Doctors at Brigham and Women’s Hospital are developing and testing a smartphone app that they hope will help patients and their doctors better manage chronic pain, and in so doing, help shrink the escalating medical costs associated with the condition.
Chronic pain affects some 100 million Americans and can stem from many causes: a long-healed injury, a surgical procedure, or myriad other conditions. A 2012 study in The Journal of Pain estimated that medical costs associated with the condition can reach up to $635 billion annually, making it many times more expensive to manage than other conditions that require long-term treatment, like diabetes or heart disease.
The Brigham app, which was designed with substantial input from the center’s doctors, is part of a broader trend. Medical institutions are increasingly looking to streamline communication between patients and their doctor using the messaging features and data-tracking tools in smartphones.
About 70 patients have been testing the app, called “PMC 320,” which is available in the Apple App Store and the Google Play Store. They have been using it in combination with a Fitbit fitness tracker.
“We’re trying to figure out a way to give them support and keep them out of the hospital and prevent unnecessary testing,” said Robert Jamison, professor of anesthesia and psychiatry at the Brigham and Harvard Medical School. “We really believe this will improve their ability to manage their condition which unfortunately we just can’t fix.”
So far, about three doctors at Dana-Farber Cancer Institute and 12 at the Brigham are using the app with their patients.
At least once a day, these beta testers are prompted to answer questions about their pain levels, mood, activity levels and other health metrics. The Fitbit transmits information about steps walked and other activity indicators to the app.
There is also an in-built messaging feature that lets patients send questions to their providers on bad days. Patients then have the opportunity to talk through the event with their doctor using the app. The hope is that these conversation will help alleviate their symptoms and anxiety. The goal is to avoid office visits, which might trigger expensive and typically unnecessary tests.
“If they’re not doing well and the pain’s increased, the app is a strategy for how to manage particular problems,” Jamison said.
Donny Soares, a 38-year-old Somerville resident who had surgery for cancer that had metastasized to his lymph nodes in January, is among the first testers of the app. He’s been using the app a month, and is already finding it helps his repeat visits.
“When I see my palliative care doctor every couple of weeks, I’m able to open it up with her,” Soares said. “This just helps talk to her about what I need in terms of short-term pain management.”
Soares said that though he knew that “there were good days and bad days” he never thought to record his daily comfort level. The app has made it more convenient to do so, he said, and he now logs his pain levels two or three times a day and has been working with his doctor to see if his activity levels are related to his more painful episodes.
That’s one of the associations Brigham’s Jamison is investigating as part of this initial rollout. Besides helping patients manage their condition, he hopes to be able to gather data about their mood and stress levels as well.
“It’s easier to swallow the pain that you’re having when you can put your finger on what it is,” Soares said. “And there’s really no price tag you can put on that.”