Written by Everyday in our country, people with musculoskeletal issues (such as back, joint and muscle pain) are facing a fragmented, confusing and medically interventional care delivery system. The treatment protocols are often not personalized to meet the specific needs of an individual. A reality that is often overlooked is that people with chronic pain often have multiple complex conditions and need personalized pathways for treatment instead of the ‘one-size-fit-all’ approach offered by the current system.
A data-driven digital musculoskeletal (MSK) solution holds a great promise to deliver personalized care at scale. It provides a personalized, connected model of care that tracks a person’s health in real-time, deliver relevant timely guidance to stay informed and healthy – with continuous access to coaches and clinical staff to assist and guide them with timely interventions.
Instead of waiting for the member to walk in the door, the data-driven digital musculoskeletal (MSK) system predicts who would need help and when and flip care model completely in the other direction. It uses predictive techniques to first identify the members who need help and then empower health coaches with the information about the interventions that are going to work for the member at this time.
The foundation
The core architecture of a data-driven digital musculoskeletal system is built around the member. It collects and analyzes various types of signals that provide a rich understanding of the member’s needs. With this knowledge, the system is able to support the members with interventions that are likely to work for them, delivered with an experience that influences behavior change.
We often see and experience this in other industries. For example, when you are navigating directions using Google maps, the system is constantly collecting information about your location, where you are going, learning your preferences, and guiding you with multiple options to help you get to your destination.
Various studies have proved time and again that a multimodal approach to pain that combines exercise therapy with digital guidance and health coaching not only help scale access to care but also offer members an effective, more personalized and in-home care experience. Machine learning, AI and data science tools when applied to this model create a self-learning system that can predict and personalize care to meet the specific needs of every member. For example, the system can help a coach by automatically creating a dynamic treatment plan with interventions that have previously resulted in great outcomes for people who share similar demographic and risk profile.
This is not a one-time activity. The data-driven digital musculoskeletal (MSK) system treats every interaction as an opportunity to learn from members to improve care delivery, support and the overall experience to drive positive behavior change, as a self-learning system.
Why is knowing member’s journey critical to understanding their pain?
Our understanding of pain is evolving. We know now that the role of the central nervous system and the member’s environment contributes a great deal to their perception of pain. Frameworks like hierarchical predictive processing (PP) seems to explain a lot about how central nervous system operates and makes sense of precepts around pain management. It is now understood that a lot of our percepts are generated and biased towards prediction based on previously held information in our system. If the information presented is the same as the prediction, the system discards it. But when there is new information, it is taken back to the system for revision.
There is a lot of strong and negative messaging from clinicians and society about chronic pain, how it is a nightmare to live with it and difficult to stay productive. That negative information forms the foundation on the basis of which the nervous system (of most people with persistent pain) is making prediction about the data expected from the peripheral system. That’s why it is extremely important to understand the information that a member is holding in their system, both implicitly and explicitly such as their past experiences, their beliefs and context about pain that are going to influence the prediction their system makes and mold their conscious experience of pain.
Start from the beginning
Data is the fuel in this data-driven system for pain management. From the initial registration or enrollment, it is important to collect claims data and combine that with other signals from computer vision, manual entries, entries made by care team, EHR to build out detailed member profile.
The next step is to build a collection of member’s pain concerns and map out which ones are met and which ones need attention. This provides guidance on what resources are needed and for whom.
The data-driven digital MSK system also provides the ability to experiment and learn how to communicate effectively with different kinds of members, based on demographics, and personal preferences. This can be very useful during enrollment, engagement, retention, and incentive campaigns. It can also be used to send relevant content to members that keeps them engaged in-between scheduled sessions.
A balancing act
Knowing members and their habits and behaviors requires a responsible and balancing act from the digital musculoskeletal solution providers. One important component of the balance is starting with member’s centric view. A member should be able to clearly state how she wants to use the service and her preferences for communication. Member privacy has to be at the center. They should have the ability to know how their data will be used and have tools to easily give or change permissions to use their data.
Clinical rigor is really important as well. All tools built with data science must go through clinical lens and validation. In musculoskeletal care, it’s not just how interesting your message is, but also if the message is clinically valid and relevant to members at this stage of their journey.
Summary
We can’t imagine healthcare without empathy – the process of building trust and sharing feelings of compassion. However the pandemic has clearly demonstrated the need of a more resilient and available system that can deliver high-quality pain management at scale. A data-driven musculoskeletal system can deliver on this promise by making each human interaction ever more informed, more personalized, and more effective at improving outcomes.
Sprite Health’s digital program for musculoskeletal pain provides a single point of access for all MSK conditions, across the entire MSK continuum. Our virtual physical therapy services provide a more affordable and convenient way to prevent and treat pain. Chronic pain management provides an evidence-based, PT-led digital program for chronic joint and back pain that includes personalized exercise therapy, behavioral health support, education & guidance.
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