Industry Voices—Surescripts exec on how tech is driving headway on opioid crisis

The power of health information technology goes beyond electronic prescribing of controlled substances (Getty/jacoblund)

In 2016, 42,200 Americans died from opioid-related overdoses. That’s an average of 120 deaths each day, nearly five every hour.

These are sobering statistics, to say the least.

When it comes to controlled substances like opioids, drug diversion is not only a significant concern but also a contributor to overall opioid addiction and abuse: 3% to 9% of diverted drugs for abuse are tied to forgery of paper prescriptions.

There is some good news to share, though: Drug overdoses are falling, thanks in part to education and public policy coupled with health information technologies such as electronic prescribing for controlled substances (EPCS), access to patient medication history, clinical record exchange and adherence alerts. At the end of the day, technology has already and will continue to have a major role to play in the battle against opioid addiction. Here are a few places where we’ve already seen an impact:

Replacing paper prescriptions with electronic prescriptions

An important tool in the nation's response to the epidemic, EPCS eliminates paper prescriptions, which can be stolen, forged or altered, and gives prescribers electronic access to a patient’s prescription history to help identify potential overuse or abuse. In addition, EPCS enhances security, privacy and prescribing flexibility as well as improved workflow efficiency for prescribers and pharmacists alike—which allows caregivers to spend more time with patients. 

Today, laws are in place in more than half of all states that require electronic prescribing of opioids, controlled substances or all prescriptions—and the SUPPORT for Patients and Communities Act (H.R. 6) requires the use of e-prescribing for all controlled substances under Medicare Part D by Jan. 1, 2021. Currently, nearly 40% of all prescribers and almost 96% of pharmacies are EPCS enabled.

To help ensure appropriate prescribing of opioids, the Centers for Disease Control and Prevention (CDC) issued new guidelines, which help prescribers deliver effective pain management in an environment fraught with risk. It covers three main areas: when to initiate or continue opioids; opioid selection, dosage, duration and discontinuation; and assessing risk and addressing abuse. The CDC has since followed up with a document that helps prescribers put the guidelines into practice

Complete view into patient medication history

In addition to EPCS, it’s essential for providers to utilize electronic access to patient medication history data. With this information available at the point of care, providers can identify potential misuse and abuse, and enhance the security, privacy and efficiency of the prescribing process.

Having an accurate and up-to-date view of a patient’s medication history enables a prescriber to make more informed care decisions. When a patient’s medication history is seamlessly integrated into the prescriber’s workflow, insightfully displaying and listing the medications—controlled or otherwise—the prescriber can identify potential adverse drug events or interactions, gaps in adherence or patterns of abuse.  

Access to patients' clinical records, anywhere, anytime

Prescribers and clinicians also need to know where a patient seeking pain relief has recently been seen and what kind of care they have received. There are tools available to locate and exchange clinical records from across the U.S., regardless of electronic health record (EHR) or care setting, allowing a prescriber or clinician to quickly identify normal care patterns as well as suspect ones.

For example, this means that an emergency room doctor can quickly see if a patient suffering from back pain has visited an outpatient addiction treatment center, indicating that there could be a problem with opioid abuse or misuse.

Stay tuned into medication adherence

Finally, given the addictive nature of opioids, prescribers need to know whether patients in need of pain relief are adhering to the right medications at the right dose. Does the patient’s prescription filling seem suspicious? Are they taking additional medications that may cause them harm? Are they refilling their prescriptions or not refilling them enough? Medication adherence alerts give clinicians and prescribers personalized messages about a patient’s medication habits in real time, at the point of care informing them whether the patient is at risk for an adverse drug event.

As we look toward a new decade, it’s important to recognize the enormity of the work that has gone into getting us here. First, lawmakers at both the state and federal levels have increasingly become proponents of the safe and secure electronic workflow for prescribing these potentially dangerous drugs. Second, prescribers in states where electronic prescribing is required by law have driven substantial growth in enablement and adoption of the technologies available to them. And lastly, the federal government’s investment in the growth of EHRs with HITECH as well as laws like the SUPPORT Act are making a significant difference in combating the opioid epidemic.

The power of health information technology goes beyond EPCS. When combined with electronic access to patient medication history data and other tools at the point of care, we’re arming prescribers with the ability to identify potential misuse and abuse and enhance the security, privacy and efficiency of the prescribing process.

Paul Uhrig is chief administrative, legal and privacy officer for Surescripts.