Impact of an electronic pain and opioid risk assessment on documentation and clinical workflow

      PainCAS™ Beta is a clinical tool that assesses and tracks pain patients over time. It offers initial and follow-up pain assessments and produces reports for inclusion in the electronic medical record. This study hypothesized that painCAS Beta would increase the frequency of risk assessment administration and documentation, and improve clinical workflow. Two specialty pain treatment settings utilized painCAS™ Beta instead of the paper-pencil assessments. Study participants, including providers and administrative staff, were interviewed at baseline and post-intervention about communication, opioid risk assessments, score calculation, documentation, painCAS Beta reports, important data elements and overall processes and workflow related to assessing patients’ pain and risk of aberrant drug related behavior. During the intervention phase, patients received the painCAS Beta assessments for 3 clinical visits and the painCAS Beta reports were attached to records in the EMR. In addition, usability testing was conducted with participants from both clinics. Perceived benefits of using the painCAS Beta system to assess patients were identified as well as challenges and barriers to implementation. Improvements to painCAS Beta that could enhance its efficiency in assessing patients and incorporation into existing clinical workflows were identified. Usability testing uncovered system processes that created workflow inefficiencies and were barriers to use and the System Usability Scale scored higher than the goal score of 80 with an average score of 83.3. Incorporating painCAS Beta into existing clinical workflows was a challenge, although some time saving benefits were noted. Specific enhancements are needed to painCAS Beta to improve its ability to integrate into clinical workflow. It is worth noting that significant increases were observed in the documentation of opioid risk assessments after painCAS Beta was implemented. This research was supported by an educational grant from Endo Pharmaceuticals.