HIMSS 2018 March on the States to Address the Opioid Crisis

The opioid epidemic has reached epic proportions. The abuse and misuse of medications cost more than $500 billion annually, according to estimates from the White House Council of Economic Advisors and researchers from the Centers for Disease Control and Prevention. As overdose deaths and costs continue to rise, policymakers across the country need to look for multifaceted solutions to this complex problem.

Leveraging health information and technology can play a key role in combatting this crisis. The Healthcare Information and Management Systems Society (HIMSS) strongly encourages you to enact policies in your state that help address the growing opioid epidemic devastating U.S. communities.

The recommendations below are aimed at supporting local and state governments, in collaboration with the health IT community’s efforts, to effectively use information and technology to drive innovations in care delivery that will result in better health outcomes for your constituents.

Enact or broaden adoption of electronic prescribing of controlled substances.

One powerful solution to combating the opioid crisis is gaining better control of tracking opioid prescriptions and securely delivering them to pharmacies. Electronic prescribing of controlled substances (EPCS), permitted by the Drug Enforcement Administration in 2010, can address fraud and abuse issues and increase patient safety with features like comprehensive medication history. Over 93% of pharmacies nationwide are EPCS-enabled, but in May 2018, nationwide prescriber enablement of EPCS was just 26.2%.

A growing number of states have enacted laws that mandate the use of EPCS. HIMSS encourages each state to review its enablement of EPCS and consider enacting requirements that would broaden its adoption to prevent further diversion of opioids and improve patient safety.

Integrate prescription drug monitoring programs into EHRs.

HIMSS encourages states to help minimize provider burden by integrating prescription drug monitoring program (PDMP) data into EHRs and further complement PDMP utilization with more provider onboarding and training. On June 11, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a letter to state Medicaid directors, providing guidance on funding authorities states can leverage for health IT, telehealth and prescription-monitoring solutions specifically targeted to help combat the opioid crisis.

HIMSS urges states to leverage existing federal funding opportunities for health IT, including the enhanced federal funding available to build a PDMP or enhance PDMP functionality, which HIMSS 2018 March on the States to Address the Opioid Crisis includes a 90% match for costs related to the design, development, and implementation of PDMPs and connections to PDMPs that meet certain cost controls and support the exchange of public health data.

Leverage telehealth to increase access to treatment and address provider shortage.

States should leverage telehealth and telepsychiatry to increase access to substance use disorder treatment and address provider shortages, particularly in rural communities. As included in CMS’s June 2018 letter to state Medicaid directors, CMS is providing states with significant flexibility to implement these services, and states should consider telehealth-optimized medication-assisted treatment and remote counseling options to increase access to care. It is essential to integrate any telehealth services into care coordination technology.

Create an integrated data infrastructure across public health, behavioral health, justice, and human services to enhance timely opioid crisis response and prevention.

HIMSS highly recommends that states continue to supercharge their community-based health IT infrastructure efforts under the HITECH Act so that they achieve usability as integrated, community-based data hubs (or open-data portals) with real-time dashboards and shared analytics to combat the opioid epidemic.

The use of these platforms supports deeper collaboration across state agencies, local health departments, hospitals, emergency responders, law enforcement and behavioral health agencies. For example, several states (California, Indiana, Missouri and Pennsylvania) have found the use of statewide data hubs and public-facing dashboards are necessary to effectively monitor opioid-related data sets in real time; inform policy decisions; increase accountability and drive coordination across the spectrum of care; and drive community-based interventions.

These tools may also be enhanced with geographical information systems or other mapping solutions to target hot spots within the state. They also may help jurisdictions address underlying social determinants, strengthen public health surveillance, and create linkages to behavioral health support services.

States can leverage existing funding resources, especially Medicaid Section 1115 Demonstration Waivers, and new funding available through the recent Substance Abuse and Mental Health Services Administration (SAMHSA) 2018 State Opioid Response (SOR) grants. The SOR grants support states' use of epidemiological data to demonstrate the critical gaps in the availability of treatment for opioid use disorders in geographic, demographic and service-level terms. All states should work with their state’s health IT coordinator to connect this important functionality in their broader state health IT architecture.

For more information, visit the HIMSS Policy Center.