Anesthesiology & Pain Medicine >> Patient Care >> Pain Medicine >> UW TelePain

UW Pain Medicine Patient Care:
UW TelePain

About UW TelePain

The University of Washington Division of Pain Medicine offers weekly UW TelePain sessions, an audio and videoconference-based consultative knowledge network of interprofessional specialists with expertise in the management of challenging chronic pain problems. The goal is to increase the knowledge and skills of community practice providers who treat patients with chronic pain.

UW TelePain conducts these collegial interactive videoconferences, which include:

  1. Didactic presentations from the UW Pain Medicine curriculum for primary care providers
  2. Case presentations  from community clinicians
  3. Interactive consultations for providers with an interprofessional  panel of specialists
  4. The use of measurement based clinical instruments to assess treatment effectiveness and  outcomes for individuals and larger populations

You are invited to present your difficult chronic pain cases to our UW TelePain panel of specialists whose expertise spans pain medicine, internal medicine, anesthesiology, rehabilitation medicine, psychiatry, addiction medicine, and nursing care coordination. You are welcome to ask questions, even if you don't present a case.

UW TelePain Sessions take place each Wednesday from 12.00pm to 1.30pm for community health care providers.

Military and VA providers are encouraged to join a special session of UW TelePain focused on military and veterans’ health care on Thursdays from 12.00pm to 1.30pm.

We also invite you to participate in an NIH-funded study to help us to measure the impact of the UW TelePain program. For information about the study for community health care providers, please click here. For information about the study for military and Veterans’ Administration health care providers, please click here.

The UW TelePain program significantly increases access to interprofessional experts who provide real-time support in the care and treatment of the most challenging chronic pain patients. It also improves outcomes and patient and provider satisfaction over geographically dispersed areas, including rural, tribal, suburban, urban, and safety net populations. This program also supports the university's goal of extending pain care expertise throughout Washington, Wyoming, Alaska, Montana, and Idaho.

UW TelePain helps meet the need for access to pain management specialist consultations that are now required by the Washington State Department of Health regulations for opioid prescribing.

They specifically endorse the use of such innovative consultative approaches for chronic non-cancer pain patients with high risk and/or poor outcomes related to the use of high dose opioids.

UW TelePain is one of many domains within the UW Medicine Telehealth division, which was first established in 2001. Using telehealth to improve pain care was first piloted at UW in 2006 as part of a project in American Indian communities, funded by HRSA's Office for the Advancement of Telehealth. In 2009, it was expanded through an NIH grant to include rural hospitals and clinics. In 2011, the UW Division of Pain Medicine's program merged in an ongoing collaboration with the University of New Mexico's Project ECHO (Extension for Community Health Outcomes), first inspired by Sanjeev Arora MD. To learn more about UNM's ECHO projects, visit http://echo.unm.edu/. UW Medicine TelePain shares Project ECHO's continuing mission to safely and effectively treat chronic, common, and complex diseases in rural and underserved areas, and to monitor outcomes of this treatment.

 

Connecting

You may participate in UW TelePain via telephone, AdobeConnect webinar, or interactive video teleconference. To join UW TelePain, please complete this registration form and return via fax or email to:

Cara Towle, RN MSN
Director, Telehealth Services
UW School of Medicine
Email: ctowle@uw.edu
fax: 206-598-4576

Technical Contact

Rande Gray
rgray@uw.edu
pager 206-587-8903*, or
cell 206-459-7946.

*the pager is the best option for reaching Rande, as cell phone reception varies throughout the University.

NOTE: for locations using NW TeleHealth, please contact your local hospital site coordinator to arrange connection. For site coordinator contact information please call Pam Currier at (509) 789-4960.

This educational activity is supported by:

  • The National Institute of Nursing Research of the National Institutes of Health under awards number #R01NR012450 and #K24NR015340.
  •  An independent educational grant from the ER/LA Opioid Analgesic REMS Program Companies. Please see http://ce.er-la-opioidrems.com/IwgCEUI/rems/pdf/List_of_RPC_Companies.pdf for see www.er-la-opioidREMS.com for a listing of the member companies. This activity is intended to be fully compliant with the ER/LA Opioid Analgesic REMS education requirements issued by the US Food & Drug Administration.
  • Didactic presentations are intended for educational use only, and do not in any way constitute medical consultation or advice related to any specific patient.

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Didactic Presentations

Weekly didactic presentations for primary care providers occur between 12:00-12:30pm during each broadcast followed by a brief question and answer period. Slides, articles, and references from these presentations are made available to participants.

The curriculum includes core topics (each is presented twice/year), and supplemental topics (each is presented once/year ):

Core topics: Supplemental topics:
  1. Taking a pain history; assessment and motivational interviewing
  2. Functional assessment
  3. Addiction assessment
  4. Establishing a pain diagnosis
  5. Risk screening tools for opioid safety
  6. UDT use, interpretation, and response
  7. Opioids and MED calculation
  8. Controlled substance agreements
  9. Prescription Monitoring Program: how to access, use, and respond
  10. Pain Tracker: Patient reported outcomes
  11. Adjuvant analgesics (neuromodulators)
  12. Anxiety as comorbid condition: assessment and treatment
  13. Depression as comorbid condition: assessment and treatment
  14. PTSD as comorbid condition: assessment and treatment
  15. Cognitive-behavioral therapy
  16. Exercise and pain
  1. Medicinal Cannabis
  2. Methadone
  3. Sleep disturbances and chronic pain
  4. Disability
  5. Complementary and alternative medicine
  6. Pain in children
  7. Pain in older adults
  8. Pain during pregnancy
  9. Primary care disorders e.g. fibromyalgia, headaches, osteoarthritis, low back pain, diabetic peripheral neuropathy, visceral abdominal and pelvic pain, etc.

