This document proposes a patient messaging system to improve outcomes measurement for pain management. The system would use SMS text messages to inquire about patients' experiences after procedures in real-time, providing more objective metrics than traditional follow-up calls. Practices could customize the questions, responses, and timing. The system integrates with Allscripts and collects anonymized data for practices to evaluate treatments and protocols. It aims to increase compliance, customize care, and accommodate changing healthcare demands at a lower cost than alternatives.
ما الفائدة من الفلسفة؟ لقد أجاب الفكر اليهودي الصوفي عن هذا السؤال على طريقته. كيف نجيب نحن، لنبلور إنّيتنا في قلب الإنسانية المعاصرة. إنها بالطبع ليست دعوة إلى الاقتداء، بل للتأمل والتبصر.
من مقدمة مترجم الكتاب: نظير جاهل
ما الفائدة من الفلسفة؟ لقد أجاب الفكر اليهودي الصوفي عن هذا السؤال على طريقته. كيف نجيب نحن، لنبلور إنّيتنا في قلب الإنسانية المعاصرة. إنها بالطبع ليست دعوة إلى الاقتداء، بل للتأمل والتبصر.
من مقدمة مترجم الكتاب: نظير جاهل
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2. Problem: Objectifying a
Subjective Problem (Pain)
• Pain is costly
– Lost productivity due to pain in 2010: $297.4
to $335.5 billion1
• Pain is complex
– Numerous, overlapping causes (muscles,
joints, discs, nerves, etc)
• Pain is subjective
– Limited metrics for treatment outcomes
– Recall bias & placebo effect further
complicate outcome metrics
1. Institute of Medicine of the National Academies Report. Relieving Pain in America: A Blueprint for Transforming
Prevention, Care, Education, and Research, 2011. The National Academies Press, Washington DC. (page 260)
3. Identifying the Cause & Effect
• Due to its subjectivity, Cause & Effect
relationships difficult to establish in
Pain Management
• Thus, no gold standards exists
– Variable treatment algorithm
(chiropractor, PT, surgery, minimially
invasive procedures, etc)
– Wide geographic variability
4. Purpose
• To Improve quality of outcome-measures
in a subjective arena
– “Did this procedure help”
– “Are we closer to diagnosing the source of
pain?”
– “What options exist for the cure?”
• To reduce hindsight bias
– Real-time inquiry of outcome vs 3-4 week
follow-up
– Quantifiable metrics
5. Design
SMS initiation with mobile web link
– HIPAA Compliant
• Initiated with text reminders without PHI
• Linked to website with post-procedure inquiries &
reminders
– Patient Feedback
• Inquire about procedure outcomes
• Directed responses in real-time vs query pain
score weeks later in follow-up
– Automated Responses
• Decision tree algorithms
• Practice-defined questions & response; real-time
customizability
6. Usability
• Procedure Rule Entry
System add-on
• Practice defines
templates for
– Questions
– Timing posted
– Responses &
algorithm for follow-
up questions
8. Integration
• Interface with Allscripts
– Customizable within Allscripts Clinical
Customization Screen
• Data Domains
– Local Fax Server
– Central Web Domain Server with HTTPS
– Local Allscripts SQL database & TxT-Rx
SQL database housed on local server
10. Market Plan
• Geographic prevalence of Allscripts
– >200 PRO-EHR sites in local region
• Beta testing
– Local geographic market
– Small clinic (< 3 physicians, 1-2 specialty)
– 10 free beta clients
• Data collection & outcome evaluation on
beta
– Change in cancellations
– Quality of data collected
11. Market Plan
• Price point: Allscripts Pro
– $1500 for license & training (conducted
online)
– Maintenance:
• Option 1: Ad-based revenue
• Option 2: $200 per physician per year
– Cost of hardware:
• With Fujitsu fax server $400
• Without Fujitsu Fax server $4000
• Price point: Allscripts Enterprise
– Pending outcome of Beta evaluation
12. Advantages of System
• Increases patient compliance & participation in
care
• Customizable
– Practice determines use of data
• Forward to insurance
• Internal review of treatment protocols
• Research
• High-cost Alternatives:
– Human interface (staff calls & record-keeping)
– Follow-up visits (recall bias, poor quality data)
• Accommodate changing medical market
– Consumer desire for interactivity
– Accountable Care Organizations & quality reporting