Opioid Abuse Prevention: Calling for EHR Change

The opioid epidemic is everywhere lately. Late last year the President even declared the opioid epidemic a public health emergency. There have been a lot of recommended solutions from supervised injection facilities to better monitoring. A memo dated 2/16/18 to the Senate Committee on Finance from the College of Healthcare Information Management Executives (CHIME) offers some interesting approaches to curbing this national epidemic.

This memo is in response to the Senate Committee’s request for feedback on policy recommendations to help fight the opioid epidemic. The findings from CHIME are thought-provoking.
Better interoperability

Every EHR offers a CCD or Continuity of Care Document. The problem comes in, however, when trying to import this CCD record from one provider’s EHR to another. The record is either “too bulky” or “not easily ingested” by the receiving provider’s EHR. And unfortunately, the current measurement system, MIPS, assumes that this interoperability already exists. Since it does not, there is the risk of Clinical Decision Support not including other medications in a patient’s treatment from one provider to the next.
Identification of High Prescribing Patterns
EHR’s need to better integrate with state and federal prescription drug monitoring programs (PDMPs). Currently, the information provided may be incomplete or inaccurate. The CDC has stated that most providers do not even use the PDMP “due to challenges related to registering…and logging into PDMP (which can interrupt normal clinical workflow…).” The idea is to integrate an interface to the PDMP directly in EHRs to prevent extra work to access that information.
Data Sharing
This point refers to the last point just a bit. Better patient identification among these registries is necessary to facilitate accuracy. One step proposed is to have a single unique identifier per patient that is consistent across all systems. Once again, ease of access to the database and its information is critical to identifying potential opioid abuse amongst patients across multiple providers.

We recommend reading the full memo here. You can also learn more about CHIME. While there are many steps necessary to limit opioid abuse, asking the right questions is a great place to start.