America’s opioid epidemic exhibits no signal of letting up. Addiction to authorized painkillers and unlawful medicine like heroin has resulted in additional than 42,000 overdose deaths in 2016, based on Centers for Disease Control and Prevention figures launched at finish of March.
Health Data Management, over the previous few months, has profiled quite a lot of healthcare organizations which can be turning to well being info know-how to fight the disaster. What follows is a have a look at 4 of these initiatives.
Geisinger: Pairing EHR and e-prescribing information
Geisinger, an built-in well being system, is curbing patient use of opioids by leveraging well being info know-how and digital prescribing, based on CIO John Kravitz, who contends that different healthcare organizations can generate related outcomes by means of successfully utilizing their EHRs or scientific order entry programs.
The group developed and initiated a number of approaches that target altering doctor patterns to cut back the prescribing of opioids—together with making a dashboard linked to an digital well being report that identifies present apply patterns amongst Geisinger’s suppliers, Kravitz testified throughout an April 12 House Energy and Commerce Committee listening to on combating the opioid disaster.
Armed with details about prescription patterns in a dashboard linked to their Epic EHR, Geisinger is concentrating on the “outliers” on its scientific employees and offering them with finest practices for ache administration, Kravitz informed lawmakers. In truth, he mentioned, the built-in healthcare providers group has almost reduce in half the variety of opioid prescriptions from a month-to-month common of 60,000 right down to 31,000.
But Geisinger didn’t cease there. Among different actions, it has adopted the next actions to curb using opioids: monitoring documentation inside the EHR and dashboard that exhibits suppliers reviewed the mandated state-run Prescription Drug Monitoring Program in the event that they thought-about prescribing a managed substance, documenting findings within the sufferers’ medical information, and integrating information from a ache app that measures bodily exercise, patient-reported ache and different metrics into the dashboard and the sufferers’ medical information.
University of Colorado Anschutz Medical Campus: A brand new mannequin to foretell threat
University of Colorado Anschutz Medical Campus researchers developed a prediction model that leverages digital well being report information to assist suppliers establish hospitalized sufferers who’re on the highest threat of progressing to continual opioid use after they’re discharged from the hospital.
The analysis workforce, which developed the software utilizing affected person information from the Denver Health Medical Center, says the mannequin may very well be built-in into an EHR and activate an alert when a doctor orders opioid remedy, informing the physician of their affected person’s threat for creating continual opioid use.
“The purpose was to establish who these sufferers had been to let suppliers know on the time of care that these sufferers are at increased threat, so that they suppose twice earlier than they prescribe an opioid or take into consideration different methods to handle their ache within the hospital setting,” says Susan Calcaterra, MD, a fellow in habit medication on the CU School of Medicine and lead creator of a study revealed final month within the Journal of General Internal Medicine.
Calcaterra contends that previous to the research by her and her colleagues, no prediction mannequin had been revealed to establish hospitalized sufferers at excessive threat of future continual opioid remedy (COT)—outlined as both receiving a 90-day or larger provide of oral opioids with lower than a 30-day hole in provide over a 180-day interval, or filling 10 or extra opioid prescriptions over the course of a yr.
Brigham and Women’s makes use of digital gadget to watch utilization
Brigham and Women’s Hospital has turned to digital tablets—gelatin capsules containing ingestible sensors and medicine—to assist observe patterns of opioid utilization amongst sufferers.
The Boston hospital claims to be among the many first healthcare organizations to discover the application of this new technology. Specifically, BWH leveraged the etectRx ID-Cap system in a pilot research of 15 sufferers who obtained prescriptions to take oxycodone digital tablets as wanted following remedy within the emergency division for acute fractures.
Patients within the pilot research had been directed to make use of oxycodone—one to 2 5-millegram oxycodone digital tablets each six to eight hours—as wanted for ache. However, to their shock, Chai and his colleagues discovered of their research that the majority sufferers stopped taking their prescription opioid after solely a quick interval, even amongst sufferers with fractures that required surgical administration. The digital monitoring system—which makes use of a radiofrequency emitter—documented that the majority oxycodone doses had been ingested by sufferers inside the first three days after discharge from the ED, and that on common they took solely six tablets regardless of being prescribed 21 complete capsules.
“The actuality is that we’re doubtlessly prescribing an excessive amount of, because the research confirmed,” based on Peter Chai, MD, a college member within the Division of Medical Toxicology inside the BWH Department of Emergency Medicine. “We know that opioids are positively a supply for diversion and non-medical use. So, let’s be sensible about prescribing the correct quantity that controls ache and no extra opioids than are wanted.” BWH’s clinicians revealed outcomes of their pilot research within the present concern of Anesthesia & Analgesia.
VA maps opioid-prescribing charges
The Department of Veterans Affairs is posting info on the speed of opioid prescribing, together with allotting charges for every VA facility displayed on an interactive map that exhibits information over a five-year interval.
By publicly releasing this information, the VA says it’ll “facilitate the sharing of finest practices in ache administration and opioid prescribing amongst medical doctors and medical heart administrators,” the company mentioned in a press release.
VA’s Digital Media Engagement workforce led the effort to develop the interactive map utilizing CARTO, a cloud-based geographic info system and net mapping software. Working with the company’s Office of Information Technology, the map and information are hosted on the VA open information portal.
According to VA Secretary David Shulkin, MD, posting info publicly on opioids distributed from the VA’s pharmacies is a vital element of the company’s efforts at transparency and to prescribe these ache medicines appropriately and safely.
“Many veterans enrolled within the VA healthcare system endure from excessive charges of continual ache, and the prescribing of opioids could also be essential medically,” he mentioned in a press release. “And whereas VA gives different ache administration choices to cut back the necessity for opioids, it’s important that we’re clear on how we prescribe opioids, so veterans and the general public can see what we’re doing in our services and the progress now we have revamped time.”
Bloomberg News contributed to this report.