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ONC Highlights Role of Health IT Use to Fight Opioid Crisis

ONC pegs clinical decision support, electronic prescribing of controlled substances, and prescription drug monitoring programs as the most useful health IT tools for fighting opioid abuse.

By Kyle Murphy, PhD

- A new resource page put together by the Office of the National Coordinator for Health Information Technology (ONC) highlights three forms of health IT use that could help address the growing opioid crisis.

ePCS, clinical decision support, and prescription drug monitoring programs

"Since 1999, deaths from prescription pain medications in the US have quadrupled, and right now, 44 people die from prescription opioid overdose each day," the federal agency states. "The Office of the National Coordinator for Health Information Technology is working with public and private partners to address this crisis."

Opioid abuse is front and center of a national dialogue about the misuse of controlled substances. Last March, the Department of Health & Human Services announced an initiative to combat opioid-related overdose, death, and dependence, a component of which was the publishing of training and educational resources for providers.

The new ONC resources highlights three health IT tools that can assist providers in addressing the opioid crisis.

The first is the use of clinical decision support, which ONC defines as "a process for enhancing health-related decisions and actions with pertinent, organized clinical knowledge and patient information to improve health and healthcare delivery."

Clinical decision support is already a popular tool among meaningful use providers as a result of being a requirement for the EHR Incentive Programs.

Second is electronic prescribing of controlled substances (ePCS). An important law impacting for New York providers went into effect late last month mandating ePCS use, with the purpose of reducing the abuse of controlled substances including opioid.

In an interview with EHRIntelligence.com, Ken Whittemore, SVP of Professional and Regulatory Affairs at Surescripts, touched on the provisions and benefits of the I-STOP (Internet System for Tracking Over-Prescribing) law:

The I-STOP law did not just mandate ePCS and e-prescribing. It also made some changes to the Prescription Drug Monitoring Program in New York. One of the changes it made was requiring that physicians access the PDMP database before they prescribe controlled substances, which obviously includes opioids. Over that time they have observed that has reduced doctor shopping by over 75 percent. So you have that aspect going on.

Coupling the ability to securely transmit prescriptions of controlled substances to pharmacies and the ability to monitor ePCS should help reduce prescription drug abuse in New York and perhaps serve as a model for other states.

And there's serious room for improvement based on data from Surescripts published by ONC. According to the federal agency, 12.2 percent of providers are enabled for ePCS compared to 82.3 percent of pharmacies.

Lastly, ONC points to the role of prescription drug monitoring programs (PDMPs) in tackling opioid abuse, programs that the federal agency considers to be "one of the most promising."

"PDMPs are state-run electronic databases that provide critical health information to physicians and other health care providers about an individual’s history of using controlled substance prescriptions," claims ONC. "This information can be used to avoid inappropriate prescribing, identify drug-seeking behavior, and allows providers to intervene when there are signs of prescription drug misuse."

The federal agency oversees the PDMP & Health IT Integration initiative aimed at developing standards for integrating PDMPs into provider health IT systems. The initiative builds on previous work by ONC in conjunction with the Substance Abuse Mental Health Services Administration (SAMHSA) on the Enhancing Access Project, comprising pilots testing technical solutions such as electronic prescribing and PDMP-enabled health information exchange.

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