Addressing Data and Information Gaps Contributing to Opioid Use Disorder

Big gaps in the exchange of data and information throughout the health care system are impeding efforts to address the opioid epidemic.

As a result of these gaps, patients in acute and chronic pain often lack access to good information about opioid alternatives to pain relief; clinicians do not have the information they need to prescribe approved opioids appropriately; and doctors, nurses, and others lack the ready information they need to refer patients to effective opioid use disorder treatment and social services to help with recovery.

NEHI urged federal and state policy makers and others to address these gaps through a series of measures, many relating to use of health information technology.  For example: 

• State-based databases, known as prescription drug monitoring programs (PDMPs), which are designed to capture information about opioid prescriptions, are not all connected to each other. Clinicians do not always have access to state PDMPs directly from their electronic health record systems, either. As a result, clinicians do not always have timely and accurate information about their patient’s pre-existing opioid prescriptions or have difficulty accessing that information in an efficient way. These gaps interfere with their ability to avoid overprescribing opioids to patients and minimize the likelihood of opioid use or abuse.
  
  In its policy brief, NEHI said that the state PDMPs should be required to share information with all other PDMPs and that electronic health records should link directly to the state monitoring programs. Increased federal funding and/or possible federal oversight of these programs should be tired to new federal requirements on state PDMPs so that medical, pharmacy, and public health professionals can better identify and prevent prescription drug abuse. 

• Electronic health records and clinical decision support systems need to incorporate federal opioid prescribing guidelines, so that clinicians know how to prescribe opioids appropriately; should provide clinicians with information that they can give to patients about non-opioid alternatives to pain relief; and enable clinicians to import patients' past prescription history directly into electronic health records from PDMPs.

• E-prescribing of opioid prescriptions -- sending them to pharmacies electronically instead of writing them out by hand or faxing them -- is woefully underutilized. E-prescribing eliminates the likelihood that prescriptions can be stolen or forged, but fewer than 1 in 5 prescriptions of opioids and other controlled substances is e-prescribed. Congress should direct the federal Drug Enforcement Administration to amend regulations that make it difficult for clinicians to e-prescribe opioids and other controlled substances.

Join NEHI’s Opioid Data Collaborative

Drawing on the findings from NEHI’s April 2018 convening of over 60 multi-sector stakeholders, including federal and state government leaders and NGOs, providers, payers, leading health information technology companies, and patient groups, NEHI has launched a collaborative, which would tackle the following topics to achieve better integration of information and improved patient care: 

• Creating greater consistency among state prescription drug monitoring programs(PDMPs) and developing national standards for reporting and use of opioid prescribing data in state PDMPs; 

• Establishing national interoperability standards around opioid use and prescription data nationwide among and across state PDMPs, health information exchanges (HIEs), and electronic health records (EHRs); 

• Improving the safety and security of opioid prescribing, as well as the capture of opioid prescribing data in state prescription drug monitoring programs, through e-prescribing of all controlled substances (EPCS); 

• Augmenting providers’ understanding of non-opioid alternatives to pain relief and facilitating patients’ access to them. 

NEHI will publish the collaborative’s recommendations with a call to action in a white paper or issue brief and will educate policymakers and other stakeholders on needed changes. If you want more information about the collaborative, please contact Lauren Choi, NEHI VP of Policy Partnerships at lchoi@nehi.net.