The Office of the National Coordinator for Health IT: Using Real Time Data and Education to Prevent Prescription Drug Abuse

The Centers for Disease Control (CDC) has declared that the United States is in the midst of an epidemic of prescription drug overdose deaths. Deaths from prescription drugs now outnumber deaths from heroin and cocaine combined. Over the past decade, prescription drug-induced deaths have approached motor vehicle deaths as the leading cause of all injury deaths.  Programs that test collaborative efforts such as the PDMP will help identify best practices to help health care professionals combat prescription drug misuse at the moment of care. 

The Office of the National Coordinator for Health IT (ONC) recently announced the launch of a pair of pilots to test the effects of expanding state programs designed to prevent abuse of prescription drugs.  The pilots in Indiana and Ohio will find out how health IT (HIT) can help increase the effectiveness of prescription drug monitoring programs (PDMPs). 

PDMPs are statewide electronic databases that providers can use to identify and intervene with prescription drug abusers.  The databases collect, monitor and analyze electronically transmitted prescribing and drug dispensing data. 

Forty-nine states have these programs or have passed legislation authorizing them. However, the databases are not being used enough, according to the U.S. Department of Health & Human Services (HHS).  The ONC initiative is designed to increase providers’ real-time access to the data. 

“The PDMP pilot projects being launched today will help hospital staff identify a patient’s controlled substance history at the point of care to enable better targeting appropriate treatments and reduce the potential of an overdose or even death,” Farzad Mostashari, National Coordinator for Health IT, said in the announcement.””We are not creating new systems, we are adding value to those that exist.” 

The Enhancing Access to PDMPs Project stems from joint efforts of public sector and private industry experts that participated in the White House Roundtable on Health IT and Prescription Drug Abuse in June 2011. In turn, the HHS Prescription Drug Abuse and Health IT Work Group of the Behavioral Health Coordinating Committee created the Action Plan for Improving Access to Prescription Drug Monitoring Programs through Health Information Technology. 

The project is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and managed by ONC in collaboration with SAMHSA, the CDC, and the ONDCP. 

In the Indiana pilot, emergency departments will receive patients’ controlled substance histories from the Regenstrief Medical Records System, a unit of the Wishard healthcare system that is also used by other area hospitals. In some states, the press release stated, EDs are responsible for almost 25 percent of controlled substance prescriptions. 

In the Ohio pilot, drug risk indicators will be included in the electronic health record at the Springfield Center for Family Medicine in Springfield, Ohio. The researchers will measure how that effects clinical decision making. 

The Enhancing Access to PDMPs Project grew out of a White House Roundtable on health IT and prescription drug abuse in June 2011. The project is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). ONC is managing it in collaboration with SAMHSA, the Centers for Disease Control and Prevention, and the Office of National Drug Control Policy. 

Under a New York bill recently passed by the state legislature, physicians will have to write electronic prescriptions for painkillers within three years and will also have to check online records before prescribing them. The measure mandates the creation of a database for controlled substances and requires pharmacists to report when they fill such prescriptions. 

Conclusion 

“Technology plays a critical role in our comprehensive efforts to address our nation’s prescription drug abuse epidemic,” said Gil Kerlikowske, director of National Drug Control Policy (ONDCP).  “Together with education, proper disposal practices, and enforcement, improving existing prescription monitoring programs is a priority for this administration.  We hope these innovative pilots will help usher in an era of ‘PDMPs 2.0’ across the nation to improve real time data sharing among, increase interoperability of data among states, and expand the number of people using these important tools.” 

As Kerlikowske recognized, “education” will play a key role in reducing prescription drug abuse.  Continuing medical education (CME) can offer a critical solution to offering healthcare professionals education.