Cleveland Clinic ED applies EMR interventions, reduces opioid prescriptions by 50%

Cleveland Clinic researchers used various EMR interventions to decrease the overall number of opioids and number of inappropriate prescriptions prescribed across several of the health system's emergency departments, according to a study published in the American Journal of Emergency Medicine.

The multicenter study analyzed a 12-month pre- and post-intervention in 14 Cleveland Clinic EDs after four EMR interventions were implemented. The EMR changes were deleting clinician preference lists, defaulting dose, frequency and quantity, standardizing formulary to encourage best practices and creating dashboards for clinician review with current opioid prescribing practices. Participating providers also received data and direct feedback on the study monthly.

Results of the study showed that during pre- and post-intervention, there were more than 700,000 ED discharges. The total number of opioid prescriptions per 100 discharges during this time frame dropped from 14.4 percent to 7.4 percent, illustrating a 50 percent decrease overall. Prescriptions exceeding three days also decreased from 5.9 percent to 0.7 percent during the time period.

Study authors concluded that EMR interventions in conjunction with direct feedback to clinicians can help standardize opioid prescribing protocol within a comprehensive healthcare system.

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