This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

 Today, on this week in health, it, there's no sense in reinventing the wheel across every state for every institution at all times. We should share that information. We should act as one voice and share that playbook. And for CIOs and CMIOs written by CIOs and CMOs to say, here's how we did it. Here's how we.

Recommend doing it. Don't go it alone. Learn from those of us who have scars.

Thanks for joining us on this week in Health IT Influence. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health. IT a channel dedicated to keeping health IT staff current. And engaged. Special thanks to our influence show sponsors Sirius Healthcare and Health lyrics for choosing to invest in our mission to develop the next generation of health IT leaders.

If you wanna be a part of our mission, you can become a show sponsor as well. The first step. It's to send an email to partner at this week in health it.com. I ran into someone and they were asking me about my show. They are a new masters in Health administration student, and we started having a conversation and I said, you know, we've recorded about 350 of these shows.

And he was shocked. He, he asked me who I'd spoken with and I said, oh, you know, just CEOs of Providence and of Jefferson Health and CIOs from Cedar-Sinai Mayo. Clinic, Cleveland Clinic and all these phenomenal organizations, all this phenomenal content, and he was just dumbfounded. He is like, I don't know how I'm gonna find time to listen to all these, all these episodes that I have so much to learn.

And that was such an exciting moment for me to have that conversation with somebody to realize we have built up such a great amount of content that you can learn from and your team can learn from. Talk to so many brilliant people who are . Actively working in health IT addressing the biggest challenges that we have to face.

We hope you'll take advantage of our website, take advantage of our YouTube channel as well. Today we are joined by members of the Chime Opioid Task Force, and it's a phenomenal group. We have Bruce Sarillo, board Chair of Nordic Consulting. We have Matt Sullivan, HVM Sullivan, atrium Health, CMIO, Sean Kelly, CMO, chief Medical Officer for Impravada.

And Scott Weiner, an emergency physician for Brigham, as well as the director of Brigham's Comprehensive Opioid Response and Education Program. Gentlemen, welcome to the show and and thanks for coming on. Nice to be here. Thanks, bill. Thank you. We're gonna start with a high level walkthrough and really set up the challenge, the problem that we are facing with regards to opioids in the us.

Perhaps talk a little bit about the current state and the crisis, then talk about the work of the task force, explore policy a little bit, and then talk about how this is being implemented at the local level, at the health system and at the hospital level, and how that work's getting done in our communities.

Uh, Scott, I'd like to, to start with you. Can you kick us off and give us an idea of the challenge that we are currently facing with this? Thanks, bill. Thanks so much for having us. It's been nothing short of tragic and it's, it's really unfortunate, particularly because of Covid, right? Because everyone has been focused on Covid and the terrible numbers we're hearing of people that have died from.

93,000 people died from overdose related death. About two thirds of those were from opioids. And like you said, it's been disproportionately affecting certain populations too. If you look at people that died from Covid, the most affected age group are those that are 85 and older. And that's unfortunate of course, but they've been able to live a full life.

People that are losing their lives from opioids and drugs. The most common age groups are like 25 to 44 people really in their prime when they should be. Experiencing experience in life, working, developing a family, and their lives are just getting lost and stolen from them. And as you mentioned, and particularly for communities of color, it's been extremely tragic.

In Massachusetts where Rashan and I work, we saw a relatively modest increase of opioid related deaths, about 5% last year, but the number amongst black males increased 69%. So it's just been tragic and this is happening all over the, the country. I think Minnesota twice as likely to die from an overdose if you're black compared to white, it's just.

I highly recommend people look at some of these statistics. If you just look at the, the numbers, it sort of takes your breath away. The pandemic exacerbated the problem of opioids. But this isn't being driven solely by one event. What are some of the other drivers adding to this crisis? Matt, we'll turn to you for that.

Yeah, bill, it's a great, it's a great point. Obviously there's no one thing that's gonna drive, uh, data to move in that direction. I think you're exactly right. We'd put it a lot of things in place nationally, we're gonna arrest that growth and perhaps even as we would. Continue on in our minds think that diminish the deaths.

The problem with, with the covid, uh, pandemic was that we, we changed the game, right? We changed the game in all of medicine and specifically around substance use treatment and the ability to get substance use treatment. When everybody has to be quarantined and stuck in their house for a while, we're not able to go out and hit the programs that are actually making an impact.

And so a lot of the issue around how do we get these people into the program, well, they can't come 'cause the doors are shut. You can't go because people are getting sick. And so we, we quickly, in the rest of medicine transitioned to a telehealth model, which we've seen to be actually relatively successful in the behavioral health space, particularly in, in youth, right?

