The last thing a patient expects after being prescribed a legitimate 10-day supply of prescription opioids is to become addicted to them. But as data in the Center for Disease Control and Prevention’s (CDC) recent Morbidity and Mortality Weekly Report (MMWR) shows, that 10-day supply quickly turns one in five people into long-term users. The line between legitimate need and abuse is thin and sliding, and is one of the main reasons that the opioid epidemic is one of the greatest public health threats that the U.S. has faced in the last decade.
There are a myriad of initiatives and legislative measures in place to drive awareness and combat prescription painkiller abuse. One of these is through the electronic prescribing of controlled substances (EPCS), which helps to thwart prescription opioid fraud and abuse. There are also the recently released CDC guidelines promoting responsible opioid prescribing practices. But perhaps one of the more underrated and yet incredibly powerful levers that the healthcare industry can pull is by using effective communications.
As we pass the one year anniversary of New York State’s e-prescribing legislation going into effect – which mandates that all prescriptions in NY be prescribed electronically — we asked some of today’s leading digital health communicators to weigh in on the tools they are using to make an impact and help promote strategies to curb opioid abuse.
1. What role does communications play in fighting the opioid epidemic? What are some key communications levers that can be pulled?
Jeffers: There isn’t a silver bullet solution to this epidemic – we need to change policy, we need to change technology and we need to change behavior. Collaboration between multiple stakeholders is key to curbing opioid abuse, and lots of solutions need to be brought to bear to make that happen. Communications is critical to making sense of all of this.
We need to clearly articulate the role that various stakeholders play in addressing the epidemic and prove the value of the solutions available. Given that Surescripts is a network that connects all sides of healthcare, it’s rare that we face an issue that affects everyone and that we hear about from all sides of the network. But reducing opioid abuse is an issue that prescribers, pharmacists, EHR providers and other technology vendors are all concerned about. This highlights two things: how big the issue is to the health of our nation and the fact that that it’s one that can’t be fixed by just one group.
Hallock: Whether it’s by engaging policy makers, media or other key influencers in the industry, there’s no shortage of interest in finding ways to combat this growing problem. Working in concert with companies like Surescripts has been an important part of educating the industry at large to issues around EPCS. Surescripts has built out its e-prescribing network for over a decade and we partnered with them using national, regional and local campaigns to educate the market about the role technology can play to combat this epidemic.
After New York’s I-STOP mandate went into effect in March of 2016, the vendor community needed to step up and help prescribers meet their needs from a technology standpoint – specifically, enable them to securely prescribe controlled substances electronically, which was not an easy task. Keep in mind, many clinicians didn’t even know that EPCS was legal. Along with external communication in the media we also worked with Imprivata’s customers that needed help communicating with their clinicians on how the technology worked and how it streamlined their workflows. We did this through a series of broad-based campaigns targeted at both policy makers and other healthcare leaders, spreading awareness that secure e-prescribing technology existed and could easily be deployed.
Treatment guidelines certainly have their value, but we wanted key stakeholders to know that there was a way to address the issue way upstream, before a prescription goes to the pharmacy. Earned media coverage also granted us the ability to better educate policy makers at the federal and state level as they were formulating various opiate legislation.
How can communications be used to better reach and empower healthcare providers to combat opioid abuse?
Jeffers: The challenge for prescribers is that they often get blamed for opioid abuse, but they are also the ones at the point of care having to manage it. They realize and recognize the breadth of the issues, but educating them is one thing; getting them comfortable with a change in behavior is another.
Doctors represent a very large population, and the recent media attention on the epidemic may have put them on the defensive. Communications gives them a voice and empowers them to be part of the solution. Once doctors are comfortable with EPCS, we’ve seen that their adoption goes up quickly. Giving them the platform to tell their story is very powerful.
Hallock: I think providers have a certain level of frustration right now. It’s not that they don’t understand the power of these drugs – they are well educated – but they need the right technologies at the point-of-care to better monitor prescribing patterns.
When it comes EPCS, providers and CIOs want to know, how does it work? What are the Drug Enforcement Administration’s (DEA) requirements? How can I deploy this technology in conjunction with my existing EHR? Communications, whether via PR campaigns, social media or other forms of marketing, allowed us to educate providers as well as state and federal policy makers to the benefits of this technology. And as we’ve seen through the uptick in EPCS legislation at the state level, once the value of EPCS is realized, providers are proponents of the technology and can make better, more informed decisions, all while reducing fraud, abuse and addressing issues like doctor shopping.
1. What makes social media an increasingly powerful communications tool in fighting opioid abuse?
Jeffers: Social media is accessible, it’s quick and it’s far reaching. It’s a great way to share compelling stories about the impact of the epidemic and raise awareness among a broader audience. For a long time at Surescripts, we thought that doctors weren’t active on Facebook. But we soon realized that simply was not true and have had great success engaging and targeting physicians on the channel. They are talking to each other, talking to influencers, posting videos, writing blogs, sharing news, etc.
Our priority is getting them the right content at the right time. Providers are not our direct customers — they often don’t even know that they are using our technology. So using social to engage with them has given us the opportunity to reach that audience with content that shows how easy it is to enable the technology.
For example, GetEPCS.com, an educational portal that walks providers through the steps to becoming EPCS enabled, has had great engagement across social. It has been shared through multiple channels on social media, our blog, news media, and industry websites such as CVS Health, Ohio Health Information Partnership, New Jersey Office of the Attorney General, and State Boards of Pharmacy.
Hallock: As I have stated, clinicians are extremely intelligent individuals. They are looking to stay ahead when it comes to new technologies, procedures, or various therapeutics that improve outcomes. It’s not an issue of them not wanting to know about new technologies and processes, but it’s a question about leveraging all the channels where they consume information. We found that social media became an extremely effective vehicle for educating the industry to what EPCS was and how it can help in addressing this problem.
Physicians tend to follow what other physicians are doing from a technical standpoint in care delivery — as long as it works. Whether it’s a clinical or management system, if it’s good, they’ll talk to others and adoption starts to spur. We saw this with the adoption of clinical systems like EHRs, and EPCS is no different. Communication and PR is critical to educating and informing them about the benefits of adopting new technologies and protocols.
But using social media or traditional PR or not, no one organization can do it alone, which is why we worked to collaborate with vendor partners like Surescripts and various EHR vendors in terms of integrations and communication efforts. Industry collaboration is so important in addressing this issue — getting providers and hospital staff to better understand their options and showing them that they can make a difference at the point of care, all while meeting DEA regulations and having transparency into any potential fraud. Communications has certainly helped providers be more informed while creating a more efficient system. The technology is mature and ready to address the problem. It’s up to communicators to make sure that message is received and then reinforced.