- Healthcare industry stakeholders have mixed opinions about recent CMS guidance advising ways states can leverage health IT and EHR technology to address the opioid crisis.
A June 11 letter from CMS provided guidance to states about funding authorities that can support health IT, EHR technology, and health data exchange to curb instances of opioid misuse.
The federal agency encouraged states to use funding to enhance prescription drug monitoring program (PDMP) use, boost interstate health data exchange, and improve EHR integration of PDMP data.
An accompanying opioid roadmap provided strategies to reduce opioid misuse among Medicare beneficiaries through prevention, treatment, and data utilization to ensure prevention and treatment efforts target the patient populations most in need of intervention.
HIMSS responded positively to these steps by CMS to enhance opioid safety.
“HIMSS applauds CMS’ commitment to utilizing 21st century healthcare solutions including telehealth and prescription drug monitoring programs (PDMPs) to address the opioid crisis,” HIMSS said in a public statement.
“CMS has set an innovative precedent by enabling states to leverage existing funding mechanisms such as the Mechanized Claims Processing and Information Retrieval Systems (90/10), Medicaid Information Technology Architecture (MITA) and the use of Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009,” HIMSS continued.
According to CMS guidance, states can receive enhanced federal funding to build or improve PDMP functionality per 42 CFR Part 2 — a federal rule governing patient health data use for substance abuse disorder treatment under the EHR Incentive Programs.
“This strategy assures that states have greater flexibility in delivering care and prevention protocols to high-risk patients,” HIMSS stated.
While HIMSS views the CMS guidance as a step in the right direction, Health IT Now’s Opioid Safety Alliance contends the federal agency’s efforts fall short.
The working group of prescribers, dispensers, professional societies, and patients brought attention to the inadequacies of PDMPs, stating the databases “operate as a patchwork of separate programs in each state, creating troubling blind spots that allow episodes of abuse and unintended misuse to fester” in some cases.
Health IT Now maintained that PDMPs in some states do not make data available in real time or include information on fill attempts.
In response to the potential pitfalls of PDMPs, alliance members promoted the use of a Prescription Safety Alert System. The facilitator model would complement PDMPs by providing real-time clinical data to prescribers at the point of dispensing medications.
"While CMS' comments about the need for integrating PDMP data with EHRs and minimizing provider burden to spur better usability are encouraging, the magnitude of the nationwide opioid crisis demands that we think bigger,” said Health IT Now Opioid Safety Alliance Executive Director Joel White in a public statement.
White recommended CMS encourage use of the Opioid Safety Alliance’s (OSA’s) Prescription Safety Alert System, which is based on National Council of Prescription Drug Programs (NCPDP) standards.
“Instead of tinkering around the edges and ultimately doubling down on a flawed system that leaves too much to chance, we need to empower clinicians with better, easy-to-use tools that complement the work of PDMPs to thwart opioid misuse in real-time — including transactions that occur across state lines," said White.
While PDMPs are a helpful tool for combating the opioid crisis and enabling better-informed prescribing practices, White emphasized that the databases are not effective enough at tracking and preventing instances of opioid misuse on their own.
“OSA supports continued efforts to enhance state PDMPs but the stakes are simply too high to rely solely on a lagging, unwieldy system that has done little to change the status quo of 115 opioid-related deaths per day,” concluded White. “The time to enact a Prescription Safety Alert System is now."
Newly-released CMS resources aimed at curbing the opioid crisis are part of an effort by the Trump Administration to reduce opioid-related deaths in 2018.