Health Systems Share Opioid Strategies at Coalition Meeting

October 13, 2017

Multiple WHA member organizations presented strategies they are utilizing to prevent opioid abuse and create new opportunities for treatment at a meeting of the Wisconsin Prescription Drug Abuse Coalition at the State Capitol October 6. The Coalition is co-chaired by Rep. John Nygren, Attorney General Brad Schimel, and Tim Westlake, MD, vice chair of the Wisconsin Medical Examining Board.

Steve Kulick, MD, CMO, ProHealth Care and chair of the WHA Physician Leaders Council, provided a presentation on ProHealth Care’s implementation of an integration of the new Wisconsin Enhanced Prescription Drug Monitoring Program (ePDMP) with its Epic electronic health record (EHR) system. 

Kulick said the ePDMP functionality enabling the ePDMP to connect to ProHealth Care’s Epic EHR removed a significant burden on physicians’ time.

“During the course of a physician’s day, those extra clicks for each check of the ePDMP added up to a lot of time,” said Kulick. Kulick and Westlake praised the value of the ePDMP data in a physician’s practice and the impact of ePDMP integration on reducing the time it takes for a physician to access that information. 

Michael Larson, PhD, director, controlled medication policy, Marshfield Clinic, provided an overview of Marshfield’s continually evolving approach to opioid prescribing, monitoring and intervention. Larson shared Marshfield’s approach to utilizing data and developing internal metrics to drive its approach to developing and utilizing targeted best practices and prescriber education for treating pain.

Larson also discussed Marshfield Clinic’s opening of their Alcohol and Drug Recovery Center through the Family Health Center that is partially supported by state HOPE grant funding and a federal HRSA grant. Larson reported the Center has seen 167 patients for medication assisted treatment (MAT) since opening and that a key component of that program is the connection of patients with care coordination teams.

Catherine Best, MD, a family medicine physician at Aurora Health Care, presented an innovative approach that she and Aurora Health Care has developed in which a primary care physician acts as a MAT prescriber. Best said the program is attempting to overcome the dual challenges of difficulties in recruiting addiction medicine specialists and barriers to utilizing already busy primary care providers in an MAT role. 

Key parts of the implementation included placement of the MAT primary care prescriber within a behavioral health center, working to develop nursing and physician protocols and templates for primary care providers to prescribe MAT, and developing a compensation model that recognizes the additional costs to primary care providers that wish to prescribe MAT. 

Charles Schauberger, MD, MS, an OB/GYN physician at Gundersen Health System shared findings and conclusions from a study undertaken within the Gundersen OB/GYN department on antepartum use of opioid medications. Schauberger shared that as a result of feedback provided to providers on their antepartum use of opioids, Gundersen saw a significant reduction in the number of antepartum opioid prescriptions following vaginal delivery.

Thomas Cheliminsky, MD, professor of neurology at the Medical College of Wisconsin shared research on pain physiology and discussed educational efforts to change primary care physicians’ paradigm on pain physiology and their approach to pain. 

Andrea Magermans, managing director of the Wisconsin ePDMP, gave a presentation on the status of the ePDMP and future enhancements. Magermans said the ePDMP vendor has now connected to five health systems’ EHRs and another five health systems are in testing/configuration for an integration with their EHR. Magermans also reported on upcoming new reporting and medical coordinator functionality within the ePDMP.

Jessica Geschke, statewide program coordinator for Wisconsin Voices for Recovery at UW-Madison Continuing Studies, discussed hospital-based recovery coaching and peer support as a model that utilizes trained recovery coaches in a hospital emergency department setting to help individuals enter into and navigate systems of care. Geschke provided an overview of how the model works and the role of the recovery coach or peer support provider. As part of a federal grant received by the State of Wisconsin, UW-Madison Continuing Studies is developing a process for hospitals to submit applications for grant funding to implement recovery coaching models within hospital emergency departments. 

If you would like to receive presentation slides from the Coalition meeting, contact Matthew Stanford, WHA general counsel, at mstanford@wha.org.
 

This story originally appeared in the October 13, 2017 edition of WHA Newsletter