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Featured image for patient-reported outcomes and AI in Pain Management

Integrated pain management is a specialty that has grown in recent years. Patient-reported outcomes and AI in pain management can provide insights to improve treatment plans. During each visit to a clinician, patients complete assessments to inform their provider about their current conditions. Each of these assessments creates a profile for the patient about their current and ongoing symptoms. Each of these patient-reported outcomes is extremely useful in tracking the success of a treatment plan. Recently, artificial intelligence (AI) has become an integral factor in learning more about these outcomes. AI can be trained to learn how different factors in a patient’s treatment plan affect their outcomes.

With pain management, it is essential to assess each patient’s pain symptoms frequently. By digitally recording responses to patient assessments, these patient-reported outcomes can be tracked more efficiently. To provide more effective treatment plans, pain management providers are using patient-reported outcomes and AI more often.

How does AI in healthcare work?

AI starts with compiling lots of data. In pain management, each time a patient visits their physician, they fill out assessments about their current symptoms and pain levels since their last visit. The provider then takes the information, compiles it, and compares it to each patient’s recent medication and lifestyle changes. In addition to this, the patient may utilize physical therapy or behavioral health resources in their treatment plan. All of these factors come into play when a provider makes decisions about the patient’s ongoing treatment will be. What has worked for them in the past? Are they improving? What else can they try?

This is where AI comes into play. AI and machine learning can take all of these factors and learn what can be an effective treatment plan for each patient. By compiling this data, AI can infer from previous assessments what is more or less likely to work for that patient based on their historical data.

AI recognizes patterns in treatment plans as data becomes available. Using this information can make a well-defined course of action for the healthcare provider. By utilizing these patient-reported outcomes and AI in pain management settings, treatment plans become more successful in pain patients.

Why is Pain Management a focus for AI?

Many different healthcare specialties can use AI with patient-reported outcomes. However, pain management tends to include a myriad of external factors for each patient. Pain management can include patients with medication dependencies, behavioral health diagnoses, and chronic diseases. Because of these factors, it is difficult to accurately weigh each one as a patient treatment plan is formed.

Because the opioid epidemic is a continuing concern for healthcare providers, AI has come into play more heavily. Digital healthcare has become a key player in combating the opioid crisis with remote patient monitoring and risk assessments. Correct dosing for opioid prescriptions is a fine line between addiction and chronic pain in patients. This is why AI has become prevalent in managing opioid use in hospital settings in recent years.

It’s also important to note that pain management is a very iterative an ongoing treatment process, and can differ greatly between patients. For this reason, collecting patient-reported outcomes to derive treatment options has proven to be successful in recent years.

How can I get started using AI in my practice?

cliexa’s pain management platform (cliexa-Ease) incorporates patient assessments and utilizes them to create a comprehensive risk score for each patient. The Symptom Severity Score (FIBR), Dallas Pain Questionnaire (DPS), Medical Outcomes Survey (MOS Core, SF-36), and Pain Disability Index (PDI) are all incorporated into the platform.

As a provider, you can create a risk matrix based on your treatment preferences and utilize this digital tool to streamline patient assessments and risk. Determining risk of a patient is the cornerstone to their treatment plan. Risk assessments assist the healthcare provider to make decisions based on many different factors that can affect a patient’s overall risk. Also, by tracking medication adherence and compliance with each patient will allow providers to better track their symptoms over time. All of these features are included in the cliexa-Ease platform and can help you to better track patient outcomes using remote monitoring and integrated risk assessments.

Learn more about cliexa’s digital platforms.

 

Combatting the Opioid Crisis with Pain Management Technology

Introduction

The treatment for chronic pain has long been debated as its management offers a wide array of options for both clinicians and patients to choose from. Medicines for depression have the potential of becoming addictive due to their calming effect on the patient. While conventional treatments have become outdated, the administration of prescription-based and over the counter drugs has exploited susceptible individuals to the harmful effects of opioid overuse. It is vital that clinicians find a solution to monitoring the use of opioids to help bring the drug epidemic to its demise and simultaneously encourage non-pharmacological options to their patients. 

