Customize Your Diary Entry Workflow

Simplifying with Tracker Collections

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If you haven’t tried defining and using a Tracker Collection, you’re missing
out on what may be a great time saver for your Diary Entry process. The
following items will give some examples of how to use Tracker Collections.

Normally when creating a new Diary Entry, you select the Tracker
items you want to include. That’s great for giving you the flexibility to
choose only those items that you need, but what if you always want to use the
same items in your Diary Entry? Then that extra flexibility can slow you down. But
with Tracker Collections, you can adapt the Diary Entry workflow to satisfy just about any approach you want to take..

Defining a Tracker Collection

To create a Tracker Collection, simply (1) Select the Tracker items you want
to include and (2) Then tap the “New Collection” button. You’ll be asked to
provide a unique name for the collection. Once saved, you can view the Tracker
Collection by (3) Tapping the “Apply a Collection” button.

width=”33%”> width=”33%”> width=”33%”> Arial,Helvetica,sans-serif;font-size: 10pt”>(1) Select your Tracker Items (2) Tap “New Collection” and Save (3) Tap “Apply a Collection” to review

 

Using the Tracker Collection

Once defined, you’re ready to start using the new Tracker Collection. There
are a few ways to use a Tracker Collection in your Diary Entry workflow. Which
one is right for you will depend on your personal needs, but we’ll illustrate
each one here starting with the least degree of automation to the greatest.

Manual Tracker Selection

Although this workflow doesn’t even use Tracker Collection, I’m still including this workflow in our examples for the sake of completeness. In this scenario, the user wants to manually select the Trackers for each Diary Entry. This gives the utmost in flexibility and customization, and for some folks that’s a blessing.

When you first start using CPT, this is the workflow you’re beginning with. Now let’s take a look at some alternative workflows that might better fit your needs.

Occasional Usage

In this example workflow, let’s consider the situation where you sometimes
create a Diary Entry that utilizes the same group of Tracker items. Maybe it’s
your first entry each day or the after dinner entry, etc. The point is that
normally you use the manual selection of Tracker Items to build your Diary
Entry, but there are those times where you are selecting the same items as
before.

For those entries where you have previously defined a Tracker Collection,
simply tap the Apply a Collection when you open the Tracker Selection screen.
This will open the Collection table and you can select the Tracker Collection
you want to apply. With this workflow, you save a few taps since the items are
already grouped together in the Collection.

Regular Usage

Now let’s consider a situation where you’ve been able to define a Tracker
Collection for each of the types of entries you create. Maybe you’ve created
one for a morning entry, one for breakthrough pain entries, one for bedtime,
etc. In this scenario, you almost always select one of your predefined
Collections rather than manually selecting Tracker items.

If this is the case, you can change a setting which will automatically
display the Tracker Collection table rather than the Tracker Selection table
when creating a new Diary Entry. This saves another tap since you don’t have to
choose the “Apply a Collection” button.

To enable this workflow, go to the Settings tab, then Diary Preferences,
then Tracker Collection Prefs. Set the “Jump to Collection Table First” to ON.
Now you will automatically jump to the Collection table when creating a new
entry. That said, if you need to, you can always manually change the Trackers
included in the Diary Entry just like before.

Default Diary Entry Format – NEW in v3.4

For the ultimate in automation, let’s now consider a workflow where you want
to use the same group of Tracker items for every Diary Entry you create. If
this is the case, then you can define one of your Tracker Collections as the
“Default” Diary Entry structure. All new Diary Entries will be created with
those Tracker items already added to the Diary Entry, so you can jump right
into data entry mode.

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This is a new feature now available in v3.4 and later. To enable it, go to the Tracker Collection table and tap
the “Make Default” button on one of your Tracker Collections. That’s it. Now
each new Diary Entry will contain the Tracker items from that Collection. As in
the other workflows, you can still go back and modify the Tracker items after
the fact, so you’re never limited by the automation.

Speed up Diary Entry creation with “Copy Last”

For many pain sufferers, pain descriptions, locations, etc may not vary too much from hour to hour or even day to day. In these situations it can be tedious to create the same Diary Entry time and time again. That’s where the “Copy Last” feature comes into play. It can make the process of creating your Diary Entry much more streamlined. Let’s have a look at how it works.

