Improve Decisions

Proove® provides understandable and actionable information at the point of care to improve healthcare decisions for the nation’s largest and most expensive health condition – pain. In comparison to the level of sophistication used for heart disease or cancer, with tools such as blood tests, medical devices, genetic testing, and other advanced techniques to better understand the underlying disease and select treatment modalities, the diagnosis and treatment of pain is far behind. Proove’s predictive analytics platform improves health care decisions, and we deliver that information through precision medicine profiles. Proove helps clinicians, patients, and payers overcome the burden of pain.

Improve Healthcare Decisions

There is a substantial difference for a patient when comparing a world without Proove versus a world with Proove. The current standard of care, if you can use those words, is highly inadequate for a patient. Using Proove, a patient is empowered to receive the treatment that will work best for them.

Patient benefits Include:

  • Better understand how your brain feels pain
  • Know which medications are more likely to work for you
  • Assess your risk for side effects
  • Use genetic information and the power of software to inform your clinician’s decision-making, instead of trial-and-error
CURRENT STANDARD OF CARE
    • Pain experienced by a patient is treated as a “symptom” rather than a condition.
    • Patients self-medicate at home taking over-the-counter medications such as acetaminophen or an NSAID
  • When OTC remedies fail, a patient goes to see their doctor who asks them to rate their pain subjectively using a 1 to 10 scale or “emoji’s” of smiley faces and frowny faces
  • When patients don’t respond to weaker pain medications, a clinician may select an opioid pain medication. Many patients are afraid of taking these medications, so if they fill the prescription, they may not take all of their pills, leaving excess addictive substances in circulation.
  • If a patient does not get relief from one doctor, they will find other doctors. Since most patients are not controlling their pain, these patients are then labeled as “doctor shopping” by their State’s prescription drug monitoring program (PDMP) which results in further denials of care or limits on access to care.
  • Pain is a condition that affects all aspects of a patient’s life – their mood, sleep, relationships, and employment. Because of the negative quality of life, they experience other co-occurring conditions, such as psychological conditions like depression and anxiety, insomnia, heart disease and diabetes.
  • Unresolved pain, due to musculoskeletal disease, leads to the leading cause of physical disability. Since 50% of chronic pain patients also suffer from mental health conditions – which are the leading cause of disability – we now have the highest rates of disability claims in U.S. history.
  • As clinicians try to help, they prescribe more and treat more – using poor decision-making – and the costs continue to spiral out of control. By increasing exposure to opioid pain medications, and putting more pills into circulation –many of which are not even used by those who are prescribed them – the U.S. is now experiencing a Rx opioid abuse epidemic.
  • If a patient or clinician chooses options other than medication management, they will pursue interventional pain procedures or surgeries in an attempt to control the patient’s pain.
  • This is the current “standard of care” and the circumstances that patients face.
CARE INFORMED BY PROOVE
  • Pain experienced by a patient is treated as a health condition, with an underlying clinical pathway, instead of a symptom in a body location.
  • Patients self-medicate at home using OTC medications based on their Proove profile, not exposing themselves to side effects associated with acetaminophen or NSAIDs if they will not work.
  • Patient pain is objectively assessed in light of their central perception or sensitivity to pain. Knowing this information informs the treatment plan.
  • Patients can ask for medications that they are likely to respond to, which are their preference, rather than the physician’s preference which may not work for them.
  • Patients do not need to “doctor shop” to find a clinician who cares, as a clinician using Proove profiles takes the time to learn what works best for them, and has a more detailed conversation about their condition and treatment options.
  • Patients can have peace of mind that their risk for opioid use disorder, NSAID side effects, and adverse events have been considered by their clinician and they will have a higher expectation of treatment success.
  • Patients have better outcomes, controlling their pain, thus avoiding co-occurring mental health conditions.
  • Patients regain their quality of life, with substantial reductions of pain, managed by appropriate therapy, so they can work, play, and engage in activities that “they used to do”.
  • Patients avoid prescription opioid abuse.
  • Patients avoid unnecessary medical procedures and surgeries.
  • Patients avoid unnecessary costs that they are now shouldering a larger burden through higher deductibles.

There is a substantial difference for a clinician when comparing a world without Proove versus a world with Proove. The current standard of care, if you can use those words, is highly inadequate for a physicians, physician assistants, nurse practitioners, and other clinicians treating chronic pain. Whereas clinicians should be considered heroes for trying to help patients overcome their pain, pain clinicians are under an unparalleled level of scrutiny for their use of medications, procedures, and laboratory testing. Using Proove, a clinician has objective information to improve their healthcare decisions, protect their patients, and protect their practice from the negative outcomes associated with pain management.

Clinician benefits Include:

