Opioid crisis: Transitioning care through a paradigm shift

April 6th, 2018 / By Michael Denton, RN

The opioid crisis has far reaching and long lasting effects, and the problem is scaling up exponentially. In 1980 there were 8,000 opioid related overdose deaths. By 2016, the United States had seen over 60,000 deaths due to opioid overdoses, a 525 percent increase. A nurse by trade, I am eager to learn how organizations and legislators are working to find solutions for this pandemic. As a Utahn, I am concerned that Utah ranks top ten in the nation for the highest mortality rate associated with opioid overdoses, increasing by 18 percent from 2015 to 2016 alone.

I recently participated in Utah’s Healthcare IT Day as an advocacy committee member of the Utah chapter of the Health Information Management Systems Society (UHIMSS). Titled “A Holistic Approach to the Opioid Crisis,” the event focused on how information systems and technological solutions can help in the fight. Our introductory speaker, Mikelle Moore, Senior Vice President of Community Health for Intermountain Healthcare, noted that Utah taxpayers are currently spending $237 million dollars per year on individuals experiencing opioid misuse. This gave me reason to be optimistic yet concerned, knowing that Utah recognizes the problem and is invested in finding a solution, but how?

Next, Dr. Benjamin Zaniello, Chief Medical Officer and Vice President of Product at Collective Medical, presented on alternative therapies and the need for preventative practices. This gave me an in depth understanding of some of the problems causing the opioid crisis from a provider’s perspective. Preventive practices require proactively identifying high risk individuals, repeat offenders, and sharing healthcare data across information systems. Enhancing data interoperability across multiple systems and increasing access to health information will improve a provider’s ability to assess, schedule and prescribe patient therapies. Towards this goal, the Utah Health Information Network (UHIN) discussed its effort compiling a unified Master Patient Index (MPI), and Utah’s Controlled Substance Database (CSD) presented a tool that would allow providers to view current and historical opioid prescriptions statewide. However, to maintain patient confidentiality, providers request access through an external source, and the CSD tool provides de-identified patient information. Thus, the tool by itself may not be able to target individual patients who may be at risk, without cooperation from the patient to verify the identification. Nevertheless, it is a useful resource and a great starting point.

The fight to eliminate the opioid crisis is just beginning. Healthcare will need to focus on preventative measures. Data interoperability will be pertinent to creating solutions with the help of technology, such as machine learning using algorithms capable of analyzing patient behavior across comparisons, triggering alerts, and screening for patient risk factors. Many challenges will continue to present themselves, but I am confident after attending this event that our community recognizes the problem. The ideas proposed during the event will require development and maturation, and significant research and funding are needed, as are interim measures to address the problem in the short-term.

Michael Denton, RN, is a clinical data analyst with the 3M Healthcare Data Dictionary (HDD) team.