The opioid epidemic has impacted the state of Ohio significantly, with an average annual overdose death rate twice the national average. Mercy Health recognized the opportunity and responsibility to change its approach and improve the health of the communities it serves. Utilizing its electronic medical record (EMR), Mercy Health designed tools and protocols to ensure compliance with Ohio legislation and improve prescribing practices.
Key clinical leaders addressed prescribing practices by creating tools that improve identification of at-risk patients, encourage early treatment referrals, establish acute withdrawal protocols and provide more efficient access to Ohio’s Prescription Drug Monitoring Program (PDMP) database.
While these tools assist with treating patients already at risk, Mercy Health continued to look for opportunities to minimize further community impact from opioids. This was accomplished through the design of provider-facing tools within the EMR to improve and measure opioid prescribing behaviors. The tools use unique orders, clinical decision support and data analytics to evaluate current and future prescribing practices.
Improving Opioid Prescribing Practices
The newly configured opioid orders display necessary information – including strength, dispense quantity and frequency – to the provider at the time of prescribing and align with morphine equivalent daily dosing (MEDD) and total day supply limits as outlined by Ohio law. The tool includes an auto calculation of the MEDD for all active opioid orders. The tool also provides additional clinical decision support to alert prescribers when orders exceed either the MEDD or the day supply set by Ohio law.
Mercy Health uses an opioid analytics platform built on a database that permits evaluation of opioid prescribing behavior at the order, provider, department, specialty, market, and enterprise levels. Frequent monitoring of the data cube enables Mercy Health to track progress for two key opioid performance metrics, including the MEDD limit for acute pain prescriptions and opiate burden.
Due to the overwhelming need to address the negative impacts of the opioid epidemic, particularly in the state of Ohio, providers and staff continually assess and act on multiple data sources describing opioid prescribing patterns. The key to enabling this activity in an effective and sustainable manner is to incorporate the data into an intuitive and seamless workflow.
The integration of the PDMP into the provider workspace affords clinicians access to multi-state data in line with review of the patient’s chart and the utility of a fully compliant and pre-configured set of medication orders. By providing access to this information, Mercy Health immediately scaled a vital patient safety tool to Mercy Health’s network of 1,300 employed providers. By making it easier for providers to recognize and act on this data, Mercy Health is taking action to reduce potential harm to patients and improve outcomes in the midst of this challenging population health problem.
Since launching the tool, Mercy Health has improved opioid prescribing practices throughout its system by substantially reducing:
1) Total opioid orders from 41,331 to 36,160 – a 13 percent reduction
2) Rate of opioid orders to all medication orders from 8.6 percent to 6.7 percent – a 22 percent reduction
3) Rate of MEDD > 30 to acute opioid orders from 14.7 percent to 9.6 percent – a 35 percent reduction
4) Rate of MEDD > 80 to opioid orders from 3.5 percent to 3 percent – a 14 percent reduction
5) Rate of supply of > seven days of acute opioid orders from 23.5 percent to 13.3 percent - a 43 percent reduction
6) Total morphine equivalents prescribed per patient from 59 to 45.2 – a 23 percent reduction
HIMSS Davies Award of Excellence
The HIMSS Davies Award of Excellence recognizes outstanding achievement of organizations that have utilized health information and technology to substantially improve patient outcomes and value. The HIMSS Davies Award of Excellence is the pinnacle of the HIMSS Value Recognition Program and highlights organizations promoting health information and technology-enabled improvements in patient and business outcomes through sharing evidence-driven best practices on implementation strategies, workflow design, change management and patient engagement.
“Mercy Health has successfully leveraged analytics tools and decision support to make it easy for providers to select the correct pain management approaches and reduce opioid prescriptions,” said Jonathan French, CPHIMS, SHIMSS, senior director of quality and patient safety initiatives at HIMSS. “In addition, Mercy has utilized a variety of technology solutions to reduce gaps in care for their outpatient services, while also enhancing revenue through improved clinical documentation in their inpatient facilities. For this, HIMSS is proud to recognize Mercy Health as a 2018 Davies Enterprise Award winner.”
“Mercy Health is dedicated to providing excellent care delivered with compassion. We continually focus on the use of technology to improve our ability to collaborate and to enable the best quality care for our patients,” said Matt Eversole, System Vice President and Chief Operations Officer, Information Technology at Mercy Health. “We are honored to be recognized with the HIMSS Davies Award for improving outcomes in our communities by using technology to amplify the impact of the care our clinicians deliver.”
Mercy Health will be recognized at the 2019 HIMSS Global Conference & Exhibition, which takes place February 11-15 in Orlando, Florida.
Learn more about how Mercy Health has embraced the value of health information and technology: explore three award-winning use cases.