Enhancing Today’s Health IT to Stem the Tide of Opioid Abuse

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By Michael Burger, Senior Consultant

I read with interest Joel White’s Op-Ed piece entitled Leverage the Power of Health IT to Stem the Tide of Opioid Abuse. One statement stood out: “Our plan calls for incorporating PDMP data directly into prescribers and pharmacists’ workflows and enabling real-time updates to prevent victims of opioid abuse from taking advantage of PDMP lag times to obtain more fraudulent prescriptions.” I couldn’t agree more – and there are solutions available today that can do just that!

Virtually all states have a prescription drug monitoring program (PDMP). The challenge to using them is that they require the prescriber to step outside of the visit workflow in the electronic health record (EHR), log into the PDMP website, search for the patient, and then access the patient’s record. But wait—there’s more.  After all that, prescribers must then turn back to the EHR to document the prescribing decision that was made, based on the PDMP data.

This process doesn’t sound like much. But even if it takes only 2 or 3 minutes, that amounts to nearly one third of the physician’s ten minutes of “face time” with the patient. That’s too much – and utilization of PDMP data reflects this.  Despite widespread availability of PDMP data, most prescribers don’t regularly look at the data.

A recent study in Florida identified that only 31% of physicians had even registered with the PDMP.

Several solutions exist that would hasten utilization of existing PDMP data. One vendor, Appriss Health, works with the majority of PDMPs across the country. They offer an ability to provide a link to PDMP data from within the EHR.  This interface eliminates the necessity to step outside the EHR workflow to check the PDMP data. The limitation to this method is that the provider must still look at data outside of the EHR, make a clinical decision and then transpose that decision to the EHR.

Another solution, as yet only accomplished in limited pilots, is to enhance the existing medication history data, used for electronic prescribing, with the PDMP data. EHRs have long had the capability of integrating medication history data, downloaded from prescription benefit managers (PBMs) through the Surescripts network. The EHRs have also integrated drug utilization review (DUR) technologies that scan the downloaded history as well as locally documented prescriptions. The DUR function alerts the prescriber to potential adverse drug events, as well as duplicate therapies. Merging the PDMP data with the existing medication history will immediately enable the ability to alert the prescriber when a patient has more than one prescription for a narcotic.

I am in favor of leveraging existing technology to deliver the information-rich data, which is available NOW and accessible from within the EHR workflow that physicians use every day. We can support this with a regulatory effort to loosen the stringent privacy rules imposed in some states and require timely updates to enable complete PDMP data to be presented in the EHR.