IT is a force multiplier for good in the opioid crisis

Healthcare IT leaders are leveraging technology to combat the ongoing opioid crisis, though significant challenges remain in coordinating care across different settings, according to expert panelists during their session “Informatics for Harm Reduction” at CHIME’s 2024 Fall Forum. The panelists, representing both clinical practice and healthcare administration, shared insights from their experiences implementing technology solutions across multiple care settings.  

“The opioid crisis has evolved through several distinct phases,” explained Dr. Greg Polston, a pain physician at UCSD and at the BA Medical Center in San Diego. “We’ve moved from prescription opioid issues to heroin, then to illicit fentanyl, and now we’re seeing dangerous combinations with methamphetamines.” 

While annual opioid overdose deaths have decreased to 84,000 from previous peaks, healthcare providers are shifting focus toward harm reduction strategies that meet patients where they are in their recovery journey. 

“Our organization previously took an inflexible approach to treatment protocols,” noted Corey Ziegler, CIO for Helio Health. “However, we discovered this rigid stance was driving patients away from care. When patients face absolute requirements they cannot meet, they often resort to riskier alternatives, ultimately increasing their chances of harm. We’ve learned that providing even one more day of treatment can make the difference between life and death.” 

Electronic health records (EHR) have become crucial tools in this fight. A new CHIME Opioid Task Force white paper analyzing capabilities across major EHR vendors found robust out-of-the-box functionality for opioid stewardship, including prescription drug monitoring program (PDMP) integration, morphine equivalent dose calculations, and automated safety alerts.  

However, implementation challenges persist. “Sometimes the opioid experts aren’t familiar with the IT side of the house and the IT side isn’t familiar with what’s actually needed from the opioid side,” explained Dr. Sean Kelly, Chief Medical Officer at Imprivata. 

A major regulatory barrier – 42 CFR Part 2 – required HIPAA-covered entities to separate substance use records from other medical records. Sharing this information could result in criminal penalties. This meant doctors often couldn’t see a patient’s full medical history, leading to potentially dangerous gaps in care. For example, an emergency room doctor treating an unconscious patient might not know about the patient’s substance use history or current treatment. The federal government relaxed these rules in February of 2024, so that substance use treatment information can be shared just like any other medical information.  

Interoperability gaps between acute care, behavioral health, and community settings continue to hamper coordinated treatment. “We’re human beings. We have a spiritual aspect, a mental aspect, a physical aspect, a housing aspect. If any of those are lacking it generally affects the other areas,” Ziegler emphasized. 

Experts emphasized that substance use disorder should be treated like any other medical condition. “Let’s put the head back on the body, let’s treat the whole person,” urged Ziegler. “The relaxation of regulations shows the stigma is going away. We’re starting to see this as any other disease that needs medical treatment.” 

The CHIME Opioid Task Force has developed resources including a CIO playbook covering opioid stewardship committees, clinician education, data dashboards, and EHR optimization. New chapters focused on medication-assisted treatment and overdose prevention are in development. 

“Don’t underestimate the power of IT as a force multiplier here for good,” Kelly noted.  

For organizations looking to make an impact, speakers recommended starting small but taking action. “If everyone in this room does one little thing, that affects a lot of change,” Kelly concluded. 

The session demonstrated how healthcare IT leaders are adapting their strategies as the opioid crisis evolves, while working to break down technical and cultural barriers to coordinated care. Success will require continued focus on both technological capabilities and the human aspects of treatment.