For clinicians treating patients with chronic non-cancer pain or workers with arm and hand injuries, making use of research is now as easy as swiping a touch screen on a mobile device.
Two software applications have been designed to bring research from the Institute for Work & Heath (IWH) to mobile devices such as iPhone and iPad. One is the Opioid Manager app. The other is an app version of the DASH Outcome Measure. Both are available at Apple’s iTunes Store.
Opioid Manager app
The Opioid Manager app was developed as an extension of the Opioid Manager, a tool physicians use before and while prescribing opioids to patients suffering from chronic non-cancer pain. Opium-based painkillers such as codeine, oxycodone and fentanyl come with higher risk of addiction and overdose. But despite the danger, prescriptions are up. In Ontario, the number of opioid prescriptions written for people receiving workers’ compensation benefits has doubled over 10 years, according to the Workplace Safety and Insurance Board (WSIB).
The Opioid Manager helps physicians determine a safe course of opioid prescription for their patients. Condensing key elements of the Canadian Opioid Guideline, the tool walks doctors through four key clinical areas: how to assess a patient’s need for the drug, how to try out a prescription, how to monitor the treatment, and how and when to wean the patient off the drug.
Dr. Andrea Furlan, the IWH associate scientist who developed the Opioid Manager and helped develop the guideline, says she’s heard good feedback from people who’ve downloaded the app since its launch in September.
Some say it helps them remember what they need to document, says Furlan. The Opioid Manager app is available for $9.99. For more information, go to the Opioid Manager page.
DASH Outcome Measure app
The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure app is an extension of the most popular clinical tool developed by IWH to date. It’s a touchscreen questionnaire that helps clinicians and therapists zero in on disabilities of the arm, shoulder and hand (hence the acronym). It asks patients 30 questions about their physical function, their symptoms, and the impact of the injury on their daily activities. Do they have difficulties carrying the groceries or pulling a sweater over their head? A shorter version, the QuickDASH, is also available as an app setting.
The app idea came from Kenneth Wilson, research and education director at a group of rehabilitation clinics based in St. Louis, Mo. Wilson was doing quality assurance work on the clinics’ outcomes data when he noticed a 40-per-cent error rate in how therapists were scoring their patients. He realized then that there was a need for an app to make scoring automatic.
The DASH app lets patients directly enter responses then automatically calculates and summarizes the scores in a report. A unique patient identification number lets therapists track a patient’s scores over many visits. The summary and cumulative reports can be viewed directly on the iPad or saved as exportable files that patients can receive via e-mail. Patients’ records are stored under numerical identifiers instead of names to ensure privacy.
There has been growing interest in both the DASH and QuickDASH in the U.S. As of July 1, 2013, professionals who treat people covered by Medicare must submit patient outcome measures in order to get reimbursed. The American Physical Therapy Association has recognized both the DASH and the QuickDASH as assessment tools that could be used to report the required outcomes.
The DASH app is sold for $4.99. For more information, go to the DASH page.