IUPUI researcher gets two grants for chronic pain information and electronic informed consent

An Indiana University-Purdue University Indianapolis (IUPUI) researcher has been awarded $1.1 million grant to develop information-based tools to help primary care providers improve care for patients with chronic pain.

The same researcher, Christopher Harle, PhD, was also awarded a second grant--$1.9 million from the National Institutes of Health--in collaboration with University of Florida researchers to develop software that will help patients better understand what they are granting access to when they approve use of their EHRs for research purposes.

Harle is an associate professor in the Department of Health Policy and Management in the Richard M. Fairbanks School of Public Health at IUPUI.

Chronic pain affects 100 million Americans at a cost of $630 billion annually in healthcare costs and lost worker productivity, according to an IUPUI announcement. The first study, funded by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality, will be based on the fact that primary care physicians have relatively poor experiences in providing care for chronic pain and patients often report low satisfaction with the chronic pain care they receive in primary care settings.

"A lot of this stems from challenges around chronic pain, which has biological, physical and psychological underpinnings and therefore can be challenging to diagnose and treat effectively," Harle said.

There's also been growing concern about the risk of misuse and addiction related to opioid therapies, he added. "Physicians are shying away from prescribing these medications, which can create challenging interactions with the patient. We want to understand at a pretty basic level how clinical work happens for chronic pain in primary care, how a doctor and other healthcare providers obtain information about patients when it comes to chronic pain, how they use that information at a detailed level, and how they make decisions regarding treatment. We want to understand those decision-making processes and the information needs of healthcare providers as well as the information they may not have."

The goal is to use that information to design new prototypes for IT-based clinical decision support, he added. Clinicians might need better tools to collect and track patient reported outcomes for pain symptoms or day-to-day functionality and feelings of depression and anxiety that often come with pain.

"Maybe we need better systems to collect that data and process it and communicate it to physicians in a way that they can take that information and modify treatment," he said.

In the second study, researchers have proposed developing an interactive software tool for informed consent that they envision being used in doctors' offices in academic medical centers or other places where research takes place.

The interactive software tool would essentially take a patient through an informed-consent process, giving the patient a better understanding of how their EHR information could be used in research. "It's potentially much larger and more comprehensive than that file folder you might imagine sitting in your family doctor's filing cabinet," he noted.

An interactive software tool would allow people to be more informed and actively consent to the use of their health information without overburdening the healthcare system by requiring significant human involvement.