A HEARING EARLIER this month on Beacon Hill underscored the critical need for Massachusetts-specific solutions to the nation’s opioid crisis. As the Legislature prepares next steps to address this critical issue, it would do well to consider a bill recently proposed by Gov. Charlie Baker that would capitalize on technological advances to help address the growing epidemic.
As an emergency physician at Beth Israel Deaconess Medical Center, I see firsthand the physical and emotional toll that opioid abuse takes on patients and their families each day. I treat multiple patients affected by opiate abuse and addiction during every shift, and I know I’m not alone: The Centers for Disease Control (CDC) reports that more than 33,000 Americans died from opioid overdoses in 2015 — including nearly 2,000 in Massachusetts — many from prescription medications supplied through illicit drug diversion and abuse.
Baker’s bill is a visionary legislative proposal that encourages a more secure opioid distribution chain by requiring that prescriptions for controlled substances be completed electronically. In September, 2017 alone, an estimated 168 Massachusetts residents died due to opioid overdoses. That’s more than five people per day. Passing this bill needs to be top priority in combatting this epidemic.
The technology solutions proposed in the Baker bill – specifically, instituting the electronic prescribing of controlled substances – can help curb opiate abuse by creating accountable and secure practices for those who prescribe and dispense controlled substances. While Prescription Monitoring Programs are in use, electronic prescribing can serve as a critical complement, providing a secure, transparent system that makes it easier to prescribe controlled substances to those patients who legitimately need them, while making it more difficult to commit fraud or abuse.
According to the prescribing network Surescripts, more than 85 percent of all prescriptions are electronic, but only 14 percent of prescriptions for controlled substances are electronic. In Massachusetts, the rate of electronic presciptions is even lower (11.2 percent), even though more than 95 percent of pharmacies can accept those transactions, and opioid prescriptions to Massachusetts residents have increased 7 percent annually since 2000. With the Drug Enforcement Agency finalizing its rules for electronic prescriptions in 2010, there are no good reasons for the sluggish uptake.
As a provider, I know technology is integral to the prevention of opiate abuse. But it must be applied in a thoughtful way that works for both providers and patients, not against them; the last thing most providers want is another electronic system to work with.
By utilizing electronic prescriptions, as legislators in New York did through the Internet System for Tracking Over-Prescribing law, Massachusetts can ensure more effective, secure prescribing practices. We can also actively prevent drug diversion by keeping paper prescriptions and doctors’ credentials out of the hands of those attempting to perpetrate fraud and drug diversion. It’s time to stop fueling the cycle of abuse, addiction, drug dependency, and deaths from drug overdoses.
These systems bolster security without disturbing existing physician workflows by connecting with existing electronic medical records programs. Together, they provide transparency, accountability, and better monitoring of prescribing habits and medication distribution.
The best way to achieve these positive outcomes is to enact legislation and create a standard that providers can adhere to – and one that patients can count on. The governor’s bill promises to save lives by ensuring that opioids are provided more securely and appropriately, and save money by reducing costly prescription errors and mistreatments. I urge lawmakers to ensure that this crucial initiative be enacted as part of any solution to combat the opioid crisis.
Massachusetts is recognized nationwide as a leader in medicine and scientific research; individuals from all over the world come to Boston to receive treatment from our top-notch hospitals. So why aren’t we also leading in health IT and security? It is not just the smart thing to do, it is our responsibility as leaders. We must set the tone for the country and implement prescribing strategies that work for patients and physicians, and effectively address the massive opioid epidemic invading our communities – lives are depending on it.
Dr. Sean Kelly is an emergency department physician at Beth Israel Deaconess Medical Center and chief medical officer for Imprivata, a technology security company based in Lexington.