By David Bucciferro and Katelyn Fontaine
EHRA Opioid Crisis Task Force 

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Volunteers on EHRA’s Opioid Crisis Task Force have made great strides in the past year in our efforts to identify the policy changes and adoption patterns needed to maximize the capacities of health IT to combat the opioid crisis.

From the start, our focus has been, What do providers need from technology to support their efforts in the opioid crisis?

When we began our work in early 2018, we were surprised to find that there was no comprehensive source for the state-specific policies and standards surrounding prescription drug monitoring programs (PDMPs) and electronic prescribing of controlled substances (EPCS). So, we set out to create our own.

State by state, we collected data, including timeframes for reporting controlled substance prescriptions to PDMPs, what data is collected, which professionals are able to access PDMP information, if and when information can be shared across states, and any limits on retaining PDMP data within an EHR.

We found wide variation among states. In the absence of a federal, standards-based approach, states have created complex environments that are misaligned, confusing, and costly to healthcare providers and EHR developers. This variation in the implementation and use of PDMPs at the state level has created a barrier to the effective use of EHRs and other health information technology in the fight against the opioid epidemic, and adds to clinician burden by not allowing for efficient and routine workflows.

The lack of standardization means that physicians and other providers in emergency departments, primary care and other settings may not have the full picture they need to effectively evaluate individual circumstances when considering pain management options. It also creates complexities for organizations and health IT developers working to incorporate data and clinical decision support tools into clinical workflows.

To address the lack of standardization for PDMP information available within the EHR, the Task Force has developed an ideal minimum dataset that we believe meets the needs of clinicians. The dataset we identified was developed with the assistance of numerous physicians and other healthcare professionals who helped refine the information down to the minimal data necessary in order to have the most impact on clinician decision making.

The identification of these dataset points is a first step in maximizing the value of an EHR/PDMP connection. The next steps in moving toward seamless interoperability between the EHR and the PDMP will be to translate the PDMP data points into a format and set of standards that are consumable and usable by an EHR.  

We hope to work with ONC and others to ensure that the valuable information collected by the PDMP can be used within a clinician’s EHR to aid in clinical decision support and reduce the burden on clinicians. This step is vital if we’re going to enable clinicians to make the best use of the information available.

Those affected by the opioid crisis demand that all of us work together toward solutions.

View the ideal minimum dataset for PDMP inquiry here. 

EHRA’s CDC Opioid Guideline – Implementation Guide for Electronic Health Records is another free resource available to healthcare organizations, offering a variety of options to implement the CDC’s clinical practice guidelines within the EHR workflow to improve opioid stewardship in clinical practice.