A comprehensive approach to addressing the opioid epidemic in a large health system

Abstract

Purpose: To describe the implementation of a comprehensive program to address the opioid epidemic in a large health system and to assess the effect of the program on opioid prescribing.

Summary: Mercy Health is a nonprofit, Catholic health system that employs over 1,400 providers and operates 23 hospitals in Ohio and Kentucky, 2 states that have experienced large numbers of overdoses. As a good community partner, the health system developed a comprehensive plan to address the opioid crisis. A system-wide Opioid Steering Committee was established to implement and manage the program. The committee was chaired by a senior pharmacy executive and supported by 4 subcommittees: the data analytics, education development, outreach and assessment, and electronic health record (EHR) subcommittees. The 4 subcommittees developed and implemented several initiatives, including forming a database with prescribing data by specialty and geographical location, implementing a standardized screening approach in the emergency department, challenging hospitals to create partnerships with local schools, and creating EHR enhancements to change opioid prescribing habits. When normalized for patient volume, the prescribed opioid burden was reduced from 65.3 to 35.2 morphine milligram equivalents per unique patient from 2016 to 2019 (a 46% absolute reduction). During this same time the number of acute prescription orders with a morphine equivalent dose greater than 30 was reduced by 52% (from 37,793 to 17,822 prescriptions per year).

Conclusion: Mercy Health's comprehensive approach to the opioid epidemic has successfully impacted opioid prescribing habits, screening practices, and community outreach.

Keywords: SBIRT; data analytics; opioid; opioid burden; opioid epidemic.