Fighting veteran addiction and suicide with better software
Connecting state and local government leaders
Decision support software can help clinicians track veterans taking multiple medications for the same or different conditions.
All across the United States, millions of Americans are grappling with the accelerating opioid addiction crisis. Last year, on any single day in the U.S., the Department of Health and Human Services reported 650,000 opioid prescriptions were filled, 3,900 people used prescribed opioids for non-medical purposes and 78 people died of opioid-related overdose.
Over 30 percent of Americans struggle with some kind of chronic pain, and opioids have become the treatment of choice for these conditions, despite their inability to provide long-term efficacy. Physicians at the Department of Veterans Affairs face the continual challenge of finding safe and effective pain management treatment for their patients. One in 10 veterans suffers from chronic pain, including 60 percent of troops returning from recent deployments and 50 percent of older veterans. Untreated chronic pain contributes to poor mental health and quality of life, yet long-term opioid therapy contributes to substance abuse, which is a key factor that has been linked to the increasing rate of veteran suicide.
Veterans will often have several physicians for routine maintenance of chronic conditions or other health related issues and can be seen at the 144 VA medical centers, along with the 1,221 outpatient facilities around the country. This can enable polypharmacy -- taking multiple medications for the same or different conditions. Veterans can easily be seeing six or seven different physicians, who could be prescribing multiple opioids or other medication for anxiety or sleep (such as benzodiazepines), which have a synergistic effect. One of every three unintentional overdoses involves a combination of benzodiazepines and opiates.
The VA should adopt decision support software to better track doctors' prescriptions and avoid polypharmacy. Such software has been proved to be effective at the VA hospitals where it is currently in use by providing real-time electronic surveillance to guide treatment decisions at the point of care. Only 15 percent of VA medical centers have access to this software even though it is being used by over 1,200 commercial hospitals.
Decision support software in VA hospitals can alert physicians to at-risk veteran populations, where prescription of any opiates along with other medications with high-addiction potential should be avoided or closely monitored. Software for direct patient care, to provide enhanced tracking and management of prescription drugs, will assist in combating both veteran addiction and suicide rates.
The effect of implementing such tools can be dramatic. After deploying decision support software, the San Antonio VA medical center documented a 23 percent reduction in adverse drug interactions and a medical care savings of $2.47 million over the first year.
Status quo processes are untenable in the face of the current opioid epidemic. Deploying software to combat opioid addiction and related drug interactions at the VA will put actionable information in the hands of providers so they can deliver better patient care. There are thousands of clinicians at the VA working extremely hard in the face of unprecedented patient levels. Our healthcare providers, and the veterans they serve, need better tools now.