That these are kids that are gamers, right? They don't mind getting on a camera, they don't mind talking to a therapist. It seems like it's pretty cool. We didn't see that impact in people that have a substance use disorder, because there was a presumption, and there's some data around this, about is there an accountability of actually presenting to a location, being who you are in front of the therapist and, and answering those questions of are you still struggling with use?

How has your progress been and some of that stuff. We haven't really quite figured out all the details, but, but we're starting to get the sense that there's some sort of personal accountability not achieved across tele telehealth. And I think we probably need to get into that and to figure out what are we doing now from a national perspective to fund that kind of research, have a better understanding of what it takes from a telehealth perspective to deliver that kind of care to someone who's suffering from substance abuse disorder.

It's really a complex issue. So I think there was some issues of how we changed healthcare, how it wasn't ideal for those people who are struggling in, in that realm, despite having great telehealth success in other arms of medicine. My two questions as I'm listening to that is, should we expect those numbers to come back as we get post pandemic?

Will they naturally come back? That's one question. Then the second is, does telehealth. Contribute to the problem at all, or, or doesn't it? Why don't I kick off a little bit and maybe pass it to Shauna and Scott here in a second? I think that I, I wouldn't say that Telehealth contributes to the problem. I think telehealth was a solution that didn't necessarily work perfectly.

I don't want to discount telehealth, obviously. I think there's tremendous value there. Obviously there are always small subsections of, of people that that will do well. But as a global overarching, as we look at that, I'm not sure that we saw the substance use . The patient population there get a tremendous benefit from telehealth.

Now, having said that, we're starting to recognize that we're starting to see SAMHSA put out a lot of national grants to study this. There's some additional work I. Coming out HRSA to try to figure out is, is telehealth the right way? So I think, and, and I'll pass it off to the other two here. Now, I think that we are reacting in the right way from a national perspective and putting the right funding in to identify what the problem is and then look for the solution.

And I, and I hope the other two have, you know, some thoughts on that. The short answer to your question of course is depends. It's a great question and I, I think that we can, we can curb these numbers, but we have a lot of homework to do and I think that, like, as Matt said, telehealth is one aspect of technology that can be brought to bear.

That gets us a little bit to the purview of the the opioid task force and talking about really many aspects of it that can be used to heavily influence morbidity and mortality. And of course, Scott brought up overdose deaths as a major marker of where the numbers are going. And of course, it has not been to a good place through the pandemic.

And Matt brought up the morbidity associated with this. It's not just the overdose deaths that we see in the er and the spillover is the last resort for people that come rolling in. But you know, people in the throes of addiction and all the other things that happen to them in their families, whether it's financial ruin or the concomitant psychiatric disorders and mental health disorders that go along with it.

And of course that's a vicious cycle and a lot of those safety networks have been eroded. Even before the pandemic, there was a lack of resources and then through the pandemic with social isolation and a lot of the societal factors, it just got worse. But I think the good news is technology can be brought to bear.

We've learned a lot of lessons through the pandemic, which I'm sure you've talked about on your other podcasts where both virtual health and many other IT fixes have come to play. And the old kind of inside joke amongst us, ER people, has never waste a good crisis. And we've learned a lot through this crisis and how we can bring technology to bear.

So I think there is hope that both with virtual care, but more importantly, some of the blocking and tackling around using technology to affect workflows for both patients and providers that actually make it easier to do that right thing. And I'm sure we'll talk about this as we get into, you know, some of the work of the task force.

But you know, the good news is with some good vetting, we can figure out what the higher impact interventions are from an IT perspective to help this crisis. I was just gonna add, yes, telehealth is fantastic. In fact, one of the changes that they made this past year with Covid is that initially to get a prescription for Suboxone, buprenorphine, like one of the medications for treatment, you needed a face-to-face visit initially, and the government changed that, where you can just get, you can do it by telehealth.

That's one step in the right direction. On the other, the end of the spectrum, there certainly are patient populations which don't have access to the technology and can't get a cell phone when we've had to just basically go by, just audio only old fashioned and just talk on the phone. Which is another option, but the technology is important, but also recognizing when the technology doesn't work for patients and making sure to, to cover those populations as well as is fundamental.

Let's start getting into the, the technology and the task force. Bruce, I, I'd like to ask you talk a little bit about the history of the Chime opioid task force when it was formed and what the charter of the group is. Sure. So very, very quick history lesson to build on what these fine physicians have already talked about.

It was the confluence of a bunch of factors. Most importantly, a gigantic need, which sadly, as I think Scott pointed out, or Matt, it's only getting bigger. There was a time we thought we might start to bend the curve. Uh, so giant need meets single opportunity. So whether it's 90,000 deaths or one death of someone.

