Author Archives: healthhelm

Monitoring COVID-19 Patients at Home During Recovery

Over 85% of COVID patients (diagnosed and presumptive or symptomatic) will be directed to recover at home.   Recovering at home is scary for patients and their families, given the potential severity of the disease and its varied course in different patients. In some patients the path is more mild, in others more severe, and difficult to predict. 

Telehealth solutions like Trusted Patient Coach™ (TPC) enable patients to report their symptoms and progress daily.  TPC reduces the burden on clinics and call centers, and enables objective triaging for intervention if a patient’s recovery deteriorates.  Patients self-report daily, using Patient Reported Outcomes Measures (PROMs) questionnaires, using CDC or other protocols designated by the public health organization or provider.   These questionnaires can be reconfigured rapidly, in most cases in a day, as symptoms tracking and contact tracing evolve.

“The precise line between a mild versus a moderate case of COVID-19 is uncertain, and the terms themselves are nonspecific,” says Dr. Richard Martinello, Associate Professor of Medicine (Infectious Diseases) and Pediatrics and Medical Director, Infection Prevention, Yale New Haven Hospital (ref.  ).

Patients can begin reporting daily from the onset of symptoms using TPC. They continue reporting during the course of those symptoms, and for another 3-5 days following the end of symptoms. Additionally, they can connect with and be cleared by a health provider before discontinuing home isolation. 

As Contact Tracing grows to mitigate and ultimately contain the further spread of COVID-19 , TPC is a weapon in the arsenal of public health [and military organizations]. Contact tracers need to quickly locate and talk with the patients, assist in arranging for patients to isolate themselves, and work with patients to identify people with whom the patients have been in close contact so the contact tracer can locate them, gather data on activities, symptoms and potential for spread. TPC can rapidly remotely register and capture patient consent, provide patient education to patients on their own mobile devices – and do so securely, assuring patient privacy and mitigating scam risks.  TPC sends standardized questionnaires at registration, enabling rapid initial baseline data collection and direct electronic capture, for follow up by tracers on TPC’s web-based dashboard and with reporting extracts for tracer follow up and public health analyses.  TPC augments the specialized interviewing by tracers, speeding the patient and disease mitigation follow up.

The benefits TPC provides Public Health Agencies and providers in support of remote monitoring of patients recovering at home and in contact tracing are:

  • High patient compliance, clinicians can rely on.
  • Easy to configure for clinician monitoring of COVID, rapidly adaptable as protocols evolve. At discharge, complex recovery protocols can easily be implemented for close monitoring.
  • Clinically validated in post-surgery and substance use recovery contexts.
  • HIPAA compliant, TPC enables secure data collection to better manage each patient’s recovery and gather important pandemic public health data.
  • Ready to deploy now: 2 hours for configuration and 2 days for platform set-up. TPC is operational today supporting patients and clinicians.

Trusted Patient Coach provides patients and families peace of mind by staying connected, is easy to use and remotely install from the App Store on a patient’s (or family caregiver’s) mobile device. TPC is ready to deploy now in Canada and the US.

mobile health

Telehealth has been around for years – seriously gaining steam as the internet has grown and with major advances driven by the FDA.  As the Agency required patient reported outcomes in the development of new drugs, for example, large, clunky paper patient diaries were replaced with mobile e-PRO, eCOA, and PROMs*.   Advances in sensing devices, data analytics, video conferencing, and a wide range of mobile apps and technologies have broadened the possibilities for telehealth. 

Yet barriers to adoption have remained, among them:

  • Limited or no payments to healthcare providers for mobile and telehealth tasks
  • Barriers to interoperability, most notably with some Electronic Medical Record systems
  • EMR overload distracting clinicians from quality patient time and solving patient needs

It has taken the COVID-19 pandemic to demonstrate what the broader impact and value of telehealth and mobile remote patient tools can be.  Had US healthcare embraced these new technologies more rapidly and extensively, the system may have been better prepared to deploy remote patient care and to achieve more meaningful patient-clinician connections.    

