The pain committee at a healthcare facility has made progress in several areas: - It updated its member list and added more pain disciplines. - It developed a more structured communication process and increased motivation among members. - A key development was a "Multidisciplinary Virtual Pain Team Consultation" program, which involves multiple disciplines providing virtual consultations to primary care providers to help support them in pain management. An initial pilot in primary care was successful. - A proposed stepped care model was developed to provide different levels of pain treatment from primary to tertiary care.

1. Stepped Care Model forStepped Care Model for
Pain ManagementPain Management
AB Consulting for HealthcareAB Consulting for Healthcare
Arney BensonArney Benson
4541 N.644541 N.64thth
St.St.
Scottsdale, AZ 85251Scottsdale, AZ 85251
www.abconsultingforhealthcare.comwww.abconsultingforhealthcare.com

2. ObjectivesObjectives
• Progress as facility pain committee
• Progress as Telehealth pain committee
• Successes
• Struggles
• Next steps

4. Pain CommitteePain Committee
• Updated pain committee member list
• Added more pain disciplines rep
• E-mail group for communication
• More structured
• More enthusiasm, motivation, energy among
members
• Updated/reviewed committee objectives
• Developed “Multidisciplinary Virtual Pain Team
Consultation”

5. ““Multidisciplinary Virtual Pain TeamMultidisciplinary Virtual Pain Team
Consultation”Consultation”
• Developed “Multidisciplinary Virtual Pain Team
Consultation”
• Subgroup of facility pain committee
• Primary and secondary (back up) key people
from each discipline
• Support from departmental chiefs and EMT
• More than 10 disciplines on the team
• Regular communication among team members
• Pilot program done in primary care

6. ““Multidisciplinary Virtual Pain TeamMultidisciplinary Virtual Pain Team
Consultation”Consultation”
• Key members from following disciplines;
1. Physical Medicine & Rehab Physician
2. Pain Psychologist
3. Physical therapist
4. Rec therapist
5. Interventional pain specialist
6. Ortho spine surgeon
7. Neurosurgery
8. Primary care physician
9. Pharmacist
10. Patient advocate
11. Social worker

7. ““Multidisciplinary Virtual Pain TeamMultidisciplinary Virtual Pain Team
Consultation”Consultation”
• Developed Telehealth consult order,
virtual/historical visit/note title/note/alerts
• Chart review by all disciplines prior to case
discussion
• Primary care provider gets invited to meeting,
short case presentation by PCP….then
consultation from all disciplines
• Opportunity for provider education about
services from different pain disciplines and pain
management
• Support for PCP
• Case example

9. TERTIARY LEVEL
SECONDARY LEVEL
PRIMARY LEVEL

10. Proposed Stepped care model for aProposed Stepped care model for a
Virtual Pain ModelVirtual Pain Model
Provider
education
Pain Medication
Management
Pain Medication Management
Pain
Policy
Pain
School
Primary Care Clinics/Teams
Bupe
Clinic/
SATS
Secondary Consults
Int
Pain
Clinic
Chronic Pain
Rehab Program
Multi-dis
pain
T
e
r
t
i
a
r
y
Sec
Primary
CBT
CBT

11. CRIPPCRIPP
CComprehensiveomprehensive RRehabehab
IIntegrativentegrative PPainain PProgramrogram
(Proposed)(Proposed)

12. CRIPPCRIPP (Comprehensive Rehab(Comprehensive Rehab
Integrative Pain Program)Integrative Pain Program)
Chronic
Pain
Consult
Screening
Clinic
Bupe
clinic/SATS
Chronic
Pain
rehab
program
PMMP
PMMP
Sec.consults/int/SATS/Biofeedba/
PT/accupuncture
CBT
CBT
Pain
School
Multi
-dis
Pain
P
C
P
Team meetings with OEF clinic,
pain clinic, CRIPP staffing, PCP
staffing (q6mon)