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User-Centered Decision Support Tools for Chronic Pain

User-Centered Decision Support Tools for Chronic Pain

By characterizing common patterns in information availability, information use, and care planning by primary care providers during patient visits for chronic pain, researchers created new electronic health record-based decision support tools to guide clinicians’ perceptions and judgments of pain to increase use of guideline-based patient assessment and treatment.

Caring for and treating complex chronic conditions

Taking care of patients who have complex chronic conditions is best facilitated when a clinician has access to their entire clinical history. A holistic approach is important to understand the best treatment plan for the patient, whether it involves prescribing opioids or other options, based on previous medical history. Electronic health records (EHRs) often have less-than-ideal navigation to access relevant patient data, and finding these data may be challenging as a clinician gets up to speed during a brief clinic visit. Because opioid misuse is a public health crisis, clinicians are eager for guidance to navigate appropriate treatment options for patients with chronic conditions dealing with pain. With a public health policy and information science background, Dr. Christopher Harle was interested in how to use computers and technology to help clinicians take care of patients with complex, and often painful, conditions.

What we designed is meant to bring information together in a single place for a primary care clinician to get a holistic picture of their patients and ultimately lead them to choose the right treatment plan.”
- Dr. Harle

Centralized data for easy access

Using qualitative methods, such as interviewing clinicians and reviewing patient medical records, Dr. Harle and the research team at Indiana University and The Regenstrief Institute in Indianapolis wanted to understand how patient information could be best displayed in EHRs to support clinicians in providing the best treatment options for these complex patients. Ultimately, this work led to designing a simplified EHR interface that focused on bringing patient information together in an accessible way for clinicians. Two user-centered prototype decision support tools were created. The first tool—the Chronic Pain OneSheet—was designed to provide accessible data in an EHR for gathering key clinical information. The second tool—the Chronic Pain Treatment Tracker—is used to track treatment and outcomes for patients with chronic pain.

User-centered design

Dr. Harle and his team found that user-centered design research was foundational in the development of usable and useful EHR interfaces, such as Chronic Pain OneSheet and Chronic Pain Treatment Tracker. The design of the prototypes captured the distinctive nature of patterns in accessing patient data by characterizing common patterns in information availability, information use, and care planning. These designs help clinicians overcome barriers of technologies that are not user friendly for treatment of chronic pain. The user-centered decision support tools allow clinicians to have an overall picture of patients in an easy and accessible way to help treat a patient with chronic pain.