Computerized progress notes for chronic pain patients receiving opioids; the Prescription Opioid Documentation System (PODS)

Pain Med. 2010 Nov;11(11):1707-17. doi: 10.1111/j.1526-4637.2010.00977.x.

Abstract

Objective: We herein provide a description of a health information technology tool using computer-assisted survey instruments as a methodology for documentation during long-term opioid therapy.

Design: We report our experience using the Prescription Opioid Documentation and Surveillance (PODS) System, a medical informatics tool that utilizes validated questionnaires to automate the assessment of opioid prescribing for chronic nonmalignant pain.

Setting and patients: Chronic pain patients answered questions that were presented on a computer terminal prior to each appointment in a Department of Veterans Affairs Pain Clinic.

Measures: Pain levels, activities of daily living, and screening for common psychological disorders were sought at each visit. Results were tabulated with some information gathered sequentially permitting evaluation of progress. Following a face-to-face interview, the clinician added additional comments to the medical record.

Results: By deploying a systematic series of questions that are recalled by the computer, PODS assures a comprehensive assessment.

Conclusions: The PODS fulfills medicolegal requirements for documentation and provides a systematic means of determining outcomes. This process facilitates the determination of the appropriate intervals between clinic visits by stratifying patients into high, moderate, and low risk.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Chronic Disease
  • Computer Systems*
  • Data Collection / methods
  • Documentation / methods*
  • Drug Prescriptions / standards*
  • Humans
  • Pain / drug therapy*

Substances

  • Analgesics, Opioid