Monitoring chronic pain and depression 

Traditional Methods 

Depression and chronic pain can overlap due to them possessing a few common neurotransmitters that are responsible for delivering messages between neurons. They also have similarities in their pathways of the brain and the spinal cord. Chronic pain has the propensity of eliciting signs and symptoms of depression. Its severity and impact on a person’s life are what contribute to depression manifesting. With underlying chronic pain, a person begins to experience struggles in how they handle losses, more extended periods of inactivity, a decrease in sociability, diminished interest in relationships, and poor work performance. People who are susceptible to depression and are simultaneously managing the effects of a chronic illness are treated for both conditions simultaneously.

Traditional medicines and management are regarded as safer and there are ample choices a doctor can implement. Conventional medicines for the management of pain are based on the many theories and beliefs of different cultures that are targeted at reducing or improving pain. Among the many opted treatment regimes, the few common ones are acupuncture, herbal medicines, and Ayurveda medicines, which have been regarded as the most common and recognized treatments universally. Regardless of their effect or cultural support, these treatments aren’t evidence-based, and their underlying mechanisms aren’t common knowledge. This limits their use by doctors in their clinics.

There has been a notable rise in the treatment of pain and depression through the use of opioid medications. The opioid epidemic brought the attention of the masses in 2017. Many federal agencies, including the US Food and Drug Administration (FDA), the Joint Commission, and the National Academies of Sciences, Engineering, and Medicine (NASEM), have begun advising clinicians to regulate prescription-based opioid drug administration and to offer more options than just medications.

Overview of the Opioid Crisis 

It’s inevitable that with many drugs being conveniently available over the counter, patients have taken to self-medicating themselves. More importantly, due to the potent effects of opioid drugs, immune-deficient or overly busy people, rely on opiates to help them get through a tough day. The use of chronic opioid therapy for non-cancer related pains has taken risen exponentially in just the previous two decades. This was noted to occur concomitantly with the increase in prescription-based opioid use as well as abuse or accidental overdose using these drugs. Opioids are sometimes even called narcotics. Some of the strongest prescription-based opiates are tramadol, hydrocodone, fentanyl, and oxycodone. Even heroin, which is an illegal drug, is an opioid. Opioids are both human-made and synthetic. Regardless of what combination of a drug is made available, they all promise to act as immediate pain relievers.

The relationship between depression and opioid abuse is a two –way relation, meaning that when a person is suffering from depression or opiate withdrawal, he will likely develop symptoms of the other condition as well. Opioid drug abuse refers to the use of this drug without the use of a prescription. It’s either used in a non-medical context or is taken in larger quantities than is required, and this inadvertently is linked to higher rates of depression, bipolar disorders, and anxiety.

Current problems associated with a standardized method of treating pain 

Currently, pain management within the oncology department, its effective pain-relieving abilities, and there were limited alternatives for relieving pain in severe conditions have increased the reliance patients, and doctors have for these potent drugs. With an increase in drug reliance, even the risk for aberrant and inappropriate behavior has risen. Also, standardization in treating cancer-related pain lacks among the clinicians who prescribe it. It’s recommended that residents and doctors who practice medicine should vary in misuse and abuse of drugs.

Coping skills for patients dealing with chronic pain

Patient Education 

Non–pharmacological pain management means managing pain without the inclusion of medications. This mode of treatment targets the mind of the patient and hopes to influence and encourage positive thoughts or alter thoughts to reduce the effect of pain felt anywhere in the body. There are many non-pharmacological options that one can subscribe to. They include:

Educational and psychological conditioning of the mind

Many people are entirely in the dark about what to expect when dealing with depression or chronic pain. It is quite stressful for them, and it is their caretaker’s responsibility to educate them about their condition to make it easy for them. If a patient has been made prepared for what they’re about to endure, it helps reduce cortisol levels and thereby reduce the amount of stress they can experience. To decrease their anxiety, the clinicians should consider engaging the patient in conversation and explaining to them vital pathological signs regarding their debilitating pain or their depression. Even explaining treatment options thoroughly might allow them to make a more well-informed decision. The use of pictures or diagrams will help everyone understand the pathway of their illness properly. Any questions that the patient has should be written down and answered diligently.

Alternative treatments to pain medication (opioids)

Among the variety of treatment options available to patients, some critical and recognized suggestions are:

  • Hypnosis

A psychologist or doctor helps guide the patient into a state of altered consciousness, and this helps reduces the pain experienced by the patient by narrowing their thoughts. The method for such treatment involves guiding the patient’s thoughts through mental images based on sight, smell, taste, and feel. This helps deviate their thoughts from the pain they are experiencing. If a child or adolescent is experiencing chronic pain or depression, then various methods of distraction should be employed. Videos, songs, and storytelling are among the multiple techniques that can be applied. Many relaxation techniques are also used, such as deep breathing and stretching, which can also help ease the discomfort.

