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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Privacy and Security, and Building Patient Trust

Earlier this year, ONC published an updated “Guide to Privacy and Security of Electronic Health Information” to help healthcare providers and ambulatory practices understand existing federal law on protected health information (PHI).  It provides guidance on how providers can use certified electronic medical record technology (CEHRT) to provide secure communications with their patients and, via secure and interoperable health IT, share patient data with other care providers.

There is a great deal of practical information provided in this guide that helps explain who is and who is not a business associate (BA), per the HIPAA regulations.   It also provides clear guidance as to when it is permissible to disclose PHI, when patient authorizations are required, and how to provide patient access to their health information.  In addition, there is a useful section on general cybersecurity explaining the threat of cyber-attacks, the use of mobile devices, and email and texting among providers and their patients.

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