More than 42,000 Americans died from opioid overdoses in 2016, exceeding the number of auto fatalities in the U.S. that year. That marked a five-fold increase in opioid-related deaths compared to 1999, according to the Centers for Disease Control and Prevention
(CDC). In a parallel trend, the amount of opioids prescribed was three times higher in 2015 than in 1999, which the CDC estimated was enough to medicate every American around the clock for three weeks.
Many hospitals and healthcare systems have recognized
that opioid prescribing has played an unintended role in
the opioid epidemic, and they have been searching for
ways to reduce prescribing while still ensuring that patients
who need opioids to manage pain get proper treatment.
A frequent ally in this endeavor has been their healthcare
IT teams, whose analytic skills have
helped health systems identify providers'
prescribing patterns and develop tools
and strategies to reduce some patients'
exposure to potentially addictive opioids.
The 2018 CHIME HealthCare's Most
Wired Survey included questions to gauge
how successful participating hospitals
and health systems have been with opioid
management. According to an analysis of
the data, half use electronic prescribing
(e-prescribing) for controlled substances
and almost half have their e-prescribing
module connected to a prescription drug
monitoring program (PDMP). Some 70 percent use nonnarcotics
in order sets as an opioid-reduction strategy and
68 percent limit the number of pills per prescription.
“These results are encouraging,” said John Kravitz, a member of the CHIME Opioid Task Force and senior vice
president and CIO at Geisinger, a 2018 Most Wired recipient
headquartered in Danville, Pa. Kravitz testified before
a House subcommittee about a Geisinger initiative that
drastically reduced the amount of opioid prescribing by its
providers. He also is a member of the CHIME Public Policy Steering Committee, which has been educating federal
policy makers about healthcare IT's potential role to stem
the tide of opioid addiction and deaths.
In October, the House and the Senate passed a
comprehensive opioids package that included a provision
to require e-prescribing of controlled substances under
Medicare Part D by 2021, and provisions for data sharing and
state use of prescription drug monitoring programs (PDMPs).
E-prescribing and the use of PDMPs are considered valuable
tools for gathering data in near realtime
on opioid use, flagging potentially
fraudulent prescribing and identifying
patients shopping for physicians. As of
press time, the bill was sitting on the
president's desk and is expected to be
signed into law.
“If we are already at 48 to 50 percent
for e-prescribing, we are well on our
way,” Kravitz said. “We have two more
years to get the remaining 50 percent of
healthcare providers to use e-prescribing
for controlled substances.”
Although efforts to limit the number
of pills prescribed is positive, the actual number makes a
difference, Kravitz pointed out. A recent study found that
some patients can become addicted with as little as a fiveday
prescription supply of opioids.
These health system-based efforts are already having
an impact. Another federal agency, the Substance Abuse
and Mental Health Services Administration, reported that
1 million-plus fewer people in the U.S. misused prescribed
opioids in 2017 compared to 2015.
“We are on the right trajectory,” Kravitz said.