Using Health Information Technology to Improve Adherence to Opioid Prescribing Guidelines in Primary Care

Objective: To evaluate the impact of a clinical dashboard for opioid analgesic management on opioid prescribing and adherence to opioid practice guidelines in primary care. Methods: A pre/postimplementation evaluation using electronic health record (EHR) data from patients receiving chronic opioid therapy (COT) between April 1, 2011 and March 31, 2013. Meas-ures include annual proportions of COT patients who received urine drug testing, signed an opioid treatment agreement, had a documented assessment of pain-related functional status, and had at least 1 visit with a behavioral health provider. Results: Adherence to several opioid prescribing guidelines improved in the postimplementation year compared with the preimplementation year: (1) the proportions of COT patients with a signed opioid treat-ment agreement and urine drug testing increased from 49 % to 63% and 66 % to 86%, respectively. The proportion of COT patients with a documented assessment of functional status increased from 33 % to 46 % and those with a behavioral health visit increased from 24 % to 28%. However, there was a small decline in the proportion of patients prescribed COT from 3.4 % to 3.1%. Discussion: Implementation of an opioid dashboard led to increased adherence to certain opioid practice guidelines and a decline in COT. This may be attributable to more efficient team-based pain management facilitated by the dashboard and increased transparency of opioid prescription practices. Health Information Technology solutions such as clinical dashboards can increase adherence to practice guidelines