Integrated healthcare services organization Geisinger has nearly cut in half the number of opioid prescriptions written in its emergency departments, physician offices and community practice clinics by using a provider dashboard linked to their Epic electronic health record.
Over the past three years, Geisinger Health System—based in Danville, Penn.—has gone from an average of 60,000 opioid prescriptions per month to 31,000.
An innovator in the use of EHRs and care delivery models, Geisinger has used the dashboard to target specific healthcare sites that were writing disproportionately high numbers of opioid prescriptions, according to Michael Evans, associate vice president of strategy and innovation and co-director of the Center for Pharmacy Innovation and Outcomes.
“We built a controlled substance prescribing dashboard” creating a best practice for appropriate pain management across the enterprise, says Evans. The dashboard serves as a “standard education process for how to treat pain,” including the differences between neuropathic and somatic pain, he adds.
In assessing the health system’s success in cutting the number of opioid prescriptions, Evans credits a proactive team approach to managing chronic pain as well as using several different treatment options to address patients who are addicted to opioids or may be at risk for addiction.
Pennsylvania, like many other states, mandates provider usage of a Prescription Drug Monitoring Program, a state-run electronic databases that tracks opioid prescribing. According to Evans, Geisinger providers are required to review PDMP data before issuing a controlled substance prescription, document in the EHR that they reviewed the database, as well as document in the EHR if the database information alters their decision to issue a controlled substance.
“We work with the Department of Health, and we do track our clinician use of the PDMP,” he adds. “Not only do providers have to check the PDMP, they actually have to document their findings in the patient’s medical record. So we’ve built a process in our EHR where we can track documentation—that’s also a part of the dashboard.”
In October, Geisinger and Purdue Pharma announced that they had enrolled the first of 240 patients to participate in a 12-month study designed to demonstrate how the use of wearable technology by chronic pain patients treated at a specialty clinic may improve health outcomes.
Participants will use an Apple Watch and iPhone with a pain app—designed specifically for this study—that will measure physical activity, patient-reported pain, disability, sleep quality, depression, medication use and heart rate. The data will be integrated into Geisinger’s dashboard and EHR system.
Outcome data for control groups will be collected retrospectively from the EHR. Dashboards—also designed for this study—will provide both providers and patients with data displays of information captured by the wearable technology.
“We are incorporating advanced technology into the traditional healthcare setting to redirect and empower the patient to take more control of their own well-being. The proposed multi-level integrated platform will facilitate and accelerate the speed of communication between the patient and healthcare providers, thereby allowing quicker patient access to appropriate care,” said John Han, MD, director of the Department of Pain Medicine at Geisinger.
“Furthermore, it is hoped providing more education as well as alternative, non-opioid treatment options and coaching to promote a long-term sustainable healthy lifestyle will improve patient function and quality of life,” added Han.
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