Using health technology and integration to address the opioid crisis
The statistic is staggering. On average, 38 people die every day from overdoses involving prescription opioids, according to the Centers for Disease Control and Prevention (CDC). Even though the number of opioid prescriptions continues to decline, more Americans are dying from drug-related overdoses than ever before, according to recent data. Although public health interventions are critical, there are also ways in which physicians can address what the federal government now deems an ‘opioid epidemic.’ Most importantly, they can use health technology to prescribe electronically and query state-specific Prescription Drug Monitoring Programs (PDMP).
Following are several strategies to use health technology for addressing the opioid crisis:
1. Leverage e-prescribing. E-prescribing brings with it a whole host of benefits, particularly the ability to reduce errors, allergies, or interactions, thereby keeping patients safer. E-prescribing also eliminates time-consuming paper forms, faxes, and phone calls.
2. Look for integrated PDMP access. Integrating PDMP access into the e-prescribing workflow circumvents the need to access the PDMP separately from the electronic health record (EHR). Physicians have the prescription drug information they need right at the point of care, making the entire visit more efficient. In addition, some states may eventually require PDMP integration. Illinois, for example, amended state laws in 2018 to include a requirement that all EHRs integrate with the state’s PDMP by January 1, 2022.
3. Know what’s included in the PDMP, query often. The PDMP is a state-specific electronic database for controlled substances. Authorized users can access data within this database for a whole host of reasons, including the following:
Informed prescribing decisions
Identify patients who are obtaining opioids from multiple providers
Identify patients who are being prescribed other substances that may increase the risk of using opioids
Perhaps most importantly, physicians with integrated PDMP access can intervene at the earliest signs of substance abuse and more quickly identify patients who should taper off opioids. For example, physicians can help patients taper opioids for chronic pain when those individuals:
Don’t have clinically meaningful improvement in pain and function
Take more than 50 Morphine milligram equivalents per day without benefit
Take opioids in combination with benzodiazepines
Show signs of substance use disorder
Experience overdose or other serious adverse events
Show early warning signs for overdose risk such as confusion, sedation, or slurred speech
PDMP queries are on the rise, and healthcare providers should make checking the PDMP a priority. The CDC recommends querying the database before starting a patient on opioid therapy and at least once every three months thereafter; however, state requirements may vary.
4. Identify time-saving strategies. For example, might it make more sense to perform bulk searches of the PDMP? What about delegating access to front desk personnel who can query the PDMP as part of the patient’s pre-visit planning?
5. Stay up to date on prescribing guidelines and best practices. Health technology alone can’t solve the opioid crisis. As mentioned above, public health interventions are critical. However, physicians can also do their part by staying abreast of best practices for prescribing opioids. For example, they can participate in training modules for applying CDC prescribing guidelines. They can also take advantage of several other CDC opioid-related courses on topics such as naloxone for opioid overdose, alcohol and opioid withdrawal management, dosing and titration of opioids, using motivational interviewing when prescribing opioids, and much more.
Conclusion
Physicians play an important role in addressing today’s opioid crisis. They are the gatekeepers of opioid medication and can help patients make wise decisions. E-prescribing with integrated PDMP access gives physicians the information they need to help keep patients safe. To learn more, visit https://www.edgemed.com/electronic-prescribing.
