The opioid epidemic may be the most challenging public health concern facing healthcare professionals today. With opioid overdose rates having more than quadrupled over the past 18 years, at least 91 Americans die every day from an opioid overdose according to the CDC.

Mercy Health serves patients battling opioid addiction in some of the most afflicted locations in the country, including Ohio and Kentucky – both among the top five states with the worst overdose rates in the nation. With annual opioid overdose death rates at twice the U.S. average in Ohio, the Mercy Health team is confronted with the horrifying reality of the opioid crisis every day in their facilities based in both states.

Identifying Patients at Risk and Reducing Opioid Prescribing

Mercy Health understood their important role in addressing the public health crisis, and strategized with their teams on how to facilitate improved outcomes and reduce the overall risk for patients susceptible to opioid addiction.

These efforts began with Mercy’s implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol via the patient’s electronic medical record (EMR). For instance, patients are given a detailed substance abuse prescreen questionnaire at the start of their first visit. Based on the prescreen response generated in the patient’s EMR, staff determines next steps in intervention with the patient.

The public health focus of SBIRT (e.g., screening everyone versus screening only patients who present to the emergency department (ED) with drug use problems and related injuries) allows for normalization of a topic that is often difficult for many patients and providers to discuss. SBIRT decreases the stigma attached to discussing alcohol and drug use, and facilitates dialogue in a way that is more comfortable and beneficial for patients and providers.

Additionally, Mercy Health developed an evidence-based order set (Opiate Withdrawal Focused) and nursing assessment (Clinical Opiate Withdrawal Scale - COWS) facilitating inpatient treatment and/or symptom management for patients experiencing withdrawal. The organization also rolled out an opiate-free emergency department program in one of their facilities to reduce overall prescriptions issued in the emergency room by transitioning to other treatment alternatives for pain management.

The Results

Within the first 18 months since the introduction of the ED program initiative, there has been a reduction in opioid prescriptions by 50% in the pilot ED.

Figure illustrates the percentage of all prescriptions that were an opioid in nature from market emergency departments. Data represents first six-months of initiative year (2017) compared to same time frame of the year prior to intervention (2016).

“I just want to say thank you so much,” stated one patient. “I came there about 30 days ago to do my detox, and now, I’m in a sober living house and been sober 30 days. The doctor and nurses treated me with love and respect.” The patient started their road to recovery with the help of Mercy’s implemented elective opiate detox program, via the organization’s newly implemented clinical opiate withdrawal scale (COWS).

“That order-set has made believers out of non-believers regarding opioid withdrawal and chemical addiction,” said Stephen Feagins, MD, vice president, medical affairs, Mercy Health East Market.

HIMSS Analytics Stage 7 Validation

HIMSS Analytics is proud to recognize Mercy Health for their recent validation as a Stage 7 hospital, based on the Electronic Medical Record Adoption Model (EMRAM). “Mercy Health demonstrated exceptional use of data driven insights to improve reimbursement and make progress against the opioid epidemic,” stated James E. Gaston, senior director, healthcare advisory services, HIMSS Analytics. “Mercy Health is using information and technology for the betterment of patient care.”

HIMSS Analytics will recognize Mercy Health at the 2018 HIMSS Conference & Exhibition, held from March 5-9, 2018, at the Venetian-Palazzo-Sands Expo Center in Las Vegas, Nev. Visit the HIMSS Analytics website for more information on the healthcare provider maturity models and the Stage 7 validation/revalidation award.

About Mercy Health

Mercy Health is a Catholic healthcare ministry serving Ohio and Kentucky. With more than 33,500 employees in seven markets, they are one of the largest healthcare systems in the country. Mercy Health’s mission is to improve community health, with an emphasis on people who are poor and underserved. At each one of their over than 500 points of care, high-quality, compassionate care is delivered with one united purpose: to help patients be well in mind, body and spirit. All of Mercy Health’s ambulatory sites and seven of its hospitals: Mercy Health – West Hospital, The Jewish Hospital – Mercy Health, Mercy Health – Urbana Hospital, Mercy Defiance Hospital, Mercy Health – Anderson Hospital, Marcum & Wallace Memorial Hospital and Mercy Health – Allen Hospital received HIMSS Analytics Stage 7 validation.

About HIMSS Analytics

HIMSS Analytics is a global healthcare technology market intelligence, research and standards organization assisting clientele in both healthcare delivery and healthcare technology solutions business development to make lasting improvements in efficiency and performance. Visit the HIMSS Analytics website for more information on the EMRAM and other maturity models.