Stories about: Eric Fleegler

TriVox Health: A window into patients’ lives between visits

Trivox Health logo Vector pediatric chronic pediatric disorder digital tracking

A lot happens in a patient’s life between office and clinic visits that can impact their health and development. This is especially the case for children with a chronic pediatric disorder like ADHD or asthma. The trouble is, how can providers and families capture that data and get a window into those experiences?

Our sister blog Vector spoke recently to Boston Children’s Hospital’s Eugenia Chan, MD, MPH, and Eric Fleegler, MD, MPH, who together have launched TriVox Health, a digital disease management platform for clinicians caring for chronically ill children. The platform started life as a way to capture reports from parents and teachers about children’s ADHD symptoms. Over time, however, it’s grown to incorporate symptom reporting, side effect reporting, quality of life measures and more for multiple conditions.

Speaking about a study their team is conducing of the platform’s impact on patient outcomes, Chan told Vector:

We are still evaluating the data, but I think we’re going to demonstrate that patients and families are better engaged, their doctors know them better, communication improves and families feel greater satisfaction with their visit. Our long-term goal is to show that we truly affect care and health outcomes.

Read what Chan and Fleegler have to say about TriVox Health and what it does on Vector.

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Racial disparities in analgesia: Who gets pain relief?

teddy bear hospital bed pain management

These are challenging times for clinicians who care for children and adults in pain. The general philosophy regarding the level of attention that should be paid to pain as well as its treatment has changed dramatically during the past 30 years, swinging wildly between extremes, and remains a moving target.

The first published recognition of pain undertreatment in adults occurred in the 1970s, with identification of similar and more dramatic concerns for children emerging a few years later. Research documenting the short- and long-term negative consequences of poorly-treated pain—coupled with the development and marketing of new opioid compounds—led to a dramatic increase in analgesia prescribing for essentially all painful conditions.

Unfortunately, although most patients who were prescribed opioids benefited, it became clear that these agents were not as benign as had been assumed, and that addiction, diversion, opioid hyperalgesia and other adverse effects were legitimate concerns. Although one would assume that these concerns would only limit the indiscriminate use of these drugs for inappropriate situations, in fact, the pendulum swung to the other extreme, with a wave of negative publicity leading to the scrutiny of essentially any use of narcotic analgesics.

As a result, at this time, we run the genuine risk of returning to a state of opiophobia and denying individuals in severe pain the mercy of access to these incredibly valuable drugs.

It is with these societal currents in mind that we read a recent article in JAMA Pediatrics that identified significant undertreatment of children with severe pain associated with appendicitis while in the emergency department (ED). …Read More

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