Health IT can play an important role in battling the opioid epidemic

EHRs are the lynchpin for providing workflow-focused health IT strategies to improve physician knowledge and skills for safely managing opioid therapy.

The COVID-19 pandemic catalyzed more use of opioids, but EHRs can support clinicians in prescribing and providing patient education.

Over the past several years, community service and health professionals have fought hard to gain ground in the battle against the opioid epidemic.

From 2017 through 2020, the number of patients receiving buprenorphine, methadone or naltrexone – common medications for treating opioid use disorder – consistently increased as more patients at risk for the disorder and overdoses were identified and treated, according to a report from Epic Research

When an epidemic meets a pandemic

The COVID-19 pandemic made treatment for those with drug addictions more difficult to access, while isolation, economic stress, personal loss and increased rates of depression set the stage for new or increased drug use.

The number of patients receiving new prescriptions for opioid use disorder medications decreased by more than 30 percent during the early months of the pandemic as compared to the three years prior. The Centers for Disease Control and Prevention recently estimated that ​​more than 107,000 Americans died of drug overdoses in 2021, up 15 percent from the previous record set in 2020.

In April, the White House released the Biden Administration’s first national drug control strategy, calling for changes in laws and policies to prioritize harm reduction by engaging drug users in care and treatment.

As regulators and healthcare providers continued work to deliver help to those who need it most, the HIMSS Electronic Health Record Association, which represents EHR companies, voted this year to elevate the group’s Opioid Crisis Task Force, which was formed in 2018, to a permanent workgroup. This signifies an ongoing commitment to examining and strengthening the role of EHR system developers in supporting opioid use disorder identification and care delivery through means such as clinical decision support, improved data sharing and increased standardization and integration of opioid use screening tools.

EHRs are the lynchpin

EHRs are the lynchpin for providing workflow-focused health IT strategies to improve physician knowledge and skills for safely managing opioid therapy.

When a clinician initiates an acute opioid prescription, EHRs can suggest nonopioid treatment options or offer guardrails to help providers prescribe the lowest effective dose. For chronic pain patients requiring longer-term opioid usage, EHRs can help clinicians document and monitor goals and, when safe and appropriate, set an individualized tapering plan to reduce or end the use of opioids with minimal withdrawal symptoms while managing pain with nonpharmacologic therapies and nonopioid medications.

Early this year, the EHR Association published an Opioid Tapering Implementation Guide for EHRs developed from evidence-based guidelines on opioid tapering from the CDC, the Department of Health and Human Services, the Department of Veterans Affairs and the Department of Defense. The guide is designed to enable healthcare organizations to more rapidly implement these best practices using EHR-based clinical decision support tools.

The EHR developer community can use this guide to steer the development of new or updated products and services that can help hospitals, physician practices and other care environments implement these and other best practices.

EHRs can better equip prescribers to leverage patient health data to address the opioid epidemic through access to comprehensive patient information, assessments and referral resources. But these tools must be efficient to work within what are often too-brief patient visits.

As more hospitals and health systems connect to state prescription drug monitoring programs through their EHR systems, prescribers are able to access more complete patient prescription histories. 

The need for standardization

While many EHR systems offer opioid use disorder assessments, there is an opportunity to further streamline and standardize assessments and follow-up into EHR workflows. With myriad substance abuse and behavioral health screening tools available, the variations in coding and terminology make what information is being collected more difficult to access and less meaningful to providers. 

Crucial steps include improving utilization of standardized assessments, connecting patients with services when a need is identified and providing closed-loop information exchange to confirm that treatment was sought.

Anecdotal evidence shows that for every 10 patients who are referred to a psychologist, psychiatrist or substance abuse treatment program, just one shows up. By ensuring that referral and attendance information is easily available during a standard patient visit, clinicians will be better able to identify and treat opioid use disorder.

Information exchange 

A 2019 study published in the Journal of Substance Abuse Treatment highlighted the need for automated information exchange between emergency departments and community providers of medication for the disorder. The study determined that to minimize drop-out in the referral process, that communication needs to be “automated, flexible and allow multiple channels of referral.”

Unfortunately, there’s now a lack of information sharing and coordination between healthcare organizations and nearby community-based organizations that specialize in serving those with the disorder.

The EHR Association advocates for data standardization needed to support increased interoperability for bidirectional information sharing to inform patient care and help “close the loop” on necessary patient follow-up. It also backs Congressional funding necessary to enable community-based organizations to adopt the required IT infrastructure. (See: EHR Association Comments on the White House OSTP Connected Health RFI and EHR Association Feedback on the Congressional SDOH Caucus RFI.)  

What’s next?

The Opioid Crisis Workgroup continues working toward its goal of identifying, recommending and collaborating on optimal health IT utilization to reduce overdose deaths through safe prescribing practices and promoting long-term treatment. It’s publishing resources, reviewing and commenting on public policies, and assessing opportunities for innovative new ways EHR companies and their clients can maximize health IT for improved patient outcomes. 

Additional EHR Association Opioid Crisis Resources are available here.

This post was originally published on the EHR Association blog and can be viewed here.


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