TelePain: A Community of Practice for Pain Management

Abstract

Introduction Comprehensive pain management services are primarily located in urban areas, limiting specialist consultation opportunities for community healthcare providers. A community of practice (CoP) for pain management could create opportunities for consultation by establishing professional relationships between community healthcare providers and pain management specialists. A CoP is a group of people with a common concern, set of problems, or a passion for something they do. Members of a CoP for pain management increase their knowledge of evidence-based pain management strategies in a way that is meaningful and relevant. In this article, we provide evidence that TelePain, an interdisciplinary, case-based pain management teleconference consultation program through the University of Washington, qualifies as a CoP and present preliminary evidence of TelePain's effectiveness as a CoP for pain management. Methods Specific behaviors and conversations gathered through participant observation during TelePain sessions were analyzed based on the 14 indicators Wegner developed to evaluate the presence of a CoP. To demonstrate preliminary effectiveness of TelePain as a CoP for pain management, descriptive statistics were used to summarize TelePain evaluation forms. Results TelePain is an example of a successful CoP for pain management as demonstrated by the presence of Wegner's 14 indicators. Additionally, evaluation forms showed that TelePain enhanced community healthcare providers' knowledge of pain management strategies and that continued participation in TelePain lead to community healthcare providers' increased confidence in their ability to provide pain management. Conclusion TelePain, a CoP for pain management, facilitates multidisciplinary collaboration and allows members to develop interdisciplinary care plans for complex pain patients through case study discussions. Evidence-based pain management strategies gained through CoP membership could be disseminated to other healthcare providers in members' clinics, which has the potential of improving the care of chronic pain patients.

Impact of Project ECHO Models of Medical Tele-Education: a Systematic Review

“…Provider Knowledge. In one study, 42 authors evaluated provider knowledge by merely asking participants after training to self-report whether they perceived their knowledge to improve. More often, studies implemented a pre-post design, in which providers were asked to self-assess their knowledge at baseline and again at endline, with significant changes observed.…”

Optimizing telehealth pain care after COVID-19

“…Furthermore, the COVID-19 pandemic has tangibly impacted exposure to clinical training and emphasized the need for continued development and provision of E-Health methodologies to extend access for pain-related science, clinical practice curriculum, and pain specialist consultations for trainees and providers. For example, the UW's TelePain program 67 —weekly videoconference sessions that incorporate competency-based pain education delivered by a panel of multidisciplinary pain specialists to address gaps in training and patient case presentations to provide necessary consultation for high-risk patients— quickly responded to COVID-19 pain care restrictions by creating a didactic presentation packed with resources for community providers to support their virtual care of patients with complex chronic pain. Furthermore, trainees at all levels (medical students, residents, and fellows), missing critical in-person clinical training, have leveraged this existing education infrastructure, gaining evidence-based and case-based education remotely.…”

“…Educational initiatives to improve outcomes may include continued use and enhanced engagement in provider-to-provider telementoring, such as Extension for Community Healthcare Outcomes 53 and UW's TelePain programs, 67 , 84 which were implemented to support community providers over a decade ago. The value of pain management telementoring programs is supported by several studies, with demonstrations of increased provider knowledge and/or confidence, 2 , 5 , 31 , 53 , 67 improved communication between patients and providers, 5 , 17 greater guideline adherence, 2 and cost benefits relative to specialty clinic visits. 85 Systemic changes (eg, leadership buy-in and modified clinic schedules) that increase the feasibility of regular participation in telementoring may be necessary.…”

Building virtual communities of practice for health

“…Additionally, online social networking enables communities of practice 4 that “offer the potential to bring together temporally and geographically dispersed actors to work towards a common purpose”. 5 Through technology, communities of practice are being implemented across health-care areas, such as integrated care, 6 pain management, 7 health visiting services, 8 and nurse education. 9 These virtual communities enable collaborative learning that transcends geography.…”