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