Managing The Opioid Epidemic: Intermountain Healthcare

Key Findings

  • After conducting a comprehensive survey to determine the usage patterns and pain management requirements of their patients, Intermountain Healthcare established a systemwide goal of reducing opioid prescriptions by 40%.
  • Leaders at Intermountain found no correlation between opioid prescription reductions and patient satisfaction, indicating patients were not adversely impacted by these changes.
  • Intermountain developed an opioid stewardship team to lead internal efforts around reducing opioid prescriptions, including comprehensive provider and patient education programs, building new prescribing defaults and alerts into the electronic medical record (EMR), and developing a centralized dashboard to track key metrics across the organization and standardize analytics around opioid management.
  • Intermountain has implemented numerous community health programs in partnership with the Opioid Community Collaborative, primarily focused around reducing opioid utilization, encouraging proper usage and disposal of opioids, and supporting the adoption of medication-assisted treatment for opioid disorders.
  • Efforts include installing opioid disposal drop boxes, offering training on naloxone use and courses around chronic pain management, and public awareness initiatives.

INTRODUCTION

The opioid epidemic is a significant public health issue affecting communities across the country. With over 214 million prescriptions dispensed nationally in 2016, the abundance of opioids has resulted in widespread abuse and addiction. In 2016, the opioid epidemic had a national economic impact of $504 billion, 11.5 million people misused prescription opioids, 2.1 million people had an opioid abuse disorder, and over 42,000 people died from overdosing on opioids. As the number of people with opioid abuse disorders has increased, emergency department (ED) visits for suspected opioid overdoses have also increased – up 30% from July 2016 to September 2017.

As communities and healthcare organizations work to manage this crisis, the severity and ubiquity of this issue resulted in the U.S. Department of Health & Human Services declaring the opioid crisis as a public health emergency in October 2017.

Health systems across the country are prioritizing opioid management, with 81% having addressed the opioid epidemic in their current strategic priorities and almost all (94%) implementing a system-wide opioid program to address the epidemic. Due to the community health implications of this issue, 52% of health systems report community relations as a function driving the need for including the opioid epidemic in the organization’s strategic priorities. Reflective of this, health system strategies often include a multi-pronged approach including both internal and community-facing efforts. A majority of health systems include community programs (65%) in their system-wide opioid programs.

Methodology

In November 2017, The Health Management Academy conducted a quantitative survey of Leading Health Systems regarding strategies implemented to address the opioid epidemic. Twenty-one Chief Medical Officers (CMOs), Chief Operating Officers (COOs), Medical Group Leaders, and Clinical Executives responded. Building off the quantitative survey, The Academy conducted in-depth qualitative interviews highlighting health systems’ efforts to reduce opioid prescriptions.

In Fall 2018, The Academy conducted in-depth telephone interviews with five executives at Intermountain Healthcare around the health system’s strategy to manage the opioid crisis, as well as the initiatives implemented and outcomes thus far. The Academy thanks the following individuals for their participation in this project:

  • Lynsie Daley, Senior Data Analyst, Intermountain Healthcare
  • Steve Hadley, Director HR Employee Analytics, Intermountain Healthcare
  • David Hasleton, MD, Senior Medical Director, Intermountain Healthcare
  • Lisa Nichols, Community Health Executive Director, Intermountain Healthcare
  • Bridget Shears, Pain Management Clinical Services Director, Intermountain Healthcare

None of the participants listed derived any personal profit or gain through participation in this case study.