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A painful problem

Statistics and software seem an unlikely combination for addressing chronic pain. But for more than 15 years, Elizabeth VanDenKerkhof, a Professor of Nursing with a cross-appointment in Anesthesiology and Perioperative Medicine and clinician researcher in the Kingston General Hospital Research Institute, has been investigating how data and technology at the point of care can both improve patient care and enhance understanding of the myriad factors behind the complexities of pain.

A doctorate in public health from Johns Hopkins University who specializes in the epidemiology of pain, Dr. VanDenKerkhof was part of a university-hospital team in the Queen’s Department of Anesthesiology and Perioperative Medicine who broke new ground in patient care at the turn of the millennium by developing an electronic documentation tool for use with an acute pain management system.  

“My role was to make sure the technology captured the data for tracking, management and research into pain,” Dr. VanDenKerkhof explains. Initially developed to care for patients with post-operative and acute pain, the approach has now been adopted at many other points of care, and is in use in hospitals in Montreal and Ottawa.

Virtually unheard-of in pre-smartphone days, the handheld technology was not initially welcomed with open arms, she says. But the experience of developing and implementing that novel tool opened up new avenues of research, by virtue of its ability to capture and store data in real time. It has also led to numerous investigations into the effects of technology on patient care and professional practice. 

More than a decade later, the tool continues to contribute to acute and chronic pain research and enhance pain management.

“We started doing studies in 2001, and we now have 12 years of point-of-care data,” she says. “It enables us to look at statistics, such as the trajectory of pain intensity after surgery and average number of clinician visits – which can be a measure of pain severity -- or to track adverse events such as respiratory depression or allergic reactions. There’s nothing that we know of elsewhere that captures pain data to the same extent at the point of care.”

Dr. VanDenKerkhof continues to integrate technology, and study its effects, in conjunction with her investigations into chronic pain. Her primary research program looks at the epidemiology of chronic post-surgical pain in women to identify subgroups at high risk for developing chronic pain after surgery, and how those women use health care resources before and after surgery.

This story is the sixth in a series on the KGH Research Institute, a collaboration between Queen’s and Kingston General Hospital, and the clinician-scientists recruited to work in the centre.