Our team has been involved in scalable mobile e-PRO and PROMs over the last 19 years, successfully deploying these programs to patients, clinicians and clinical investigator teams globally. Our solutions have achieved high, sustained compliance among patients by engaging them in daily routines critical to their recovery and disease management:

  • Getting patients prepared for surgery, a medical procedure or doctor’s visit
  • Reporting their clinical status, symptoms and recovery progress after such events
  • Keeping them connected in meaningful ways to their clinical team – enabling rapid, easy-to-use, secure messaging back and forth; answers to concerns; patient education or videos; or simply a check-in and kind word showing caring and concern

Lessons learned are many, foremost among them:  remote patient management must be simple, easy and quick to use, reliable, actionable and timely, keeping patients and their clinicians connected in meaningful ways when it counts. 

Engaged patients connected with their clinicians, particularly during challenging, stressful recoveries, can overcome what our clinicians call the “zone of darkness” while unsupervised at home – and stay on track for a successful recovery.

Our Health Helm Team is supporting patients, clinicians, public health and family caregivers in this battle.  

*Notes:  e-PRO – electronic patient reported outcomes, e-COA – electronic clinical outcome assessment, and PROMs – Patient Reported Outcomes Measures

The American Medical Association notes, “Medication adherence is a growing concern for physicians and health care systems. There is increasing evidence of noncompliance among patients and correlated adverse outcomes that follow.”  (January 29, 2020).  Marie T. Brown, MD, a geriatric and internal medicine specialist at Rush University Medical Center, in Chicago has been studying this. She has been listening to patients and her fellow clinicians to get to the root cause of why patients don’t adhere.  Reference Building patient trust to support medication adherence (American Medical Association) for more information.

Poor communications between clinicians and patients combined with poor or inconsistent education about medications are key factors contributing to non-adherence.  When coupled with other patient barriers and concerns, adherence is driven lower.  Among those barriers are that patients: 

  • Don’t think they need the medications anymore – especially true for “silent killers” such as hypertension and kidney disease;
  • Fear side effects from taking the medication;
  • Cannot afford the medications
  • Distrust medicine and/or pharmaceutical companies

Non-adherence to other care plan tasks can be attributed to similar factors, for example, important tasks assigned to patients following surgery, such as tracking symptoms of infection or other clinical complications and maintaining physical activity and physical therapy.

Patient Reported Outcomes Measures (PROMs) can play a role in overcoming these barriers, particularly PROMs that are easily accessible to patients through their mobile devices.  Mobile apps like Trusted Patient Coach™ (TPC) are clinically proven, intuitive, reliable ways to collect standardized, consistent PROMs data directly from patients about medication and care plan adherence and patients’ clinical status and progress. 

Daily PROMs demonstrate higher adherence reinforced by both daily routines for patients and the regular connection with and monitoring by their clinical teams.  As patients report taking their medication, indications of infection or other clinical issues, their clinical team can intervene early, before an issue festers into a more serious problem.

In using daily or routine mobile tools like Trusted Patient Coach, the physician and patient now have a stronger connection showing the patient that the physician really cares about adherence and therefore their overall outcomes and well-being. 

Patient education about medications are extremely important, which can be reinforced with PROMs tools.  For example, one of the clinician and patient groups using Trusted Patient Coach prescribed aspirin post-surgery as an anticoagulant; reported adherence was dropping.  Clinicians followed up the non-adherence and learned that patients thought aspirin was for pain and had stopped taking it as pain subsided.  Up front patient education and providing education through the TPC mobile app helped to correct this gap, leading to higher anticoagulant adherence.

The easy to use connection and timely responses between the patient and his/her clinical team help to re-enforce essential patient-clinician communications.  Use of Trusted Patient Coach by patients in post-surgery recovery and supporting chronic diseases such as Substance Use Disorders, has demonstrated steady adherence and enabled the human touch and trust with clinical teams.


“Our health care system fails family caregivers” – What can we do about it?

