Advocacy groups say better data sharing, consistent privacy laws will help control opioid prescribing

A wide array of technology can help limit the impact of the opioid epidemic, according to the College of Healthcare Information Management Executives (CHIME), but only if certain policy changes address long-standing concerns like patient matching and telehealth reimbursement.

Answering a call for industry input earlier this month from leaders of the Senate Finance Committee, CHIME President and CEO Russell Branzell and Board Chair Cletis Earle underscored the need for a data-driven approach to prescribing practices and the use of clinical decision support to help control prescribing practices.

“Since nearly half of all opioid overdose deaths involve a prescription opioid, CHIME believes there is an important role for technology to play in helping prevent, identify and educate those prescribing opioids and other substances,” CHIME officials wrote in a letter (PDF) to Sen. Orrin Hatch, R-Utah, and Sen. Ron Wyden, D-Ore. CHIME recently kicked off a new opioid task force led by Stanford Children’s Hospital CIO Ed Kopetsky, whose son died of an overdose last year.

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Several of CHIME’s suggestions included well-worn policy changes, such as better integration of EHRs with prescription drug monitoring programs (PDMPs), which would limit workflow challenges for physicians. The organization also called on lawmakers to expand telehealth reimbursement for federally qualified health centers to provide additional options for opioid addiction treatment.  

CHIME officials reiterated their recommendation that federal regulators be allowed to identify standards to improve patient matching. Although the group abruptly dropped its National Patient ID Challenge last year, CHIME has previously supported allowing federal agencies to fund private-led patient matching initiatives.

“Without a consistent patient identity matching strategy, the creation of a longitudinal care record is simply not feasible,” Branzell and Earle wrote.

The organization also advocated for more consistency with patient privacy laws, both at the state and federal level, to improve data sharing. That policy shift, including aligning Substance Abuse and Mental Health Services Administration (SAMHSA) rules around 42 CFR Part 2 with HIPAA, was echoed by the Association for Behavioral Health and Wellness (ABHW), which highlighted instances in which payers were unable to share opioid-related data with providers because of the regulation commonly known as Part 2.

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In a letter (PDF) to Hatch and Wyden, ABHW recounted a specific example in which one payer found that over 200 members had been to the ED more than seven times in a six-month period—some of whom were attempting to obtain opioids from different EDs. But the insurer was unable to share that data because it may have indicated that the member had a substance abuse disorder. 

“ABHW members say Part 2 is one of the biggest—if not the biggest—barriers to fighting the opioid crisis,” CEO Pamela Greenberg wrote.

Earlier this year, the Department of Health and Human Services issued new changes to Part 2, allowing patients to provide a general disclosure for substance abuse information, and the agency hinted that it “plans to explore additional alignment with HIPAA.”