Overview of PainTracker &

Progress to-date at UW Medicine

Brian Theodore, PhD Mark Sullivan, MD, PhD

David Tauben, MD

What is PainTracker?

1. The UW PainTracker is a web-based tool to assess and graph core patient-reported outcomes of chronic pain management over time.

2. 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.

3. 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:

1. UW PainTracker initially supported primary care content and

workflow, and also TelePain

2. Content added to support sports medicine and ortho needs and rebranded “UW ActionTracker”

3. Content added to support chronic pain at CPR

Core Measures

1. Pain location 2. PEG – Pain Intensity, Interference with Enjoyment of Life and

Interference with General Activity 3. Pain interference with sleep initiation and maintenance 4. Pain interference with patient-defined “Most Important Activity” 5. PHQ 4 – Mood screener for depression & anxiety 6. Opioid Risk Tool 7. Medication tracking 8. Prescription opioid dose (MED) and utilization 9. Satisfaction with Pain Treatment

Service-Specific Measures 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 1. Integration with Epic

2. Labor intensive

3. Completion rates

4. Access to dataset

Workflow Analysis

In collaboration with UW Department of Human Centered Design & Engineering

Progress with Integration

Epic

Scheduling Daily Activity Report

Pain

Tracker

PSS/Outcomes Coordinator Reminder Calls

Progress with Completion Rates

45% 50%

0%

20%

40%

60%

80%

100%

Baseline Followup

Baseline: 131 patients observed over 7 weeks at CPR Followup: 163 patients observed over 7 weeks at CPR

Progress with Completion Rates

73%

27% Completed at Home (with orw/out assistance)Completed in-Clinic (with orw/out assistance)

Progress with Completion Rates (single clinic champion)

128 patients observed over 8 weeks at CPR

Progress with Data Access 1. Current development of flat file with raw and

summary scores (Est. Dec 2014/Jan 2015)

2. On-demand download into Excel file

3. Available on-demand for QI

4. Available for research with IRB approval

Questions?