Healthcare must reach patients where they are:  in their homes, at work, outside of the hospital.  Healthcare must support patients and their family care givers wherever they are in their healthcare journey:  recovering from surgery or a procedure, or dealing with a chronic long term disease.  Ellen Bender’s Boston Globe Opinion article, April 25, 2019, states it well, “Caring for a patient freshly discharged from the hospital can be a harrowing experience. Family and friends are asked to take on roles that until recently had been performed by health care professionals, such as administering medications and changing dressings.” And, Ms. Bender notes, “‘There is a surprising lack of consistency in both the process and quality of discharge planning across the health care system,’ reports the Family Caregiver Alliance.”

One of the Senior Surgeons with whom Health Helm works describes this period as the “Zone of Darkness.”  For patients and their families, they are confused about the myriad of instructions.  Or worse, they are confused about conflicting instructions. Clinicians also experience the Zone of Darkness:  is the patient on track?  How are they progressing?  With higher risk patients, physicians wonder if they are developing complications.

Trusted Patient Coach™ (TPC) and our team are focused on shedding light into the Zone of Darkness, enabling patients to better manage themselves, alone or with the support of families and friends.  Patients, or their family coaches, self-report daily or regularly on their progress in recovery from surgery or post-acute treatment, chronic condition symptoms, potential infections (e.g., from incisions or wounds) and clinical complications, medication adherence and physiologic data.  Clinicians monitor these Patient Reported Outcomes Measures (PROMs), “red alerts” generated by patient responses or non-compliance.  Simple messaging within the app is HIPAA-secured, can be initiated by the clinician or patient, and can transmit photos (e.g., of incisions). 

Trusted Patient Coach works for patients and their families on their own mobile device – cell phone or tablet – where ever they are, at home, at work or traveling, is convenient and simple to use, taking a couple of minutes a day.  Patients report, “TPC has been very helpful because I feel more secure being connected to my clinical team.”  And, “It is such a relief to be able to reach out for help when I need it.”

“Supporting family caregivers isn’t just the right thing to do. It can also save money.”  Ms. Bender continues, “Mistakes in home care can lead to hospital readmissions, which are associated with yearly costs of about $41.3 billion as well as reimbursement penalties imposed on hospitals by Medicare as a way to reduce readmissions. About 14 percent of people discharged from hospitals are readmitted within 30 days. “

We are thankful for Ms. Bender shedding more light on this urgent priority!

A Patient’s Journey after Knee Surgery:  The Zone of Darkness

The following is a real patient account following orthopedic surgery.

Upon leaving the hospital after knee surgery (ACL reconstruction), I felt good and assumed I had the information I needed for recovery.  I had a folder full of papers and supporting documents from discussions I had with the physical therapist and nurse upon departure.

I got home, napped, and then read the instruction sheet from the hospital.  I had instructions for the bandages, exercises, the stocking on my leg, pain, showering and crutches.  They sent me home with a cryocuff pack to ice my leg. 

Upon leaving, I’d asked the nurse how to place the ice pack; she confirmed that I should place it on top of the brace. I followed her instructions and put the pack outside the brace, which prevented any cold sensation at all.   I assumed I was doing it wrong.  To at least feel the cold, I moved it under the brace.  It would have been nice to have more specifics. I wished I had someone to email or message just to see how to do this. 

The instructions told me to take two pain killers at bedtime, two in the middle of the night and two upon wakeup. The departure nurse said the nerve block administered before surgery would last 12 to 24 hours.  There is a big difference between 12 and 24 hours.  I really had no idea if I should wait and see if the nerve block wore off before bed or just take the pills. 

I really did not want to take painkillers and was nervous as to how I would feel.  But instructing me to take 6 pills in 8 hours must have meant it is really going to hurt. At bedtime, I still felt no pain, so I took ibuprofen for inflammation and went to bed.   I assumed I would wake up in pain. Again, I wished I had someone to ask.  It was late so the office wasn’t open.

