Opioid Control Application

OH Combats the Opioid Epidemic

Setting the Stage

The opioid epidemic has been a nationwide crisis, with the State of Ohio among the top states with the highest opioid-related overdose deaths. At a state level, the government has worked to combat the issue by implementing increased controls around the prescription of opiates and controlled substances. Laws have been outlined and enforced requiring both prescribers and pharmacists to enter and review data in the statewide monitoring system before prescribing or filling prescriptions. By adhering to the guidelines, the database would ultimately inventory and track the use of controlled substances, with the ability to identify:

  1. Individuals that “doctor shop,” meaning they seek medical attention from several prescribers with the goal of obtaining multiple prescriptions of the same controlled substance.
  2. Identify prescribers who are writing high valued prescriptions that may not be necessary.
Data Analytics
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Problem

The State of Ohio uses the Ohio Automated Rx Reporting System (OARRS), a standalone database, independent of the tools that an Electronic Medical Records (EMR) or Fulfillment tool that a healthcare worker or pharmacist would use. The additional database resulted in a data redundancy step, requiring the same data to be entered into two different systems. As a result, the system was not maintained or utilized on a consistent basis, resulting in a lack of oversight and inability to track the abuse or mismanagement of prescriptions.

Solution

KSM Consulting partnered with a firm to run a small pilot as a proof of concept for the State of Ohio. The pilot was run with a large grocery store chain, based in Ohio, using their pharmacy fulfillment system and integrated the data with the statewide system. Prior to the pilot, the utilization of the statewide system was around 16 percent; upon integration with the state-administered database, the utilization rate exceeded 100 percent.

With the results of the initial pilot, KSM Consulting was able to bring the Ohio Board of Pharmacy and the State CIO together to propose a statewide effort that would expand the efforts in data integration and controlled substance monitoring.

The KSM Consulting Project Manager developed a statewide approach for the implementation of the contract and outlined and managed the deployment of the controlled prescription database.

Impact

As a result, Ohio has the largest utilization of the controlled prescription database, allowing the state to take a proactive approach against the controlled substance crisis.

Ohio continues to carefully track progress with the OARRS 2018 Annual Report Executive Summary noting the following highlights.

  • Decrease of 325-million doses of opioids dispensed.
  • Decrease of 100-million doses of benzodiazepines dispensed.
  • 7,900% increase in OARRS queries.
  • 41,000 prescribers and pharmacists have integrated access to OARRS.
  • 89% decrease in doctor shoppers.