Reducing Opioid Prescribing Rates in Emergency Medicine

Ochsner J. 2018 Spring;18(1):42-45.

Abstract

Background: Pain management is one of the most common reasons patients visit the emergency department. Understanding the contributions of emergency medicine-and specifically Ochsner Health System's emergency providers-to the opioid crisis is important. Benchmark prescribing data indicated that Ochsner Health System emergency medicine providers' opioid prescription rates were significantly higher than the national average in emergency medicine.

Methods: Data relevant to visit and opioid prescription counts were extracted from the organization's electronic health record system. Opioid prescription rates were calculated for each provider. A data transparency project was initiated in which provider opioid prescription rates were unblinded and distributed among the provider group.

Results: Opioid prescription rates declined in aggregate for the emergency services from 22% to 14% during the 1-year project timeline. Some physicians demonstrated a 70% reduction in prescription rates. Importantly, patient satisfaction scores were not negatively impacted by declining opioid prescription rates.

Conclusion: Provider performance transparency using unblinded and transparent data analytics can efficiently and significantly alter provider practice.

Keywords: Analgesics–opioids; chronic pain; drug prescriptions; emergency medicine; quality improvement; systems analysis.