Leveraging digital technology to impact the opioid crisis

opiod crisis
What if the digital tools available to the healthcare community today could be used proactively to reduce the potential for dependency or overdose?

Opioids. The topic has been inescapable in the news this past year, and with good reason. The U.S. Centers for Disease Control and Prevention (CDC) states that the majority of drug overdose deaths in the United States involve an opioid (prescription opioids, heroin, and fentanyl) – killing more than 42,000 people in 2016. Prescription opioids are involved in nearly half of all opioid overdose deaths. The data is so significant that the CDC has classified opioid overdose as an epidemic and awarded more than $28 million in additional funding to 44 states and the District of Columbia to strengthen prevention efforts. And the effects of this epidemic are societal as much as they are individual. For example, the total economic burden of prescription opioid misuse alone in the United States is estimated at $78.5 billion a year.

How did we get here?

Patients don’t just decide to become addicted to opioids, and epidemics don’t just pop up overnight. A variety of factors combined to form the current crisis, such as: Guidelines for the use of prescription opioids to manage pain vary from state to state; prescriptions from multiple providers and pharmacies can overlap; and available data on risk factors such as mental illness or prior substance abuse is lacking. Additionally, a widely used yet misinterpreted 1980 study in hospital narcotics use contributed greatly to misrepresenting the potential dangers of narcotic painkillers, dulling the warning signs, and helping prescriptions of opioids become more commonplace.

Government and private entities are taking action to address the issue

Government agencies have been taking action, with the creation of a presidential commission to address opioid addiction; support for cutting edge pain and addiction research by the Department of Health and Human Services; improved overdose prevention and interventions by the National Institutes of Health; and establishment of statewide prescription drug monitoring programs that provide database information about a patient’s prescription history.

Similarly, there are many private sector programs that support funding for safe stations (designated firehouses) that allow addicts to be quickly connected to nearby resources; safe sites that allow people to use drugs under the guidance of trained professionals; plus numerous community centers and self-support groups.

The work to date by the public and private sectors is important, and these programmatic actions are an essential part of the solution. But we should continue to explore more solutions to help curb the crisis, like ways to apply digital technologies to the problem.

How digital healthcare tools could help

Let’s think more about what technology’s role could or should be in the solution. What if the digital tools available to the healthcare community today could be used proactively to intervene: identifying and reducing the potential for dependency or overdose? It’s a practical idea, given the available state-of-the-art technologies enabling personalized care.

Software systems based on dynamic case management and digital process automation already provide a foundation for the management of highly complex data and decision making. These systems are able to collect medical data from disparate systems of record and analyze it, along with contextual data from patient interactions and patient care history. The result is a comprehensive, real-time understanding of each individual that provides insight and guidance to the healthcare team.

By applying end-to-end dynamic case management, health organizations can define patterns of information that, when identified by the system, automatically trigger a defined response. For example, a patient presenting prescriptions for large quantities of pills, duplications of prescriptions, and prescriptions for combinations of controlled-substance medications are just some of the warning signs that, individually or combined, could be built into a case management system to trigger further action to be taken by the healthcare provider.

Three other emerging technologies that could also help are:

Internet of Things (IoT): Imagine a pill bottle that would not open unless accompanied by a smartphone app or only at certain geographical locations. What if these bottles have sensors to count the number of pills prescribed and the ones that remain? How about sending notifications with information about when and how to dispose of the expired pills? These ideas may sound far-fetched, but combine connected devices with case management and the possibilities are groundbreaking.

Artificial Intelligence: Benjamin Franklin said “an ounce of prevention is better than a pound of cure,” which is true in healthcare’s most literal sense. A lot of addictions begin in a fairly benign fashion by someone prescribed a painkiller for actual pain relief, such as after a surgery. What if there was a way to look at a patient’s insurance claim plus socio-economical and behavioral data, in combination, to determine if someone was more likely to be addicted if prescribed a certain medication like an opioid? Artificial Intelligence and machine learning capabilities could be applied to this data to discern such patterns.

Blockchain: Leakage of opioid pills at many stages of the supply chain has contributed towards the crisis. Imagine if you could trace each opioid pill using its full distribution picture and an immutable audit trail. Well that’s exactly what blockchain technology can provide. Blockchain is like an open, accessible ledger that records all the events related to a transaction. While the technology may not stop someone swiping a few pills from someone else’s pill bottle (see IoT for that issue), it provides a record of how a pill bottle got into a person’s cabinet in first place.

In all circumstances with the technology above, comprehensive dynamic case management platforms are the foundational backbone. Their abilities to track all care data, provide a complete patient history, automatically notify stakeholders, and provide recommended actions are extremely useful tools.

The tech industry should be part of the discussion

The reality is, while a lot has been done to try and solve the opioid crisis, it is still not nearly enough. We need to be able to use all the tools at our disposal to help and to support continuous patient engagement across the healthcare ecosystem. As an industry, let’s commit to developing best-practices and standards of care to apply these digital tools preventatively to benefit our patients and our greater communities.


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ABOUT THE AUTHORS:

In her role as Vice President and Health Business Unit Leader at Capgemini, Aimee Sziklai helps healthcare organizations plan and implement strategic initiatives to improve growth, performance, and patient relationships.

Jitesh Rohatgi, Pega’s global director and healthcare/life sciences principal, has over 15 years of experience advising life sciences and healthcare organizations on the most effective use of CRM, MDM, and AI technologies to improve clinical safety and patient care.