(May 2017) Doctors should be able to fight opioid misuse by relying on online
computer data-bases, but so far, existing systems such as online
databases that track prescriptions have failed to live up to their
So Jason Hoppe,DO, an associate professor of
emergency medicine, and a team of physicians and software developers
have developed a pilot project that links the Colorado Prescription Drug
Monitoring Program and University of Colorado Hospital’s electronic
medical records system.
The federally funded project is an example of how CU Anschutz faculty and researchers
could have a national impact on the opioid abuse epidemic, possibly
leading to improved software that helps doctors and hospitals across the
country ensure patient safety, identify people vulnerable to addiction,
and stop prescription medication misuse.
Diagnosing a digital disconnect Software
that tracks prescription medications has been available for years.
Since 2008, Colorado has had an online statewide database recording when
a pharmacy dispenses controlled substances including opioids such as
Vicodin and OxyContin, and other potentially addictive medications, such
as stimulants like Adderall and benzodiazepines.
allows providers to review a patient’s history before writing a
prescription. Hoppe said the databases also could be effective tools for
identifying people who visit multiple doctors in an attempt to get prescriptions for opioids or addictive medications.
can use information stored in the database to determine whether
patients should be referred for addiction treatment. Databases also can
warn doctors if a patient takes a dangerous combination of medications,
and in the future, software could perhaps create risk profiles that
identify patients susceptible to addiction.
“I think there are
positives, and there is evidence that shows they improve patient
safety,” Hoppe said. “But there are a lot of barriers to using it.”
Hoppe noted that statistics show that nationally doctors check the
databases in their states only 12 percent to 20 percent of the time
before writing a prescription for a controlled substance.
would like to get that number a lot higher,” said Hoppe, who is co-chair
of the Colorado Consortium for Prescription Drug Abuse Prevention’s
working group focused on improving the database.
element for providers is time. Doctors need to quickly diagnose and
treat patients while simultaneously reading and updating electronic
medical records (EMR). Switching to a different software program to
check the state database takes several steps and distracts both doctors
“If you’re in a busy primary care clinic or
emergency department, and you’re seeing patients for only five minutes,
and it takes you five minutes to load the system, you’re unlikely to
use it,” Hoppe said. If doctors think a patient needs an opioid
painkiller and do not see signs that raise concerns about possible
misuse or abuse, they often write prescriptions without checking the state’s database.
An obvious solution would be to integrate the
state database and EMR systems. To overcome technical problems, Hoppe
and the team worked with Epic, the software company that sells one of
the most widely used EMR systems. UCHealth uses Epic’s software and is
part of the project.
The initial pilot project is small, Hoppe
said, with doctors in the SOM’s Emergency Medicine Department and the
University of Colorado Hospital being the first users.
to see how it does, how people like it, and if we can make it solvent in
terms of cost,” Hoppe said. The U.S. Department of Justice funded the
pilot project, and the software will have to show results before
receiving more financial support.
Users at CU Anschutz like the
system so far, Hoppe said, and it already has made his job easier. “I
use it for 90 percent of patients now that it’s just one click,” he