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EHRs might help suppliers extra safely taper affected person opioid use

Electronic well being data can play a significant position in protected opioid tapering for sufferers who’ve relied on the treatment to deal with continual ache, says a brand new HIMSS Electronic Health Record Association white paper compiled by Dan Seltzer and the EHRA Opioid Crisis Task Force.

For sufferers with continual ache, opioid use is clinically indicated, and may present efficient reduction. 

Governmental {and professional} pointers suggest gradual opioid-dose discount for sufferers taking greater than 90 morphine milligram equivalents every day when opioid unwanted effects turn into unmanageable, when the opioid use is not efficient or when suppliers are involved about substance-use dysfunction or overdose.

“EHRs are the pure platform for physicians to provoke, observe and preserve opioid tapering plans,” say the paper’s authors. 

WHY IT MATTERS

Rapid opioid withdrawal can current extreme, typically life-threatening signs in sufferers. Instead, suppliers ought to cut back dosage in sufferers who want tapering 5% to 20% each 4 weeks. 

Still, tapering presents a problem for a lot of suppliers. Since each affected person has totally different wants, the EHRA paper authors word {that a} extremely customizable plan for tapering is commonly required.

“The EHR ought to present versatile instruments that allow suppliers to individualize remedy plans and adapt remedy over time primarily based upon the affected person response,” the authors word.

The first step, the EHRA says, is to make sure that amenities have applied opioid stewardship applications that make use of EHRs.

Then, suppliers can use digital instruments resembling morphine milligram equal calculations, robotically generated tapering schedules, clinical-decision help selling non-opioid remedy alternate options, specialised doctor notes, evidence-based order units monitoring unwanted effects and screening assessments for withdrawal signs, with a view to safely and successfully taper a affected person’s opioid use. 

The EHRA paper additionally proposes a number of EHR developments that would additional enhance remedy, resembling predictive fashions to spotlight potential tapering candidates, detailed MME graphic and monitoring throughout the chart, price controls to generate plans primarily based on affected person circumstances, early warning techniques for withdrawal, patient-facing views of the taper calendar and determination help on dose changes.

“These options must be versatile sufficient to accommodate supplier judgement whereas additionally simple and inclusive of medical pointers,” write the paper authors.

THE LARGER TREND

The opioid disaster within the United States has spotlighted the issues with over-prescription and punitive responses to substance-use dysfunction. Providers who deal with sufferers with continual ache additionally face challenges adhering to federal pointers and state legislation round opioid prescriptions. 

EHRs and different applied sciences can act as essential instruments for implementing clinically indicated opioid remedy. In beforehand revealed supplies, the EHRA has famous that suppliers can incorporate ache and useful targets into care plans, chart shows and different stories by way of EHRs.

Clinicians can even use “EHR analytics to watch and enhance adherence to opioid remedy agreements for continual ache populations, in addition to [to monitor] compliance with regulatory necessities,” the EHRA suggested in a CDC Opioid Guideline in 2018.

Other hospital executives have relied on automated affected person alerts, telehealth and steady digital monitoring of patient-controlled analgesia to cut back opioid misuse and dependancy. 

ON THE RECORD

“With the opioid disaster nonetheless unresolved and the COVID-19 pandemic making sufferers extra weak to opioid misuse, the necessity is pressing for the digitization of the opioid tapering plan, and organizations can act now to create, develop, and implement this resolution,” write the paper’s authors. 

“In the long run, there are a lot of thrilling new frontiers in EHR improvement that may advance this course of and might help suppliers to steadiness safer, proof primarily based, and equitable use of opioids with patient-centric care plans,” they proceed.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.



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