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Elizabeth Snell

The Healthcare Leadership Council’s roadmap addressing the opioid crisis states improved EHR integration regulatory requirements can help EPCS adoption.

Adopting electronic prescriptions for controlled substances (EPCS) through modern regulatory requirements, including improved EHR integration, is one critical solution to opioid abuse, according to the Healthcare Leadership Council’s (HLC) “Roadmap for Action.”

Having a national prescription drug monitoring program (PDMP) and better opioid stewardship and disposal were also key recommendations from the Council.

More than 70 healthcare organizations, including Surescripts and the National Association of Chain Drugstores have already announced their support of the roadmap.

“EPCS is just one tool in our arsenal to fight opioid abuse,” Surescripts said in a statement. “Robust, electronic medication history data is available nationwide across all care settings. Having an up-to-date view of a patient’s medication history at the point of prescribing empowers prescribers to make the best care decisions for their patients.”

HLC members include chief executives from numerous healthcare stakeholders, including but not limited to hospitals, health plans, pharmaceutical companies, medical device manufacturers, biotechnology firms, and health product distributors.

The council’s National Dialogue for Healthcare Innovation (NDHI) organized the Opioid Crisis Solutions Summit on May 14, 2018 in Washington, DC. The Roadmap was created based on discussions at the Summit.

The Roadmap highlighted five priority areas for healthcare leaders, policymakers, and regulators:

  • Improve healthcare system approaches to pain management
  • Improve healthcare system approaches to prevent opioid misuse
  • Expand access to evidence-based substance use disorder (SUD) treatment and behavioral health services
  • Promote improved care coordination through data access and analytics
  • Develop sustainable payment systems that support coordination and quality care

The Roadmap then discussed specific recommendations for healthcare leaders, policymakers, and regulators, with ten to 15 suggestions for each group.

The Drug Enforcement Administration (DEA) should modernize current regulatory requirements for EPCS. This could improve EHR integration and help reduce the extra cost and burden on healthcare providers.

CMS should “provide a secure electronic transmittal infrastructure that would facilitate electronic prior authorization in Medicare Advantage and Part D and move towards greater standardization and efficiency in the prior authorization process,” the Roadmap recommended.

Healthcare leaders should pledge to adopt e-prescribing for all controlled substances by 2020, and will also need to develop a plan for improving access to a range of evidence-based, non-opioid, opioid sparing, and non-pharmacological pain management therapies.

Healthcare leaders should also work to close the SUD treatment gap by working to increase access to appropriate in-person or telehealth SUD treatment and recovery services.

“Specific efforts could include organizational commitments to reducing care fragmentation, providing or incentivizing medication-assisted treatment (MAT) training in underserved areas, and investing in peer and recovery support workforce and services,” the Roadmap explained.

“While public policy has a vital role to play in removing barriers to advancements in care and empowering accelerated therapeutic innovation, private sector leadership is critical on every aspect of this issue, from improvements in pain management to data-driven proactive interventions to strengthened opioid stewardship,” Roadmap authors concluded.

“By building upon ongoing initiatives that are already yielding promising results, healthcare leaders can and will make a difference in stemming a crisis that has already claimed too many lives and damaged too many families and communities.”   

CMS released its own roadmap earlier this month, highlighting the need for interoperability and clinical data to help curb the current opioid crisis.

The agency explained that it would use health data to target prevention and treatment efforts and identify trends of fraud and abuse among patients.

“CMS is working to ensure that beneficiaries are not inadvertently put at risk of misuse by closely monitoring prescription opioid trends, strengthening controls at the time of opioid prescriptions, and encouraging healthcare providers to promote a range of safe and effective pain treatments, including alternatives to opioids,” CMS said in a June 2018 blog post. “We are also working on communications with beneficiaries to explain the risks of prescription opioids and how to safely dispose of them, so they are not misused by others.”

Leveraging health data to understand opioid use patterns across populations can be greatly beneficial, the agency explained. Additionally, that information can promote healthcare interoperability and health data exchange across the care continuum, helping monitor trends to assess the effectiveness of prevention and treatment solutions. 

“The roadmap is also a demonstration of CMS’ commitment to explore and offer viable options to address the crisis, to share the information we collect with other agencies and organizations, and to protect our beneficiaries and communities affected by the crisis,” CMS concluded.