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As an example, let’s say that you Pain Description terminology and your Pain Location Map would often be the same from entry to entry. Rather than selecting the same 4 or 5 pain descriptions from the table each time, or painting the same Pain Location Map each time, you can use the Copy Last button in the Tracker title bar (shown to the right) to copy the data from your previous entry into the current entry.

In some cases, this may be all you need to do and you can move on to the next item in the entry. But, you always have the option of modifying what was copied into the new entry so even if your pain has changed a bit from your previous entry, using the Copy Last button can still have benefits. As an example, consider the Pain Location Mapping Tracker. For complex pain patterns it can take some effort to get the pain map just right. Using the Copy Last button allows you to bring your previous entry’s map forward so that you can simply fine tune for your current pain profile rather than starting from scratch again.

As you can see in the image, the Copy Last button is present in the title bar for each Tracker, so this functionality exists for all the Diary Entry tools. You can choose to use this button during the Diary Entry creation process, or if you find that you are constantly using the button for a particular Tracker, you may want to set the Copy Last option as the default behavior for a particular Tracker. Again let’s use the Pain Description Tracker as our example.

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Going to the Settings tab and selecting Diary Preferences, then tapping Pain Description will bring you to the default settings for this Tracker. Here you can see the first option is for “Default from Last Entry”. Setting this option to ON will automatically trigger the Copy Last process whenever you add that Tracker to a new Diary Entry.

After making the change in the Settings tab, try creating a new Diary Entry and add the Pain Description Tracker to the entry. You’ll notice that the table will immediate display the selections from your previous entry. The table still remains fully editable, so if your pain has changed slightly, you still have the ability to make modifications before saving the entry.

I hope this information is helpful to those of you that have some degree of consistency in your daily pain profiles. If you have questions or suggestions about how we can make the Diary Entry process even more efficient, please contact us via one of our support request options and let us know.

Testing Medication Effectiveness in Relieving Pain

The Challenge of Evaluating Pain Relief Efficacy

Let’s face it, most people dealing with Chronic Pain take some type of pain relief medication – often multiple types. But do you know if they are really working? And when your doctor suggests trying a new medication to see if it is more effective than your current drug – how can you tell?

Unfortunately, most of the time you can’t objectively say whether one drug is working better than another, or even if either of the drugs is having a real impact on your pain levels. To get truly subjective data on the matter generally requires a laboratory like environment with rigorous data collection processes to ensure that medication intake and pain relief impact is captured on a regular basis. This is just not a realistic situation for most chronic pain folks.

Capturing the Data

However, using the latest analytical tools within Chronic Pain Tracker, you CAN document and analyze this type of data. You and your doctor can now see the statistics describing the reality of your medication and pain interaction over the past month(s), so that you can both make better informed decisions about how to best treat your condition. How does this work? Well, let’s take a look…

When we want to look at medication effectiveness, there are two main sets of data we need to capture:

  • Medication History – what was taken, how much was taken, and when was it taken
  • Pain Intensity – how badly are you hurting and when

 

Both of these data sets are easily recorded using Chronic Pain Tracker. Users are able to create their own customized lists of medications being taken which can record the name, dosage, and date/time of the med being taken. Similarly, recording a current pain level is as easy as selecting from the visual pain indicator scale.

Medication Analysis Window

Another important factor that needs to be considered is the time frame over which the drug is supposed to be effective. For example, many breakthrough pain meds should start to work within about 30 min and last 4-6 hours. Other types of meds may be effective for up to 12 or even 24 hours. And, if you’re dealing with something like a Fentanyl Patch, it may be several days that you need to evaluate.

Medication Entry WindowYou can now specify this effectiveness window period (hours) within the definition of your medication in CPT. You simply enter the number of hours over which you want to analyze the drug’s effectiveness. This value can vary for each medication entry and can be adjusted at any time. The screen image to the right shows the location of this field.

