April 25, 2018
Combating the Opioid Crisis, Together
DrFirst’s technology is being increasingly used across the country to fight the opioid epidemic by giving prescribers the tools they need to identify patients who are addicted, or at risk of becoming addicted, to these dangerous drugs. On March 16, Maryland Lieutenant Governor Boyd Rutherford, who heads Governor Larry Hogan’s Heroin and Opioid Emergency Task Force, visited our Rockville, Md., headquarters to talk with healthcare leaders focused on solving this epidemic and to see a demo of our solution that makes opioid prescribing safer and compliant with Maryland’s coming prescribing mandate.
Maryland Makes the Leap
Rutherford’s visit came as Maryland prepares to implement new policies to address that crisis. On July 1, Maryland will join 40 other states in requiring prescribers to check the database of the state’s Prescription Drug Monitoring Program (PDMP) before they prescribe controlled substances to patients. Maryland will also become the 26th state to allow data on patients’ prescription opioid histories to be accessed in providers’ e-prescribing workflow, using DrFirst’s PDMP tool. DrFirst has been working with CRISP, the state health information exchange, which administers Maryland’s PDMP, to enable physicians to see this data when they are prescribing controlled substances.
Addressing the Opioid Epidemic’s Top Issues
At our meeting with Lt. Gov. Rutherford, we discussed a range of issues, starting with the need to make it easy for doctors to access PDMP data. Jim Chen, CEO, and founder of DrFirst pointed out that prescribers normally have to exit their EHR workflow to access their states’ PDMP websites, log in, then enter the patient’s identifying information in order to view their controlled drug histories. Brandon Neiswender, COO of CRISP, said that many Maryland doctors will not take the time to leave their EHRs to check this data on the PDMP portal, even when they’re required to do so. He stressed the importance of making sure that providers can access the data directly from their workflow.
We also discussed the issue of physician overprescribing and what to do about it. CRISP maintains information on how often doctors check the PDMP database, but Neiswender said that CRISP has not been asked to make that information available to prescribers or anyone else. Gary Pushkin, MD, president of MedChi, indicated that, as a provider, he’d like to see this data on a monthly or quarterly basis to find out whether anyone has been prescribing opioids in his name.
Kate Jackson, PMO and policy director for the Maryland Department of Health, agreed with Dr. Pushkin, but also noted that PDMP data could be used to allow doctors to compare their opioid prescribing patterns against those of similar cohorts of physicians in the state. Rutherford agreed that this analysis could be helpful in educating doctors about their prescribing habits.
The participants noted that it is important to educate doctors who overprescribe opioids, rather than punish them. Any education program should not “spook” doctors and cause them to stop prescribing opioids, potentially forcing patients to seek even more dangerous street drugs.
Collaboration is the Key
The topics we discussed with the Lt. Governor are pivotal to making PDMPs effective in balancing tighter controls on opioid prescribing with compassionate and effective patient care, but the real inspiration for me was having such a broad stakeholder group speaking with one voice about how to work together on impactful strategies in the fight against over-prescribing and inappropriate use of opioids. With representatives from CRISP, MedChi (the Maryland medical society), the University of Maryland School of Dentistry, the Maryland State Department of Health (manager of the PDMP), and the Maryland Governor’s office, Maryland is an example of true and broad stakeholder collaboration toward a singular goal.
I walked away inspired and hopeful that Maryland’s collaborative efforts will powerfully impact our generation’s latest – and perhaps most destructive – epidemic.