Among other options available to the patient and doctor are comfort therapy, occupational therapy, physical therapy, psychosocial counseling, and neuro-stimulation. These can be utilized instead to help relieve pain, and many patients find comfort in them instead of ingesting large amounts and frequent doses of medications. To further elaborate, these therapies are listed below:

  • Comfort Therapy

It involves companionship, hot or cold compresses, exercises, massages, meditation, drama or music therapy, counseling, and occupational therapy.

Physical and occupational therapy are beneficial and can be implemented through aqua-therapy, desensitization, psychosocial therapy, and strengthening exercises for the muscles that may have lost power and tone due to immobility.

  • Psychosocial Therapy: 

It involves counseling in the form of family, group, or individual counseling. This method helps a patient become more accustomed to their condition and helps teach coping mechanisms.

  • Neuro-stimulation: 

This method involves electrical nerve stimulation, which immediately helps relax tense muscles and improves neural impulses through fatigued muscles, acupressure, and acupuncture.

How does cliexa monitor its patients? 

Remote Monitoring

Clinicians need to have a profound grip on opioid use. The only solution to narrowing down the prevalence of this epidemic is by finding a method to track the intake, risks, and effects on a patient dealing with crippling chronic pain. The way clinicians can do this is by using cliexa to their advantage. The cliexa platform allows patients and their clinicians to seamlessly track the activity and progress of the disease, whether in-clinic or through a remote monitoring program. Their proprietary technology is exceptional and allows for intelligent correlations between the dosage of medicine the patient is ingesting, their frequency of drug use, and whether symptoms have heightened or lessened. Managing chronic pain has become better because the best way to reduce an opioid or drug overuse is by ensuring that drug intake stops once the patient becomes better and shows no reason to continue his drug intake. The system allows their patients to connect to software that will enable them to communicate with their physicians without any interruption. This technology assists the providers through its ability to adequately document changes in any baseline metrics and helps patients get access to timely treatment. This would inevitably result in lesser complications.

The remote monitoring services allow patients to use their phones to send any healthcare data to their providers, and easily covering either a range of diseases and make necessary amendments in their ongoing treatment. This trend is powered by cliexa through its ability to provide clinically validated assessments with an automated disease activity score, all through its ability to gain real-time data through the wearable devices their patients wear. The wearable allows for data collection that could easily go undetected in many patients. This helps to improve the reported outcome vastly and improves patient satisfaction immensely.

Connect to claims data to visualize prior hospitalizations

The data is made available to clinicians through cliexa’s Evaluation and Management services. It’s responsible for medical coding and medical billing. These E/M services integrate history, exam, and medical decisions that are vital for establishing patient visits that are thorough and detailed. Medical compliance is based on proper documentation of medical records that help physicians and extended healthcare professionals evaluate their patients excellently. Treatment options are then made optimal and accessible. Real-time data that is gathered for the patients is used by the physicians to provide the utmost high quality of care when dealing with their patient’s mental health.

Wearable devices for real-time, activity data collection

Among their numerous mobile applications, cliexa-SENSE is routinely implemented in behavioral clinics where patients dealing with depression, alcohol abuse, narcotic abuse, and opioid abuse are treated. cliexa-EASE is a mobile application that is a pain assessment model for monitoring chronic pain. This app helps maximize reimbursements and helps improve chronic care management. cliexa- RA is responsible for reporting rheumatoid arthritis symptoms using patient-reported outcomes using clinically validated assessments. The disease activity scores are reported diligently through this, and quality care is further optimized for patients. cliexa-COPD is tasked with providing preventive and value-based care for people who are afflicted with COPD.

