The Chronic Pain Epidemic and the Role of AI

Chronic pain management is one of the most pervasive and, in some ways, one of the most underreported areas of modern healthcare. It’s also an area that impacts not only patients who are suffering from chronic pain conditions, but providers, caregivers, hospital networks, insurance firms and others within the greater healthcare ecosystem. However, the encouraging news is that advances in Artificial Intelligence (AI) and related technologies are opening up new possibilities for addressing how chronic pain management can be made more effective. The end result can be improved care for debilitated patients, and greater efficiencies for providing critical management and services overall.

A 2016 symposium at the Harvard T. H. Chan School of Public Health addressed the worldwide epidemic of chronic pain, which is defined as pain lasting longer than three months or longer than expected healing time. The symposium addressed the depth and breadth of its impact within economic, social, clinical, and other related frameworks of those affected directly and indirectly.

Statistics related to chronic pain worldwide are alarming – so much so that it’s difficult to classify this trend as anything less than an epidemic. Consider the following:

• An estimated 100 million Americans are affected by chronic pain.
• Worldwide that number grows to approx. 1.5 billion people.
• 27% of chronic pain is related to low back pain.
• Chronic pain is the number one cause of long-term disability in the United States.
• 77% report of chronic pain sufferers report feeling depressed due to their condition.
• 63% seek treatment by medical doctors, 25% by chiropractors and 15% by pain specialists.
• The economic burden to the US is approx. $635 billion per year.
• Chronic pain conditions result in 36 million lost days of work in the US.

Interestingly, opioids continue to be prescribed to patients suffering from chronic pain despite the fact that its use is broadly accepted to be most effective for acute pain, cancer pain, and palliative care. Additionally, only 23% of patients suffering from chronic pain found opioids to be effective.

A Strategy for Pain Prevention and Care

Recognizing the need for addressing the chronic pain epidemic, the National Institutes of Health (NIH) contracted with the Institute of Medicine (IOM) in 2010 to undertake a study and make recommendations “to increase the recognition of pain as a significant public health problem in the United States.” The resulting 2011 IOM report called for a cultural transformation in pain prevention, care, education and research, and recommended development of “a comprehensive population health-level strategy” to address these issues.

In response to the report, the Assistant Secretary for Health in the Department of Health and Human Services (HHS) asked the Interagency Pain Research Coordinating Committee (IPRCC) to oversee creation of a National Pain Strategy (NPS).  The six key areas are addressed in the NPS are:

• Population research
• Prevention and care
• Disparities
• Service delivery and payment
• Professional education and training
• Public education and communication

The chronic pain ecosystem includes a plethora of government programs, healthcare delivery organizations, clinical providers, home care organizations, healthcare insurance companies, the entire employer community and many others.  This ecosystem over time has integrated a wide range of evolving technologies designed to improve patient outcomes by enhancing data availability and overall communication to both patients and providers.  These technologies include software such as electronic medical records (EMRs), hardware including home-based medical devices and multi-modal multi-channel telecommunications (Web, mobile apps, smartphones, etc.). In fact, for years a multitude of clinical/technology-based publications have highlighted the expansion of smartphone-based apps and distributed connectivity for addressing chronic pain management.  Additionally, this ecosystem is now being viewed holistically and, as such, its current delivery model requires rethinking and re-design.

Leveraging AI for Pain Management

Fortunately for all concerned, especially patients suffering from chronic pain, the overall technology landscape — and AI solutions specifically -- have evolved significantly since that Harvard Symposium two years ago. Now more than ever, AI solutions are poised to deliver greater cost effectiveness, ease of use, better insights into complex data, and other benefits for patients, providers and caregivers.  This includes the migration of Robotic Process Automation (RPA) and AI out of the sole purview of research labs into the mainstream, accompanied by advances in cloud computing and affordable wireless connectivity that can bring RPA and AI to wider audiences and ecosystems.

However, if chronic pain management is to improve and benefit from the AI technology evolution, there is a pressing need for improvements in coordinating back-end autonomic processes that are then coupled to a cognitive conversational front-end. This interface needs to be designed to engage with a multitude of end users ranging from patients to providers.

We will explore how chronic pain and effective management of such conditions can be impacted in new and innovative ways through a series of blog posts published in the next few months about advancements in RPA, cognitive AI, digital colleagues and other AI-related areas. We hope to provide insights into how AI can address a variety of economic and clinical areas associated with chronic pain management, and spur discussions about what solutions would be the most beneficial.