CMS asks state Medicaid directors to use HIT to fight opioid crisis

Agency guidance calls on states to integrate prescription drug monitoring program data into EHRs.

The Centers for Medicare and Medicaid Services is looking to combat the nationwide opioid epidemic by having states increase their utilization of health information technology to target prevention and treatment activities.

CMS on Monday sent a letter to state Medicaid directors providing them with guidance on how they may best use existing federal funding to support health IT efforts designed to fight drug addiction and the opioid crisis.

“The HITECH Act makes available a 90 percent enhanced funding match for state expenditures on activities to promote health information exchange and encourage the adoption of certified electronic health record (EHR) technology by certain Medicaid providers until 2021, if certain criteria are met,” according to the letter. “States should discuss with their CMS contacts as to whether HITECH funding or (Medicaid Information Technology Architecture) funding might be more appropriate for the proposed activities, or a combination of both.”

In particular, the agency is encouraging the states to integrate prescription drug monitoring program (PDMP) data into electronic health record systems to minimize provider burden and improve interstate health information exchange.

“This integration removes the requirement for providers to log in to a separate system, manage a separate log in and disrupt their workflow to query the PDMP,” wrote Tim Hill, acting director for the Center for Medicaid and CHIP Services, to the state Medicaid directors. “Single sign-on interoperability between EHR and PDMP, such that PDMP results are displayed when the EHR indicates a controlled substance is prescribed, could be supported, as an example.”

In addition, the CMS guidance recommends that states consider integrating PDMPs into health information exchanges (HIEs) “where further integration with pharmacy data, shared care plans, drug utilization review (DUR) programs, Emergency Medical Services (EMS) data, Medication Assisted Therapy (MAT) data, advanced directives and other EHR data might assist clinical decision making.”

The agency also encourages states to “consider linking screening data from risk assessment tools such as the Opioid Risk Tool into EHRs and/or HIEs to facilitate targeted case management or to deploy other resources or follow up interventions,” noting that “such integration might be incorporated into Certified Electronic Health Record Technology (CEHRT) in a manner consistent with Objective 6, Measure 3 of the Stage 3 meaningful use objectives and measures” and potentially could be supported by a 90 percent federal match.

Also See: How EHRs can help in the battle against the opioid crisis

“State-level innovation, including the use of prescription drug monitoring programs and electronic health records, has been and will be a key piece of ending this crisis,” said HHS Secretary Alex Azar in a written statement supporting the data-driven approach to both prevention and treatment.

According to Hill, the guidance from CMS to the state Medicaid directors is in alignment with a final report issued last year by the President’s Commission on Combating Drug Addiction and the Opioid Crisis, which made a number of recommendations, including enhancing PDMPs, to help improve appropriate and safer prescribing of opioids.

“States might also consider using Medicaid support to add systems supporting the Electronic Prescribing of Controlled Substances (EPCS),” wrote Hill. “These systems might be integrated into other pharmacy systems or health information exchange architecture and complement broader state initiatives around securing prescribing processes.”

The guidance concluded with the hope that “states will use this information to improve the technological capacity of state Medicaid agencies, providers and partners to address the opioid crisis and improve the health outcomes for Medicaid beneficiaries,” adding that “CMS is available to provide technical assistance to states on the matters described in this letter.”

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