Jun 22 2017

Health IT’s Role in Curbing the Opioid Crisis

As overdose-related death rates continue to rise, states and hospitals call on new tools to monitor painkiller abuse and better deliver resources to those in need.

The opioid epidemic is on the rise. Government data published June 20, which surveyed opioid-related hospital visits between 2005 and 2014, revealed a 64 percent uptick in inpatient care and a doubling of opioid-related emergency room visits.

Of the 30 states involved in the study, Maryland topped the list as the hardest hit by the epidemic. A state report released in June found that opioid-related deaths had nearly quadrupled since 2010.

“We see overdoses in all ethnic groups, in all Zip codes,” Leana Wen, Baltimore City’s health commissioner, told the Washington Post. The city is one of the hardest hit by the issue, seeing nearly two deaths a day from drug- and alcohol-related overdoses in 2016.

As a response, Gov. Larry Hogan declared a state of emergency in March and committed an additional $50 million to fight the crisis. Five other states have also declared states of emergency in response to the crisis, including Arizona, Alaska, Florida, Massachusetts and Virginia.

As hospitals struggle to manage the influx and states seek ways to quell the crisis, many are turning to technology to better deliver services to those seeking help for addiction.

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GIS Helps Guide Kentucky Communities to Resources

In northern Kentucky, for example, where five times more citizens died from overdoses than car crashes in 2015, the county’s Northern Kentucky Health Department turned to geographic information systems (GIS) to battle the epidemic. The county’s Heroin Impact Response Team (HIRT) launched a story map in October 2016 that has proven to be instrumental in using data to bring resources to those impacted by the epidemic; it has also created a more informed public.

“Citizens can look through the map and see how it is really impacting their neighborhood. How often police are responding to drug-related activities in their area. How are emergency medical services responding; what’s going on with overdoses and hospitalizations; how long people in your area have spent in a hospital for addiction, etc.,” said Ned Kalapasev, the agency’s GIS manager, in the StateTech article, noting that the opioid-related arrest rate skyrocketed between 2011 and 2015. “You can really see how it affects your area rather than just thinking that it’s not your problem.”

Drug Monitoring Programs Look to Spot Doctor Shopping

In April, the Missouri Senate approved legislation that made it the last state in the union to implement a prescription-drug monitoring program (PDMP). These programs are taking hold in several states as a way to identify patients that may be seeing multiple doctors for the same drug.

The tool allows doctors to tap into a state database of federally controlled substances to check patients’ medication histories alongside their use of other drugs, such as sedatives and muscle relaxants, to determine whether they’re at risk of addiction or overdose, Stateline explains.

For instance, after implementing a monitoring program in Florida, the state saw a 50 percent drop in deaths related to oxycodone overdoses. Kentucky was the first to implement a PDMP and saw a significant drop in controlled substance use in the first year, analysis by the University of Kentucky’s College of Pharmacy found.

Taking its PDMP one step further, Virginia Gov. Terry McAuliffe announced a $3.1 million grant from Purdue Pharma to set up a sophisticated new tool as part of the state’s monitoring system that connects the PDMP with electronic health records. The aim is to make the system easier for doctors to use.

The Bayview Physicians Group in Tidewater, Va., is the first to try the new tool, called NarxCare, which aids doctors looking to identify those at risk of addiction or overdose by providing visuals, such as graphs and risk scores, alongside a quick summary of the patient’s prescription history.

“[Prescribers] can see at a glance whether they want to slow down [prescriptions],” David Brown, the director of the Virginia Department of Health Professions, told Williamsburg Yorktown Daily. He added that other clinicians are lined up to employ the technology as well. “It gives you a tool to show you if the person is doctor shopping or is already addicted. It will tell you if prescriptions are being dispensed at different pharmacies.”

With the goal to provide PDMP program data for 18,000 prescribers and 400 pharmacies in Virginia by the end of the year, the state is anticipating a drop in opioid deaths.

IBM’s Watson Tracks Those Most at Risk for Addiction, Relapse

Building off of these databases, IBM Watson could soon help sift through patient data and identify those at the greatest risk for relapse. Through a new partnership with MAP Health Management, the solution aims to “fill the current gap in long-term care” identifying those most at risk and then deploying treatment and intervention resources.

“The actionable data that should be guiding the patient’s treatment experiences are being siloed and their full story is often out of the reach of providers. There is much unstructured data in counseling session notes and tremendous value in understanding what a patient is experiencing. Currently, the unstructured data just sits there, but MAP’s collaboration with IBM Watson Health gives MAP the capability to derive meaning from it and mobilize that data to optimize the patient’s experience,” explained Jacob Levenson, founder and CEO of MAP Health Management, in a blog post on IBM Think.

Levenson told StateScoop that Watson will look at clinical data, diagnostic histories, behavioral health data and medication adherence, running it through an algorithm that can determine individual risk.

The greater aim is to tip the tables toward policy that allows for better treatment.

"Criminalizing this is further exacerbating this problem," he told the site. "We're greatly disadvantaging these people ... and I think it's up to the system — the health care system, legislators and society at large — to take away the stigmas that push people back to addiction."

Ben Goode/Thinkstock

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