Beyond Prescriptions: How Organizations Are Tackling All Aspects of Opioid Abuse

By | October 20, 2018

Ed Kopetsky, CIO, Stanford Children’s Health/Lucile Packard Children’s Hospital

The timing couldn’t have been better.

As leaders from the provider, vendor, and policy communities gathered in Washington, D.C. for the CHIME Advocacy Summit, a bill aimed at curbing opioid abuse was passed (quite overwhelmingly) by Senate. The legislation, which now goes to the White House, “creates, expands and reauthorizes programs and policies across almost every federal agency,” and most significantly, aims to address all aspects of the epidemic, including prevention, treatment, and recovery.

“This is monumental,” CHIME President and CEO Russ Branzell said in his remarks, praising the “rare bipartisan effort” that marked a significant victory in the fight against opioids.

Fittingly, it had been previously identified as a key priority for CHIME, which launched a Task Force earlier this year to address the crisis that resulted in 72,000 deaths last year. Headed by CIOs Jim Turnbull (University of Utah Health) and Ed Kopetsky (Lucile Packard Children’s Hospital), the Task Force was able to hit the ground running due to strong support from leaders across the industry. In addition to hosting webinars and meeting with lawmakers, they are working on a “playbook” to provide appropriate prescription guidelines, along with other useful information.

“We’re waking up as a country to this,” said Kopetsky, praising the efforts of the Task Force, which offered input on the legislation that was passed. “To see CIOs stepping out of the technology role and being healthcare leaders has been incredible.”

What’s been key, he noted, has been the ability to leverage the knowledge of health IT leaders to educate lawmakers, share best practices with one another, and raise awareness. “We know about data analytics and interoperability – we’re on the front lines of this,” Kopetsky said.

In that spirit, CHIME held a panel at the summit, featuring Turnbull and Kopetsky, along with CIOs John Kravitz (Geisinger Health System) and Dave Lehr (Anne Arundel Medical Center), both of whom have led successful initiatives aimed at curbing opioid use. And although there is by no means a silver bullet when it comes to an issue as complicated as addiction, the presenters did offer some helpful advice based on their experiences.

  • Leverage analytics to identify trends. Whether it’s pain management, obstetricians, or dental clinics, it’s critical to pinpoint the individuals and organizations that are prescribing the highest percentage of pain medications, said Lehr, whose organization has been able to reduce the amount of pain medications being doled out.
  • Apply peer pressure. At Geisinger, Kravitz’s team started publishing data internally so that providers could see firsthand how their prescribing patterns compared with those of their colleagues. “Nobody wants to be on that list,” he noted.
  • Take it a step further. As important as it is to prevent addiction, what’s just as critical is providing safe and effective treatment, said Kravitz. Geisinger, a 12-hospital system covering a large area, is developing a scale that leverages artificial intelligence and machine learning to determine how likely a patient is to become addiction to pain medication. The most intriguing aspect, he noted, is that it will be incorporated into the clinician’s workflow, leaving them more time to focus on the patient.
  • Speak up. Although all states are required to have a prescription drug monitoring program (PDMP), which can help enormously in identifying frequent flyers, data sharing between states is still challenging, said Kopetsky. He encouraged all leaders to get educated on their states’ requirements, and advocate to relax the privacy rules that stand in the way of collaboration, and put patients at risk. “Privacy is the enemy here,” Kopetsky stated.
  • Educate. “So much of this comes down to awareness,” said Kravitz, who believes public education is “critical in understanding the scope of the problem.” Educating the community about addiction can help end the stigma faced by those are dealing with it, as well as their loved ones. As Liz Johnson (CIO, Acute Care Hospitals & Applied Clinical Informatics, Tenet Healthcare) pointed out during a previous panel, “this is a disease, not a decision someone has made.”
  • Get radical. If the industry wants to make headway in combating opioid-related deaths, leaders need to think out of the box – way out, according to Kopetsky. One way is through Mobile Medical Clinics (or Teen Vans), an initiative at Stanford Children’s Health that provides care for high-risk kids and young adults, assuring “a safety net of health care, social services and educational programs.” The intent is to keep kids out of correctional facilities – especially those who suffer from addiction. Some areas even offer safe injection sites for homeless individuals, with the idea of drawing in those who abuse pain medications and opioids, rather than turning them away. “Addiction is a lifelong disease,” Kopetsky said. “It’s not enough just to cut off the supply of opiates. We have to embrace addiction. We have to think radically if we’re going to solve this problem.”

Most importantly, the industry can’t rest on the laurels of the recent legislation, and instead must keep the momentum going, he said, adding, “We can change this.”

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