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To Present a Case at UW TelePain Broadcast

1. To present a case at the UW TelePain broadcast:

Send a completed Pain Medicine Case Consultation Request Form* on the Monday before the broadcast.
*Complete the form to the best of your ability in advance of your presentation, including patient responses to the UW Pain Tracker tool within the form. This will improve the quality of our evaluation of your patient. The data will be shared and analyzed by all of our pain management experts. Follow-up and review of your patient's progress will be scheduled with you as necessary, again using the Pain Tracker tool.

2. What to expect after we receive your completed form:

All personally identifiable health information will be de-identified and we will assign a confidential ID number to your case, and to confirm a presentation date. When you are called on to present the case during the confirmed UW TelePain broadcast, all parties will refer to the patient only by the confidential ID number.

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To Receive CME for Attending UW TelePain Broadcasts

To receive CME credits, participants will be asked quarterly to evaluate the UW TelePain sessions they attended. CME credits are awarded annually.

Accreditation

The University of Washington School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The University of Washington School of Medicine designates this live activity for a maximum of 72 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. (Each session is 1.5 credits)

OBJECTIVES: Upon completion of this activity, attendees should be able to:

  1. Describe the different major types of chronic, non-cancer pain and their corresponding treatment modalities.
  2. Optimize pharmacologic treatment of chronic non-cancer pain to improve function and safety, as measured by ability to measure morphine equivalent doses in patient prescriptions.
  3. Detect unsafe combination therapies such as opioids and benzodiazepines.
  4. Identify non-pharmacologic treatment modalities available for patients.
  5. State the legal requirements applicable to treatment of pain and addicted patients in their setting.
  6. Be able to describe the screening tools useful for management of chronic pain in primary care setting including those measuring pain intensity, function, and addiction risk.
  7. Identify elements of safe opioid prescribing and be able to assess patients for treatment.
  8. Model effective communication skills to improve provider-patient interaction and build trust as well as demonstrate ways to manage requests for opioid therapy from patients for whom this type of therapy is appropriate, and those for whom it is not appropriate.
  9. Describe the risks of serious adverse outcomes from opioid use, according to characteristics of opioid regimens and patients, and apply this knowledgein their patient assessment and ongoing treatment plans for improved patient safety.
  10. Successfully document treatment and patient action plans, and know how to counsel patients on how to safely use, store and dispose of opioid medications.
  11. Discuss general and product-specific drug information concerning extended-release and long-acting opioids.

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Who to Contact about UW TelePain Broadcasts

Please feel free to contact any one of us, should you have questions or need assistance.

For questions about participating in the UW TelePain program, and about CME credit, contact:

Cara Towle, RN MSN
Director, Telehealth Services
University of Washington School of Medicine
ctowle@uw.edu

For technical questions about how to connect to the UW TelePain broadcasts, contact:

Rande Gray
Videoconferencing Support
Office 206-616-7257
Cell 206-459-7946
Pager 206-587-8903
rgray@uw.edu

Testimonies about the Value of UW TelePain

"UW TelePain is a remarkably effective video conference-based consultative network providing tertiary center/university level expertise to assist community providers (both primary and specialty) in the management of complex and challenging chronic pain problems. I practice in Lewis County where I am the lone pain specialist.  I am thus the recipient of some very difficult chronic pain referrals from my colleagues and in the past I have often felt like I was by myself at the end of a very long rope.  Yet thanks to UW TelePain, I can join in a lively, interactive session where I can gain access to expert second opinions and collegial advice on tough cases.  I have come to truly look forward to Wednesdays now!"

"I have found these conferences to be very helpful in helping me maintain and increase my knowledge and skills needed to treat the complex chronic pain patients that I see in my community practice.  This allows me real time access to multidisciplinary experts capable of providing helpful recommendations to assist me in caring for these most challenging patients."
Gregory T. Carter MD MS, Centralia, WA


“The teleconferences are a huge asset for me, as a mid-level working in a rural setting. I get some tough cases to manage – people on astronomical doses of opiates and benzodiazepines together. I wanted to know more about morphine-equivalent dosing.  Providers don’t always know what to do, and these sessions let you know you’re not alone. As you listen to other doctors presenting cases and diagnoses, you hear something and wonder, ‘Why didn't I think of that?’ You're always learning.”
Rachel Stappler, PA-C, Coos Bay and Medford, Oregon


“Their presentations are very up-to-date, so you get the latest on how to manage patients with chronic pain: Do the physical therapy, do the tapering, lab and x-ray studies. They talk about complementary care like acupuncture, exercise, massage, even chiropractic – because if you’re telling patients that medication will be less, you want to give them something else.

We inherit these patients who are already at a higher dose, so we’re kind of stuck. How do we turn it around and get opioid-dependent or addicted folks back to more appropriate dosing? The UW faculty gave me the tools to be firm and establish that opioid levels need to come down. They gave me confidence in my direction.”

Ron Bergman, MD, Port Angeles, WA


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