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Clinicians need better opioid data within their workflows, says EHRA

The HIMSS Electronic Health Record Association says it’s working toward policies and procedures that will allow physicians better visibility for opioid data in the EHR.

“We were surprised to find that there was no comprehensive source for the state-specific policies and standards surrounding prescription drug monitoring programs and electronic prescribing of controlled substances,” write David Bucciferro and Katelyn Fontaine of the task force in a blog post this week. “So, we set out to create our own.”

The EHR Association looked at state-by-state data to gain insights on an array of key factors: how long it took providers to report controlled substance prescriptions to prescription drug monitoring programs, what data is collected, who is able to access PDMP information, whether and when such data can be shared across states and how retention of that prescribing data might be limited within an EHR.

“We found wide variation among states,” said Bucciferro and Fontaine. “In the absence of a federal, standards-based approach, states have created complex environments that are misaligned, confusing, and costly to healthcare providers and EHR developers.”

That variation, they said, has hindered the ways EHRs can help combat opioids and is burdensome for clinicians in that it doesn’t allow for efficient and routine workflows.

A lack of standardization means that docs, whether they’re primary care physicians or work in the emergency department “may not have the full picture they need to effectively evaluate individual circumstances when considering pain management options,” they said. “It also creates complexities for organizations and health IT developers working to incorporate data and clinical decision support tools into clinical workflows.”

So EHRA’s Opioid Crisis Task Force has put together what it calls an ideal minimum data set, developed with input from physicians and others. It’s a refined list of the “the minimal data necessary in order to have the most impact on clinician decision making,” they said.

Electronic health records have become a critical tool in the fight against the opioid epidemic. “We’re in the midst of the most challenging public health concern facing healthcare professionals and first responders today,” said Jedediah Tuten, director of acute pharmacy operations at Bon Secours Mercy Health.

More and more, hospitals are depending on their EHRs to help them make safer prescribing decisions, and are demanding improved functionality from their vendors to enable that. Providers expect those vendor to “step up and partner with them to help solve the opioid crisis,” according to a recent report from KLAS.

Some major health systems, such as Intermountain, have taken it upon themselves to make adjustments to their own EHR systems to reduce unnecessary opioid prescriptions.

“The identification of these data set points is a first step in maximizing the value of an EHR/PDMP connection,” wrote Bucciferro and Fontaine. “The next steps in moving toward seamless interoperability between the EHR and the PDMP will be to translate the PDMP data points into a format and set of standards that are consumable and usable by an EHR.

“We hope to work with ONC and others to ensure that the valuable information collected by the PDMP can be used within a clinician’s EHR to aid in clinical decision support and reduce the burden on clinicians,” they added. “This step is vital if we’re going to enable clinicians to make the best use of the information available. Those affected by the opioid crisis demand that all of us work together toward solutions.”

Twitter: @MikeMiliardHITN
Email the writer: [email protected]

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