It’s long past time for healthcare providers to follow the pioneers who are using data, AI and other high-tech tools to fight the opioid crisis.
You never know when the pain might strike. I had just zipped up my winter coat and was headed for the door one morning last week when I saw an unfamiliar greeting card standing on a shelf. Thinking it was a baby announcement or a belated holiday note, I paused and grabbed the card, only to find old photographs of my cousin Courtney — snapshots of a little girl’s birthday party held more than 20 years ago. I was crushed.
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She died from an accidental opioid overdose in September 2013. She would have turned 27 this month. The card in my hands was my aunt’s notice that this year marked Courtney’s sixth birthday since her passing, but it seemed designed to double as a reminder that she was ever alive at all.
In the healthcare news business, it’s incredibly difficult to avoid the opioid crisis. Health systems, payers, government agencies, digital health startups — they seem to all be invested, in some way, in fighting a scourge of opioid addiction that has come to overwhelm the U.S. There are many it-just-might-work pilot programs and even more it-could-eventually-work proposals designed to thwart the opioid crisis. Our collective enthusiasm is encouraging, and it could one day help people suffering through opioid addiction.
But for now, little appears to be changing.
Take this remarkable new Injury Facts report from the National Safety Council, which details how likely U.S. citizens are to die from a number of afflictions, accidents and assaults. The statistic that gripped me was so eye-opening and troubling that I shuffled my calendar to write this column: For the first time ever, people are more likely to die from an opioid overdose (one in 96) than an automobile crash (one in 103).
Consider the implications of this statistic. Despite the country’s 222 million drivers and vast numbers of automobile passengers and public transit riders, opioid overdoses have eclipsed car crashes as the great accidental killer. And this comes in spite of the reliable and longstanding, if underappreciated, risks that are inherent to hitting the road. Almost everyone drives or gets driven — in comparison, few people regularly use or misuse opioids, prescription or otherwise. But opioid overdoses sting in a way we’re simply unprepared to handle, especially with the spread of fentanyl.
It’s worth examining where opioid overdoses stand with other causes of death. People are most likely to die of heart disease (one in six), followed by cancer (one in seven), chronic lower respiratory disease (one in 27) and suicide (one in 88), according to the report. Then come opioid overdoses, which beat out falls, gun assaults, drowning, fires, accidental gun discharge, choking and so many other tragic incidents. The high ranking of opioid overdoses, then, leaves little doubt that this is a problem that must be solved.
Nearly a year ago, I wrote a story for this publication detailing actual, ongoing efforts in health tech to gauge and clamp down on the opioid crisis. Like in this column, I led the piece with a look into my family’s trials with opioid addiction, this time spotlighting a cousin who transformed his life for the better. But much of the story centered on how academic researchers, states and their prescription drug monitoring programs, electronic health records vendor Cerner and health insurer Aetna were using big data, artificial intelligence (AI) and other high-tech tools to chip away at the opioid epidemic. The piece must have struck a chord, as it became one of our most-read articles to date, likely because it covered actions over speculation.
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Today, however, much of the conversation surrounding opioids and health-tech solutions has returned to guesswork. In its Morning eHealth newsletter, for instance, Politico yesterday described the barriers preventing telemedicine from quickly being used to treat patients with opioid addictions, despite a provision expanding reimbursement eligibility. Experts told the publication that telemedicine adoption in the fight against the opioid crisis has yet to blast off, as healthcare providers wait for incoming clarifications and regulations.
Still, individual health systems, payers and healthcare companies are finding ways to use tech to help their patients. We in the health-tech universe ought to track these experiments, successful or otherwise, in case they prove effective or teach us a hard-learned lesson. After all, the opioid overdose problem is too great to brush aside, and tech may well offer unique paths forward.
First, there’s reSET-O, the newly U.S. Food and Drug Administration-cleared digital therapeutic for patients with opioid abuse disorder. Its developer, Pear Therapeutics, said the prescription-only app could plug treatment gaps, and nearly every stakeholder is cautiously hopeful that reSET-O could improve outcomes. But we can’t yet understand its effects at scale.
Health systems and provider organizations, meanwhile, have leveraged data and analytics to impede opioid overdoses in their own way. A cancer center in New York used patient and specialist feedback to build data-driven rules that slashed opioid prescribing. Two of Pennsylvania’s greatest health systems, Geisinger and Penn, launched comparable campaigns and saw similarly impressive results. And the Yale New Haven Health System decreased opioid prescribing by more than 15 percent, or 25,000 fewer pills, with one small tweak of its electronic health record system.
Other notable efforts include analyses of data to identify heavy-prescribing outlier doctors, physicians who believed they prescribe fewer opioids than they do, and patients who are likely abusing opioids. The point is, there are many ways that healthcare can harness the power of exciting tools like AI and virtual care to prevent needless deaths. We just need to try.
Each January awakens memories of my cousin Courtney, half-recalled glimpses of a life cut too early. This will never change. And I will almost certainly receive many more heartbreaking birthday cards from her mother.
There’s no wiping out opioids and their dreaded effects. But not every family must go through this annual ritual, and not every addict must overdose and die.
Steps taken by the U.S. healthcare system to this point have yielded subpar results, with rising overdose and addiction rates, the questionable efficacy of many rehab programs and so on. It’s clear that it’s time to try something new, to embrace the future and its technologies and their promise. Some pioneers — mostly entrepreneurs and clinicians desperate to save their patients — have proved successful in using tech to combat small pieces of the opioid crisis, providing healthcare with ammo in the form of ideas.
Tech companies are developing highly advanced self-driving cars to improve road safety. In the near future, motor vehicle crashes could become rare — relics of another time. Now, healthcare and tech have a chance to develop solutions that could prevent or negate the effects of opioid overdoses, and neither industry can pass up this chance. Opioid overdoses are, after all, a greater American killer than anything on our roads.
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