According to the World Health Organisation (WHO), access to effective pain management is classified as a human right. However, for many aged care providers, demonstrating that this is the case in their facility can be difficult without the necessary tools, processes or documentation.
While there are many manual or paper-based pain assessment tools that clinicians can use, they are often underutilised due to the subjective nature of assessing pain for those who are not able to self-report. This has resulted, in many cases, in care teams relying on their personal opinion or previous knowledge of a resident to gauge what level of pain they appear to be in.
The industry is evolving, driven by technological advancements and the overarching digitisation of care. Digital pain assessment tools, such as PainChek, are paving the way for a future where every resident and patient has access to best practice pain management in aged care — all enabled by industry-leading technology.
So what are the benefits of digital pain assessment tools compared to manual paper-based methods? In this article, we explore how technology can drive better care outcomes, improve clinical workflow for carers, and help facilities demonstrate compliance with national and global standards of care.
Accurately assessing and detecting pain with AI and facial recognition technology
Many manual pain assessment tools ask the assessor to rate (usually out of 0-3) the severity of certain indicators of pain, such as vocalisations, behavioural changes, and more. This opens a realm of subjectivity for the assessor as they make these judgements to the best of their ability, based on their existing knowledge of the resident. While experienced nurses and carers familiar with a resident may be able to assess when a resident is in pain, those who are new or unfamiliar may struggle to detect the indicators associated with pain. Conversely, behaviours may be ‘normalised’ and not recognised if an assessor has had a long association with a resident.
The face has been proven to be a valuable domain in effectively assessing pain for people for cannot self-report, as certain involuntary micro-facial expressions are indicative of pain. Digital pain assessment tools like PainChek® recognise this and work to empower care teams to be able to quickly, accurately, and safely assess and subsequently manage pain.
To achieve this, artificial intelligence (AI) is used to find those micro-facial expressions which prove challenging to identify manually. The application of AI in this situation vastly reduces the subjectivity for the assessor, giving them confidence that they are providing their residents with the most effective interventions.
Looking beyond the facial domain, it is important to assess other domains (such as behaviour, activity, voice, movement, and body) to paint a holistic picture of a person’s pain severity. PainChek® further reduces the subjectivity in these domains (where AI is not required) by shifting from a subjective rating system to a binary checklist.
Rather than asking an assessor to rate the severity of pain indicators, they are presented with questions such as ‘is this person guarding a body part?’, ‘Is this person refusing care?’. Ultimately, rather than a subjective rating, the assessor now simply answers yes/no style questions which provide care providers with confidence in their assessment outcomes.
Yvonne Ayre, General Manager at Regents Garden in Australia, talks about the accuracy of pain diagnosis through the PainChek® assessments, which in turn enables a more accurate treatment plan:
“Having the evidence to support a pain diagnosis has often proved difficult when caring for people with dementia. Pain and behaviour management often go hand in hand and PainChek® has provided us with a simple but effective tool to diagnose that a person has pain and effectively manage that pain. As a result, we now have a number of documented cases of reduced use of behaviour medications (such as antipsychotics) and an improvement in the quality of life for the residents.”
Improving clinical workflow for care staff
PainChek® is designed to support the day-to-day clinical work conducted by nurses and carers — ensuring that any pain assessment conducted results in the most efficient, accurate and consistent outcome possible. By automating and simplifying the process, PainChek enables care staff to complete a comprehensive, accurate digital assessment in less than three minutes.
According to St Mary’s Mount Care Home in the U.K:
“PainChek® accurately assesses pain in those living with dementia at the point of care, replacing the need for paperwork. The assessment takes no more than 2-3 minutes to complete, with all data automatically uploaded to the PainChek Web App Portal. Carers, GPs and other medical staff can then access the data online.
St Mary’s Mount has experienced a marked improvement in the accuracy and consistency of pain assessment outcomes since introducing PainChek®. In addition, we have seen a huge time saving from administration.”
Beyond this, it’s difficult to document, store and access pain scores conducted using paper-based methods. Often, carers will conduct a pain assessment on a resident, make observations, then sit down at the end of the shift to write notes for the subsequent shift. Historical data can quickly disappear, creating inefficiencies in care planning and effective communication with clinicians. However, with digital pain assessment tools, all data is stored electronically and securely in the cloud. Carers can easily view records of a patient’s pain scores over time, and note down observations for future shifts.
In addition to accurately detecting pain in those who cannot verbalise their pain, digital technology can help document the pain scores of those who can verbalise their pain. The soon-to-be-released PainChek® Universal can document manual pain scores conducted using the Numerical Rating Scale (NRS), as well as those conducted using PainChek® technology. This means that, regardless of their condition or ability to communicate their pain, carers have easy access to a resident’s historical pain scores, conducted using PainChek® or the NRS, all in one place.
Demonstrate compliance and enable best-practice pain management
With the PainChek digital pain assessment tool, all pain scores and observations are stored securely in one place. This makes it easy for facilities to report on, and demonstrate compliance with, best-practice pain management and treatment in their country.
According to Ciaran Foley, CEO of Allambie Heights Village in Australia:
“PainChek® enables easy record-keeping which can be integrated with existing software record systems. It provides accountable and clear record-keeping and evidence availability for staff, GPs and for auditing purposes.
From a funding perspective, PainChek® offers an evidence-based process that allows Operators to meet the requirements of the current Aged Care Funding Instrument (ACFI) Model across several domains.”
Beyond reporting, the ease of using digital tools supports carers to conduct more assessments of pain on residents on a regular basis. Some facilities, such as Australian-based Barossa Valley Aged Care, have seen a 72% uptick in the number of pain assessments completed after introducing PainChek. In turn, this has translated into more pain interventions applied to residents, including PRN medications and therapy-based solutions.