CHIME is composed of CIOs and Chime has the benefit of the industry muscle of 150 to 200 foundation members, companies. What can we do to tap those groups to make a difference? They formed the Chime Opioid Task Force backed by Russ Brazel and the team, they blessed it, they stamped Chime on it and they let us, the folks on this call do our thing.

So the committee was formed, it's, it was co-led originally by Ed and a gentleman named Jim Turnbull. It's now co-led by Ed Patty Lly and Dave Lear. And there's a whole bunch of people, including Sean and the other folks on this phone that are helping. So the task force in business, if you will, for three years, the mission is to leverage chimes unique position at the intersection of healthcare delivery and information management to give tools and information flow to folks who can make a difference in the ER or in their community, or somewhere in this ridiculous chain of pain and death.

It's underway and there are subcommittees, and I won't bo you with all the details, but literally, well, I would say close to a hundred members have been with us in and out since we founded donating tens of thousands of free labor hours to take their time, treasure, or talent to try to make a difference in this ridiculous crisis.

Wow. We've had Ed on the show and he shared his story and I, you know, just applaud his courage to make, you know, something good out of a tragedy like that. It does. Yeah. And I think courage is the right word to, to get out there and help people to really be aware of it. People might be listening to this saying, Hey, I wanna be a part of this.

So I lead on the, the tip of that spear. But there are many other fine organizations that are also lending people and donations, if you will, to support the operational expenses of this organization. I'll add to that too, bill. So the composition of the group's changed a little bit, and like Bruce said, it's primarily CIOs and then foundation members from the industry side that are somehow involved or passionate about this issue.

And then we've had a growing number of clinical leaders, um, from both the provider side and. The industry side. And like me, I sit on both sides of that fence with being a practicing, uh, clinician, but also an informaticist on the industry side, trying to usher in good technology to fight to this epidemic.

And, and so we see a lot of like-minded individuals and the common variable really is that we really wanna focus on the power of it as a force multiplier. To affect change and, and in a positive direction. And there are a lot of committees and a lot of people working on the opioid crisis from an operational and clinical standpoint.

But we can talk a lot about, and I think we should do a deep, deep dive in a minute on the power of it and how human beings really are fundamentally subject to human factors when they interact with their digital world. To influence and affect care, and they'll do what the setting is in that computer if the default setting is set correctly.

And so what we've increasingly done is bring on more of a clinical voice into the committee to be a liaison out there to those out in the world like Scott Weiner here, who's running the opioid stewardship committee and really trying to leverage the IT experience of Chime and the networking. To empower those like Scott and Matt out there on the front lines.

Can can I add one other thing? Uh, to what Scott? Excuse me. What Sean just said. See Sean. I like, I don't remember Irish people's name. Just kidding. He was making an Italian joke earlier. So just to be clear, there are subcommittees which include a clinical committee, um, which in comprised mostly of practicing positions.

There's an education committee. There's a public policy committee. There is a marketing communications committee whose mission, quite frankly is just get the word out and it all coalesces around the opioid action center.com. That's a website that's meant for us to produce and make available. Original content that these groups of people are developing and to compliment that with regularly curated, refreshed information and resources from everywhere.

So it is a go-to place, which is kind of our public face of all the work that's going on behind the scenes. Opioid action center.com. When I'm doing my research for any interview I'm gonna do where I know this is coming up, that's the first place I go because you guys are also aggregating a bunch of articles.

You're aggregating research, you have a podcast, you have ACIO playbook. I mean, there's just, it is loaded with great information, but it's also for me in what I do. It's a great place. Finding the Commonwealth Statistics took me all of about two minutes. I hit your site, went to the uh, resource center.

Looked up the most recent articles on it, found that there's just a wealth of information. So highly recommend people check that out. We're gonna go down into that technology stuff. But, you know, one of the things I wanna talk about just briefly, under Russ's leadership, chime has had a more significant role in Washington and I, I really appreciate that.

I, I'm wondering if the task force has been able to help move things forward in Washington with regard to policy. I don't know who wants to, uh, take that question. So this is Bruce and I know enough to be dangerous and I can turn it the back to the physician for a more specific content Chime and Russ is getting a lot of love today.

Was lucky. We were lucky enough. We, the opioid task force for Chime to allow us to tap into some of their existing strength and capabilities, one of which was a Washington based lobbying team. And part of their efforts, well all of their efforts were to promote chimes agenda in Washington. They, we were then lucky enough to be allowed for them to promote with some of their energy chimes opioid task force specific agenda.

And so they were very instrumental in the scramble that occurred, the funding scramble that occurred in 17 and 18, that resulted in a pretty massive, in the billions of dollars. It was, it was Washington's way of trying to make a difference, whether it was prevention or treatment and or education and or access to technology.

