Maine | 50 states of population health

KATIE FULLAM HARRIS. Senior Vice President of Government Relations and Accountable Care with MaineHealth and Co-Chair of MaineHealth Opioid Use Work Group (Portland)

On the top challenge

"The opioid epidemic continues to be an issue of primary concern to our patients and health system alike. A recently released report from Maine's attorney general found that 418 Maine people died of drug overdose in 2017, an 11 percent increase from 2016 and an increase of 170 percent since 2010. More than 2,100 Maine people have died of drug overdose in less than 10 years. It is an epidemic that is impacting the fabric of Maine's communities."

On the hospital's response

"In 2016, MaineHealth, the state's largest, nonprofit integrated healthcare system, created an internal workgroup comprised of clinicians representing each of our member and affiliate hospital organizations as well as Maine Behavioral Healthcare, our integrated behavioral health provider. Recognizing the opioid epidemic requires a multifaceted approach, the workgroup focused on those aspects of the problem for which the provider community can make a difference — and be held accountable. In fall 2016, the MaineHealth Opioid Use Work Group presented recommendations to system leaders in four areas: prescribing, education, treatment and perinatal treatment.

In 2017, MaineHealth implemented systemwide tools in our Epic EHR that have helped to reduce unnecessary opioid prescribing for chronic pain; our education workgroup leaders helped train 110 clinicians to get waivers to provide medication assisted treatment to patients in need; and our perinatal workgroup developed a plan to improve access to treatment for babies and pregnant women in rural areas. Our system also implemented a comprehensive 'hub and spoke' model, which provides treatment for patients with higher levels of acuity through Maine Behavioral Healthcare-run 'hubs' and ongoing treatment for stable patients in our primary care patient centered medical homes with our integrated Behavioral Health clinicians and primary care providers, who provide integrated medication assisted treatment. A foundation of performance measures underlies this effort, and thus far MaineHealth members have served more than 750 patients in this model since October 2017.

The opioid epidemic has not yet subsided in Maine, as there remain a number of barriers to further progress, including a large percentage of uninsured patients in need (Maine has not yet implemented Medicaid expansion). However, MaineHealth is focused on doing its part to address this urgent crisis. In 2018, we are looking to expand our treatment capacity, implement our perinatal treatment model, build upon our data infrastructure and further develop recovery services for patients in our hubs."

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