Combatting the Opioid Crisis
By: Dr. Foster Goss, DO, MMSc. Emergency Physician, Clinical Informaticist, Entrepreneur (Guest Author)
In 2015, 97.5 million people in the United States used prescription pain relievers.1 That’s 36.4% of the population. Of those, 12.5 million misused the medication and 33,091 died from an overdose.2 Emergency physicians see the impact of the opioid crisis every day.
There is no debate that the opioid crisis is taking a significant toll: in healthcare costs, in lost productivity, and most importantly, in lives. The most recent analysis (from 2013) estimated that the total economic burden of the opioid crisis is $78.5 billion.3 While the rate at which opioids are being prescribed has declined since 2011, providers are often faced with a lack of information that makes it difficult to determine whether their patient has a legitimate need for opioid medication or whether they may be at risk for misuse of opioids or other prescription drugs.
THERE IS NO DEBATE THAT THE OPIOID CRISIS IS TAKING A SIGNIFICANT TOLL: IN HEALTHCARE COSTS, IN LOST PRODUCTIVITY, AND MOST IMPORTANTLY, IN LIVES.
In some areas, regional or statewide tracking databases (e.g, Prescription Drug Monitoring Programs) have been established to help combat misuse of opioids or other prescription drugs, and appear to be the most promising state-level interventions currently available, particularly when integrated into the electronic health record.4 However, these databases are not without limitations. They are often based on claims or periodic transfer of clinical data – not real-time data.5 In addition, data is generally regional and does not include dispensing of controlled prescription drugs outside of the state. Lastly, technology limitations within the database itself make it difficult to perform advanced analytics. Therefore, decision support and trend analyses are inherently retrospective rather than prospective.
The BurstIQ platform allows providers to see a complete and up-to-date view of a person’s health profile and healthcare system encounters, which provides critical information to determine whether a person is at risk for opioid abuse or other prescription drugs.
But the platform also goes beyond point-of-care decision support. First, the BiQ Ecosystem provides a foundation from which people could access a myriad of potential support services: addiction treatment programs such as Medication-Assisted Treatment (MAT),3 telehealth-enabled counseling, support groups, medications to support recovery, and other products and services. These could be accessed by the person directly or through a physician referral. And because the services would be accessed through the same platform that manages the person’s overall health data, the care team would be able to seamlessly monitor engagement and progress as the person undergoes treatment.
THE MACHINE LEARNING CAPABILITIES OF THE PLATFORM ALLOW HEALTH SYSTEMS AND INSURERS TO IDENTIFY PEOPLE AT RISK OF DEVELOPING OPIOID DEPENDENCY BEFORE IT OCCURS.
Second, the machine learning capabilities of the platform allow health systems and insurers to perform complex predictive analysis – identifying people at risk of developing opioid dependency before it occurs. The potential benefits of preventing opioid dependency are monumental. In addition to direct financial benefits for health systems, public and private insurers, employers and people, prevention could have significant indirect benefits: reduction of adverse childhood experiences (ACEs) and toxic stress in children of at-risk parents, increased engagement and employment in adults, increased public safety, and much more.
The opioid crisis in the United States is a complex, multi-faceted problem. Providers, including Emergency physicians, have much to benefit from technology to predict and understand opioid dependence. If people and their care teams have the right information to make the right decisions at the right time, we can and will mitigate and eventually prevent these epidemics. And that benefits each and every one of us.
1 2015 National Survey on Drug Use and Health (SAMHSA), Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR2-2015/NSDUH-FFR2-2015.htm
2 The Opioid Epidemic in the U.S., Retrieved from https://www.hhs.gov/opioids/about-the-epidemic/index.html
3 The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013. Florence CS, Zhou C, Luo F, Xu L. Med Care. 2016 Oct;54(10):901-6
4 Learn more at: https://www.cdc.gov/drugoverdose/pdmp/index.html
5 Griggs CA, Weiner SG, Feldman JA. Prescription Drug Monitoring Programs: Examining Limitations and Future Approaches. Western Journal of Emergency Medicine. 2015;16(1):67-70.
6 Learn more at: https://www.samhsa.gov/medication-assisted-treatment