Now, considering the timeframe, it will be important to track your pain levels at the start of taking the medication and then several times over the course of the analysis window period. For example, let’s say that it is 1:00PM and you have just taken a Vicodin. So you create a Diary Entry that records the taking of 1 Vicodin pill and your current pain level (eg. 7). if the analysis window for the drug is 8 hours, then you should plan on creating additional Diary Entries at perhaps 1, 2, 4, 6, and 8 hours after the initial entry where the medication was recorded. There are no hard and fast rules on how many data points you need to capture each time, but its better to err on the side of too much data rather than too little.

The Summary Report Analysis

The magic of the process begins to happen when you run a Summary Report for a particular time period. Let’s say you’ve been testing out Vicodin for the last month and want to get an idea of how it has been working for you. So after following the steps above throughout the month, you’re now ready to produce the Summary Report to review with your doctor.

Summary Report - Medication Taken - Pain Reduction AnalysisBefore explaining what goes on behind the scenes, let’s jump straight to the end result – the Pain Reduction Efficacy graph shown in the Medication Tracker section of the report. You can see a sample of this report on the left. In a normal Summary Report, you would see one of these graphs for each medication listed. This one happens to be a sample for Vicodin 10mg over a 14 day period.

The graph is structured with Time (hours) as its x-axis. The Time represented is the time since the particular medication was taken. So you can see that it starts with 0 hours on the left and goes up to whatever number you plugged into for the Analysis Window – in this case 6 hours.

The vertical axis represents that relative increase/decrease of pain levels over the time period. Each time you take the medication and provide a starting pain level, the app will look for additional Diary Entries that fall within the analysis window timeframe and will check whether your pain level went up or down compared to the starting pain level. This is represented as a percentage value on the vertical axis. The actual data points are shown as the color diamonds on the chart. A green diamond is one where the pain level dropped from the starting point, a yellow represents no change in pain level, and a red shows an increased pain level since taking the medication.

The individual data points are connected by thin gray lines which are shown as a way to see the progression of pain levels for that particular medication cycle. You will also see several diamonds with a thick black border around them. These represent entries where an additional dosage of the same medication was taken. If you start to see clusters of these bordered markers earlier in the analysis window, it may indicate that your medication is wearing off earlier than it should be, and is a good time to raise the question with your doctor.

The thicker blue line shown on the graph is the aggregated pain reduction impact for the medication during the analysis timeframe. This is a great tool for seeing the average effect of the medication on your pain levels. The sample shown illustrates the effect we would expect to see with a medication like Vicodin. After a short period of being digested, the medication begins reducing pain levels over the course of hours 1 to 4. By about hour 5 or 6, pain levels have again returned to their original level and you’re seeing signs that the patient has taken another dose at that point (the bordered diamonds).

Medication Pain Reduction - Sample 2Not all of your graphs are going to follow this idealized curve, there are just too many variables that impact the efficacy of your medications. For example, if you pain normally gets worse towards the end of the day, then a medication taken mid-afternoon will probably show more of a steady-state pain level until it starts to wear off and pain levels rise.

Let’s take a look at a couple other samples based on real world data captured from one of our users. In this first graph, we’re looking at the short acting pain reliever Dilaudid with an analysis window set to 8 hours. As mentioned before, we don’t see the idealized curve from the Vicodin sample above, but that doesn’t mean there isn’t valuable information here.

If we look in the area (A)  on the plot, we see that around hours 3 to 4 there is a large number of bordered markers which indicate that the patient is taking additional doses at those points. This suggests the relief from the medication is not lasting more than 4 hours for this patient. This is further verified with the area (B) where when the patient did go further into the analysis period without taking more medication, the pain levels began to steadily rise over time.

Medication Pain Reduction - Sample 3

The next sample has a longer analysis window (12 hours) for the drug Robaxin. Again, we don’t see the idealized curve, but we can draw some valid conclusions from the graph. In area (A), we’re seeing a short-term increase in pain levels. However, there are very few data points within the first 4 hours of the drug being taken, so we may conclude that the increased pain levels are only due to a lack of data points in the area.

