Lack of interoperability contributes to opioid epidemic

Nearly 115 Americans die each day from opioid abuse and misuse, according to the National Institute on Drug Abuse, and providers, pharmacists, and other healthcare stakeholders say a lack of interoperability is a big factor.

“Opioid misuse is a 21st-century epidemic and it demands forward-thinking, 21st-century solutions,” said Joel White, director of Health IT Now, a policy group comprised of health organizations and technology companies. Its 20-member Opioid Safety Alliance launched in January 2018, with a goal to strengthen health information technology to fight the opioid abuse crisis. 

“Together, we are fighting to strengthen our network of prescription drug monitoring programs with a facilitator that transmits information securely, in real-time, and captures data from across state lines. We are also working to reform privacy laws that, for too long, have kept doctors in the dark by isolating patients’ addiction records from the rest of their medical history,” White says.

Some of the member organizations include Aetna, athenahealth, IBM, McKesson, Verizon, and the National Alliance on Mental Health.

One versus many

White says the group is advocating for a facilitator model for a nationwide database that will track the real-time data of prescription drug transactions. Red flags to providers and pharmacists would prompt them to question patients on the spot before prescribing or providing them with addictive prescription drugs, including opioids. White says the cost of the database would be $100 million to $200 million and could be built within 12 months.

In January, White and other members of the Opioid Safety Alliance testified before the FDA to discuss the facilitator model and other ways technology should be used for prescribing intervention.

“A nationwide system that can be added to the current work flow and provide real time data is easier to accomplish than trying to get the current databases to connect,” White says. “Right now, there are different standards and different types of data for the databases that are set up at the state level.”

Currently, there are 49 state-level prescription drug monitoring programs (PDMP) that allow doctors and pharmacists to access controlled substance records in each state. The time interval when each state updates its databases varies from each day to once a month. Also, most databases don’t automatically exchange information with EHR systems, so users have to log out of their current systems to access them or create their own solutions to integrate them into work flow.

Forty-two state PMPDs are currently connected through the National Association of Boards of Pharmacy Prescription Monitoring Program InterConnect, but are still limited to providing data based on each state’s rules.

“Governance is also important. There is one state (Missouri) with no PMDP,” White says.

Next: Other tech solutions

Other tech solutions

The coalition is also pushing for telehealth and virtual peer support groups as part of substance abuse treatment reimbursed by Medicare, and more dollars behind emerging technology to connect patients to treatment resources.

“There is often a stigma connected to substance abuse treatment, and some people don’t want to go to the doctor office,” White says.

It also aims to reform 42 CFR Part 2 to allow for the appropriate sharing of patient substance abuse information.

“Healthcare providers need to have a complete view of a patient’s medical record,” White says. “We should be using artificial intelligence and blockchain technology to spot trends before they become problems.”