Combatting Opioid Misuse with Technology and Governance

Program Goals

• Give providers tools to prevent opioid misuse

Organizational Outcomes

• 80th percentile for provider agreement that the EHR helps prevent opioid misuse
• 80th percentile for nurse agreement that the EHR helps prevent opioid misuse

Keys to Success

• Make sure the technology is solving a need. WVU Medicine needed a solution that accessed not only their state PDMP but also the PDMPs of surrounding states. Without that ability, the technology would be less useful.
• Integrate so as not to add additional steps. Add-ons are most successful when they do not interrupt workflows and are more readily adopted when they provide clinically relevant, helpful information.
• Operations and IT must work as partners to address complex challenges in healthcare.

What WVU Medicine Did

West Virginia is one of the hotbeds of the opioid crisis, both in numbers of opioids prescribed as well as in number of deaths attributed to opioid misuse. Realizing this, WVU Medicine used both technology and governance to combat the opioid epidemic. A few years back, in partnership with the West Virginia Health Information Network, WVU Medicine began a pilot with NarxCare (from Appriss Health), a solution that can query multiple states’ prescription drug monitoring databases. West Virginia has many border states in close proximity, so it was essential that this solution would be capable of looking at data from neighboring states. Around the same time that the pilot with NarxCare began, WVU Medicine also implemented EDie (from Collective Medical) into their emergency department tracking board. This technology allows ED providers to quickly see when a patient has been seen multiple times at other participating emergency departments or has complex care needs. This allows providers to have more insight when providing care for these patients.

In 2018, West Virginia passed legislation that would subsidize NarxCare for all providers in the state. As a result of their early experience with NarxCare, WVU Medicine was able to quickly enable use of this solution by all of their providers across all care settings. WVU Medicine integrated NarxCare into the Epic EHR as an activity tab. Users can obtain a report from NarxCare without leaving the Epic EHR and without entering another set of credentials. Of all the complex development initiatives related to the EHR at WVU Medicine, this rather simple deployment of a valuable tool has received some of the most positive feedback from providers.

Beyond using NarxCare and EDie, WVU Medicine created a pain task force to review what the health system is doing with pain assessments, pain management protocols, controlled substance prescriptions, and use of NARCAN. This committee also monitors the ever-changing state and federal guidelines surrounding opioids. This committee is led by operations personnel, and members include safety and quality personnel and others who work in pain management centers. Participants on this committee were nominated by leadership. IT personnel also participate as partners working to solve the complex challenges associated with opioid misuse.