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Seeking Solutions: The Opioid Crisis

The CHIME Opioid Task Force is Identifying and Promoting Best Practices

By William Spooner, FCHIME, LCHIME, CHCIO
Founding Advisor
Next Wave Health Advisors, a Huntzinger Company

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While substance abuse has been a societal problem for generations, only in the last few decades has the problem become a crisis, largely precipitated through actions of the healthcare industry itself. A 1980 New England Journal of Medicine paper asserting that opiates are not inherently addictive led to aggressive industry efforts expanding their use in the treatment of pain. Patient pain scales were instituted, pain became viewed as the “fifth right,” and patient satisfaction surveys collected feedback on the provider’s treatment of pain.

Much of the effort was fueled by intense marketing and education by pharmaceutical manufacturers, who sprinkled money liberally among all providers who would listen. When providers began to call out high addiction rates among their patients, pharma brought in strong legal teams to contest those findings. Only in recent years have the industry and government recognized the crisis, with overdose deaths exceeding 60,000 in 2016 and 70,000 in 2017.

The principal IT tools engaged in the fight have been prescription drug monitoring programs (PDMPs), electronic prescribing of controlled substances (EPCS) and various analytics capabilities that evaluate prescribing patterns and predict addiction propensity. Most states require PDMPs – with several supplied by the single vendor Appriss – albeit with inconsistent design and rules of their use. PDMP use will be required nationally by 2022. EPCS will be required nationally by 2021, although some states have already implemented. 

In late 2017, the College of Healthcare Information Management Executives (CHIME) formed its Opioid Task Force following a long-time CHIME member losing a family member to an opioid overdose. The Task Force’s charge is to identify and promote best practices in play across the nation, provide input on related federal policy initiatives and to promote standards around PDMPs and EHR interoperability. This team of committed CIOs and vendor representatives will share its learnings through a playbook and online knowledge hub, both currently in development. The first four chapters of the playbook are nearing completion and cover the formation of an opioid stewardship committee, developing benchmark reports and dashboards, as well as educating physicians and others in the prescribing workflow and best practices around pain management. The next four chapters will address topics such as electronic prescribing, PDMPs, patient education and community outreach. CHIME members are being surveyed for their local success stories and challenges. A fundraising effort is underway to finance the ongoing work.

To learn more about the CHIME Opioid Task Force, visit its website here.

Topics: Advisors' Advice