The military is using the MHS Opioid Registry, along with telementoring, telemedicine, education, and relying more on integrating clinical care treatment into the behavioral health system. The goal is to treat as many service members as possible with severe opioid-use disorders by eliminating a dependence on pain medications, heroin, or both.
Chris Nichols, Defense Health Agency https://health.mil Program Manager for Enterprise Intelligence and Data Solutions under the DHA Office of the Deputy Assistant Director for Information Operations, gave an update on the MHS Opioid Registry at the HIMSS 2018 Conference held in Las Vegas.
The MHS Opioid Registry launched in 2016 and released to all sites in 2017, is a patient lookup tool that has been used at the point-of-care to assess opioid-induced respiratory depression risk in over 5,000 patients taking opioids.
Data in the MHS Opioid Registry includes more than 200 variables including demographics, medications, morphine equivalence daily doses, results from urine drug testing, and opioid risk factors. In the future, the Opioid Registry will also be able to evaluate and track alternative non-opioid therapies for pain management.
In addition, the Opioid Registry will also incorporate medication and risk factor data as MHS GENESIS data becomes available. Other future benefits include enabling early detection of opioid misuse and then using proactive management to detect individuals who may be at risk for substance abuse or suicide.
A future registry to be accessible by both DOD and VA providers and staff is currently under development. The registry will focus on the subset of the population in the process of separating from DOD and transitioning to the VA. A major benefit for the future registry would be to reduce errors by providing a shared view of clinical, lab, and medication reconciliation information.
In addition to the Registry, educational support is provided with up-to-date information on pain management to primary care. A telementoring program update information on the management of pain and opioids was established through the ECHO program that provides clinical education on a weekly basis.
Also, Primary Care Pain Champions (PCPC) leaders in pain management have helped coordinate pain care between the primary care setting and pain management centers. The goal of the PCPCs is to maximize assets in the primary care setting and to coordinate the weekly ECHO programs. In addition telemedicine is being used to bring specialty care for pain to remote locations.
Army medicine has also implemented the Comprehensive Pain Management Program (CPMP) to provide more information on developing a comprehensive pain management program by using state-of-the-science modalities and technologies to advance the field of pain medicine.
Therapies within CPMP include interventional medicine, physical therapy, occupational therapy, chiropractic, nutrition, medical massage, acupuncture, and movement therapy. The Army has also begun relocating and integrating substance use disorder clinical care with behavioral health clinics using embedded behavioral health teams.
In 2017, the Army revised several policies to advance pain management services, including an operations order along with the concept of operations for the CPMP plus an executive order that requires a profile for every opioid prescription and then transferring the profile from providers to commanders.