I woke up feeling a bit stiff and achy, but I was not experiencing pain.  I assumed the nerve block was still working.  So, I figured I’d eat and take the pain pill after breakfast. Fast forward a few hours, and I still was not experiencing any pain.

Over the course of my recovery, I used zero of the 50 painkillers prescribed.  It’s not like I am super tough; I just never even got close to needing a single pill.  Why did they prescribe 50?  And why did the instructions tell me to take six opioids in eight hours when I needed none? 

I was told that after two days, I should remove the dressings and place bandages over the incisions.  The paperwork noted I had two small incisions.  But, when I took off the bandages, I had three small incisions, one which was all white, and a 1-inch incision which was covered in blood.  I hoped the white wasn’t a sign of an infection.  I bet some people might think it was and go right to the hospital.   (Also, I’m not sure why it said two incisions, as I could see four).  I pulled everything off and put a band aid over each of the four incisions.  What I learned a day later, was that the white on one of the incisions was some type of glue because it fell off!  It would have been nice to know that, so I wouldn’t have worried about it being an infection.

I couldn’t find any information on the CPM (continuous passive motion) machine that was delivered to my house.  (You put your leg in it and it keeps the leg moving while you are seated.) I wasn’t sure how frequently to use it and there was some conflict as to the setting.  The man who delivered it set it at 40% but he said the doctor suggested 60%.  He told me to ask the doctor as 60% was very high.  However, I didn’t see the doctor after surgery and forgot to ask the nurse.  I dug through the paperwork that was sent to the house when I registered a couple of months ago.   On that paperwork I found, ‘Do not remove the steri strips over the incision’.   What?  I removed them this morning following the other instructions.  Am I going to get an infection?  Should I call the office? 

But, as I continued reading, it said to remove all dressings on day three before a shower.  I think I was only a day off.  I guess no big deal.

Fast forward to my nurse appointment five days after surgery.  She asked why the steri strips were still not in place.  What?  I told her I had two conflicting sets of instructions, but one said to take the dressing off on day two and one said day three (and they both said ‘all the dressings’).   She said that didn’t mean the steri strips.  Once again.  Confusion and no clear instructions.   Thank goodness there were no signs of infection. 

The instruction sheet from the hospital said to use the crutches from partial to full weight bearing in three days.   But I found another sheet that said crutches 14 days, followed by an indecipherable word that was written by the doctor.  I also had a leg brace.   I really didn’t know if I needed to use both the brace and crutches and really had no idea for how long.   It would have been helpful to be able to send off a quick message for clarification. 

At day five, I was able to ask the nurse.  Apparently, I really shouldn’t have been walking with full weight bearing.  I hope I didn’t injure anything inside my knee. 

Regarding exercise, I had two sets of instructions from the hospital.  One included pictures but the before and after was the same picture so it didn’t make sense. Additionally, one sheet was different than the other sheet.   So, I just did a series of exercises.  When I saw the nurse at day five, she gave me a prescription for physical therapy containing a number of exercises.  When I got home, I read it.  The post op exercises on the list were not what had been discussed in the appointment.  They also had terms like ‘walk with normal gait’.  Does that mean walk like I usually walk?  I am definitely not doing that.  And these exercises were different than the first two sheets of exercises I was given.  I really had no idea what exercises I should be doing. 

Needless to say, during my first week post-surgery, I had numerous questions and many inconsistencies in my care plan.  It would have been very helpful to have someone to contact or email.  I didn’t bother calling the office for two reasons.   Nothing was truly urgent, and last time I called, it took days for a response, so why bother?  I feel that in the end, I was lucky enough to figure it out and have no complications, but I’m certain that would not be the case for everyone. 

Health Helm’s Trusted Patient Coach solution is designed to mitigate communication gaps and provide consistent instructions and messaging to patients as they recover from surgery or manage through chronic conditions.  Our mission is to support patient wellness through patient-reported outcomes and patient-clinician collaboration.



Older patients have demonstrated that they will use mobile technology to push successful outcomes in their own healthcare. 

