic visits and pre + post surgical interventions, client providers have access to a Command Center that shows a variety of population-level data elements: a heat-map of pain severity across their market for hot-spotting, patient improvement by appointment type/intervention type (look at what device or technique is performing best in what category), patient response by PRO, patient improvement % by PRO type and much more.