Six-hospital Deaconess Health System, which serves southwest Indiana, is monitoring patients who are being prescribed opioids to identify those who may be at risk for drug abuse.
In the past year, Indiana’s Legislature has strongly encouraged providers to improve how they monitor patients who are being prescribed controlled substances. While legislation was not passed, Deaconess started work to implement the program, says Diane Hunt, MD, chief medical information officer at the delivery system.
More than 40 other organizations across the nation are using software from Appriss Health to support prescription drug monitoring programs for controlled substances. In Michigan, for example, the state government paid to buy the software and integrate it into provider electronic health records.
The software analyzes a patient’s health history and controlled substances usage patterns to identify at-risk individuals and assign an overdose risk score, ranging from 0 to 999.
For instance, providers might be alerted if a patient is using four or more opioid or sedative dispensing pharmacies in any 90-day period during the past two years, or using five or more opioid or sedative providers in any year of the past two years.
Deaconess could have used Indiana’s existing automated prescription system, called Inspect, that monitors controlled substances, but it found it difficult to use, and it requires providers to take additional steps to get patient medication histories, according to Hunt. Physicians did not want to have to query Inspect for information or pay for these queries; what they wanted was direct integration of the prescription system into the electronic health record system to enable them to check opioid information from within their present workflows.
Several state boards of pharmacy have worked with Appriss Health to present its software to providers, and that’s how Deaconess learned about the vendor, Hunt says.
Deaconess also worked with a third-party vendor to deliver one-click access to pharmacy records via the EHR, and also got some integration advice from colleagues in Ohio. One-click access was important, says applications analyst Nick Martin, because that was a feature that physicians preferred.
With Deaconess just going live on Appriss Health in late April, it is too early to see significant progress in lowering instances of overdoses, according to Hunt. However, being able to identify patients at risk opens the door for her and other doctors to have discussions with patients about drug use.
Now, Deaconess is starting to share real-time prescription drug monitoring data with neighboring states, reaching out to hospitals and other providers in Indiana to share what it has learned, and has conducted a handful of presentations on the Appriss Health system. “Hopefully, we will be an example for the state of Indiana and share what we learn with others,” Hunt says.
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