Will Older Patients Use Mobile Technology?  YES!

As the US population ages, adults age 50+ are expected to increase by 17 million in the next 12 years.  Today, an estimated 57% of baby boomers use technology, up from 40% in 2012(1).  The increase can be attributed to people more willing to adopt technologies that keep them connected and entertained. 

In a survey conducted by Marketing Charts, almost 50% of respondents indicated an interest in learning about new technology, while at the same time they adopt new devices like smart TVs and voice activated home assistance devices.  Baby boomers are slightly behind their younger counterparts with tablet ownership, but are catching up on social media use.  

What does that mean to the medical industry? 

Trends indicate that technology adoption, and a comfort level with the use of mobile devices, is becoming more ubiquitous in the older population.  And while over 91% of older adults own computers, more users are getting tablets, connecting to the internet through mobile devices, using social media, and entertaining themselves with device-based games. 

As medical care needs increase with aging, elderly patients are more open to using technology.  This offers an opportunity for healthcare providers to leverage mobile technology to collect real-time  recovery progress from patients. Home device usage to complement medical care can keep patients connected during a typical “zone of darkness” following surgery, opening windows to prevent infection that were previously not visible. 

Mobile Technology for Patient Outcomes – Clinical Study

Trusted Patient CoachTM, our patient reporting tool, was designed as an easy-to-use mobile app, specifically tested with an elderly population.  Our clinical study showed how to prevent unnecessary office visits and hospital emergency department visits, and that patients well into their 70’s and early 80’s were willing – and able – to use mobile technology without difficulty.  Moreover, these patients reported benefits of staying connected to their clinical team after discharge.

The opportunity to prevent readmissions and reduce medical costs for hospitals, clinicians and patients is significant.  Clinicians are using TPC to stay connected to their patients, reinforcing medication compliance, and collecting real-time data to intercede before infection occurs.  Let’s call that a win-win-win.

(1) Marketing Charts, May 9, 2018.  Tech Update: Mobile & Social Media Usage, by Generation




A Physician’s Perspective

Interview with an Endocrinologist About Patient Reported Outcomes

Health Helm’s Operation Lead, Lisa McCarron, sat down with an Endocrinologist to discuss the challenges of patient centered care for clients with diabetes.

1. What are some key challenges for physicians in helping patients manage chronic medical conditions?

The challenge becomes how to improve care between visits and how do we help the patient overcome the difficulties that they face. They may contact the office with questions or concerns and then the next time you see them in 3 or 6 months, they are not better off. This in between time is a “zone of darkness” with little feedback or communication.

Diabetes as a chronic condition has about 10% compliance to care plans in patients, with relatively poor outcomes. Drug compliance is difficult to quantify but I believe most patients take their medication although not as prescribed. We need a better way to communicate and motivate the patient. If we can’t motivate them to change their lifestyle, we can’t improve the outcome. Those who do get well at the beginning, after hearing their diagnosis, are motivated but that motivation diminishes over time.

A platform to communicate and motivate can help improve the doctor-patient relationship. There is no doubt that interacting with patients between visits would be beneficial. The patient feels that if the doctor cares more then they will care more and be more motivated.

2. What are some key challenges for patients as they manage chronic medical conditions?

Staying motivated is the most difficult. There is no feedback loop in between visits to let them know how they are doing against their plan. We even tried to incentivize patients with a $0 co-pay if they met their goals at the next visit. None were motivated by $0 co-payment.

Patients have to measure blood sugar and report to the physician’s office. Without feedback we can’t make adjustments to improve their condition. If the doctor doesn’t know what the patient is doing, they can’t motivate them.

Adherence to prescriptions is reasonable with about 50% compliance. Again, if the doctor could monitor this more we could then motivate them to do better or discuss issues with regard to cost, side effects, motivation, etc., in between visits.

3. What type of data do you have in supporting patients? What information are you lacking?

We use the glucose readings and weight primarily. Hemogoblin A1C is the gold standard for diabetes management. The higher the A1C, the higher blood sugar and the more likelihood of complications. The reading is an average blood sugar over 2-3 months.

