Opioids are an effective tool for managing pain. However, they can be addictive, resulting in widespread abuse in recent years and culminating in public health crises in Canada and elsewhere. A team of health technology companies had an idea for a technology solution that could help reduce the number of people who developed a dependency on opioids after surgery. With our international reputation in harm reduction, Providence Health Care was their first choice for a clinical partner.
The challenge
Approximately eight per cent of people who are prescribed opioids for pain will develop an addiction to opioids. For many years, doctors didn’t have the information they needed to minimize this risk at the time of prescribing opioids, nor did they receive follow-up data to reduce the rates of addiction.
“Ideally, people would not use opioids unless necessary. In addition to the risk of addiction, opioids have side effects like drowsiness, mental fog, nausea, constipation and slowed breathing,” says Dr. Ainsley Sutherland, Co-Physician Lead for the Transitional Pain Clinic at St. Paul’s Hospital.
DIGITAL and a consortium of industry and academia partners including Careteam, Thrive Health, BC Children’s Hospital, Excelar and Providence Health Care Ventures, invested in developing a clinical platform that could help doctors identify high risk patients before they had their surgery and support them after surgery to minimize the number who developed a dependence on opioids.
“It is exciting to see an organization like Providence Health Care innovating to improve care,” says Mark Nazemi, Director, Clinical Solutions & Innovation, Thrive Health. “They are willing to work with the tools and technologies we have available to find solutions and change how care is provided.”
The strategy
The project launched in late 2019. The advent of the COVID-19 pandemic in early 2020 put the project on hold for several months. The PHC Ventures team was able to step in and provide leadership when the project restarted in 2021. We oversaw multiple external partners and navigated internal processes, like privacy and ethics approvals. This allowed our clinical experts, like Dr. Sutherland, to focus their time and energy where it would add the most value to the project.
“One of the most useful outputs of this project was the risk assessment tool we developed with Thrive Health,” says Dr. Sutherland. “We integrated the tool into the standard health history questionnaire patients complete before surgery and we developed an algorithm to determine if a patient was high or low risk for prolonged opioid use after surgery. The longer a patient takes opioids, the greater the risk of developing an addiction.”
High-risk patients were streamed to the Careteam technology platform, where they received more pain-related interventions to help improve their outcomes post-surgery. Low risk patients stayed in the Thrive Health platform, where their quality of life was monitored for one year after surgery. The Thrive Health platform collected data on pain levels, medication use, and readmission rates. It also offered patients educational resources.
The impact
This project led to the creation of the Transitional Pain Clinic. Once the technology was in place to identify high-risk patients, the clinical team realized they needed to put additional supports in place to help these patients. With support from PHC Ventures, the team was able to secure funding for the new clinic.
In operation since 2021, the clinic is staffed by two physicians, one nurse navigator and a psychologist. The team sees patients before surgery and educates them on how to manage the risks of opioid dependency. After the surgery, the team continues to see the patients to help them manage persistent pain. Almost all patients are weaned from opioids during their time with the clinic.
Story by PHC Ventures
