Smart Pain Relief: Bringing Value-Based Thinking to Digital Therapies

As digital health continues its rapid ascent, one domain has been notably slower to evolve: chronic pain management. Despite growing enthusiasm for virtual therapies, the integration of digital psychological interventions into routine care remains sporadic. But a recent perspective from PAIN journal reframes the conversation, arguing that a value-based healthcare (VBHC) approach could be the lever that finally translates these digital tools from promise to practice.

The article, authored by a multidisciplinary team from The University of Queensland, makes a compelling case: while digital psychological interventions have shown efficacy in treating chronic pain, widespread adoption is hindered by systemic, financial, and logistical barriers. Many interventions demonstrate small to medium effect sizes and cost-effectiveness, yet their use in clinical settings remains limited. What's missing, the authors argue, is a framework to prioritize not just efficacy, but total value. 

Enter value-based healthcare, a strategy increasingly shaping modern health systems. Built around the so-called “quadruple aim,” VBHC seeks to improve population health, enhance patient experience, reduce per-capita costs, and support clinician well-being. This holistic framework offers a practical blueprint for chronic pain services grappling with the rising demand, limited access, and high costs associated with long-term pain care.

The application of VBHC principles to digital psychological interventions could reshape how we evaluate and implement these tools. The article notes that successful examples already exist. Integrated care units in Australia and the U.S. have reported measurable reductions in surgeries and hospital stays by aligning treatment strategies with patient-centered goals and real-time outcome tracking. In these cases, value isn't just theoretical—it's quantifiable.

For chronic pain patients, this shift could be transformative. Pain is inherently personal, and digital tools offer the flexibility to tailor interventions to what patients care about most, whether it's returning to work, reducing opioid use, or simply being able to walk their children to school. A value-based model would empower clinicians to match interventions with patient-specific goals, drawing from a growing menu of digital therapies now validated through clinical research.

But the authors warn against relying solely on efficacy data. Without a rigorous, system-wide value assessment, digital interventions risk being either underutilized or misapplied. To that end, the article outlines six strategic recommendations: assess alignment with VBHC principles; deepen understanding of patient needs; evaluate clinician experiences; strengthen feedback loops; compare cost-efficiency; and rigorously publish implementation outcomes using value-based terminology.

A striking insight in the paper is that value-based care doesn't just concern patients and payers but also uplifts clinicians. By ensuring digital interventions are practical, evidence-based, and satisfying to prescribe, VBHC could combat burnout and improve the therapeutic alliance between provider and patient. This is no small feat in a field where trust and rapport are vital, yet often strained by time and resource limitations.

While digital psychological interventions will never be a one-size-fits-all solution, value-based thinking could help healthcare systems identify and elevate the highest-impact tools. It also offers a way to address the chronic underfunding and fragmented nature of pain psychology. Importantly, the authors advocate for involving stakeholders at every level—from patients and clinicians to health system managers and policymakers—in crafting a unified implementation roadmap.

As the healthcare landscape shifts toward accountability, transparency, and outcomes that resonate with real lives, the fusion of VBHC and digital pain interventions seems not only logical but necessary. For the millions navigating the complexities of chronic pain, that shift could mean the difference between a system that treats pain and one that treats people.

Source

Eather, Chloe-Emily; Sterling, Michele; Sullivan, Claird; Elphinston, Rachel A. Leveraging value-based health principles to improve translation and impact of digital psychological interventions for people with chronic pain. PAIN 166(4):p 755-758, April 2025. | DOI: 10.1097/j.pain.0000000000003441