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As a both a practicing emergency medicine physician, and Chief Medical Officer at AffirmHealth, an organization dedicated to combatting opioid abuse in this country, I spend a significant amount of time thinking about the right tools we need to develop to make pain management practices more effective. In the clinic, healthcare providers are operating at a time when we have never had more information about our patients readily available. Conversely, however, this wealth of information often creates the challenge of “too much noise; too little signal” and it can be easier to fall into the trap of simply maintaining old practice patterns that have worked for us in the past. Unfortunately, the outdated practices of yesterday will not be enough to effectively reverse the worsening opioid epidemic in our country.
Instead of simply developing tools that repackage or aggregate existing data on the number of opioids prescribed, at AffirmHealth, we’re working to develop clinician support instruments that effectively answer four questions:
First, how will this instrument make clinical decision making easier? With the patient-physician relationship as the foundation for all clinical management, I believe that physicians struggling to make sense of the opioid crisis are looking for tools that make effective recommendations that are rooted in the most up to date scientific guidelines. It cannot be enough right now to simply aggregate data, turn it over to the clinician, and expect them to know what to do next. Clinicians often suspect that there is a problem with opioid abuse before they see the PDMP data. Instead, our tools need to show them what to do with that data.
Second, does the instrument create discrete endpoints that can be measured? With increasing pressure to show progress against federal clinical practice improvement guidelines, clinicians need tools that can help facilitate that progress without taking time away from the bedside. As a clinician, I don’t just need to show that I’ve checked a state opioid registry…what I need to show is that I’m prescribing responsibly with specific data to support that claim. Fighting the opioid epidemic has to move away from qualitative reporting and into more granular, quantitative data that shows we are making progress.
Third, does the instrument make the clinician’s job more or less complicated? The problem with existing state PDMP tools right now is that they are often labor intensive and take clinician time away from the patient. The tools we are developing must integrate into the physician workflow in a manner that facilitates the patient-physician relationship, not detracts from it. That’s the problem with too much of the data that’s out there now—it pulls us away from the patient bedside where we get the most important feedback.
And fourth, what do clinicians say they want? At AffirmHealth, we actively seek feedback from our users and thought leaders in the healthcare industry to ask what features of their practice need support. How can we support the clinician that needs help seamlessly transitioning a patient into substance abuse treatment? How can we efficiently integrate reporting requirements into our platform? Those are the kinds of questions we are developing solutions for.
Making progress in the fight against opioid misuse is going to take a change in the clinician support discussion. We need to stop simply aggregating data that leaves the clinician without guidance about what to do next. Version 2.0 must answer those four questions. At AffirmHealth, we’re working to do just that.
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