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Risky drinking screening goes digital

If you visit the Sandoval Regional Medical Center in the next month, you may be talking to your provider about alcohol use via iPad.

Since June, psychiatry professor Brandi Fink has been working with Mission Quest Biomedical to develop the Personal Alcohol Management System, an application created to improve the way primary care practitioners screen patients for risky alcohol use.

“The World Health Organization, way back in 1979 said that it might be best if everybody would just screen and do a brief intervention for alcohol use in primary care,” Fink said. “So for decades this has been what we’ve been trying to do, but the actual implementation of it is really quite low.”

In 2010, the Affordable Care Act directed, via a federal mandate, that all patients be screened for alcohol disorders — but that screening does not happen in a consistent way across clinics, Fink said.

“I have a friend who studies this as well, and she even identified herself as a risky drinker and nobody has ever said a word to her about it. So it’s just not being done,” she said.

Much of the reason behind the inconsistent application of the screening process lies in something that may be out of the hands of medical practitioners: Fink said there simply isn’t time in most cases, maybe 15 minutes.

That isn’t a lot of time when others are waiting to be seen, she said.

Fink also said providers may feel inadequately trained to address alcohol use, or feel uncomfortable bringing it up with patients because of stigmas surrounding alcohol use. The public health cost of alcohol use is higher than other illicit substances, and most of this cost comes from people who are not considered alcohol dependent or alcoholic.

“These are people who are drinking at heavy rates, or binge drinking, so it puts them at risk for certain cancers, risks of violence, DUI, things like that,” she said.

This is where Fink’s new iPad app comes in.

The app conducts a standardized screening for alcohol use and, based on the person’s response, will provide a brief intervention, Fink said.

“The app also communicates to the provider and tells the provider, ‘Hey, your patient is screening as having some risky drinking. What we’ve done is given them this brief intervention. What you need to do is be available to answer any questions your patient has,’” she said, adding that this process helps take away the sense of uncertainty some medical providers may have in addressing the topic.

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Patients can request that their doctor call to check in with them one to five days after an intervention done through the app, Fink said.

Prior to the app’s creation, she said primary health care providers were supportive of the concept.

“We surveyed primary care providers and asked them if they thought this would be helpful, and really we got a universally positive response to it,” Fink said. “They thought it would be very helpful to have their patients do this while they’re in the waiting room waiting for their appointment, and they felt that it would help them taking care of their patients’ health. Everybody was really positive about it.”

The creation of the app is being funded by a small business innovation research grant from the National Institute on Alcohol Abuse and Alcoholism, she said.

Testing will begin in a few weeks in the family practice clinic at the Sandoval Regional Medical Center and should take five months, she said. Then they will apply for a grant from the National Institute for Health to conduct testing on a national scale.

“There’s some good research that people are actually a little more honest in their reporting when they’re interacting with things in that electronic manner about their alcohol use,” Fink said. “So I think that we’ll get more honest reporting, which I think is going to be helpful to the providers in helping the patient address their health concerns.”

She said this is the first app of its kind.

“There are some things that people can do that are web based, but nothing that’s portable for use on an iPad in a doctor’s office like we have it, or that communicates back to the provider the way ours does,” Fink said. “So we’re unique in that aspect.”

Cathy Cook is a news reporter at the Daily Lobo. She can be reached at or on Twitter @Cathy_Daily.


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