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Monday Mar 07, 2016

E-prescribing Holds Potential to Curb Opioid Abuse

Nearly 2 million Americans have substance use disorders involving prescription pain relievers. Roughly 44 of them will die today, and 44 more the day after that, because prescription opioid abuse leads to more than 16,000 deaths each year.

The problem is complex, and there are no easy answers. However, one step we should all be considering seems obvious. Since Vermont came on board in August, electronic prescribing of controlled substances is now possible in all 50 states. E-prescribing provides better tracking and reduces diversion by creating a direct link between the physician and the pharmacy.

Conversely, paper prescriptions can be easily manipulated(www.freep.com). Signatures can be forged(theadvocate.com). Numbers can be altered. And paper prescriptions can be lost or given to -- or stolen by -- others.

According to a report published in May 2015(surescripts.com), nearly three-fourths of U.S. pharmacies were capable of receiving electronic prescriptions for controlled substances in 2014. Based on recent conversations with industry sources, the number now may be closer to 85 percent.

So if e-prescribing is the answer to reducing death and diversion, physicians must be rushing to get on board, right?

Not yet.

According to that same May 2015 report, only 1.4 percent of physicians who write physicians for controlled substances are set up to do so electronically. The fault, however, doesn't lie solely with prescribers.

In many cases, physicians are handcuffed by the limitations of their electronic health records systems and vendors' reluctance to make any changes without additional investments. Instead, they would prefer to nickel and dime physicians while people continue to die.

Family physicians are repeatedly asked by payers, the administration and others to make changes that require investment. Last year, the Academy joined a White House-led effort to curb opioid abuse. As part of that initiative, the Academy set goals to increase

  • family physician education in appropriate opioid prescribing practices,
  • the number of family physicians who complete training in how to provide medication-assisted treatment for opioid addiction, and
  • overall awareness about opioid abuse and pain management.

The Academy also joined the AMA Task Force to Reduce Opioid Abuse, a group of more than two dozen physician organizations seeking to identify best practices to combat abuse and implement those practices nationwide.

The White House asked for our help, and we've responded. Family physicians are taking more education about opioids and pain management. According to the American Board of Family Medicine, more than 22,700 family physicians have completed the ABFM's pain management self-assessment module in the past six years. Furthermore, in each of the past four years, more than 16,000 family physicians per year have reported CME credits related to pain management or opioids, and those FPs reported completing an average of eight CME credits on this important topic.

Now it is time for electronic health record system vendors to also take responsibility for public health and ensure physicians have the tools available to address this crisis without the burden of another crippling expense.

Wanda Filer, M.D., M.B.A., is president of the AAFP.

Posted at 11:38AM Mar 07, 2016 by Wanda Filer, M.D.

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