Michigan | 50 states of population health

DAVID WOOD, JR., MD. Executive Vice President and CMO of Beaumont Health (Southfield, Mich.)

On the top challenge

"The opioid crisis is consuming the state and our health system with full force right now. The epidemic is taking so many young lives in the state, and thankfully our legislature has acted with new regulations of opioids. However, the regulations have some unintended consequences. Our state mandated some pretty austere opioid prescribing regulations, and our patients are at risk of not getting adequate pain management. In Michigan, beginning this summer, if a physician prescribes more than three days worth of an opioid, they must log on to a state database that records all opioid prescriptions, search the individual to whom you're prescribing the medication, see whether they're getting opioids from other providers and document it in the medical record. In addition, the maximum number of days of opioids you can prescribe is seven for acute pain. 

So one of the concerns is when patients get surgery such as rotator cuff, healthcare providers are able to do nerve blocks that are extraordinarily effective, but they wear off after about 10 to 12 hours. If the medication wears off and the patient is in significant pain, started taking their opioids, but runs out on a Saturday, their doctor could end up sending them to the emergency room because they cannot call in opioid prescriptions on the phone. You know when that person goes to the emergency room, their acuity is going to be low and they may have to wait a while and occupy resources needed by sicker patients, let alone getting in a car a few days after surgery is no picnic. We are also concerned physicians may not want to log on to the State database and thus prescribe less than adequate pain medication."

On the hospital's response

"We are developing an education plan for our physician community about opioid prescribing in the ambulatory, inpatient and emergency settings. That's been taking a lot of effort."

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