Simple Quick & Easy
We live in a culture where we like things “simple, quick & easy” — recipes, hairstyles, tax services, car maintenance and clinic visits. In medical practices we wish for “simple, quick & easy” scheduling, EMR systems, diagnostics and especially payments. So what about outcomes? Are there “simple, quick & easy” patient outcome measures for a busy specialty clinic?
Let’s take pain medicine as an example. Pain is subjective and difficult to measure — especially in a simple quick and easy way. Fortunately, Jared Younger, PhD, Rebecca McCue and Sean Mackey, MD, PhD (Stanford) put together a resource for measuring pain outcomes. In Pain Outcomes: A Brief Review of Instruments & Techniques (2010), they looked at uni-dimensional, multi-dimensional and behavioral instruments, and an alphabet soup of tools: NRS, VAS, VRS, PGIC in one dimension and SFMPQ, BPI-SF, WHYMPI, TOPS, SF-36, ODQ, POQ-VA in the multi-dimension.
The “why” behind measuring outcomes in this article is directly tied to demonstrating efficacy of pain care. The “how” is determined by the types of patients seen, the philosophy of care and care pathways used in the pain clinic. The infrastructure and information systems that are in place or being developed to make outcomes data collection are also essential “how” factors.
Some pain specialists began measuring outcomes and developing tools in the 1980’s. Gathering outcome data is now a requirement. Specialists are trying to invest in tools that are simple, quick and easy — yet powerful enough to demonstrate the specialty care’s effectiveness. Specialists have developed their own proprietary systems or partnered with academic institutions to measure pain outcomes, with some outcomes tools chosen to meet specific payer requirements. Other specialists have selected valid and reliable outcomes tools from the alphabet soup of options available in today’s marketplace.
Common outcome measurements include: Pain symptom relief, physical function (ADL’s or work tasks), psycho-social adjustments, medication use, sleep, QOL and other measures.
From prior experience, if you keep outcomes data collection simple quick and easy, there will be greater compliance of data collection for the long-term. Whether you’re starting to measure or looking for ways to simplify, you might want to read the Pain Outcomes article — before trying to digest the whole bowl of alphabet soup of outcomes.
“Life is not complex. We are complex. Life is simple and the simple thing is the right thing.” –Oscar Wilde