Essays

Essays October 2018

How Safe Prescribing Through EMRs is Helping Address the Opioid Crisis

OntarioMD

It is no secret that Canada is experiencing an opioid epidemic. According to the latest numbers published by Health Canada, more than 3,800 people died from opioids in 2017 compared to 2,978 in 2016. That is an increase of 28% over one year! According to a report published by Health Quality Ontario, 9 Million Prescriptions, 1 in 7 Ontarians filed an opioid prescription. This accounts for 14% of the population with over 9,152,247 prescriptions filled by 1,939,924 Ontarians. The largest opioid prescriptions that are filled are codeine (47%), oxycodone (27%), and hydromorphone (13%). In 2016 alone, 1.3 million new opioid prescriptions were filled.

While these numbers are alarming, there are ways that clinicians can help to safely prescribe opioids to their patients through their Electronical Medical Record (EMR). OntarioMD has partnered with Health Quality Ontario (HQO) to provide Ontario clinicians with resources, tools and support from our experienced Peer Leaders and Practice Advisors to help clinicians better manage patients’ chronic pain, emphasize the safe use of opioids, help combat the opioid crisis and get people the care they need.

How do EMRs help address the opioid crisis? It is important to remember that opioids can still have a role in pain management and there are opioid guidelines to support prescribing decisions. The EMR has become a helpful digital tool that enables clinicians to better understand their patients. Every patient is different, and many have complex care needs. EMRs give clinicians the whole picture for each patient, and help them tailor a care plan that fits that picture.

An EMR search will show clinicians how many of their patients take opioids and the number of different drugs prescribed along with their dosages. EMRs help clinicians identify patterns of high risk for addiction prescribing. By learning more about their patient demographic, clinicians can conduct a more thorough analysis and take preventive measures to help prevent addiction and overdoses. Clinicians can create reminders and alerts within the EMR for patients on high doses to better monitor their health. Using a narcotics contract between the clinician and patient can help reduce the risk of addiction and further harm by opioids. Patients prescribed opioids for longer than 30 days should be placed on a contract combined with an assessment for addiction risk. Using all these EMR features, clinicians can monitor their patients for high-risk drug combinations, recalls for follow-up, those lost to follow-up, those without narcotics contracts and patients up for contract renewal.

OntarioMD is also leading a proof of concept initiative with OSCAR EMR and TELUS Health Solutions Inc. to demonstrate improved clinical value to Ontario clinicians through an EMR Quality Dashboard framework. The dashboard will help clinicians better manage their patient populations, including those who take opioids. EMR-connected clinicians get a user-friendly visual view of their EMR data, using widely-recognized primary care indicators from Health Quality Ontario, the Canadian Institute for Health Information and the Association of Family Health Teams of Ontario. The opioid indicators allow clinicians to manage opioid-related risk by showing which patients have been prescribed opioids, the dosage range. The proof of concept will include up to 500 participating clinicians, and will focus on scalability so new data quality, practice, and clinical indicators can be easily integrated into the dashboard.

While EMRs are the cornerstone of managing patient care, clinicians can support each other to understand the diversity of needs and challenges faced by patients with opioid addictions. The OntarioMD Peer Leader Program is a network of physicians, nurses, and clinic managers across Ontario who are proficient EMR users. They are available to consult with clinician practices on more efficient EMR use and workflow, optimization of existing EMR functions and improved clinical decision support. Peer Leaders share best practices for narcotics contracts, monitoring opioid prescribing and dosages, harmful drug combinations, and general practice management advice. 

Clinicians can also take advantage of accredited learning opportunities offered by OntarioMD to gain valuable knowledge to address the opioid crisis. The evening seminar series On the Road with OntarioMD focuses on Partnered Efforts in Safe Opioid Prescribing to help clinicians learn how to use the features in their EMR described above. OntarioMD’s 2018 EMR: Every Step Conference in Toronto on September 27 also includes a session by a family practice on how they use their EMR to combat the opioid crisis.  

Learn more about these events and the full range of OntarioMD digital health products and services at www.ontariomd.ca.

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OntarioMD.ca

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