1. Purpose
- This document encompasses the process for interdisciplinary patient care and the patient experience at Override.
2. Scope and Responsibilities
- This Standard Operating Procedure (SOP) applies to Override physicians, behavioral health providers, physical/occupational therapists, health coaches, and care navigators.
- The development, implementation, and maintenance of a patient's personalized pain plan (Plan) is an interdisciplinary process.
- All disciplines involved in the care of a patient at Override collaborate to develop the patient's personalized pain plan.
- The patient/family/significant other is included in the development, implementation, maintenance, planning, and evaluation of the care provided.
- Patients receive care and treatment based on an assessment of their needs, and the severity of their disease, condition, impairment, or disability. The data obtained from regular assessments, as well as direct communications between the patient and his/her providers are used to determine and prioritize the patient’s plan of care.
- The personalized pain plan will be revised on a monthly basis.
3. Delivery of Care - Licensed Providers
- The patient has a conversation or free consultation with an Override care navigator to confirm interest and eligibility (see Appendix).
- An Override administrator reviews the patient’s eligibility for reimbursement/payment and confirms the payment method/plan.
- The patient is invited to the EHR platform and completes intake forms.
- The patient is scheduled to meet with a pain physician who recommends a personalized plan of care outlining which services the patient would benefit from (i.e. behavioral health, coaching, and/or PT) along with a suggested frequency of visits per month. She will then assign the appropriate team members to the patient’s designated team.
- At the completion of the initial assessment visits with the appropriate team members, assessing providers are invited to an interdisciplinary team meeting led by the pain physician, during which providers collaborate to discuss findings and create an initial personalized pain plan. Each patient case should be discussed for no longer than 20 minutes.
- The personalized pain plan is sent to all members of the care team and the patient for review.
- Any given plan can recommend 1:1 coaching up to 2x a month, physical therapy up to 2x a week, psychology up to 1x a week, and physician follow-up visits up to 2x per month.
- Follow-up appointments are scheduled accordingly.
- Interdisciplinary meetings will recur on a monthly basis.
4. Coaching Protocol
- Every patient will enter the coaching program. Group coaching will take place 1x per week and individual coaching will take place between 2-4 times per month, depending on the recommended care plan.
- The patient will schedule his or her first meeting with the assigned coach. The coach will have primary responsibility for helping the patient implement and adhere to their personalized pain plan.
- The coach will have the most significant contact with the patient and will be responsible for regular check-ins with the patient via messaging outside of scheduled sessions.
5. Patient Education
- The patient engages in a pain neuroscience curriculum where each lesson is discussed in weekly group coaching sessions.
6. Remote Monitoring
- Patients answer survey questions weekly or monthly regarding their pain levels, functional status, sleep, mood, and quality of life.
- An Override team member reviews the data on a weekly basis.
- The Override care team receives a monthly summary of the data to allow for adaptation of personalized plan.
7. Patient-Provider Communication
- Patients may send messages (video/audio/text) to their care team as needed.
- Providers are expected to reply within 1 business day.
8. Documentation
- A personalized pain plan is documented for all patients during the interdisciplinary team meeting.
- Any interaction outside of scheduled appointments and messages inside Healthie are documented in the patient record by the provider who communicated with the patient.
- The patient’s goals and plan of action are updated by the individual who identified the problem, or by other healthcare team members according to their expertise and credentials. Multiple healthcare team members may have input to and document a plan of action for any healthcare concern.
9. Prescribing limitations
- Override providers do not prescribe any opioid medications to Override patients.
- Providers may suggest recommendations on the use of already prescribed opioid medications for approval by the patient’s prescribing provider.
- Override providers may communicate with patients’ (non-Override) prescribing providers if desired.
Last Updated: September 1, 2022