Identifying opiate risk 

cliexa has partnered with Colorado Clinic, New Health Services, and more pain, behavioral health, and mental health facilities to combat the opioid crisis exceptionally. This is their method of improving chronic pain care and management. cliexa has digitized the entire process of the patient’s arrival, consent documentation, and chief complaints. At-risk patients will be monitored in this manner and will have to fill out screener questions that will be based on the Screener and Opioid Assessment for Patients in Pain model. This model is designed in such a manner that it will help self-report and address the extent or appropriateness of therapy in patients suffering from chronic pain. They will receive intelligent treatment options that will be aimed at minimizing the extent of pain. This information will be entered into the EMR system. The scores that will be generated after the patient is screened, and their responses gave the appropriate score, their risk of opioid abuse will be graded as low, medium, or high. This will help clinicians strategize treatment and duration of drug administration accordingly. The health care providers will even have to ensure they use urine drug monitoring as a necessary part of their clinical assessment, as this will help monitor the patients before their drug therapy and following their drug therapy. Random and routine urine analysis can help manage low and high-risk patients fruitfully. It’s even been studied and proven that urine drug monitoring will help drug compliance and prevent misuse of drugs. cliexa’s AI helps software hopes to optimize pain management by continually producing intelligent solutions from patient input. 

Conclusion

Innovative methods to manage patients are continually being used by clinicians and hospitals as they wish to optimize the quality of care that they deliver to their patients. Patient education must be encouraged as this will make patients self-aware of the harm they can inflict upon themselves by poorly complying with drugs. Doctors and patients must work together to reach a solution that aims at reducing the number of medications ingested to manage pain and related mental disorders. This way, drug complications will be narrowed down, and the risk assessment for many patients liable to misuse drugs will decrease.

 

 References

  1. https://www.ncbi.nlm.nih.gov/m/pubmed/28226333/?i=2&from=/29149119/related
  2. https://www.practicalpainmanagement.com/amp/22565
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069064/
  4. https://www.hindawi.com/journals/prm/si/674036/cfp/
  5. https://www.webmd.com/depression/guide/depression-chronic-pain
  6. https://medlineplus.gov/opioidmisuseandaddiction.html
  7. https://www.psycom.net/depression.central.opioid.abuse.html
  8. https://www.cliexa.com/evaluation-management-services/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6699803/
  10. https://www.cliexa.com/?cat=-1
cliexa is now available in the athenaHealth Marketplace

Today, cliexa Inc., a thriving producer of mobile health care management services, revealed a partnership with athenahealth, Inc.® through athenahealth’s “More Disruption Please” (MDP) Marketplace program. As an MDP partner, our cross-communication platform developed for chronic pain patients and providers, cliexa-EASE, is now immediately available to athenahealth’s network of 100,000+ providers and countless prospective clients. EASE enables patients and clinicians to make intelligent correlations between medication dosage, frequency and heightened or reduced symptoms by leveraging an application that functions as a pain assessment model for chronic pain management with seamless scalable EMR integration via API and global HL7 connectivity.

cliexa provides the ideal pain management application to leverage patient-reported outcomes to improve treatment decisions and patient experience, while also maximizing compliance and reimbursement. cliexa-EASE is designed for chronic pain management, podiatry, and general patient wellness. cliexa-EASE allows providers to gather digitized intake data and customize assessments to correlate data that best adheres to their patient population.

In order to provide physicians with high accuracy metrics, cliexa-EASE uses patient reporting methods on visual body maps, and pain expression in voice, face, and body movements. This allows physicians to view the physical attributes of pain beyond self-reported descriptions which can often be difficult to translate into clinical diagnostics terms. Tracking these markers allows physicians to use patient-reported outcomes to treat the “whole patient.”  One of cliexa’s existing clients, Anderson Podiatry Center, is already seeing the benefits of using the cliexa platform with a custom digital patient intake and screening process, also digital consent forms, integrated to their athenahealth electronic medical record (EMR).

The athenahealth Marketplace partnership opens up a hyperconnected, national network of healthcare professionals providing chronic pain management. With this partnership, the two companies align to provide measurable financial and clinical results for providers. cliexa is a real-time data provider for future medicine and will continue to build on our vision to increase patient-provider engagement and compliance through mobile health solutions.

“We are excited to partner both with athenahealth and Anderson Podiatry Center to deploy cliexa platform into the marketplace as this is the first of many subspecialties we currently have in our portfolio. We are looking forward to implementing other subspecialty applications to the athenahealth marketplace which will strengthen our partnership in healthcare space,” says Mehmet Kazgan, Founder and CEO of cliexa.

