Partnered Efforts in Safe Opioid Prescribing
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1 Partnered Efforts in Safe Opioid Prescribing On the Road with OntarioMD March 7, 2018 Dr. Kevin Samson
2 2
3 Partnered Efforts in Safe Opioid Prescribing On the Road with OntarioMD March 7, 2018 Dr. Kevin Samson
4 OntarioMD Initiatives Partnered Initiatives OntarioMD Delivers Clinical Value Our Delivery Partners OLIS ONE ID 4
5 Presenter Disclosure Presenter: Kevin Samson Relationships with commercial interests: None Disclosure of Commercial Support Commercial Support: None Potential for conflict(s) of interest: None Mitigating Potential Bias None 5
6 6 Is There an Opioid Crisis?
7 7 Is There an Opioid Crisis?
8 8
9 Ministry of Health Response As the government rolls out $222 million in new investments to fight the opioid crisis that were announced last week, the Premier and I have directed that the flow of funding for harm reduction initiatives be accelerated. September 7,
10 10 Health Quality Ontario s Response
11 11 Health Quality Ontario s Response
12 12 Which narcotics are prescribed?
13 Opioid Rx s per 100 population by LHINs 2015/
14 The Opioid Crisis for Clinicians Feels like
15 The Opioid Crisis for Clinicians Feels like
16 What will it take to solve it? Complex problem no simple solution Get going before we get good Responsibility is all of ours 16
17 17 Provincial partner work
18 18 Greater chance of success in partnerships
19 14
20 20 Health Quality Ontario
21 21 Health Quality Ontario
22 22 Health Quality Ontario
23 Ontario College of Family Practitioners Mental Health Chronic Pain and Addictions FP Focused Evidence based 23
24 Centre for Effective Practice Guidelines based toolkits Academic detailing Combination of education and behavioral change High touch and individualized Up to 1000 clinicians to be supported with funding approval Launching in
25 University of Toronto Faculty of Medicine Online courses regarding safe opioid prescribing Accredited, 7.5h of time (three modules), Rolling through the year 25
26 Centre for Addiction and Mental Health Expanding treatment networks throughout the province Educational content and courses with partners (in person) Subject matter expertise 26
27 College of Physicians and Surgeons of Ontario Have identified and contacted highest risk prescribers On a path of assisting in a non-punitive way with guidance and steering people to seek help without acting reflexively Public safety: do not want abrupt withdrawal of narcotics 27
28 Association of Family Health Teams of Ontario QIDSS support for data analysis on the EMR Quality reporting through D2D EMR algorithms to identify at risk patients on opidoids Working with CAMH on education delivery 28
29 Practice Based Approach Tier 1 High Risk High volume Rx High dose Rx High risk patient population Tier 2 Medium Risk Medium risk practices due to patient population or prescribing variance Tier 3 Average Risk Average practices 29
30 Individualized Support Assistance to physicians to meet their needs and support analysis of their practice Education for change in prescribing habits Assistance with skills in reducing narcotic starts Learning about techniques for gradual tapering where appropriate Ensuring that doctors do not feel alone in the journey 30
31 What can you do in your EMR? List patients on opioids Morphine Equivalents (MEQs) List high dose patients List patients on opioids and benzo s Narcotics contracts Screening tools ORT, BPI, 31
32 What can you do in your EMR? List patients on opioids Morphine Equivalents (MEQs) List high dose patients List patients on opioids and benzo s Narcotics contracts Screening tools ORT, BPI, Reminders Decision support tools Starting, Rotating, Tapering Resources and references 32
33 33 EMR Tools
34 34
35 Opioid Prescribing Data High 9% Medium 32% MEQ's Low 59% 35
36 Opioid Prescribing Data High 9% Medium 32% MEQ's Low 59% 36
37 Partnered Efforts in Safe Opioid Prescribing Thank You! 37
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