Unfortunately, it is all too easy to find a news story about the devastating impact of opioid abuse as the epidemic continues to spiral out of control and ravage lives across the country. From babies born to opioid-addicted mothers—and children ignored while parents overdose—to the music superstar Prince dying suddenly from an accidental fentanyl overdose, the plethora of stories that have surfaced in recent years is truly tragic. According to the CDC, more than 183,000 people died in the United States from 1999 to 2015 from overdoses related to prescription opioids, with the number of victims quadrupling over that same period.
How did we get to this point? A national poll conducted by STAT and the Harvard T.H. Chan School of Public Health offers insight: While 37 percent of adults say that opioid users themselves are mainly responsible for their own addiction, 34 percent say that physicians are responsible due to overprescribing. And as a doctor myself, I confess to agreeing with the latter group. Whether doctors are motivated by increasing patient satisfaction scores to secure greater reimbursement or issuing prescriptions to emergency room patients in an attempt to treat them quickly, we have been overprescribing opioids for far too long.
The good news is that policymakers and healthcare providers are now paying attention. In Massachusetts, for example, state health officials recently issued a comprehensive report detailing the factors leading to the opioid epidemic in the state and offering recommendations moving forward. Meanwhile, the CDC has released new opioid-prescribing guidelines, including advice to:
- Seek to manage pain with nonpharmacologic therapy and non-opioid pharmacologic therapy, if possible;
- Prescribe the lowest effective dosage, avoiding more than 90 milligrams per day;
- Avoid prescribing opioids and sedatives together whenever possible; and
- Use data to identify patients who are at risk.
The last point reflects how population health analytics can provide a major benefit. Using a tool such as Verscend’s Enterprise Intelligence, for example, health plans and provider groups can drill deep into prescription data, examining which providers are prescribing narcotics. One available technique is a geospatial analysis to look at regional variations: in what states, counties, and cities are opioids being prescribed the most frequently? One can also track narcotics usage by diagnosis, tracing the top musculoskeletal conditions (such as back and hip disorders) or the top psychiatric conditions (such as mood and anxiety disorders) associated with opioid prescriptions.
Patient-level analysis is also extremely valuable in combatting opioid abuse. For example, by breaking down prescription counts by month, you can see which patients receive two or more prescriptions per month, which can be a red flag for potential doctor shopping or early addiction. By setting up patient cohorts, a prescriber can identify members who are taking both opioids and sedatives at the same time.
At the end of the day, it will take all the important players in the healthcare industry—policymakers, health plans, providers, and of course, patients themselves—working together to combat the opioid epidemic. Population health analytics is a valuable tool with which we can arm ourselves to fight this difficult battle.
Learn more about how your organization can implement effective population health management by downloading our checklist, “8 tips for supporting your population health management programs.”
About the author:
Philip Finocchiaro, MD, FACP, serves as senior medical director concentrating on HEDIS quality measures and value-based healthcare at Verscend. He works closely with the entire clinical team developing population health strategies to improve healthcare across the care continuum. Dr. Finocchiaro holds a BS in Science from Boston College and a MD/MS in Medicine and Physiology from Georgetown University School of Medicine. He is a fellow in the American College of Physicians. He continues to practice medicine as a hospitalist at New England Baptist Hospital, with a focus on post-operative care for complex orthopedic patients, and also serves on the hospital’s quality and safety committee.