At the 2018 American Academy of Pain Medicine Annual Meeting a session discussed identifying the ideal candidates for interdisciplinary care. The speakers included: Ravi Prasad, PhD – Stanford University School of Medicine Patricia Cole, PhD – Shirley Ryan AbilityLab There is a big difference between acute pain and chronic pain. Acute pain has a clear pathway for treatment with a fixed end point and usually has a single cause. Chronic pain has many causes and there is no fixed end point for treatment. Immobilization may be essential to treat acute pain, but it can worsen chronic pain. Medications play a
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At the 2018 American Academy of Pain Medicine Annual Meeting, James Atchison, DO, from Shirley Ryan AbilityLab discussed working with patients to build a self-treatment plan. Patients need to be educated on both the physical and mental (cognitive) elements of pain. Physical areas of focus for a treatment program: Posture. Body mechanics/positioning. Pacing. Exercise including strengthening, muscle balance and an aerobic component. Cognitive areas of focus for a treatment program: Relaxation including breathing. Sensitization/desensitization. Graded Motor Imagery including left-right discrimination, localization and mirror. Categories of treatment – Medical: Is work-up complete? Are there known contraindications/restrictions? What are self-imposed limitations/restrictions? Will
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At the 2018 American Academy of Pain Medicine Annual Meeting, a session discussed how pain impacts the brain and how treatments can change this. The speakers were: Kristin Lucas, PT, DPT – Swedish Medical Group Elizabeth Gaffron MOTR/L – Shirley Ryan AbilityLab Pain is a natural protective mechanism that impacts many areas of the brain. The brain reacts differently when processing chronic pain vs acute pain. The brain changes can be reversed through treatment. The brain will trigger production of chemicals in the body that increase many elements of mood and body function. Pain interferes with these chemical productions. Psychological
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At the 2018 American Academy of Pain Medicine Annual Meeting, James Atchison, DO, with Shirley Ryan AbilityLab discussed medication tapering. Opioid reduction/tapering is a key element in any interdisciplinary pain management program. The goal is to reduce the medications while at the same time offering alternative pain management strategies. The goal is not to criticize the patient for using opioids, but instead focus on giving them new tools to assist with their pain. Usually by the time a person gets to a pain management program, it is established that the medication is not solving the problem. The patient may resist
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At the 2018 American Academy of Pain Management Annual Meeting, Ravi Prasad, PhD from Stanford University School of Medicine discussed outcome assessments in pain management. Outcomes tracking challenges: Financial limitations Logistical barriers Uncertainty, what should we assess Implementation of findings Most clinicians are not tracking outcomes because they don’t know how to use this information in their practice, have no infrastructure for this tracking, or many other reasons. They feel outcomes assessments are more important for researchers than practitioners. What would be useful to measure: Medication usage Physical functioning Pain level Pain interference Mood functioning Disability perception Sleep In surveys,
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At the 2018 American Academy of Pain Medicine Annual Meeting, a panel discussed lessons learned from past use of multidisciplinary pain management programs and how to overcome those barriers in the future. The panel included: Kimberly George – Sedgwick (moderator) Dianne Flynn, MD, MPH – Madigan Army Medical Centers Michael Harris, PhD – Pacific Rehabilitation Centers Marcos Iglesias, MD – Broadspire Heather Kroll, MD – Rehabilitation Institute of Washington Jeffrey Livovich, MD – Aetna Insurance Judith Scheman, PhD – Cleveland Clinic The panel discussed a wide variety of topics. The highlights included: Many programs dropped their CARF accreditation but not
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At the 2018 American Academy of Pain Medicine Annual Meeting, Kimberly George from Sedgwick discussed the payer’s perspective on how stakeholder collaboration can advance the field of pain management. Stakeholders There are many different payers involved in the healthcare payer market. This includes the federal government in terms of Medicare, the Department of Defense, and Federal employees, state Medicaid programs, self-insured employers, third party administrators, and insurance companies. The workers’ compensation system is another element of the healthcare system. On the group health side, you can see self-insured employers with a few hundred employees and several hundred thousand employees. These
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At a session during the 2018 RIMS annual conference, Steven Sachs, EVP, Director Real Estate, Hotel and Gaming Practice, Willis Towers Watson and Tim Kraft, Consultant, Risk Management & Insurance, Warrior Consulting Ventures, lead a discussion on habits of highly successful risk professionals and how to relinquish control and create active listening. Steven Covey’s book titled “Seven Habits of Highly Effective People” (Risk Professionals) is a wildly successful book of wisdom. There have been over 25 million copies worldwide since publication in 1989. The book stresses the “Character Ethic” and to align values with “universal and timeless” principles. The book
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At the 2018 RIMS Annual Conference, a session discussed the wave of litigation against pharmaceutical companies, pharmacies and distributors related to the opioid epidemic. The panel included: John Denton – Managing Director, Marsh Anna Engh – Partner, Covington & Burling, LLP We all remember past litigation by governmental entities against industries for the ills of society. The best example of this is the tobacco litigation, but we are also seeing suits against gun manufacturers, wine and spirits companies and even oil and gas companies because of climate change. Status of Litigation The big wave of opioid litigation really started in
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Presented by: Darrell Brown, Executive Vice President and Chief Claims Officer, Sedgwick Claims Management Services, Inc. Denis Algiers, Director, Risk Initiatives/National Medical Director, Albertson’s Safeway, Inc. This session at the RIMS Annual Conference & Exhibition in San Antonio was an overview of the state of recreational and medicinal marijuana legislation and impact with respect to employer policies and workers’ compensation claims programs. During the November 2016 election and continuing during legislative sessions in 2017, states are expanding legal use of marijuana for medical use as well as adult recreational use. Federally though, the use of marijuana even for medicinal use,
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