#ViVE2022 panel addresses opioid epidemic

The new ViVE 2022 healthcare information technology conference now taking place in Miami Beach is a giddy whirlwind of delegates taking maskless selfies after surviving 2-years of COVID-19 lockdown.

This merger of meetings from the College of Health Information Management Executives (CHIME) and the HLTH digital marketplace offers fluorescent colours and images, breathless pitches from healthcare start-ups and seemingly endless repetitions of health IT’s current favourite buzz words and phrases (‘transformation’, ‘value-based care’ and ‘equity’ ranking high on the list).

But it also offers sessions where respected clinicians discuss how digital health can be brought to bear on some of North America’s most significant healthcare issues – the opioid epidemic being a prime example.

On the first day of ViVE, a panel of five experts provided an update from the front-lines on an epidemic which took 100,000 lives in the US in the last year, an increase of 28.5% over the previous year. One of the panelists, Dr. Scott Weiner, chief of health policy and public health at Brigham and Women’s Hospital, Boston noted the number of overdoses associated with opioids has risen over the last two years even though the number opioids being prescribed has actually dropped significantly – pointing to the impact of the COVID-19 pandemic – and mental health issues associated with being isolated.

While acknowledging the role fentanyl and the illicit supply of synethic opioids is currently playing in the pandemic, much of the presentation at ViVE focused on how digital health is helping encourage and monitor appropriate prescribing in acute-care settings post-surgery.

Patricia Lavely, VP and Chief Information and Digital Officer in the Health District of Palm Beach County, described reported results from a CHIME survey of these opioid-use reduction technologies and strategies.

The results from 2021 showed that:

  • 100% of organizations had electronic prescribing of controlled substances
  • 92% had order set maintenance to offer non-opioid options
  • 90% had an eprescribing modules connected to the State or regional Prescription Drug Monitoring Program (PDMP)

Other data from the survey showed organizations reported that this eprescribing connectivity had the highest impact on opioid-use reduction. It was also noted that CHIME has an Opioid Task Force to offer resources for its members but many hospitals were not yet taking advantage of all the health IT tools available and doing all the “easy things” they could do to help deal with this issue.

Lavely said despite the use of technology and electronic health records, opioid overdose deaths continue to rise at a “horrific pace” and that much more needs to be done to identify at-risk patients and those with an opioid use disorder.

Panelist Dr. Matt Sullivan, chief information officer at Atrium Health, noted that while health informatics specialists have huge amounts of data on patients in association with opioid use more needs to be done to analyze and share what can be learned from this information.

A discussion of existing patient risk scores concluded their usefulness was limited because they depend on patients giving honest answers and also fail to take into account many other variables besides prescription drug use associated with the risk of having a substance use disorder.

Panelists acknowledged the importance of harm reduction and especially the use of naloxone to reduce opioid deaths and also said more must be done in healthcare institutions to reduce the stigma against drug use.

“One thing we can take away from this session (on the opioid epidemic) is that harm reduction and naloxone will save lives,” said Dr. Sean Kelly, chief medical officer of WELL Heath and moderator of the session.

It was acknowledged at the start of the session that many patients need adequate pain relief and may fail to obtain it. But as panelist Dr. Greg Polston, chief informaticist and associate medical director UC San Diego Health noted more than once, misprescribing opioids is something that can lead to a clinician losing their license.

Overall it was noted that while clinicians and those working in health IT are doing a lot to help deal with the opioid epidemic more can be done even though many of the variables involved remain out of their control.

Opioid Panel at ViVE 2022

Something is happening here … #HIMSSEurope18


You try so hard but you don’t understand
Just what you will say when you get home
Because something is happening here but you don’t know what it is
Do you, Mr. Jones?

                                             Ballad of a Thin Man: Bob Dylan

The problem with a Health Information Management Systems Society (HIMSS) meeting – any HIMSS meeting – is that there is so much going on at one time that it is impossible to craft it into one coherent narrative.

