Post-op Crowd Sourcing Health Data Via Text-messaging
| Status: | Enrolling by invitation |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 10/6/2018 |
| Start Date: | October 1, 2018 |
| End Date: | April 30, 2020 |
Using Text-messaging to Engage Patients and Crowdsource Data: an Opioid Pilot Study
The Center for Disease Control has labeled the opioid prescription drug crisis an "epidemic"
in the United States and recently this epidemic has been named a public health emergency.
Various medical and surgical societies have begun to release general opioid prescribing
guidelines for providers addressing acute pain, but these do not highlight the patient
perspective or experience. Identifying an acceptable opioid dose and duration has remained a
challenge and is a nuanced process. Though policy and provider driven changes may begin to
augment practice, these avenues may miss a crucial perspective; the patient's.
in the United States and recently this epidemic has been named a public health emergency.
Various medical and surgical societies have begun to release general opioid prescribing
guidelines for providers addressing acute pain, but these do not highlight the patient
perspective or experience. Identifying an acceptable opioid dose and duration has remained a
challenge and is a nuanced process. Though policy and provider driven changes may begin to
augment practice, these avenues may miss a crucial perspective; the patient's.
This is a quality improvement project aimed at building upon prior telephone-based patient
follow-up. The research team will be launching a text messaging interface to collect and
describe patient pain, functional status, and opioid usage with patients undergoing elective
surgical procedures within the departments of orthopaedics and sports medicine, as well as
patients treated in neurosurgery, general surgery, and the ED who own a mobile phone and can
receive SMS text messaging (as measured by pain scale, patient reported functional status,
and proportion of opioids used). Additionally, this project aims to evaluate the current
standard of care of prescribing opioids to patients among orthopedic surgeons and emergency
medicine providers for acute pain.
There is no randomization, there are no control subjects, and therefore there is no
probability of group assignment.
BACKGROUND
The study team has shown the ability of gathering patient level data from telephone follow up
to guide physician behavior. In recent work, providing orthopaedic surgeons with data on
patients' unused prescribed opioids has changed practice - patients now reporting a change
from twenty unused pills down to seven unused pills.
Though effective, telephone follow up is laborious and time consuming. The researchers seek
to test an alternative approach for a rapid, scalable means of engaging patients and
gathering patient level data to help inform provider practice.
Text messaging offers a unique opportunity to quickly capture, analyze, and understand the
patient experience. The research team has demonstrated the successes of communicating with
patients via text-messaging by guiding patients through pre- and postoperative recovery via
the program "Engaged Recovery at Penn" (ERAP). This program has enrolled over 900 patients
across surgical specialties with automated text-based reminders. The researchers will
investigate the intersection of digital patient centered communication, acute pain, and
consumption of prescribed opioids to ultimately help inform providers and health systems.
METHODS
The study team will contact adult patients (age ≥18) undergoing elective surgical procedures
within the departments of orthopaedics, sports medicine, and neurosurgery, as well as
patients undergoing procedures in general surgery and the ED who own a mobile phone and can
receive SMS text messaging at the University of Pennsylvania or Penn Presbyterian Medical
Center. The researchers will build upon previous work by Dr. Delgado in which patients were
approached for follow up data collection via telephone communication and translate the
telephone script into a functional and approachable text messaging script. The researchers
will work to build an automated bi-directional text script within Penn's innovative research
platform, Way to Health (WTH). The research team will test the ability to engage patients in
these departments, gather data, and measure satisfaction with the automated text-messaging
system.
Data collected through WTH will be used to demonstrate the ability of bi-directional texting
to enhance data collection and then the researchers will utilize this data to develop,
implement, and evaluate the use of EMR defaults for opioid prescribing for specific surgical
procedures or acute painful conditions.
follow-up. The research team will be launching a text messaging interface to collect and
describe patient pain, functional status, and opioid usage with patients undergoing elective
surgical procedures within the departments of orthopaedics and sports medicine, as well as
patients treated in neurosurgery, general surgery, and the ED who own a mobile phone and can
receive SMS text messaging (as measured by pain scale, patient reported functional status,
and proportion of opioids used). Additionally, this project aims to evaluate the current
standard of care of prescribing opioids to patients among orthopedic surgeons and emergency
medicine providers for acute pain.
There is no randomization, there are no control subjects, and therefore there is no
probability of group assignment.
BACKGROUND
The study team has shown the ability of gathering patient level data from telephone follow up
to guide physician behavior. In recent work, providing orthopaedic surgeons with data on
patients' unused prescribed opioids has changed practice - patients now reporting a change
from twenty unused pills down to seven unused pills.
Though effective, telephone follow up is laborious and time consuming. The researchers seek
to test an alternative approach for a rapid, scalable means of engaging patients and
gathering patient level data to help inform provider practice.
Text messaging offers a unique opportunity to quickly capture, analyze, and understand the
patient experience. The research team has demonstrated the successes of communicating with
patients via text-messaging by guiding patients through pre- and postoperative recovery via
the program "Engaged Recovery at Penn" (ERAP). This program has enrolled over 900 patients
across surgical specialties with automated text-based reminders. The researchers will
investigate the intersection of digital patient centered communication, acute pain, and
consumption of prescribed opioids to ultimately help inform providers and health systems.
METHODS
The study team will contact adult patients (age ≥18) undergoing elective surgical procedures
within the departments of orthopaedics, sports medicine, and neurosurgery, as well as
patients undergoing procedures in general surgery and the ED who own a mobile phone and can
receive SMS text messaging at the University of Pennsylvania or Penn Presbyterian Medical
Center. The researchers will build upon previous work by Dr. Delgado in which patients were
approached for follow up data collection via telephone communication and translate the
telephone script into a functional and approachable text messaging script. The researchers
will work to build an automated bi-directional text script within Penn's innovative research
platform, Way to Health (WTH). The research team will test the ability to engage patients in
these departments, gather data, and measure satisfaction with the automated text-messaging
system.
Data collected through WTH will be used to demonstrate the ability of bi-directional texting
to enhance data collection and then the researchers will utilize this data to develop,
implement, and evaluate the use of EMR defaults for opioid prescribing for specific surgical
procedures or acute painful conditions.
Inclusion Criteria:
- Adults 18 or older
- Undergoing elective surgical procedures within the departments of orthopedics, sports
medicine, and neurosurgery, as well as patients undergoing procedures in general
surgery and the ED at University of Pennsylvania Hospital or Penn Presbyterian Medical
Center
- Own a mobile phone and can receive SMS text messaging
Exclusion Criteria
- Under 18
- Does not own mobile phone
- Owns mobile phone but cannot reliably receive SMS text messages
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