New Guide Offers Guidance for Digitizing Opioid Tapering Plans

By Daniel Seltzer, Co-chair of the EHRA Opioid Crisis Task Force

Care disruptions due to the COVID-19 pandemic and other ongoing events have put long-term opioid therapy (LTOT) patients at increased risk for opioid-related harm and heightened the urgency around addressing the opioid crisis. This has, in turn, presented a significant opportunity to leverage technology to improve certain care processes around opioid therapy, starting with digitizing the tapering plan and incorporating existing clinical practice guidelines into clinical decision support (CDS) tools. 

These are areas that have been researched extensively by EHRA’s Opioid Crisis Task Force, which was formed in 2018 to explore and recommend ways EHR technology can help solve the complex opioid crisis puzzle. This research culminated in the newly released Opioid Tapering Implementation Guide for Electronic Health Records, a set of clinical practice guidelines that can be operationalized to improve opioid stewardship and opioid tapering in clinical practice. 

EHRA’s goal with this Opioid Tapering Guide is to enable an organization’s health IT team to implement tapering best practices more rapidly using EHR-based CDS tools. The EHR developer community can also use it to steer the future development of new or updated products and services that can help hospitals, physician practices and other care environments implement these and other best practices. 

In developing the guide, the Task Force leveraged evidence-based guidelines on opioid tapering published by several organizations and agencies with subject matter expertise, including clinical recommendations from the United States CDC, VA/DOD, and HHS. These referenced guidelines include tapering plans for pain lasting longer than three months or past the normal tissue healing time frame, outside of active cancer treatment and palliative or end-of-life care. 

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Cybersecurity Career Awareness Week

By Nam Nguyen, Vice Chair
EHRA Privacy & Security Workgroup

October is Cybersecurity Awareness Month, and the Electronic Health Record Association (EHRA) will use this opportunity to share helpful reminders of cybersecurity fundamentals throughout the month. 

The 2020 HIMSS Cybersecurity Survey provides a look into cybersecurity issues facing US healthcare organizations. Based upon the feedback from 168 US-based healthcare cybersecurity professionals, “Cybersecurity budgets are still lacking with typically 6% or less of the information technology budget allocated for this purpose. A large attack surface exists within many healthcare organizations due to the profound lack of resources.”

Even as cyberattacks are increasing exponentially, businesses including healthcare organizations are facing another significant risk –  a shortage of available, qualified cybersecurity professionals. 

According to the fifth annual global study of cybersecurity professionals by the Information Systems Security Association (ISSA), more than 57% of organizations have been negatively impacted by the “cybersecurity skills crisis.” Of the professionals surveyed by ISSA, 95% indicated the skills shortage has not improved in recent years and 44% say it has worsened. 

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Because COVID-19 Didn’t Erase the Opioid Crisis… How Health IT Can Support Opioid Tapering Plans

Screen Shot 2020-05-18 at 6.37.00 PMThe COVID-19 crisis started to consume the United States just as it had been turning the corner on the most severe chapter of the opioid crisis. Opioid prescribing rates and drug overdose rates both remain distressingly high, and some patients on opioids are more vulnerable to impacts from COVID-19. At the same time, for patients with severe chronic pain, opioids are clinically indicated, and provide meaningful relief from a life of constant pain that could otherwise be debilitating. For these individuals, prescribers are often challenged with adhering to CDC guidelines and state laws that limit opioid use while effectively treating pain, and this is especially true for patients who have been treated with higher doses of opioids for extended periods of time. 

The EHR Association’s Opioid Crisis Task Force has written a white paper to comment on the role that health information technologies, including EHRs, can play in assisting physicians with responsible opioid tapering.
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Shaping the Substance of MACRA: EHRA Comments Set Foundations for Success

Few, if any, health care payment and delivery initiatives underway promise to have as much impact on the nation’s shift from volume to value-based reimbursements, holistic clinical delivery, and overall system sustainability as the Medicare Access and CHIP Reauthorization Act (MACRA).

By establishing distinct and relatively complex delivery and payment tracks – the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) – programmatic vigilance and collaboration is needed by all healthcare stakeholders.

And with current and future healthcare information technology solutions a critical part of the equation – building upon similar public and private payer programs such as patient-centered medical home (PCMH) and accountable care organization (ACO) structures – the Electronic Health Record Association (EHRA) submitted detailed comments November 17 to the Centers for Medicare & Medicaid Services (CMS) in response to the agency’s MACRA request for information (RFI).

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EHRA’s Advice to ONC on Information Blocking

In October, we provided comments to ONC on its April 2015 “Report on Health Information Blocking”, in the spirit of collaborating to establish an environment where the right data can flow to the right party at the right time using a set of agreed-upon standards.  While some press coverage characterized our comments as negative (“…Prove It”), we in fact attempted to provide balanced feedback, recognizing that the first challenge is to come up with a definition of “information blocking” that everyone agrees on.

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When Health IT is Personal

Leigh Burchell, EHRA Chair and VP for Policy and Government Affairs for Allscripts, recently wrote about her own experience with health IT and how that has broadened her perspectives as both vendor and patient.  An excerpt:

“Recently…health IT has been personalized for me in an entirely different way, and I understand it from a new perspective. Thankfully, unlike many people who speak about the challenges they’re still encountering, my experience has largely been positive since becoming a breast cancer patient.”

Read the full post, “When health IT became personal: My journey with breast cancer” on the Allscripts blog.

 

 

 

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