The Tightrope of Pain Management
Pain management is one of the most difficult of medical skills for a healthcare professional to attain. Despite its presence among all medical and nursing specialties, it remains a symptom treated differently according to its classification as acute or chronic, the specialty of the physician treating a suffering patient, the perceived etiology of the pain complaint, the risk of the development of substance abuse issues and a patient's overall pain tolerance. The tightrope upon which a physician must walk involves decreasing pain while avoiding undue sedation and encouraging maximum performance of activities of daily living (ADLs). With so many issues that factor into what medication or therapy might be prescribed or contraindicated, it is imperative to use standardized templates to account for patient pain complaints, prescribed therapies or medications and the efficacy of these attempted interventions.
The Promises of Certified Pain Management EMR Systems
Certified Pain Management EMR can assist a practice in documenting all aspects of a patient's biological, psychological and social conditions upon a patient's first referral.
Subsequent treatment modalities or interventions can be documented within the same record, including whether or not the treatment was effective in decreasing a patient's subjective pain complaints as well as any evident incongruities between a patient's self-assessment and physical abilities.
For those practices that include treatment components such as a physical therapy clinic, physical therapy treatment modalities or a return-to-work simulation program, all of a given patient's information is available to any of the practice members at any time. This data might include recent x-ray results, laboratory work, a gain or loss of weight and physical therapy progress charts.
In addition, the patient's current medications and prescribed dosages will also be a necessary part of the Certified Pain Management EMR.
Other data, however, may be of unexpected value to health care evaluators and include how often early refills for pain medication are requested, whether reported pain "migrates" over time into unexpected areas and how often appointments are missed. Unexcused absences from physical therapy treatment or return-to-work simulation programs may indicate the need for a closer coordination of services, especially in situations involving liability or worker's compensation issues.
Finally, the original referring physician can be provided regular updates from the pain practice's electronic medical record system.
The Limitations of EMR Systems
According to the US Department of Health & Human Services online bulletin, Health IT Buzz, EMR and EHR are not two different terms for the same system. Peter Garrett and Joshua Seidman explain this misunderstanding in their article, "EMR vs. EHR -- What is the Difference?" Electronic Medical Records or EMRs are simply electronic versions of a patient's old paper chart. The electronic version is by far a more convenient form of the paper version. More than one physician, professional, paraprofessional or office staff member can access the same patient's chart at one time. Communication to professionals outside of the practice using a given EMR system is often as bulky, labor-intensive and paper-dependent as old systems. Thus, providing any real data or information to the physician who originally made the referral to a given pain clinic still requires the time for the electronic chart to be reviewed, a summary letter to be dictated and transcribed and any necessary medical studies to be copied.
The Promises of Certified Pain Management EHR Systems
Garrett and Seidman specifically promise the electronic health record (EHR) system to be capable of all of a electronic medical record system EMR's benefits in addition to the portability of the EHR system throughout the practices and systems of all of a patient's healthcare providers -- a benefit of particular importance when considering the potential for dangerous behavior in regard to pain medications. The transparency of previous treatments, reports of similar injuries or documentation of drug-seeking behavior can only help protect physicians from potential liability and patients from the development of full-blown addictions.