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Credit: NEHI
May 23, 2018, WASHINGTON, DC -- Big gaps in the exchange of data and information throughout the health care system are impeding efforts to address the opioid epidemic, NEHI (the Network for Excellence in Health Innovation) reported in a policy brief released today.
As a result of these gaps, patients in acute and chronic pain often lack access to good information about opioid alternatives to pain relief; clinicians do not have the information they need to prescribe approved opioids appropriately; and doctors, nurses, and others lack the ready information they need to refer patients to effective opioid use disorder treatment and social services to help with recovery.
NEHI urged federal and state policy makers and others to address these gaps through a series of measures, many relating to use of health information technology. For example:
- State-based databases, known as prescription drug monitoring programs (PDMPs), which are designed to capture information about opioid prescriptions, need to be upgraded substantially, NEHI said in its policy brief. The programs should be required to share information more readily and operate more consistently among the states. Increased federal funding for these programs should be tied to new nationwide requirements that make them more valuable tools for clinicians who want to track whether patients have already received opioid prescriptions.
- Electronic health records and clinical decision support systems need to incorporate federal opioid prescribing guidelines, so that clinicians know how to prescribe opioids appropriately; should provide clinicians with information that they can give to patients about non-opioid alternatives to pain relief; and enable clinicians to import patients' past prescription history directly into electronic health records from PDMPs.
- E-prescribing of opioid prescriptions -- sending them to pharmacies electronically instead of writing them out by hand or faxing them -- is woefully underutilized. E-prescribing eliminates the likelihood that prescriptions can be stolen or forged, but fewer than 1 in 5 prescriptions of opioids and other controlled substances is e-prescribed. Congress should direct the federal Drug Enforcement Administration to amend regulations that make it difficult for clinicians to e-prescribe opioids and other controlled substances.
NEHI depicted the gaps in data and information exchange that block efforts to address the opioid use disorder crisis in two infographics available here. One illustrates the "best case" scenario for responsible patient care and opioid prescribing, and another illustrates what happens when these information gaps and barriers get in the way.
"These gaps in data and information aren't the root cause of the opioid use disorder epidemic, but they constitute serious barriers to addressing it," said Susan Dentzer, President and CEO of NEHI. "Policymakers should work hand in hand with states, clinician groups, health information technology providers, and others to close these gaps, and make it easier to do right by patients, rather than making matters worse."
NEHI's recommendations emerged from discussions with representatives from government agencies, clinician groups, health information technology providers, and other stakeholders with an interest in fostering appropriate opioid prescribing while minimizing opioid use disorder abuse. For more details on all recommendations, click here to download the full policy brief.
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As an organization that seeks to advance innovation and improvement in health and health care, NEHI has formed a collaborative to further develop and implement the recommendations. For more information, contact Lauren Choi, NEHI VP of Policy Partnerships, at lchoi@nehi.net.