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What can health systems do to combat the opioid crisis? This is the kind of question that fascinates me as I think about how we can improve healthcare outcomes through the combination of risk-adjusted data and process improvement. I find it fascinating because the imperative to change is clear---if we want different outcomes we must change the way we work---and there are many ideas we can bring to bear that might improve outcomes.

Eugene Christian MD, Chief Medical Affairs Officer describes work at Bon Secours Mercy Health (BSMH) to improve care delivery in the best interest of the people served by their delivery system. The work started with organizational leadership stating the need to investigate ways to reduce the horrific consequences of this crisis. The organization convened a multi-disciplinary team to investigate, implement and track results and provided the team with access to the resources needed to be successful.

Dr. Christian describes a number of interventions, from standardizing the approach to narcotics prescribing, enhancing non-narcotic pain regimens in emergency rooms as well as post-operative settings, brief surveys with brief interventions to address narcotics use, enhanced capacity to assist entry into substance abuse treatment and more.

Bon Secours Mercy Health achieved a lower level of narcotic use after total joint procedures, which reduced risks of post-operative mobilization, increased speed of recovery and reduced time in the hospital, all while maintaining or improving patient experience of care with pain management. 

Some of their emergency rooms experienced a reduction in the rate of narcotics-seeking visits---a dramatic enough reduction to cause some to raise concerns regarding reduced revenue. It is very difficult to reduce any revenue stream, but BSMH’s mission of patient care has so far trumped the fact that healthcare payment continues to reward volume over value.

BSMH enabled this work through the effective use of data to identify at-risk population segments, track the impact of interventions and to help nudge physicians to consider clinically appropriate non-narcotic alternatives.

Listen to a conversation we recorded for the Inside Angle podcast in which Dr. Christian describes BSMH’s journey to better outcomes through better opioid management.

L. Gordon Moore, MD, is Senior Medical Director, Clinical Strategy and Value-based Care for 3M Health Information Systems.