In response to the Institute of Medicine’s Report Relieving Pain in America, Stanford has developed and implemented the Collaborative Health Outcomes Information Registry (CHOIR) system. This open source, open standard, free data-collection software was created in partnership with the National Institutes of Health.

Relieving Pain in America made clear that there is not enough data being collected on pain patients. This is despite the fact that chronic pain affects more than 100 million Americans and costs about $560 billion to $630 billion per year in direct and indirect costs. Not having data on pain patients means that we don’t know as much as we need to about the problem itself, or who might benefit the most from future treatments.

CHOIR begins to fix this problem. It allows doctors to collect qualitative information on pain patients in a safe, secure, and easy-to-use system. Doctors can then use that information to better treat each individual patient by, say, seeing charts about how a patient’s pain responds to treatment over time. Doctors can also take data from many patients together to learn more about pain conditions and hopefully develop better treatments.

CHOIR was rolled out at Stanford Pain Management Center on August 14, 2012. It has been integrated smoothly into the clinic using Internet-enabled mobile devices (such as iPads). Today, there are approximately 15,000 unique patients, 64,000 visits, and 40,000 follow-up visits. In addition to Stanford, medical centers across the country use CHOIR in clinical practice and in biomedical research.

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