Harnessing the Hidden Power of EHRs in the Opioid Crisis

The U.S. opioid overdose epidemic continues to devastate communities nationwide. While healthcare providers grapple with this complex crisis, a powerful tool often remains underutilized: the electronic health record (EHR). Recognizing this potential, the CHIME Opioid Task Force (OTF) embarked on a mission to assess the current state of opioid-related capabilities within major EHR systems. Their findings, detailed in a recent white paper and further explored in a clinical advisory panel discussion, reveal both promising opportunities and significant challenges.

13 essential capabilities: A framework for action

The OTF identified 13 essential EHR capabilities spanning five categories: education, monitoring, alerts, prescribing support, and screening. These capabilities range from embedding educational resources and generating prescribing analytics to providing real-time alerts for high-risk patients and integrating prescription drug monitoring programs (PDMPs). As Dr. Sean Kelly, co-chair of the Clinical Advisory Group, emphasized, “There is a lot of good capability out there.”

However, the research also uncovered a stark reality: the ease of implementing these capabilities varies significantly across EHR vendors. While some functionalities, like PDMP integration, are now commonplace, others, such as clinical decision support for opioid use disorder screening, remain elusive. This variability underscores the need for healthcare organizations to proactively assess their EHR’s capabilities and collaborate closely with their vendors to implement and customize these essential tools.

Room for improvement

The OTF’s survey of three leading EHR vendors revealed that only one of the 13 capabilities was considered “easy” to implement by all vendors. Many require at least some degree of customization, and some even necessitate significant technical expertise or future vendor development. This highlights the complexity of integrating these tools into existing workflows and underscores the importance of strong partnerships between clinical and IT teams.

As Dr. Scott Weiner, an emergency physician and addiction medicine specialist, noted, “If you’ve seen one EHR implementation, you’ve seen one EHR implementation.” This variability in implementation can lead to missed opportunities and potentially fatal consequences for patients.

Collaboration is key to bridging the gap

The advisory panel discussion emphasized the critical need for collaboration between clinical leaders, IT staff, and EHR vendors. Dr. John Lee, an emergency physician and clinical informaticist, stressed the importance of prioritization and communication, suggesting clinical operations leaders need to emphasize to the CIOs that these tools, while not revenue-generating, save lives.

Successful implementation requires a shared understanding of the available capabilities, the technical effort involved, and the potential impact on patient care. By working together, healthcare organizations can streamline workflows, reduce alert fatigue, and empower clinicians to make informed decisions at the point of care.

The promise of AI vs. opioids

While AI was not explicitly addressed in the white paper, the panel discussion touched upon its potential role in opioid management. Dr. Weiner expressed enthusiasm for AI’s promise in areas like risk prediction and patient monitoring. However, he also acknowledged its current limitations due to data quality and ethical concerns.

The panelists agreed that AI is not yet ready for widespread adoption, but it holds significant potential for the future. As data sharing improves and ethical considerations are addressed, AI could revolutionize how we identify, monitor, and treat patients at risk for opioid use disorder.

5 ways to leverage EHRs for better opioid management

The CHIME Opioid Task Force’s research and the insights from the clinical advisory panel serve as a powerful call to action for healthcare organizations. The findings provide a framework for health systems to review their current opioid management practices and prioritize implementing evidence-based capabilities with their EHR vendors and IT teams.

EHRs have the potential to be a game-changer in the fight against the opioid crisis, but only if we fully leverage their capabilities. By prioritizing the implementation of essential opioid-related functionalities, fostering collaboration between clinical and IT teams, and staying abreast of emerging technologies like AI, we can harness the power of EHRs to save lives and make a meaningful impact on this devastating epidemic.

Here are five action items for organizations looking to leverage EHRs for better opioid management:

1. Start a dialogue between clinical leaders and IT/EHR vendor teams to understand available opioid management capabilities
2. Prioritize implementing at least one high-impact, evidence-based intervention
3. Leverage resources from CHIME Opioid Action Center for guidance
4. Continue partnership between IT, clinicians and vendors to streamline workflows for opioid best practices
5. Explore opportunities for AI solutions once data quality improves and ethical concerns are addressed

Check out the full podcast of the OTF Clinical Advisory Subcommittee.

For more details on the Opioid Task Force survey, download The Current State of Opioid-Related Capabilities in Enterprise EHRs: Availability and Level of Technical Effort (September 2024).

About the CHIME Opioid Task Force

The CHIME Opioid Task Force (Linkedin, Twitter/X) was assembled in 2018 with a sole mission: to turn the tide on the opioid epidemic using the knowledge and expertise of the nation’s health care IT leaders. For more updates on the current state of the opioid crisis visit opioidactioncenter.com and listen to the Opioid Action Center podcast for the latest insights from HIT industry leaders.