Stepped Care Model for Stepped Care Model for Pain ManagementPain Management

AB Consulting for HealthcareAB Consulting for HealthcareArney BensonArney Benson4541 N.644541 N.64thth St. St.

Scottsdale, AZ 85251Scottsdale, AZ 85251www.abconsultingforhealthcare.com

ObjectivesObjectives

• Progress as facility pain committee• Progress as Telehealth pain committee• Successes • Struggles• Next steps

Pain CommitteePain Committee

• Updated pain committee member list• Added more pain disciplines rep• E-mail group for communication• More structured• More enthusiasm, motivation, energy among

members• Updated/reviewed committee objectives• Developed “Multidisciplinary Virtual Pain Team

Consultation”

““Multidisciplinary Virtual Pain Team Multidisciplinary Virtual Pain Team Consultation”Consultation”

• Developed “Multidisciplinary Virtual Pain Team Consultation”

• Subgroup of facility pain committee• Primary and secondary (back up) key people

from each discipline• Support from departmental chiefs and EMT• More than 10 disciplines on the team• Regular communication among team members• Pilot program done in primary care

““Multidisciplinary Virtual Pain Team Multidisciplinary Virtual Pain Team Consultation”Consultation”

• Key members from following disciplines;1. Physical Medicine & Rehab Physician2. Pain Psychologist3. Physical therapist4. Rec therapist5. Interventional pain specialist6. Ortho spine surgeon7. Neurosurgery8. Primary care physician9. Pharmacist10. Patient advocate11. Social worker

““Multidisciplinary Virtual Pain Team Multidisciplinary Virtual Pain Team Consultation”Consultation”

• Developed Telehealth consult order, virtual/historical visit/note title/note/alerts

• Chart review by all disciplines prior to case discussion

• Primary care provider gets invited to meeting, short case presentation by PCP….then consultation from all disciplines

• Opportunity for provider education about services from different pain disciplines and pain management

• Support for PCP • Case example

TERTIARY LEVEL

SECONDARY LEVEL

PRIMARY LEVEL

Proposed Stepped care model for a Proposed Stepped care model for a Virtual Pain Model Virtual Pain Model

Provider education

Pain Medication Management

Pain Medication Management

Pain Policy

Pain School

Primary Care Clinics/Teams

Bupe Clinic/SATS

Secondary ConsultsInt Pain Clinic

Chronic Pain Rehab Program

Multi-dis pain

Tertiary

Sec

Primary

CBT

CBT

CRIPPCRIPPCComprehensive omprehensive RRehab ehab IIntegrative ntegrative PPain ain PProgramrogram

(Proposed)(Proposed)

CRIPPCRIPP (Comprehensive Rehab (Comprehensive Rehab Integrative Pain Program)Integrative Pain Program)

Chronic Pain Consult

Screening Clinic

Bupe clinic/SATS

Chronic Pain rehab program

PMMP

PMMP

Sec.consults/int/SATS/Biofeedba/PT/accupuncture

CBT

CBTPain School

Multi-dis Pain

PCP

Team meetings with OEF clinic, pain clinic, CRIPP staffing, PCP staffing (q6mon)