EHR tool to assess patient risks for opioid abuse
Electronic health record vendor eClinicalWorks has built a new software module, embedded in the EHR system, to help clinicians assess a patient’s risk for opioid misuse.
The Opioid Risk Tool module will be included in the vendor’s next upgrade in January 2019. The software includes clinical decision support that estimates a patient’s risk and provides suggestions for prescribing alternatives to opioids or opioid antagonists, which block the effects of opioids.
The decision support also calculates the morphine milliequivalents for patients and alerts the clinician when the Center for Disease Control and Prevention recommended opioid dose has been exceeded.
In addition, eClinicalWorks—in partnership with drug monitoring analytics vendor Appriss Health—has built a prescription drug monitoring program integration that enables clinicians to access state-run PDMP databases at the point of care. Currently, 33 states use the Appriss analytics which integrate with the EHR to streamline data access for providers.
The tool can also be administered and scored in less than one minute within the EHR system. A score of 3 or lower indicates low risk for future opioid abuse, 4-7 indicates a moderate risk, while a score of 8 or higher presents a high risk for abuse.
“The opioid risk tool will assist in combating the opioid epidemic, ensuring patients have access to safer treatment for chronic pain and reduce the misuse of these drugs,” says Girish Navani, CEO at eClinicalWorks. “We can do our part to limit the number of pills in circulation and believe the Opioid Risk Tool will lead to progress in providing better and safer medicine across the nation.”
By leveraging the tool in the EHR, a clinician knows the medications a patient is using, the social history of the patient, and why the patient is coming to the doctor, Navani notes. The physician also knows the social determinants of health for the patient, such as the ability to pay for medication or afford a taxi to buy the medication.
These factors and others are used to calculate a risk score for opioid abuse by the patient, Navani explains.
The tool has been validated in both male and female patients who suffer from pain. To improve patient safety, if a doctor writes a prescription for oxycontin or other similar agents higher than a recommended threshold, the eClinicalWorks software prompts the clinician to also prescribe an antagonist medication that blocks the effects of opioids, particularly when used with alcohol.