Emergency Medicine Opioid Data Infrastructure - Key Venue to Address Opioid Morbidity and Mortality

05/09/2019

Build Clinical Data Research Infrastructure to Enhance Capacity to Use EHR Data and PROs to Conduct Opioid Research in Emergency Departments
Agency
  • National Institutes of Health's National Institute on Drug Abuse (NIH/NIDA)
Start Date
  • 6/1/2018
Functionality
  • Standardized Collection of Standardized Clinical Data
  • Collection of Patient-Provided Information
  • Linking of Clinical and Other Data for Research

 

STATUS: Active Project

BACKGROUND

EHR data are often used in research to improve patient outcomes in the field. The quality of this research could be improved by including opioid relevant common data elements (CDEs) in clinical data registries and EHRs. EHR vendors have been slow to incorporate CDEs related to opioid use disorders (OUDs), and clinical data on OUDs are not collected in a uniform format. There are also inconsistencies in terminology used and types of information recorded about OUD patients. The American College of Emergency Physicians (ACEP) developed the first emergency medicine registry called the Clinical Emergency Data Registry (CEDR). CEDR has the functionality to measure emergency medicine outcomes, identify practice patterns and trends, improve the quality of acute care, exceed quality reporting standards, and eliminate and/or increase payer revenue.

This project will facilitate standardized measurement through use of OUD-specific CDEs in order to track and improve the quality of care at the point of contact with persons with OUD. In recent years, there has been an increased focus on PROs. PROs place patients at the center of health care research and ensure that research is of maximum value for both clinicians and patients. This project will also explore the feasibility of collecting PRO measures in Emergency Department (ED) setting and after an ED visit, and identify PROs most appropriate for inclusion in ED settings. Improved measurement and enhanced EHR infrastructure could provide benchmarking data such as how many providers provide naloxone for OUD, and can facilitate tracking of quality improvement efforts.

Improving clinical data infrastructure in ED settings addresses key areas of the HHS 5-point strategy to combat the opioids crisis by improving access to treatment and recovery services; promoting use of overdose-reversing drugs; providing support for cutting-edge research on addiction and pain; and advancing better practices for management of OUD and pain.

PROJECT PURPOSE & GOALS

The goal of this project is to build clinical data research infrastructure that will begin to enhance capacity to use EHR data and PROs to conduct opioid-related research in emergency Departments (EDs). The project will improve interoperability and linkages between EHRs, research networks, and registries for research relevant to the opioid epidemic.

The project objectives are to:

  • Identify existing OUD CDEs relevant to the ED setting by conducting an environmental scan of current, publicly available data systems, data elements, and quality measures
  • Demonstrate the CDE from an EHR can be integrated into the ACEP CEDR test sites by translating and mapping electronic OUD data elements to the National Library of Medicine (NLM) Value Set Authority Center (VSAC).
  • Explore feasibility of collecting electronic PROs such as PROMIS and other measures (e.g., pain intensity, substance use disorder treatment/status) at one or more of the National Institute of Drug Abuse’s (NIDA) Clinical Trial Network’s (CTNs) sites.