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Tina Reed


An electronic medical record system is being credited with helping a public health system in Ohio reduce its opioid prescriptions for acute pain by more than 60% in the last 18 months.

Officials from Cleveland-based MetroHealth System said they also cut opioid prescriptions by 25% for chronic pain. In all, they estimate they cut opioid prescriptions by 3 million pills.

How'd they do it? Officials pointed to the alerts they set up in the EMR system.

In particular, those alerts for prescribers were set up to flag patients who may be at risk for addiction to guide them toward alternative drugs and lower doses. They also had an alert to add a prescription for the antidote drug Naloxone when prescribing opioids. That alert led to a 5,000% increase in Naloxone prescribing in the past three months.

Beyond the EMRs, officials said every provider that is licensed to prescribe narcotics is required to be trained in alternatives for pain relief and attend mandatory town hall meetings to identify processes and tools for safe opioid prescribing. The health system implemented a safe opioid prescribing simulation program to allow providers to practice difficult discussions with patients seeking opioids.

“We’ve been tackling the opioid epidemic for a long time. Not until recently, did we recognize that providers can do a lot more,” said Akram Boutros, M.D., president and CEO of MetroHealth.

The health system also opened a Pain & Healing Center, which includes alternative pain management therapies such as acupuncture, infusion therapy, reiki, pain management, neurology, psychology and psychiatry.

This comes a year after MetroHealth created an Office of Opioid Safety to focus on education, advocacy and treatment.

It's also part of a broader shift in MetroHealth's approach. In January, MetroHealth began transforming its campus to include far more green space, designing it as a "hospital in a park." At the time, officials said the change wasn't just about beautifying its campus but about incorporating more holistic healing strategies.