  • Objective assessment of patient pain sensitivity
  • Objective assessment of patient risk for opioid use disorder
  • Pharmacogenetic analysis of drug metabolism and drug-drug interactions
  • Ability to better understand the clinical pathways of pain
  • Information to help select the best medication for a particular patient
CURRENT STANDARD OF CARE
  • Clinicians treat pain based on its location in the body, similar to cancer 50 years ago.
  • Clinicians usually see a patient after they have tried to self-medicate with OTC medications at home.
  • Clinicians assess pain severity or injury severity by asking a patient on a scale of 1 to 10 to rate their pain, or to select an “emoji” rating of smiley faces to frowny faces.
  • Clinicians will order x-rays and other radiographs to ascertain underlying injury.
  • Most clinicians do not have access to multi-modal treatment options and will rely on medication management and possibly interventional procedures.
  • Clinicians are not able to help most patients control their pain with current treatment modalities, except for temporary relief from interventional procedures.
  • Clinicians are under an unparalleled level of scrutiny due to: (1) doctors going to jail on multiple counts of murder in California1, (2) doctors being sued by patients who overdose2, and law enforcement (DEA, FBI, US Attorneys, and state police) raiding doctors’ offices3.
  • Clinicians rely on opioids, benzodiazepines, anti-epileptics, NSAIDs and other medications without knowing risk or response, in advance of prescribing. They usually have certain “go to” medications that they feel comfortable prescribing.
  • Clinicians use survey instruments to ask patients to tell the truth about whether they are going to lie about their prescriptions.
  • Clinicians use urine drug screens as a “gotcha” test to try to catch patients who are using illicit drugs or aberrant pharmaceuticals.
  • This is the current “standard of care” and the circumstances that clinicians face.
  1. http://www.latimes.com/local/lanow/la-me-ln-doctor-prescription-drugs-murder-overdose-verdict-20151030-story.html
  2. http://www.cbsnews.com/news/west-virginia-allows-painkiller-addicts-to-sue-doctors-who-got-them-hooked/
  3. http://www.nbcnews.com/news/us-news/drug-enforcement-administration-raids-pill-mills-four-southern-states-n361956
CARE INFORMED BY PROOVE
  • Clinicians can objectively assess a patient’s pain sensitivity or perception based on their central perception of pain. This leads to a meaningful conversation about their pain and how the patient’s pain sensitivity will affect their treatment options.
  • Clinicians can understand the underlying clinical pathways contributing to a patient’s pain.
  • Clinicians collect a more rigorous set of medical history, diagnostic criteria, and functional assessments leading to more informed decision-making and rationale for medical necessity of treatment.
  • Clinicians can use this information to avoid unnecessary MRIs, procedures, and surgeries by better understanding a patient’s pain.
  • Clinicians can have a meaningful and effective conversation that isn’t “adversarial” but rather “advocating” with a patient and possibly their caregiver about opioid abuse and the patient’s risk profile.
  • Clinicians can review the Proove results with a patient about treatment response and drug metabolism. Patients will volunteer information about how certain medications have not worked for them before and how the results are either consistent or inconsistent with their experience.
  • Clinicians can give insights to patients, and provide them with a copy of their Proove results to guide how their other clinicians prescribe medications, as well as how the patient may use OTC medications by themselves.
  • Clinicians build a higher level of trust with their patients and set higher expectations on treatment outcomes.
  • Proove tracks patient outcomes prospectively, helping inform Clinicians about patient pain management changes, and other co-occurring disorders.
  • Clinicians who guide treatment using Proove have patient outcomes 2X better than when patients are not guided by Proove information to improve decision-making.
  • With higher reductions in pain, improvements in function, and lower utilization of opioids, Clinicians have better outcomes measures to report to CMS for MACRA compliance, to their ACO for reimbursement rates, or other payers who are interested in rewarding better patient outcomes.
  • Clinicians have added numerous assessments to their decision-making to protect their patients from prescription opioid abuse and to protect their medical practice.

There is a substantial difference for a payer when comparing a world without Proove versus a world with Proove. The current approaches are leading to rapidly increasing costs and poor outcomes. Using Proove, a payer can influence clinician decisions in unparalleled ways – rather than just having population health data to influence blanket policy decisions.

Payer benefits Include:

  • Influence and impact on clinician decisions for individual patients
  • Ability to track patient outcomes with quality clinical data that would usually only be available in a small clinical trial, rather than relying on claims data
  • Reductions in utilization of medications, specifically opioids, as well as repetitive use of expensive radiographic diagnostic procedures
  • Use of genetic information and predictive analytics to inform policy and clinician decisions
  • A partner with Proove who will share risk

Proove is a proud member of the Coalition to Stop Opioid Abuse and the Collaborative for Effective Prescription Opioid Policies4. We have sponsored local non-profits as they support National Take Back Day initiatives, and we are interested in working with policy makers to help solve the prescription opioid abuse epidemic as well as reduce overall healthcare and disability costs.

Public policymakers desire solutions, but the current approaches put in place over the past several years are failing. Opioids now kill more people than gun homicides – less than a decade ago, gun homicides outpaced opioid deaths by more than 5 to 1.5

Clearly, law enforcement initiatives by the police, FBI, and US Attorney offices is not enough. Clearly, legislative efforts such as Prescription Drug Monitoring Programs are not enough. Just as we have a “moonshot” for cancer, Proove is leading a precision medicine initiative for the nation’s largest and most expensive health condition that is driving creation of the prescription opioid abuse epidemic. Proove seeks to partner with law enforcement, legislators, and policy makers to help solve this problem.

More than 52,000 Americans died from drug overdoses in 2015, a “drastic increase” from the previous year according to the CDC, fueled largely by deaths caused by heroin, fentanyl, and other illicit opioids. According to new data released by the CDC in December 2016, heroin deaths increased more than 20 percent from 2014 to 2015, and deaths linked to synthetic opioids such as fentanyl soared by more than 72 percent. The death rates “increased across all age groups 15 and older, in both sexes, and among all races/ethnicities.”6

The outcomes data clearly shows that conventional approaches are not working. This is why Proove is clearly positioned to be a partner with policymakers in delivering a solution.

Policymaker benefits are clear:

  • Opioid abuse is having a huge negative impact on communities and by reducing opioid abuse rates, other social programs and criminal justice programs will not be burdened.
  • The criminal justice system and the network of jails and prisons are full of cases involving persons afflicted by drugs. By reducing opioid abuse rates, the justice system will have far less volume of cases.
  • Opioid abuse and unresolved pain is the nation’s most expensive health condition – more than cancer, diabetes, and heart disease combined. With taxpayer-funded programs like Medicare and Medicaid being the largest payer of U.S. healthcare dollars, policymakers have a responsibility to better spend those dollars and reducing the opioid abuse epidemic and reducing the costs of pain management will clearly do so.