Topic: Opioid Crisis

The CHIME Opioid Task Force was launched in early 2018 with a straight-forward mission: to turn the tide on the opioid epidemic using the knowledge and expertise of the nation’s healthcare IT leaders. While our mission is straight-forward, achieving it is a complicated challenge. Opioid addiction is a complex disease that requires long-term, if not lifetime, care from well-informed clinicians who are supported with easy-to-use and reliable tools. The CHIME Opioid Playbook has been created by CIOs and CMIOs for CIOs and CMIOs to help them develop a program that will help their providers, healthcare organizations and especially patients be successful.

The playbook provides a framework to build IT-based supports for launching and maintaining system-wide initiatives to reduce the disease of opioid addiction in our communities. It is based on the knowledge, experience and insights from the diverse membership of CHIME and CHIME Foundation partners, with real-world examples, best practices and links to valuable resources. The playbook is tailored to CIOs and CMIOs who serve as members of their organization’s Opioid Stewardship Committee, but we expect that others will find it to be a useful guide to understanding technology’s role in creating a solution.

This playbook is a living document. It is designed to offer up-to-date IT-based leading practices for addressing opioid addiction. For instance, portions of this iteration of the playbook focus on reducing prescriptions of opioids to patients being seen in the hospital setting. By exposing fewer patients to opioids, or lessening exposure for those who will benefit from treatment, is likely to lessen the number of people who inadvertently become addicted. Later iterations may focus on the population of people who had become addicted and now need long-term care to help them remain addiction-free.

Many of today’s opioid success stories have a solid foundation of similar steps, which we compiled here. Each chapter is tailored to fit its specific purpose, but generally we describe the background for a specific component, provide real-world examples with keys to their success, offer guidelines for measuring success, key takeaways and links to resources. Yet every state, region and community are different and there is no one-size-fits-all solution. As you go through this process, we encourage you to identify the needs, strengths and opportunities within your own organizations and the communities you serve. You may find that certain steps work well for you while other steps need to be modified. You may discover an innovative solution that better fits your circumstances. We welcome hearing about your lessons learned and successes as you embark on this important work.

Thank you for joining us in our efforts to end the opioid crisis.

The CHIME Opioid Task Force   

The opioid epidemic has been named a national crisis for several years. The data for the city of Chicago, shows that in the neighborhoods surrounding Rush University Medical Center, the rates of opioid use disorder and opioid related deaths surpass city and national averages. In efforts of addressing the epidemic, on October 23, 2017, the Substance Use Intervention Team (SUIT) was launched in the Rush University Medical Center to provide a comprehensive program for substance use screening and treatment on the inpatient medical and surgical units as well as in an Addiction Medicine Clinic on Rush’s Campus.

This endeavor involve intensive and targeted utilization of the electronic medical record and interdisciplinary participation from inpatient nursing, hospital case management, pharmacy, and our own interdisciplinary Substance use intervention team and clinical staff. The admission navigator as well as flowsheets within the electronic medical record (EMR) were leveraged to seamlessly integrate non-bias screening questions to be asked of all individuals receiving inpatient care. This interdisciplinary endeavor is purposed to promote universal screening for all substance use, decease stigma and biases regarding substance use in the health care setting as well as support early intervention and efficient comprehensive care.

In addition to universal screening, Rush recognized the barriers to treatment that many patients and hospital staff encounter, such as access to care, affordability of comprehensive care, and education around addiction and addiction treatment. Rush addressed these barriers by opening an Addiction Medicine Clinic which is staffed by the same members of the inpatient consult team along with a full time licensed clinical social worker and medical assistant. The barrier of affordability is often a result of patients having inadequate coverage of mental health and addiction treatment from their insurance or having no insurance at all. The Addiction Medicine clinic helps to alleviate these barriers by being situated outside of psychiatry and providing free case management services. This program also created an education platform for patients and staff alike, allowing for staff training for motivational interview for inpatient social work, online modules for inpatient nursing, and patient education regarding medication assisted treatment and naloxone in the outpatient clinic.

As a result of this SUIT Intervention, Rush was able to improve the standard or care for substance use disorders across the medical center, identify a unique population in need of intervention and provide them with comprehensive care, increase communication between different types of clinicians and levels of care, provide access to the appropriate clinical care, and decrease the length of stay and readmission rates for individuals in this population.

We are excited to have been awarded an second year of funding from the Illinois Department of Human and Health Services to continue this initiative and are continuing to expand our reach by creating education programs to equip providers across the state with tools to continue to relentlessly fight this epidemic.

Niranjan Karnik, MD, PhD, is the Cynthia Oudejans Harris, M.D., Professor and Vice Chair for Innovation in the Department of Psychiatry at Rush Medical College and a conjoint faculty member in the Department of Community, Systems and Mental Health Nursing at the Rush College of Nursing

Kristin Hill, MA is the Practice Administrator for the Section of Population Behavioral Health in the Department of Psychiatry at Rush University Medical Center

With over 42,000 opioid induced overdose deaths in 2016 and overdose deaths rising 21.5% from the year before, the opioid epidemic has gripped the nation with many Americans suffering. Since the President declared the opioid crisis a national Public Health Emergency in October of 2017, the federal agencies and Congress have been busy working on solutions to help bend the curve of opioid addiction. In October of 2018, following months of hearings and the introduction of dozens of bills, Congress passed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (H.R. 6) which authorizes new techniques and programs to end the crisis, many of which involve healthcare IT. Please join the CHIME Public Policy Team as we dive into the comprehensive legislation and offer an overview of those sections of most interest to our members. Topics covered will include patient consent policies, telemedicine, prescription drug monitoring programs (PDMPs) and ePrescribing, among others. Mari Savickis, VP, Federal Affairs at CHIME
Leslie Krigstein, VP, Congressional Affairs at CHIME

“The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. Part one of the series proposed a strategic framework for evaluating and pursuing technical solutions. Part two explored technologies that enhance situational awareness. Part three tackled clinical decision support for opioid management.”

The Electronic Health Record Association (EHRA) is committed to bringing leaders
from our EHR developer community together to collaborate on solving industry
challenges. In 2018, the Association’s Opioid Crisis Task Force was formed to
research and provide recommendations on ways EHR technology can help with
solving the complex puzzle of the opioid crisis. One area that the Task Force has
researched is clinical practice guidelines that can be operationalized to improve
opioid stewardship in clinical practice.

The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. Part one of the series proposed a strategic framework for evaluating and pursuing technical solutions. Part two explored technologies that enhance situational awareness.

The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. Part one of the series proposed a strategic framework for evaluating and pursuing technical solutions. In this article, we will explore situational awareness as part of the strategic framework.

“The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. In this article, we propose a strategic framework for evaluating and pursuing technical solutions. Future articles will explore specific areas and solutions within this framework.”

Medical pain management is in crisis: from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care has prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC.

Cindi Scheib wanted to die.

A three-day weekend spent jumping and dancing on Labor Day 2014 had left her with a neck injury – specifically the cervical spine – that was possibly an exacerbation of an unrecognized mountain biking injury earlier that year. To make matters worse, her doctor performed the surgery to fix the injury on the wrong part of her spine.