Pain Assessment Interview and Clinical Advisory System

描述（由申请人提供）：该应用程序基于Inflexxion的项目研究，以开发疼痛临床咨询系统（PAIN-CAS），这是一种对疼痛患者进行系统性和经验证的评估，沿着包含治疗建议和患者反馈报告的提供者报告。这样的疼痛管理资源，具有关于患者健康状况的最新具体信息，将允许医生最大化就诊的可用时间，同时最小化治疗的潜在不利影响，例如对镇痛剂的成瘾。慢性疼痛是一种昂贵的综合征，影响一个人的功能的各个方面。慢性疼痛的治疗，根据定义，经常解决复杂的临床表现，包括共病的医疗条件，精神问题，也许是唯一的，药物滥用的可能性。尽管有这种复杂性，但治疗决定是基于越来越多的非专家进行的更简短的诊所接触。这往往会导致过度关注医疗干预，而对可能加剧疼痛的（看似）无关的心理社会问题重视不够。患者和提供者都对疼痛症状感到沮丧，需要反复就诊，但改善有限。拟议的PAIN-CAS利用Inflexxion在应用技术方面的专业知识来解决医疗保健问题，以影响疼痛管理的方式。PAIN-CAS的主要特征包括：（1）患者评估模块/摄入和随访评估，将评估疼痛、物质使用、精神状态和共病身体状况，沿着成瘾可能性筛查和药物误用和滥用监测。评估部分的设计将使美国大量文盲患者容易完成。(2)提供者报告将包括一份摄入报告，包括治疗建议和一份随访报告。(3)将根据患者对评估的反应设计患者反馈报告，以增强患者的权能，鼓励积极参与治疗并与之合作。最后，（4）一个在线工具包将允许供应商从他们的诊所上传机密的、符合HIPAA的数据，并检查他们自己的汇总数据，并将这些数据与全国其他参与诊所收集的统一汇总数据进行比较。Inflexxion将与专家咨询小组合作，在第一阶段实现一系列雄心勃勃的目标，包括（1）为Pain-CAS的提供者和患者输出创建样本报告格式，（2）创建将编程到系统中的疼痛治疗算法，（3）概述在线工具包的功能，（4）创建Pain-CAS评估的流程图和概述，（5）创建和测试演示程序，（6）创建PAIN-CAS程序的技术简介，以及（7）完成与提供者和疼痛患者的PAIN-CAS组件的满意度和验收研究。拟议的PAIN-CAS可能解决现有努力的局限性，以加强慢性疼痛治疗的评估和实践。项目叙述：随着社会越来越多地要求医疗专业人员解决慢性疼痛患者的复杂临床表现，越来越重要的是，提供者受益于标准化的计算机管理的评估沿着计算机化的治疗建议。成功开发和传播一个全面的、综合的疼痛临床咨询系统（PAIN-CAS）将有助于加强慢性疼痛的评估和治疗，并被利益相关者视为非常有价值。因此，我们认为该产品具有巨大的商业可行性和公共卫生重要性。

DESCRIPTION (provided by applicant): This application builds on programmatic research at Inflexxion to develop the PAIN Clinical Advisory System (PAIN-CAS), a systematic and validated assessment of pain patients along with provider reports containing treatment recommendations and patient feedback reports. Such a pain management resource, with up-to-date specific information about patients' health status, would allow a physician to maximize the available time in an encounter while minimizing potential adverse impacts of treatment, such as addiction to analgesics. Chronic pain is a costly syndrome that influences every aspect of a person's functioning. Treatment of chronic pain, by definition, regularly addresses complicated clinical presentations, including comorbid medical conditions, psychiatric problems, and perhaps uniquely, substance abuse potential. Despite this complexity, treatment decisions are based on ever-briefer clinic encounters that are increasingly conducted by non-specialists. This tends to result in an over-focus on medical interventions and insufficient emphasis on (seemingly) unrelated psychosocial issues that may exacerbate pain. Patients and providers alike are frustrated by pain symptoms requiring repeated visits that yield limited improvement. The proposed PAIN-CAS utilizes Inflexxion's expertise in applying technology to address healthcare problems in an effort to impact how pain management is conducted. Key features of PAIN-CAS include: (1) Patient Assessment Module/Intake and Follow-up Assessments, which will assess pain, substance use, psychiatric status, and comorbid physical conditions, along with screening for addiction potential and monitoring of medication misuse and abuse. The assessment component will be designed to be easily completed by the large number of illiterate patients in the US. (2) Provider Reports will include an Intake Report, complete with treatment recommendations, and a Follow-up Visit Report. (3) A patient feedback report, tailored to patients' responses to the assessments, will be designed to enhance patient empowerment and to encourage active participation and cooperation with treatment. Finally, (4) an Online Tool Kit will allow providers to upload confidential, HIPAA compliant data from their clinic and examine their own aggregate data and compare these data with uniform aggregate data collected at other participating clinics around the country. In collaboration with an Expert Advisory Panel, Inflexxion will achieve an ambitious series of goals in Phase I, including (1) creation of sample report formats for provider and patient output of the PAIN-CAS, (2) creation of pain treatment algorithms to be programmed into the system, (3) outline of the functionality of the Online Tool Kit, (4) creation of a flowchart and outline of PAIN-CAS assessments, (5) creation and testing of a demonstration program, (6) creation of a Technical Brief for the PAIN-CAS program, and (7) completion of satisfaction and acceptance studies of the PAIN-CAS components with providers and pain patients. The proposed PAIN-CAS potentially addresses limitations of existing efforts to enhance assessment and practice in the treatment of chronic pain. Project Narrative: As society increasingly demands that medical professionals address the complex clinical presentations of patients with chronic pain, it is increasingly important that providers have the benefit of standardized computer- administered assessments along with computerized treatment recommendations. Successful development and dissemination of a comprehensive, integrated PAIN Clinical Advisory System (PAIN-CAS) will go some distance toward enhancing assessment and treatment of chronic pain and be perceived as highly valuable to stakeholders. Thus, we believe this product has enormous commercial viability and public health importance.