Tx t rx
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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.
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Tx t rx
- 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
- 7. Development Stage Idea Complete Algorithm Complete Code Complete 02/09/13 Integrate w/ Allscripts 02/23/13 Testing phase 03/01/13
- 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