Report highlights patient safety issues with EHRs and the opioid epidemic

Photo: The.Comedian via Flickr

While technology alone cannot solve the opioid epidemic, it can play an important role in reducing overprescribing and co-prescribing opioids with other drugs that can raise the risk of overdose. A new report has offered recommendations on improving technologies in clinical settings for safer prescribing practices.

The ECRI Institute, a respected patient safety research nonprofit, and the HIMSS Electronic Health Record Association, an electronic health records (EHR) trade group, convened a workgroup to analyze health IT data from patient safety organizations and other sources.

In two-thirds of patient safety events related to opioid prescribing, the workgroup found that existing clinical decision support (CDS) mechanisms were either ignored, bypassed or did not function as expected.

The workgroup issued three recommendations:

  • Enable technologies to measure and monitor prescribing patterns for safer opioid prescribing, such as leveraging external databases like the state Prescription Drug Monitoring Programs.
  • Ensure that EHRs can collect and access data (such as risk information, cumulative dosages prescribed and co-prescribed medications that increase overdose risk such as benzodiazepines) to support measures and drive clinical decision support.
  • Ensure opioid-prescribing CDS interventions are delivered at the right time to clinicians in the workflow (and limiting repetitive CDS) for patients who both have and have not previously taken opioids.

The authors note that their recommendations are addressed in a proposed rule on enhanced interoperability recently issued by the Office of the National Coordinator for Health IT. More on that in another post.

Earlier in March, ECRI named diagnostic errors and improper management of test results in EHRs among the most serious patient safety challenges facing health leaders in 2019. Mobile health technology also carries risks for patient harm, the group concluded.

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