As the healthcare industry devises new solutions to tackle the opioid epidemic, experts say technology will take a leading role in monitoring the spread of drugs and flagging patients who are at risk.
In West Virginia, which has the highest rate of overdose death in the country, public health officials conducted a "social autopsy" to get a complete picture of how the opioid epidemic was impacting the state.
Officials analyzed data on every person who died as a result of an opioid overdose in 2016, and looked at information on every facet of their lives, from employment to education to marital status to their interactions with the healthcare system, said Rahul Gupta, M.D., commissioner of the state's Bureau for Public Health. It was a rare example of using big data to direct public health officials in getting their arms around the epidemic.
"We are often data rich and analysis poor when it comes to addressing crises," Gupta said.
Gupta was one of several speakers at an event on the role of technology in tackling the opioid epidemic, which was hosted by The Hill.
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The analysis revealed a number of trends, and in particular highlight that prescription drugs continue to play a role in driving the epidemic in West Virginia. With that analysis in place, public health officials were able to craft responses to the epidemic, such as expanding treatment access and pushing for more first responders to carry naloxone.
"This is an issue that doesn't have any respect for city or state or county lines": @DrGuptaMD says we need to understand the opioid epidemic both in its medical implications and socioeconomic factors at play #TacklingOpioidsWithTech
— The Hill Events (@TheHillEvents) June 20, 2018
In addition to taking advantage of data analytics, telemedicine is a crucial tool for providers to fill access gaps in treating rural patients who are addicted to opioids. In Virginia, officials are taking that approach one step further, and harnessing tech to better train rural providers, said Nassima Ait-Daoud Tiouririne, M.D., associate professor of psychiatry and neurobehavioral sciences at the University of Virginia Health System.
Tiouririne said that while telemedicine can provide remote patients with access to specialists, it's also important to ensure that providers closer to home are able to treat patients with addiction. Local physicians already have existing relationships with patients in the region they serve and have a greater cultural competency to interact with them, she said.
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"One provider can only see so many patients in a day," she said. "So instead of me seeing patients, [local] clinicians see them, and we learn from each other."
Although we encourage and we provide incentives for physicians to treat addiction, very few of them end up treating these patients: @uvahealthnews's Dr. Nassima Ait Daoud Tiouririne speaks to victims of the opioid crisis and lack of access to care #TacklingOpioidsWithTech
— The Hill Events (@TheHillEvents) June 20, 2018
UVA Health System also has a robust prescription drug monitoring program and relies heavily on e-prescribing—two other tech trends highlighted as potential opioid epidemic solutions. The key to making PDMPs and e-prescribing work, Tiouririne said, is to embed them in the electronic health record to ensure it's as easy as possible for physicians to use them.
David Meyers, M.D., chief medical officer at the Agency for Healthcare Research and Quality, said emerging technologies like PDMPs are effective at addressing a specific concern like the opioid epidemic, but wider adoption also ensures that providers are prepared for what the next health crisis may be.
"What we need to be doing is developing solutions that prepare us for the next problem," he said.
Meyers said another example of tech that can serve that dual purpose is clinical decision support. The alerts and tools that providers can use to better navigate their choices don't have to apply strictly to one issue, he said.
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As providers take steps to integrate tech solutions into their opioid response plans, several pieces of legislation winding their way through Congress could ultimately support those efforts. The House has already advanced dozens of bills, with more in the pipeline. A total of about 50 bills target very specific areas of the opioid epidemic and will be pulled together into a larger package for the Senate.
Rep. Tom MacArthur, R-N.J., who co-chairs the House's bipartisan opioid task force, likened the bills to "rifle shots." He said he intends to introduce shortly another bill, which would focus on uniting Medicare claims data and private insurance claims data to enhance analytics and flag patients at risk of addiction more quickly, and enhance communication between pharmacies, prescribers and payers.
"There's no other way to do it other than through technology," he said.