ONC to help fight Rx drug abuse

Developing standards to bring prescription info from state databases into EHRs and HIEs
By Mike Miliard
11:27 AM

In an effort to combat the prescription drug abuse epidemic, the Office of the National Coordinator has launched a new interoperability initiative to better link drug monitoring programs with health IT systems.

In a blog post, Jennifer Frazier, ONC's behavioral health subject matter expert, says the new Standards & Interoperability Framework Initiative seeks to solve problems related to the lack of common technical standards and vocabularies that could help prescription drug monitoring programs "share computable information" with health IT systems.

The PDMP & Health IT Integration framework "will bring together the PDMP and heath IT communities to establish a standardized approach to retrieve data stored in the PDMPs and deliver it to EHRs and HIEs," Frazier writes.

Finding a better way to give care providers easy access to PDMP data "can't happen quickly enough, as clinicians across the country struggle to fight a growing national public health crisis," she adds. "Opioid painkillers, such as hydrocodone and oxycodone, are typically the most abused drugs. Patients are prescribed these drugs to help manage pain from injury or surgery. When taken as prescribed, these medications are generally safe; but when misused or abused, they can be highly addictive – even deadly."

Indeed, Frazier notes, CDC data shows that 15,000 people each year die from overdoses involving prescription pain killers – a rate that's more than tripled since 1999, surpassing automobile accidents as the nation's leading cause of accidental deaths.

PDMPs are state-run electronic databases that track the prescribing and dispensing of controlled substances. When made available at the point of care, that data can help clinicians distinguish between patients who legitimately need opioid medications and those who may be seeking to misuse them.

Still, "while PDMPs can serve as a valuable tool, most clinicians typically don't use them," Frazier writes. "This is largely because they have been cumbersome or time consuming to access (especially when outside of a clinician's normal prescribing workflow)."

Health IT can helps improve access to to that data. For example, she points to Indianapolis-based Wishard-Eskenazi health system, where prescription drug databases were accessed infrequently, thanks to the added work it entailed.

"To examine how health IT could optimize this process, ONC commissioned a pilot to use health IT to integrate PDMP data directly into the clinical workflow," Frazier writes. "For Wishard, this pilot equipped emergency department staff with the ability to automatically search the state's PDMP database without adding steps to the patient admission process and enabled PDMP data to be available in the patient's EHR at the point of care.

"Using health IT to connect clinicians to PDMP data saves time and energy," said John "JT" Finnell, MD, an emergency physician who participated in that pilot. "It's a 'one-stop shop' for clinicians who are looking for the medical and prescribing history of patients. Instead of having to manually log on to multiple databases, the pilot's connection provided seamless interaction with health data and quickly 'fetched' pertinent prescription information.

"For patients who suffer from substance abuse, PDMP data helps doctors spot drug-seeking behavior," he said. "It allows us to compare the prescribing record to the patient's story, because sometimes they don't match up."

[See also: DEA: They want a new drug]

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