Eric Seyler, CEO of Anderson Podiatry Center, says, “The transition to a digital patient intake has given us more opportunities to help our patients than we had envisioned. Our patients have spent less time in the waiting room with more time delegated to their doctor’s visit. The integration is done in real-time which supports our goal to be more efficient with clinic resources while helping to provide the best possible patient experience.”

cliexa enables patients to track their chronic disease activity by quantifying symptoms using scientifically-proven and clinically-validated scoring models. cliexa delivers quantified disease activity and documentation through real-time integration to athenahealth electronic medical record, which streamlines processes and increases efficiency in population health management.

View our listing here: //marketplace.athenahealth.com/product/cliexa

cliexa PTSI Press Release

We are proud to announce that we have officially joined forces with Preventative Technology Solutions, who will now become apart of the cliexa family.

Here is the link to the press release about the acquisition: //www.pr.com/press-release/768313

 

Digital health benefits

2018 has seen a significant boom in the application of technology in digital health innovation, which are poised to disrupt the healthcare industry. Innovations have included advances in mobile health (mHealth), health information technology (IT), as well as wearable and Internet-of-Things (IoT) devices.

cliexa has identified six specific areas of medicine already reaping the benefits of digital health innovation:

1. Rheumatology

Disease Activity Scoring (DAS) metrics remotely collected by cliexa from patients are used by physicians in their offices when assessing the severity of rheumatoid arthritis through a Q & A approach. cliexa empowers patients with the ability to communicate their patient-reported outcomes to their physicians at the touch of a finger, on their own mobile devices, providing physicians with instantly-scored clinically-validated assessments. The application of cliexa innovations in rheumatology drastically increases the efficiency and quality-of-care for both patients and their providers.

Check out the cliexa mobile platform for Rheumatoid Arthritis, cliexa-RA: //www.cliexa.com/cliexamobile/rheumatoid-arthritis/

2. Pain Management, Primary Care, & Integrative Medicine

Chronic pain, affecting over 10% of American adults, is a leading cause of opiate abuse. Managing and overcoming chronic pain is a complex obstacle for many healthcare providers. With the increased shift away from the prescribing of opioids in the treatment of chronic pain, cliexa enables providers to remotely monitors opioid-prescribed patients while empowering them to relay their patient-reported outcomes and track their mental health conditions in association with their chronic pain, while catering specifically towards the individual needs of each patient-provider relationship.

Check out the cliexa mobile platform for Pain Management, cliexa-EASE: //www.cliexa.com/cliexamobile/pain-management/

3. Behavioral Health & Addiction Treatment

Though struggles with addiction are becoming increasingly more prevalent in society, the present methods of addiction treatment are limited. Through innovations in health technologies, patients and providers are shifting towards new ways of treating addiction. The monitoring of patients in real-time is essential for positive treatment outcomes for both patients and their providers. By leveraging patient-reported data, patients adhere to their treatment plans and overcome addiction as a disease, rather than as a fault.

Check out the cliexa mobile platform for Behavioral Health, cliexa-SENSE: //www.cliexa.com/cliexamobile/behavioral-health/

4. Digestive Health

Through cliexa innovations, providers better manage chronic gastrointestinal diseases, such as inflammatory bowel disease or ulcerative colitis, using specifically-designed, highly-structured treatment plans that leverage disease activity scoring models taken from qualitative patient responses to assessments which quantify and track symptoms over long periods of time.

Check out the cliexa mobile platform for Digestive Health, cliexa-IBD: //www.cliexa.com/cliexamobile/inflammatory-bowel-disease/

5. Respiratory Care

cliexa enables providers to qualitatively track chronic diseases of the respiratory system, like chronic obstructive pulmonary disease (COPD), through remote patient-reported outcomes. The ability to structure individualized and specialized care leads to improved patient-provider experiences.

Check out the cliexa mobile platform for Respiratory Care, cliexa-COPD: //www.cliexa.com/cliexamobile/chronic-obstructive-pulmonary-disease/

6. Pediatric Care

cliexa health technology drives innovations in mental health resiliency in adolescents, a hot topic in today’s health community. cliexa’s clinically validated medical assessment applications, coupled with its mHealth prevention services, help providers identify and reduce risk behaviors in adolescents and young adults. cliexa’s mobile patient-engagement applications equip providers with the tools adolescents use to overcome anxiety and depression, increasing the overall quality-of-care for both patients and providers.

Check out the cliexa mobile platform for Pediatric Care, cliexa-OPTIONS: //www.cliexa.com/cliexamobile/adolescent-resiliency/