Tommy Thompson: Here’s how we can use better data to combat opioids

As a former Governor and Secretary of the U.S. Department of Health and Human Services, I care deeply about and continue to work on the widespread epidemic of both illicit and prescription drug abuse which is fueling the opioid crisis nationwide.

In 2017, the Aspen Institute’s Health Strategy Group, which I co-chair, focused on the opioid epidemic in a year-long study. One of our top five recommendations to address the crisis was to invest in data and knowledge management. Health-care providers need quicker and more comprehensive access to critical information about patients’ medical history and prescription drug profile.   

{mosads}As the House takes up an impressive number of bills to address the opioid crisis this week, I am pleased to see that one bill specifically implements our recommendation: The Creating Opportunities that Necessitate New and Enhanced Connections that Improve Opioid Navigating Strategies (CONNECTIONS) Act of 2018, introduced by Rep. Morgan Griffith (R-Va.) and House Energy and Commerce Committee Ranking Member Frank Pallone (D-N.J.).

The name of the bill might be a mouthful, but the idea behind it is simple: Let states continue to do what they do best through innovation. This bipartisan bill recognizes the important work that many states have undertaken in recent years to improve prescription drug monitoring programs (PDMPs) and provides additional federal resources and incentives to ensure that accurate information is available to providers and dispensers in a timely way to improve clinical outcomes for patients.

In 2011, the National Association of Boards of Pharmacy created PMP InterConnect, a PDMP data sharing hub that enables 45 states to share prescription information across state lines to prevent doctor shopping.

Building on the widespread success of PMP InterConnect, some states are beginning to incorporate interstate PDMP data directly into a prescriber’s Electronic Health Record system or a pharmacist’s Pharmacy Dispensation System. Integration is critical to ensuring more providers view PDMP information prior to a prescribing or dispensing event, while also reducing the burden of checking a separate system.

One of the best examples of the success of this innovation is Ohio. Since the state began integrating its PDMP data into clinical workflow in January 2016, they have seen an incredible 1000% increase in provider usage of the PDMP thanks to improved ease of access. The CONNECTIONS Act provides funding for more states to follow their lead in tackling the opioid crisis by maximizing data and technology.

In addition to integration, the bill encourages adoption of PDMP best practices, including checking the PDMP before prescribing or dispensing a controlled substance, reporting dispensing information in near real-time, and participating in interstate data sharing with neighboring states through an interoperable network such as PMP InterConnect. The bill also promotes improved analysis of PDMP data through red flag alerts to enhance identification of individuals at risk of misuse or abuse of opioids as well as any providers demonstrating outlier prescribing practices.

As the opioid crisis persists despite prescription pill counts falling in recent years, it is clear that illicit drugs are an increasing part of the problem. A recent Journal of American Medical Association report indicated that illicit synthetic opioids, such as fentanyl, are now the leading cause of opioid overdose death. PDMPs have made significant progress in tracking patient prescribing history, but with the rise of illicit substances, clinicians need more from state PDMPs in order to accurately identify and treat at-risk patients.

States recognize this growing threat and are starting to incorporate more sophisticated data analytic and treatment referral tools as part of an integrated PDMP. Tracking and reporting of nonfatal overdoses is another area states are seeking to improve. History of a nonfatal overdose would be a critical piece of patient information for a physician to know, but it would not be included in a conventional PDMP report. The CONNECTIONS Act would allow states to explore these types of new and innovative approaches.

I am pleased to see Congress recognize states’ ongoing efforts to improve PDMPs by sharing prescription history with neighboring states and integrating data into clinical workflow, while also examining the potential of new data analytics and clinical tools to improve outcomes for patients.

The CONNECTIONS Act furthers this effort by promoting PDMP best practices and providing the resources needed for more states to take advantage of the best that technology has to offer as PDMPs evolve to the changing nature of the opioid crisis.

Better PDMP data presented in a more meaningful and actionable way is just one component of combating the opioid crisis, but it has the potential to make a measurable impact as providers on the front lines encounter patients at risk of addiction and have the opportunity to make a difference one person at a time.  

Tommy G. Thompson was the 42nd and longest serving governor of Wisconsin (1987-2001) and the 19th secretary of the Department of Health and Human Services for President George W. Bush. He now serves as a volunteer senior fellow at the Bipartisan Policy Center and works with on their long term care initiative, related to opioid issues. Thompson also serves as the co-chair of the Aspen Institute’s Health Strategy group.