Curbing opioid abuse. Partnering with the CDC.
Prescription drug abuse. It often starts with pain relievers prescribed for a limited time. It can lead to addiction and drug-seeking, whether physician-prescribed or hustled on the streets.
It’s an epidemic commanding national attention, and a battle that often poses more questions than answers.
“We’re in the midst of a massive opioid health crisis, and we’re working to make our prescribing practices as safe and effective as possible,” said Dr. Ezekiel Fink, System Medical Director of Pain Management.
To combat the issue, we’re partnering with government agencies and other medical organizations nationally to pilot an electronic solution.
When the CDC rang, we answered.
The Centers for Disease Control and Prevention invited us to help design a platform within Epic, to guide physicians in safer, more effective pain management. This model is not only for our EHR, but for EHRs nationwide.
“This was an opportunity that fell in line with the Houston Methodist vision of patient safety, optimizing pain management and creating a less opioid-centric pain model,” Dr. Fink said.
Delivering proper pain management. Stopping opioid abuse.
It’s not a black-and-white decision point.
“In the U.S., about 100 million people live with chronic pain. Some of these patients require opioids to achieve pain control, and it’s appropriate to prescribe this medication,” Dr. Fink said.
“Our goal isn’t to say no to opioids. We want to enable physicians to make wise decisions, easily tracking and optimizing dosages.”
Epic single-click access.
Improving access to prescription drug monitoring databases can reduce medication misuse and overdose.
“We want to effectively deliver proper pain management with proper safeguards,” he said. “We’re seeking to design fail-safe mechanisms within Epic that direct physicians in appropriate opioid prescribing.”
Currently, if physicians want to see what other opioids a patient has taken, they must stop what they’re doing in Epic and log in to the statewide prescription monitoring database. Physicians don’t often use the database because it’s hard to access, according to the CDC.
We’re working to make this information available in one click without leaving Epic. If physicians spot a sign of possible opioid abuse, they can intervene as needed.
In Epic, opioid prescriptions will also default to a three-day prescription. Research shows people are more likely to continue taking opioids if their first time taking them is longer than a three-day regimen.
“If physicians decide on the five-day prescription, they’re making an informed decision,” he said.
Better data. Better medicine.
Including this functionality in Epic also allows us to take a “big data” approach in looking at patients with chronic pain. We can explore the details of opioid prescribing – when to prescribe, what dosage and which diagnoses respond best.
“This will be a robust data set we can learn from,” Dr. Fink said.
