EHR tool to assess patient risks for opioid abuse

EHR tool to assess patient risks for opioid abuse – Joseph Goedert – October 23,  2018

Electronic health record vendor eClinicalWorks has built a new software module, embedded in the EHR system, to help clinicians assess a patient’s risk for opioid misuse.

The Opioid Risk Tool module will be included in the vendor’s next upgrade in January 2019. The software includes clinical decision support that estimates a patient’s risk and provides suggestions for prescribing alternatives to opioids or opioid antagonists, which block the effects of opioids.

So it seems this system would never suggest continued opioid therapy, no matter what the patient’s situation.  

The decision support also calculates the morphine milliequivalents for patients and alerts the clinician when the Center for Disease Control and Prevention recommended opioid dose has been exceeded.

I’ve posted before about how incredibly unreliable these conversions are:

In addition, eClinicalWorks—in partnership with drug monitoring analytics vendor Appriss Health—has built a prescription drug monitoring program integration that enables clinicians to access state-run PDMP databases at the point of care.

This is a dangerous precedent…

Here are some previous posts showing how Appriss is standardizing our medical evaluation and treatment:

What Every Patient Should Know About NarxCare

What is NarxCare? Appriss Health developed NarxCare as a “robust analytics tool” to help “care teams” (doctors, pharmacists, etc.) identify patients with substance use disorders.

Each patient is evaluated and given a “risk score” based on their prescription drug history. According to Appriss, a patient is much more willing to discuss their substance abuse issues once they are red flagged as a possible abuser.

NARxCHECK – another barrier between patients and pain meds

Appriss Inc., a leading technology provider for risk assessment and analytics, announced it has acquired NARxCHECK™ from the National Association Boards of Pharmacy Foundation (NABPF) to automate prescription drug abuse assessment and management through patented analytics.

If the analytics are patented, no one can check to see if they are valid. Many patients could be wrongly accused of opioid abuse and no one would know why

Developed by an emergency room physician and in collaboration with hospital associations, state pharmacy boards, NABPF, an affiliate the National Association of Boards of Pharmacy (NABP), and others, NARxCHECK can quickly identify those patients who may be at heightened risk for misuse of controlled substances.

The non-profit Boards of Pharmacy (NABP) sold its own project, thus converting it into a for-profit enterprise, even though it remains a fundamental part of the non-profit’s strategy. This virtually guarantees business for NARxCHECK and a tidy profit for investors.

~~~ now back to the original article ~~~

Currently, 33 states use the Appriss analytics which integrate with the EHR to streamline data access for providers.

The tool can also be administered and scored in less than one minutewithin the EHR system.

A score of 3 or lower indicates low risk for future opioid abuse, 4-7 indicates a moderate risk, while a score of 8 or higher presents a high risk for abuse.

The opioid risk tool will assist in combating the opioid epidemic, ensuring patients have access to safer treatment for chronic pain and reduce the misuse of these drugs,” says Girish Navani, CEO at eClinicalWorks. “We can do our part to limit the number of pills in circulation and believe the Opioid Risk Tool will lead to progress in providing better and safer medicine across the nation.”

By leveraging the tool in the EHR, a clinician knows the medications a patient is using, the social history of the patient, and why the patient is coming to the doctor, Navani notes.

The physician also knows the social determinants of health for the patient, such as the ability to pay for medication or afford a taxi to buy the medication.

These factors and others are used to calculate a risk score for opioid abuse by the patient, Navani explains.

The tool has been validated in both male and female patients who suffer from pain. To improve patient safety, if a doctor writes a prescription for oxycontin or other similar agents higher than a recommended threshold, the eClinicalWorks software prompts the clinician to also prescribe an antagonist medication that blocks the effects of opioids, particularly when used with alcohol.

Author: Joseph Goedert is senior editor of Health Data Management, a SourceMedia publication.

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