Uncover underlying issues that will derail treatment
Patients with chronic pain have often progressed to the point where they are extremely complex cases requiring the clinician to understand not only the medical pathology, but also the psychosocial state of the patient.  Using an Electronic Patient Interview is a proactive, cost-effective way for a clinician to identify underlying psychosocial complications that can greatly influence the outcome of treatment.

Functional complaints and disability
Dramatic improvements in function are more easily achieved during the acute and sub-acute stages of an illness or injury.  In contrast, the treatment of chronic conditions often involves a systematic approach to achieve incremental reductions in pain and disability.  Identifying these incremental changes requires a means of accurately measuring and tracking pain and function.  By tracking these incremental changes, it becomes possible to identify treatments producing a positive outcome.  This is valuable not only for patient care, but also for demonstrating treatment efficacy to payors. 

Psychological issues
Prolonged pain and disability can often lead to psychological disorders, such as depression, anxiety and somatic preoccupation.  To manage your patient's psychological condition, at a minimum, depression, anxiety and somatic complaints should be monitored for incremental changes, similar to functional complaints and disability.  Extreme emotional distress or the presence of more serious psychopathology potentially indicate that psychological treatment is needed before therapeutic pain treatment will be effective. 

Red Flags, Yellow Flags and Critical Items
Whether initially evaluating a patient or determining surgical readiness, a number of psychosocial variables need to be assessed.  Using principles of evidence based medicine, a systematic review of psychosocial complications leading to poor surgical outcome shows the psychosocial variables that were needing to be assessed were pain, functioning, depression, anxiety, somatization, low education, passive coping, job dissatisfaction, and length of time off of work/duration of the condition (den Boer, et al, 2006).  The BBHI^TM 2, assesses 7 out of 9 of these risk factors, while the longer BHI^TM 2 assesses all of them.  Additionally, the BBHI 2 uses critical items to assess other clinically relevant variables including, sleep disorder, dissociation, panic symptoms, psychosis, satisfaction with care, chemical dependency, home life problems, compensation focus, doctor dissatisfaction, pain fixation, random responding, death anxiety, and suicidal ideation.  It is important to recognize that by using the automated BBHI 2 assessment, assessing these variables takes almost no staff time and less than 10 minutes of patient time. 

More than just a clinical tool

Clinical View - Interview patients electronically before their visit, enabling trended reports like the BBHI2; computed, summarized and in your hands before you start the visit.  You utilize your patients as a resource for data entry and the system reports the results with effectively no additional burden on your staff.

Good Science: Unlike informal measures of pain and function that are often used, the BBHI 2 and BHI 2 tests are published, standardized tests. Standardized tests are different in that they have undergone the psychometric rigors of a formal standardized test development process to establish their validity and reliability, and to establish test norms. These norms make it possible to compare your patient’s level of symptoms to a national sample of patients, and to a national sample of normal persons in the community.

Outcomes - Adding a few additional questions to log standard categorical information, and treatment/tracking protocol information, standard clinical data can be aggregated to show protocol-based outcomes, as well as provide data for Evidence-Based Medicine (EBM) analysis.

Performance - In addition to protocol-based outcomes, aggregate patient feedback can be collected around perceived outcome, Quality-of-Life (QoL) and satisfaction, and compared to regional and national norms to gage how well your practice and its providers are performing.

Please Contact Us to learn more or discuss how we can help in your Chronic Pain setting.