That is the challenge with HIMSS Europe 18 currently underway here in Sitges near Barcelona, Spain as hundreds gather to discuss the latest in digital health and health information technology and to network, network, network. And it’s doubly challenging as this meeting is being held in conjunction with Health 2.0, the health innovation conference recently purchased by HIMSS.

(Now wait a minute, wait a minute you say – you get to go all the way to a resort hotel in Spain, with a clothing optional beach within 5 minutes walk, where they serve wine at the some conference buffet luncheons, only to cop out and say you can’t write coherently about it. Patience please).

As a social media ambassador here and lively live tweeter I can supply you with an endless number of insightful tweets or sound bites from just the first 24 hours. For example:

“We have gone from a paper world to a digital world in a short period of time”: Dr. Robert Wachter

“There is a lot of tokenism in health(care) innovation, and some think you can change or even fix health(care) overnight. It is not about technology, nor about the process, it is about changing the culture of an organization”: Lucien Engelen

“Pay patients and value them as the experts that they are”: Marie Ennis-O’Connor

But while I think these tweets provide a useful running commentary of the meeting they – and even the twin meeting hashtags #HIMSSEurope18 and #health2con – provide only a partial and episodic picture of what is going on.

Individual presentations or sessions are also noteworthy. For instance I have never heard as passionate a presentation supporting the role of nurses in the future digital world as that given by Angelien Seiben and Shawna Butler from Radboud University Medical Center. And Dr. Jordi Sorreno Pons a GP and CEO of the Universal Doctor app jammed so many ideas into his 8 minute presentation on future developments in medical innovation that it was almost incomprehensible.

The big subject areas – patient engagement, big data, artificial intelligence – are all given their own sessions or streams here.  But in the time available they tend to focus on specific projects or regional initiatives.

Certain things have changed from HIMSS or eHealth meetings held 15 or 20 years ago. The digitization of patient records is now a reality and not a vision and patients are not only discussed but included (#patientsincluded) as presenters in their own right.

But as to what all of this means for the future of digital health in Europe or worldwide – we are too much in the moment to have a clear picture given the complex nature of health systems and the endless number of variables that impact such systems.

For the numerous people here with an start-up to promote or an niche application to profile the meeting is a far simpler place.

(This is the first of what we hope will be a series of posts from Sitges)

#Ehealth2016 – inquiring minds want to know


ehealth_ambassadors_badge_300x300Canada’s premier conference on health information technology – #ehealth2016 – is now less than a month away.

That means it’s a good time to start to contemplate some of the big questions facing the health IT community in Canada and wondering whether this mega-meeting hosted in Vancouver.\, courtesy of COACH, Infoway and CIHI will provide any answers to these questions.

At its worst, this annual meeting can be an annoying combination of sometimes irrelevant keynote speakers and simultaneous sessions that do not live up to their titles/abstracts. But over the past decade e-health (however one chooses to write the name – hyphen, no hyphen, capital on ‘e’ or no capital on ‘e’ etc.) has become THE meeting for those interested in health IT to network, hear leaders in the field and gain insights into really interesting work going on at local/regional and provincial/territorial levels.

As an observer, I would suggest a few interesting questions this conference may help to provide answers for:

  • With the death or evolution of the big dinosaur programs for funding physician EMRs (POSP, PITO etc.) what is being done to continue to involve and engage physicians in improving how they use electronic records to improve care?
  • What is Infoway planning on doing with its new infusion of funding courtesy of the last federal budget?
  • Is patient engagement a thing in Canada in health IT and if so what does it mean?
  • Is the vendor space for EMRs and EHRs going to continue to consolidate ?
  • And that interoperability issue – is anything substantive happening to better connect physicians and hospitals.
  • Big data. (enough said).
  • Are hospitals and practitioners adapting to the mobile revolution in health?
  • Are these the correct questions to be asking? At HIMSS this year there was a big shift towards discussing digital connectivity beyond the electronic record and major discussions about data security in health. Should Canada be having those discussions too.

Inquiring minds want to know.