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Communities Tackle Opioid Abuse with EHRs, Population Health

Lawmakers and activists are leveraging population health management strategies to combat opioid abuse in their communities.

Opioid abuse and population health management

Source: Thinkstock

By Jennifer Bresnick

- The opioid abuse epidemic continues to ravage communities across the nation despite increased attention to physician prescribing habits, unauthorized drug access, and population health management strategies intended to reduce misuse of addictive substances.

With tens of thousands of deaths each year directly attributed to prescription opioids and related street drugs, local activists, healthcare systems, and government officials are starting to mobilize in an effort to safeguard at-risk patients, identify and treat those with addiction problems, and develop different strategies for treating chronic pain.

“The reality is that this threat is rapidly escalating,” said Maryland Governor Larry Hogan as he signed an executive order declaring a state of emergency that would allow him to free up resources to combat the problem. 

The Washington Post reports that he is seeking $50 million over the next five years from the state budget to address prevention and treatment in Maryland.

In Alaska, Governor Bill Walker is aiming to reduce the development of opioid dependence by limiting outpatient prescriptions to a seven-day supply, with certain exceptions.  Healthcare providers would be required to take additional education on opioid prescribing and increase their reporting to the state prescription management database.

READ MORE: Addressing Opioid Abuse with Analytics, Population Health Strategies

Even veterinarians would need to register for the reporting system to prevent consumers from abusing opioids prescribed for their pets.

In Missouri, the only state in the nation without a statewide electronic prescription monitoring program, new population health management strategies are in development.  Members of the state senate is hoping to pass a bill that would create a new program under the auspices of the state pharmacy board that would promote safer use of painkillers.

Funding under the legislation could not be used to develop an electronic database, says CBS St. Louis.  The effort to create a regional tracking system has stalled in the state due to privacy concerns.

The Department of Veterans Affairs may take the opposite approach, however, and drastically improve the sharing of electronic health records between VA facilities and community health providers. 

Senator Joe Manchin (D-WV) has introduced the Vet Connect Act of 2017, which would eliminate the need for veterans to provide written consent to the VA in order to share records with community provider organizations.  Providers would still need to meet HIPAA requirements for data sharing, however.

READ MORE: Big Data Analytics Cuts Medicaid Opioid Abuse, Ups Patient Safety

“We have a responsibility to our veterans to provide safe and effective pain management services and end the scourge of prescription drug addiction that too often overcomes them,” Senator Manchin said. 

“More than half a million VA patients are abusing opioids and VA patients overdose on prescription pain medication double the national average. While the VA has implemented programs to reduce opioid prescriptions and instituted some safety measures, it is obvious that more needs to be done. This commonsense legislation will help remove red tape that is preventing veterans from receiving the care they need.”

Manchin previously introduced the Budgeting for Opioid Addiction Treatment Act in 2016, which proposed a one cent tax on every milligram of active opioids sold in the country.  The bill was referred to the Senate Committee on Finance in May of 2016 and has not advanced since.

In Massachusetts, government efforts to reduce opioid dependence are being bolstered by a record private gift to Boston Medical Center (BMC).  Eilene and John Grayken have donated $25 million to establish a new center for addition medicine, which will engage in research, education, and clinical programming to prevent and treat substance abuse.

“The new Grayken Center for Addiction Medicine will further elevate Boston Medical Center as the national leader in community-based addiction medicine and harm reduction programs,” said Senator Edward Markey (D-MA).

READ MORE: CMS Releases Medicare Opioid Prescribing Maps, Data Resources

“If we are going to reduce the supply of the opioids devastating our communities in Massachusetts and beyond, we have to reduce the demand through treatment. This new center will make that possible by developing and disseminating the most effective new models of care. This donation from Eilene and John Grayken is helping shed light on a disease normally cloaked in the shadows, and I thank them for raising awareness of opioid abuse and addiction with this historic contribution.”

Clinicians and researchers at Boston Medical Center were among the first to integrate primary care providers into addiction treatment, developing a program that has since been replicated in 35 other states.  The program also includes tailored options for special needs populations, including pregnant women and teenagers.

An associated initiative that connects inpatients with addiction services has reduced ED visits for those vulnerable patients by 30 percent, a press release added.  BMC also provides clinical training and addiction medicine residency and fellowship programs to educate clinicians about the treatment of chronic pain.

“Boston is well-established as the epicenter of medicine and healthcare, where groundbreaking research occurs and where the best and the brightest clinicians train and practice,” said Boston Mayor Marty Walsh. “In addictions and recovery medicine, Boston Medical Center provides international leadership, pioneering innovative and effective new treatments. This impressive gift will accelerate our battle against addiction, support recovery efforts, and allow BMC to keep doing what they do best."


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