Unlike area (A), when we look at area (B), we see lots of data points which should suggest a more representative view of the drug impact on pain levels. In this period we’re seeing a gradual uptick in pain levels starting at about the six or seven hour mark. Given this increase and the quality of the data here, this probably suggests that the drug is working for roughly the first 6 hours for the patient, but not really beyond that point. It also looks like area (C) is demonstrating that the patient is taking more Robaxin at roughly the 10 hour point. Given the findings in area (B), it may make sense to move the next dose a bit closer say at the seven or eight-hour mark.

Again, you shouldn’t rely on a graph alone to make medical decisions. You should always review the graphs along with your other history factors with your doctor before making any medical decisions. However, we believe that the tools in Chronic Pain Tracker, like the Pain Reduction Analysis, can be an invaluable tool for you to use in your continued care. We hope you find these tools beneficial.

Understanding all those report graphs

Have you wondered about some of those graphs that appear on the Summary Report? Couldn’t quite interpret where or how the data you’re seeing was generated? If so, then we’ve got a great new page for you.

Check out this Report Graphs: In-depth discussion that will take you through each of the many graphs appearing in the Summary & Analysis Report format.

 

Summary Report: Medication Details

Summary Report: Medication Details

Even if you have a pretty good handle on the many graphs CPT offers, we do suggest you take a look at the section talking about the Medication Tracker graphs. We’ve added a new graph in v3.0.4 which is about to be released which does a Pain Reduction assessment to test the effectiveness of your medications in reducing pain levels.

This type of a Medication Graph has been requested by many users and now you’ve got it. Please take a moment and read this information to learn how to understand it so that you can share the info with your doctor.

A Reminder about Diary Entry Reminders

Diary Entry Reminders

Diary Entry Reminders

For those of you that haven’t started exploring the Settings tab in CPT 3.0, you might not have noticed that we’ve added a reminder mechanism to help you collect timely pain information. This tool enables you to set one or more daily reminders which will notify you when its time to fill out a Diary Entry. In fact, the reminder will even create the Diary Entry object and present it to you with a single click on the notification alert.

We’ve put together a short video tutorial on the Diary Entry Reminders. Have a look and soon you’ll be creating your pain entries on a more consistent basis.

Enhanced comment entry for Diary Entries

With the v3.0.1 update of CPT, we included a refreshed comment entry dialog that should make adding comments to a Diary Entry much easier and more efficient. For those of you that haven’t noticed this feature, let’s have a quick look.

With the v3.0.1 update of CPT, we included a refreshed comment entry dialog that should make adding comments to a Diary Entry much easier and more efficient. For those of you that haven’t noticed this feature, let’s have a quick look.

Comment Entry FormComment Entry - Landscape

The first thing you’ll notice now with the comment entry is that as soon as you tap the Comment Tracker to begin an entry, the table cell morphs into a modal dialogue that includes the comment display area, the keyboard and an upper toolbar. This helps to isolate the comment entry area and prevents inadvertent touches outside the comment window which previously ended the entry session.

Along the toolbar, you’ll see four buttons. On the left is a “Clear” button which will clear the contents of the comment window. In the center, you’ll see a Font Size increase and decrease button. And, on the right side, you’ll see the “Save” button to end the comment editing session.

The first thing you’ll notice now with the comment entry is that as soon as you tap the Comment Tracker to begin an entry, the table cell morphs into a modal dialogue that includes the comment display area, the keyboard and an upper toolbar. This helps to isolate the comment entry area and prevents inadvertent touches outside the comment window which previously ended the entry session.

Along the toolbar, you’ll see four buttons. On the left is a “Clear” button which will clear the contents of the comment window. In the center, you’ll see a Font Size increase and decrease button. And, on the right side, you’ll see the “Save” button to end the comment editing session. If you prefer the larger Landscape format keyboard, just rotate your device and type away.

For those of you with an iPhone 4S, you can use the new Siri technology to create your comment via Siri’s dictation capabilities. If you look at the keyboard in the images above, you’ll see the small Siri Dictation microphone just to the left of the space bar. To start dictation, tap the mic button and begin speaking. You’ll see the Siri indicator blinking as it accepts your speech input. Once you’re done speaking, Siri will generate the text from your voice input. Note, an active internet connection is required for Siri functionality.