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TEMPO QUERI Evaluates the Impact and Cost of Implementing Virtual Pain Teams

Evan Carey, PhD

It is estimated that 50 million adults – or 21% of the US adult population report pain on most days or every day – and that 1 in 5 American adults experiences chronic pain, which is associated with reduced quality of life, increased medical costs, and significant economic costs (Yong, et al., 2021). Chronic pain also has been linked to dependence on opioids. Pain-related conditions are the most common service-connected disabilities in VA. Further, more than 10% of Veterans have high-impact chronic pain that limits their ability to participate in work, recreation, and self-care activities. Led by Jessica Chen, PhD, in Seattle, WA, Evan Carey, PhD, in Denver, CO, and Sherry Ball, PhD, in Cleveland, OH, TelePain Evaluation, Metrics & Pain Outcomes (TEMPO) QUERI enhances VA’s ability to improve access to high-quality chronic pain care through telehealth. The goal of TEMPO QUERI is to evaluate the clinical impact and costs of implementing virtual interdisciplinary pain teams (TelePain) enterprise-wide that deliver evidence-based pain care.

Dr. Jessica Chen

VA is a leader in re-envisioning the delivery of high-quality chronic pain care. TEMPO QUERI is excited to work with our operational partners to evaluate and continuously improve this ambitious implementation of virtual interdisciplinary pain teams nationwide. –Dr. Jessica Chen

Interdisciplinary Pain Management

Interdisciplinary pain management is the standard of care for high-impact chronic pain, but nearly 1 in 3 VA facilities lack the staffing and infrastructure for interdisciplinary pain teams. Telehealth helps close this gap by bringing virtual pain teams (TelePain) to low-resource areas. Evidence-based interdisciplinary pain management teams address the biological, psychological, and social aspects of individuals suffering with chronic pain. To help the patient tackle all of these, his or her team usually includes a physician/prescriber, pharmacist, care manager, physical or occupational therapist, psychologist or social worker, and medical support staff.

Evaluation Processes

To evaluate the impact of implementing TelePain, TEMPO QUERI utilizes a variety of data sources, including administrative data from VA’s electronic health record, a patient survey, and interviews with patients and providers.

Expected Impacts

TEMPO QUERI is expected to:

• Increase the use of interdisciplinary pain management, particularly among Veterans residing in rural settings;
• Reduce reliance on low-value pain services and community pain care; and
• Produce a TelePain Implementation Toolkit, which will include an implementation guide, templates, workshop, stakeholder engagement recommendations, research summaries, FAQs, and more.

TEMPO QUERI provides ongoing evaluation to assess whether TelePain is benefiting Veterans and VA, as intended, and will provide data for course correction, if needed.

Dr. Sherry Ball

The qualitative team is excited to be part of this effort. We will be there listening to and partnering with Veterans and frontline providers to identify practical and feasible refinements to TelePain implementation before, during and after rollout across 13 VISNs. – Dr. Sherry Ball

Partners

TEMPO QUERI is working with national program offices, as well as regional and local health system leaders to support high-quality implementation of TelePain. TEMPO QUERI works in partnership with VHA Pain Management, Opioid Safety, and Prescription Drug Monitoring Program Office.