The healthcare industry is all too familiar with the opioid crisis, which is having a pervasive, devastating effect on the country. Prescott, Arizona, home of Yavapai Regional Medical Center, is no exception.
Yavapai Regional provided care to seven neonatal abstinence cases, seven fatal overdoses and 138 non-fatal overdoses during the first year it began tracking and reporting these cases to the state registry (June 2017 to July 2018).
“Our organization was motivated both by a desire to more effectively and safely manage opioids in our patient population and by the need to keep pace with state law requiring advanced access to opioid utilization data for our patients across the spectrum of care delivery,” said Dr. Ronael Eckman, chief medical information officer at Yavapai Regional Medical Center.
“Prior to this implementation, our providers’ only option was to log into a separate website to the state PDMP and manually search for the patient.”
"There were 3,826 reports accessed for the three months prior, and 4,566 reports accessed for the three months post. This represented a 20% increase in PMP report utilization."
Dr. Ronael Eckman, Yavapai Regional Medical Center
This was time-consuming and frustrating for providers, and fraught with the challenges of having to maintain (and recall) separate logins and passwords and to have to key in patient data hoping to make a successful manual patient match to be able to view the data crucial to effectively manage patients with chronic or repeated opioid use.
“Our specific goals for this project were to: One, save providers time; two, increase utilization of the Prescription Drug Monitoring reports; and three, decrease overall opioid prescriptions,” Eckman explained.
The proposal involved the option to have an embedded link within the provider workflow to allow them to open the Prescription Drug Monitoring data for controlled substance prescribing and fill history. Yavapai Regional turned to its EHR vendor Cerner for the answer.
There are many vendors with electronic health records systems on the health IT market today, including Allscripts, Cerner, eClinicalWorks, Epic, Greenway Health, HCS, Meditech and NextGen Healthcare.
MEETING THE CHALLENGE
Yavapai Regional adopted the Cerner integration to enable providers to access the PMP data directly from their existing workflow within the EHR. This allowed them to avoid the tedious tasks of manually launching a separate website, recalling and entering the login and password, and manually searching for the patient.
Provider credentials are automatically validated in the new integrated workflow, patient demographic data is automatically passed and the patient is matched through the interface. This means that providers now can view the critical data with a single click.
Yavapai Regional gathered time-study data for the first month after integration implementation. For 296 providers, the organization had 1,561 total views of the PDMP reports. This represented 42.2% of the organization’s total providers viewing a PDMP report at least once.
The time study showed the old workflow took an average of 144 seconds to view the report. The new, integrated workflow takes 10 seconds. This resulted in a total time savings of 58 hours across the organization.
“We reviewed total access data from the state pharmacy board for our providers accessing the PMP reports for the three months prior to our implementation and the three months post,” Eckman noted. “There were 3,826 reports accessed for the three months prior, and 4,566 reports accessed for the three months post. This represented a 20% increase in PMP report utilization.”
Yavapai Regional also obtained data from the state pharmacy board about the total number of controlled substance prescriptions for the three months pre and post. The organization had 11,326 total prescriptions for the three months prior and 10,637 prescriptions for the three months post, reflecting a 6% decrease.
ADVICE FOR OTHERS
“The benefits of integrating access to controlled substance prescribing and fill data into the provider’s workflow and eliminating manual login and patient search were immediate and profound,” Eckman advised. “We strongly recommend this type of integration for all providers managing controlled substances and using an electronic health record.”