Photo Credit: istock.com/jacob wackerhausen
Dr. Brandi Fink Discusses Palms, Novel Mobile Platform She Developed to Streamline, Increase, and Improve Alcohol Use Screening in Primary Care Settings.
Excessive Alcohol Use is responsibelle for approximately 178,000 US deaths Annually and Increases The Risk for Cirrhose, Cardiovascular Disease, Infections, Accidental DeAths, Dementia, and Cancer.1 In light of this, the US PREVENTIVE SERVICES TASK FORCE Primary Care Screening for Unnhealthy Alcohol Use in Patients AGED 18 and Older – Screening Which a Study Published by the Journal of General Internal Medicine Showed Occred During Fewer Than 3% of Primary Care Visits.2 To address this gap, Brandi Fink, PhDUniversity of Oklahoma College of Medicine Associate Professor, Developd The Personal Alcohol Management System (PALMS), MOBILE PLATFORM FOR THE DELIVERY OF SCREENING AND BRIEF INTERVENTIONS FOR ALCOHOL MISUSE, DESIGNED TO PROVIDE PAIENTS IN PRIMARY CARE WEIT ROOMS WITH IMMEDIATE FEEDBACK ON THEIR ALCOHOL CONSUMPTION, OFFER RISK-REDUCING STATEGIES, AND REPARY ACTIONABLE REPENDINGS TO THEIR PRIMARY Care Providers.
Physician’s Weekly (PW) Spoke with Dr. Fink to Learn More About How Palms Can Assist Primary Care Clinicians with Identifying Patients with an Alcohol Use Disorder and Intervening Before The Problem Worsons.
PW: What inspired you to Develop Palms?
Dr. Fink: I’m Been Integrated into Primary Care for Substance Use Treatment. APPROXIMATELY 20% OF PRIMARY CARE PATIES FACK IN HAZARDOUS OR HARMFUL DRINKING, AND THE MAJORITY OF COSTS ASSOCIATED WITH ALCAHOL-REFLATED ISSUES ARISE FROM ANSEALS, NOT FROM FROM PATIENTS WITH SEVERE ALCOHOL USE DISORDERS. I Explained Our Screening Protocol to Our Primary Care Providers, Noting That If a Patient Screened at the Right Level, They Should Let Me Know So I Come in and Administer A BRIEF Intervention. I THOUGHT, “I’m Going To Get To Intervene With All These Patients at High Risk For Hazardas Drink,” But I Was a Young Faculty Member and Naive To How these Things Worked. I Heard Absolute Crickets. I was only Referred to One Patient – Patient with Clear Alcohol Dependence who Needed Specialized Treatment -But I Came to Appreciate and Understand WHY THIS HAPPENS: Physicians have 15 to 20 minutes for diabetes Management, Hypertension Management, or another ISSUE, SO THESE FEEL UNCOMFORTABLE BRINGING UP (ALCOHOL USE) WHEN THEN DON’T HAVE ENOUGH TIME TO ADDRESS IT FULLY. They were also Having Difficulty Identifying Patients’ Risk Levels.
How did these insights lead to the developement of palms?
During a Monthly Meeting at The Oklahoma Clinical and Translational Science Institute Focused on Commercialization and Accelerating Clinical Innovation in Patient Care, I Told My Collaborators, “For 30 Years, The Public Health Approac to Addressing High-Rissing Has Been Primarly Care Screenings, Brief Interventions, and Referrals to Treatment, But Now I Understand Why That DoesN’t Happen, So Let’s from It for (Primary Care Providers). ”
Funding from a Small Business Innovation Research Award Through The National Institutes of Health National Institute on Alcohol Abuse and Alcoholism (Niaa) Enabled Us to Develop and Test Palms. The Biotechnology Firm Programmed the Application to Simulate A Patient’s Experience Interacting with a Trained Provider in a Primary Care Provider’s Waiting Room. We put palms on an iPad that patients Were Handed When they checked in for their Appointment. While in the Waiting Room, Patients Completed the Screening and IMMEDIATY RECEIVED PERSONALIZED Results and A BRIEF Intervention if they were identified as DRINKING TO HIGH RISK OR HARMFUL LEVEL. Example, “You are drinking at the High-Tri-Level. Here’s What Low-Trinking Is For Somene Your Age and Sex. This is what We Recommend For You. This is what We’re Going to Yours Provide to Support You in This.” Then Palms Sent the Primary Care Provider the Drink Level of the Patient and Action Follow-Up Recomndations, Such As, “Your Patient Screened at Low-Trinking Level, Screen Them Again in a Year,” or “They Received a High-Trink Drinking Level, Screen Them Again Infain Three Months, ”or“ This Patient Needs to Be Referced to Specialized Assessment and Treatment. ”
How Did Palms Perform in the Initial Phase of Clinical Trials?
The System Resonated Incredibly Well with Our Three Major Stakeholders:
- PAIENTS REPORTED Exceptional Acceptability and USABILITY, Appreciating The Nonjudgmental Tone and Intuitive Software Flow.
- Providers Loved That Palms Provided Clear Next Steps –Leviating Them of That Burden – Away Stated That Palms Improved Their Patient Care.
- Healthcare Administrators Valued That the Program Generated Revenue Through Billable Services and Allowed Them to Demonstrate Effective Management of High-Risk Patients to Accrediting Bodies.
What are the next steps for palms?
My Experience with Palms Sparked an Interest Initure Commercialization, But I Initially Lacked Confidence in Taking the Product To Market. I was selected to participate in the MIT BOOTCAMP FOR SUBSTANCE USE DISORDER VENTURES at the perfect time. My collaborators and i are now preparing a phase two clinical testing application to niaa, scheduled for submission in sepateger. Our Goal is to demonstrate non-inferity to interventions delivered by current provides. If Successful, We Can Pursue FDA Approval, Positioning Palms as Bonafide Commercial Product for Sale and Use in Healthcare Settings.
COULD PALMS BE ADAPTED TO SCREEN FOR USAGE OF OHER SUBSTANCES?
There is Potential for Expanding Palms to Cannabis Use. The Growing Burden on Primary Care Providers Underscores The Need For Such Innovations. Primary Care Providers are being asked to be a be-all, end-all for entry into identifying patient Idues-whether that’s alcohol use, depression, or many, many oil –and that’s a lot for the with 20 minutes with a patient. Our Goal with Palms is to Unburden Primary Care Providers. I Want Them To Know That Help Is On The Way.
