Electronic Opioid Risk Assessment Program for Chronic Pain Patients: Barriers and Benefits of Implementation

Authors: Butler, S. F., Zacharoff, K., Charity, S., Lawler, K. and Jamison, R. N.

Pain Practice, 14: E98–E105. doi:10.1111/papr.12141, 2014

Objectives

A preliminary electronic pain assessment program known as Pain Assessment Interview Network, Clinical Advisory System (PainCAS), was implemented in 2 pain centers over the course of 10 months to understand the tool’s impact on opioid risk assessment documentation and clinical workflow. The program contains validated electronic versions of screeners for opioid misuse risk (SOAPP-R and Current Opioid Misuse Measure).

Methods

Charts of patients with an initial and 2 follow-up visits were randomly selected for review of presence of opioid risk assessments before and after implementation of the electronic assessment program. Clinical and administrative staff members were interviewed to gain their perceptions of the impact of the program.

Results

Significant increases were observed in the documentation of opioid risk assessments between the baseline patient chart reviews before implementation of the program (n = 66) and the postintervention patient chart reviews after the implementation of the program (n = 39), for both initial and follow-up clinic visits (P < 0.001). Specific benefits of the program identified by 7 clinicians and 8 administrators included ease of use, reduced paperwork, completion of the assessment before the clinic visit, and incorporation of information directly into an electronic medical record (EMR). Perceived barriers to implementation included poor patient compliance, changes in administration workflow, and difficulties associated with patients with no email addresses, and limited computer skills.

Conclusions

Implementation of an opioid risk electronic pain assessment program significantly increased the likelihood that a risk assessment would be included in the medical record, which has implications for improvement of quality of care.