We get feedback on patient’s progress every 3 to 6 to 9 months. Success is when patients call in between visits and then the doctor can monitor the status of the patient. A doctor is not going to call a patient in between visits. The patient needs to provide that information.

4. What makes for successful outcomes in managing chronic medical conditions?

Motivation is key to keeping the patient on their care plan, especially when there are complications. And preventative measures, based on feedback in between visits, would help to keep the patient motivated and aligned to their goals.

5. What will be most practical for doctors and their teams to get patients to share information on their care plan compliance and clinical status between visits?

The answer is TPC (Trusted Patient Coach). It provides proof of provider outcomes with data collection directly from the patient. It can also be a potential for reimbursement for monitoring patients in between visits.

Trusted Patient CoachTM is a reporting and engagement platform designed to connect and communicate with patients in acute and chronic care to improve outcomes and reduce costs.

mobile app screenshot

Addiction treatment has gained much attention with the veracity of overdose deaths and a spike in the increase use of opioids. (Substance Abuse and Mental Health Services Administration, 2017)(1). Much has been studied and learned about the disease of addiction, including elements necessary to support and sustain long-term recovery. However, solutions beyond traditional inpatient and outpatient treatment have been slow to evolve. One women’s residential treatment program in the Northeast enhanced their evidence-based treatment program to expand support to their graduates. They augmented their Modified Therapeutic Community treatment program with recovery coaches and Health Helm’s mobile app, Trusted Success CoachTM, to stay connected with graduates over a year following graduation. Read more about the success of this innovative program and the use of Trusted Success CoachTM as an integral program element.

(1) Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Rockville: SAMHSA.

To request access to a copy of Health Helm’s full white paper, please contact us below to receive access to our Information Dashboard:

Dashboard Access Request



February 2019

Bob Kocher and Bryan Roberts, health care investors and partners at the venture capital firm Venrock, predict “Telemedicine Takes Off,” in their Fortune article, “10 Health Care Predictions for 2019 From a Pair of Venture Gurus” (December 10, 2018).  They note that payers are finally realizing it’s better to “embrace and encourage telemedicine usage as opposed to burying it in their unengaging member portals and clunky mobile apps.”    

The time for telemedicine is now!   Patients, as consumers, are demanding this.  It’s been well established that patients of all ages and socioeconomic backgrounds are using mobile technology in their lives – from all the conveniences of retail or travel, to simply sharing photos and stories with family and friends.  According to a recent global survey by Cisco, 74 percent of patients prioritize access to health care services over in-person interactions with health care providers, and 70 percent said they were comfortable communicating with providers via text, email, or video, in lieu of an in-office visit.

Yet some clinicians still ask or protest: “My elderly or low income patients won’t use mobile health technology.” Smartphone adoption continues to grow rapidly in the US market:  Pew Research in 2018 reports 77% of Americans own a smartphone vs. just 35% in 2011, and 53% own a mobile tablet device (e.g., iPad or Android). 

In our experience, patients over age 65 using our Trusted Patient Coach mobile solution on their smartphones or mobile tablets are just as, if not more compliant than other demographic groups.

Some providers protest, “They can use our electronic medical record (EMR) portal.”  But those are also clunky to use.  Many are web based or supported by clunky mobile apps and are used for episodic tasks such as viewing diagnostic test results, refilling a prescription, or scheduling an appointment.  Sara Heath, in Patient Data Access News, reports that even among patients registering to use EMR portals (and many patients do not), their utilization is only 20-35% of the time. 

Clinical evidence shows that patients who track themselves do a better job of managing their health and have better clinical outcomes – e.g., managing a chronic condition or recovering after surgery.

At Health Helm we focus on Patient Reported Outcomes and self-tracking, providing clinical teams and their patients with a secure, reliable way to track and report meaningful information about their progress on a daily or routine basis . Clinicians know that when communications with patients are better, they can identify complications or problems earlier and then intervene to address them earlier. 

Kocher and Roberts note that even medicare is adding codes to reimburse telemedicine. Other insurers are, also – recognizing that meaningful, sustained connection using telehealth results in better outcomes at lower costs, with a better patient experience.  Bottom line:  Kocher and Roberts, “Expect telemedicine usage to more than double in 2019, while making substantive inroads beyond flu and cold into areas such as chronic disease management.” 


Heath, Sara, “Patient Access to Health Data, Patient Portal use Increases.” Patient Data Access News, Patient Engagement HIT, October 12, 2017.


Interview with Nurse Practitioner About Patient Reported Outcomes

Health Helm’s CEO, Pamela McNamara, sat down with a Nurse Practitioner in a pain management practice in New England, to discuss patient centered care, patient reported outcomes, and how these could enable her patients to receive a more holistic approach to care.

close-up-doctor-health-42273-300x300 The Importance of Patient Reported Outcomes from the Perspective of an NP

What does patient centered care mean to you and your practice?

We follow the CDC guidelines and apply judgment given the risk factors. For example, we ask patients how long they have been on pain medications — opioid or others. We treat each patient holistically, considering her/his situation: How functional are they, are they working or disabled? What activities do they want to be doing with or without medication? What are they doing to avoid pain? What other medical considerations, such as social and mental health ailments are they affected by?

We consider and encourage trying alternatives to opioids for each patient, such as aquatic therapy for an osteoarthritis patient, chiropractic care for a younger patient, acupuncture, massage and/or yoga.We also attempt to use other pain management options including non-opioid prescription including over-the-counter aspirin, ibuprofen and acetaminophen, pain creams and patches. Medical cannabis including CBD creams and oils can be beneficial for chronic pain helping patients with anxiety, sleep and muscle spasms. We offer surgical procedures high-tech treatments using radio waves and electrical signals or implantable spinal cord stimulation. Unfortunately not all patients have access to these alternative therapies. Many of these therapies are not covered by insurance or these patients have access to care issues causing barriers to receiving this type of care.

How would a mobile patient reported outcomes tool fit in to your practice: supporting you as a clinician, while aiding in the treatment and management of your patients, as well as enabling them to better manage themselves?

A top priority for our patients is to gauge the extent to which they are trying to manage themselves and deal with their pain, and pain-related issues, rather than solely seeking more pain medications. If we know a patient is trying, we can work with them to utilize alternative approaches to opioids.

One benefit of patient reported outcome data will be to see evidence of how the patient is trying to manage their pain and with what result.

This patient reported outcome data can provide me, as a clinician, with a better basis for building an ongoing relationship with my patients to manage their pain and make progress.
Patient reporting would enable me to track their pain and other medication, track the extent and circumstances in which pain meds including what doses, numbers, and pills are being taken.

How would the PRO tracking work in your practice?

Typically we see a patient on chronic opiate therapy monthly. Patients on non opioids therapy are followed every three to six months.

During that four week period, we monitor their pain using pain scale tools. The use of a pain scale can help guide the clinician in creating a treatment plan as well as measure the effectiveness of the treatment. Indications a treatment plan may be ineffective include if a patient scores a 10 consistently (on the traditional pain scale of one to 10), the patient also reporting that they’re repeatedly out of medication early? The mobile tracking would help us monitor that more closely.

A mobile tool to monitor patient reported outcomes would be useful during the middle of that two month period, to alert us if problems are occurring. For other patients, patient reported outcome data is useful just before or during the four week follow-up visit to assess clinical status, progress, or problems, and to focus the patient visit on key issues. In preparation for this type of patient, the data would be scanned for sleep pattern variations, increased or decreased activity levels, issues related to ambulation, and responses to questions such as “ Do the current medication you are keep you functional and able to perform the daily tasks you need to do?”

The clinician would look at a snapshot for that patient over the prior month and be better prepared for a discussion about what’s going on, what can be changed in the pain management regimen, and what may need to change in other related activities.