There was literally billions of dollars that were funded and chimes, um, lobbying team in part fueled by the opioid task force representatives. That was a gigantic victory. More work continues. Hey Bruce, we refer to him as advocacy. We don't refer to him as lobbyists, by the way. Yeah. Okay. Yeah, and I'm really tall and I'm five eight and I'm really not tall, so I got it.

I can give a little color on a couple of. The policy issues I think were particularly important and maybe Scott can do a little bit of a embellishment too, but I think that a, a couple of technologies specifically have great relevance to the it. One is EPCS or electronic prescribing and controlled substances.

And I think this is a good topic to consider when really as clinicians need to own up to the fact that prescription drugs were a big part of this problem and we all know a lot of the history. Behind pharma and clinicians, and even things like the culture that we grew up in with the Joint Commission and others treating pain as the vital sign.

And if you're not treating pain down to zero, you're not doing anyone any favors and. Actually giving too many of these prescription medications to patients that ended up creating people that were addicted, that fed into this cycle. There's a long history there, and I don't want to go too much into that, but from an IT perspective, shedding light on all of this process and creating an electronic prescribing system that is transparent and accountable, efficient, audible, but again, needs to be.

A good technology because you can't put expensive onerous technology that blocks clinicians from doing their job. You need a good technology that actually does all those things from a regulatory and auditing standpoint and prevents misbehavior by a certain minority of clinicians. But something like EPCS and, and influencing that in the right way with those advocates on the hill, but even more importantly at the state level to say, look.

We need good technology. It can't be too expensive. It can't be too onerous, but it needs to be there and we need to modernize the way that we prescribed. Another case would be . The PD DMPs or the prescription drug monitoring programs, or we actually can have visibility as frontline clinicians and others to who's actually been getting prescription medications and where have they gotten them, and lack of interoperability.

There has been a blocker in the past, we're getting over some of those humps, but you know, the fight is not over there as far as standardizing and. Working on those systems, but that's right to the heart of what it can do is to make these systems easier and readily available to the practicing clinicians.

And that really takes cooperation between the providers, the legislative bodies, the monitoring and auditing bodies, and the vendors involved, like the EHRs and other vendors IM Management and EPCS. So I'll turn it back to Scott and Matt and others for comment, but I just wanna highlight a couple areas where advocacy lined up with the practicality of the frontline tools.

Just probably onto the PD MP, I was gonna use that example as well too, which has been a, my mind has been a resounding success. We used to fly blind people would come into the, to the Ed wouldn't know if they had just literally gone across the street to, to Sean's hospital or my hospital with what prescriptions they had.

It was really important near the beginning when there, there was a lot of, it's a derogatory term now, but like doctor shopping, which I think has really been curbed by the existence of PMPs, where patients know that they, if they go from hospital to hospital, their, their physician, their prescriber does know that they've gotten these other prescription.

And I think that's empowering all around. Some patients say like, don't you have a database where you can see my medications now? And clinicians also feel protected. One step we took further was that we, we integrated with one click integration of the PD DM P in our, our EHR. And it's fantastic. I just push a button, five seconds, I get the result.

It automatically queries the for closest states as well, which is awesome. And we found that by just by doing that, we increased the number of searches by 43%. And it's like one of these awesome clinicians would love it because you don't have to log into a website, you just push a button and you get it.

So that's just a, a really nice example of how it can make our lives easier. It would be very fascinating to have a debate with Scott and I, I think I'm on the other side of the spectrum and, and I think that the PD and P has been somewhat helpful, but I operate and practice in a different environment where I literally live on the border between two very large Geograph states and Scott.

Has a lot of states around New England where he has to really look and and find those. We, we don't see people driving to Alabama from, from North Carolina to doctor shop, so it's a little less complex, but it, we also have been plagued a little bit with the ability of the state to manage the PDMP and each state does it a little differently and, and as we've seen that maturation grow, it's really time to think about.

What are we doing from a national perspective so that we don't have to negotiate with each one of the states? And, and again, at Atri Health being large geographic across four states, you have to figure out all the rules are different in each state and all the access points are different in each state.

And, and so that one click interoperability, the physicians think it's just automatic, right? But in the reality behind the scenes is that there are a couple people like us that are trying to wire all of it up to make it actually work well. And sometimes it takes a little bit more effort than just sort of

So I, I'm a huge proponent of having the data. I'm a pretty seasoned ed doc and occasionally it was fairly obvious who was looking for medications and for the most part, I think given the other recommendations that we've rolled out as far as limited supply and partnership with our surgical colleagues, not to be handing out.

A month's worth of opioids after a surgery. There's lots of great things we've done in medicine that actually has eliminated my need to even see the PD DMP. And so then it becomes a question of is this a mandate that that we don't need anymore? And so again, maybe at a later time, Scott and I can debate the thing I love about that, if I think about Boston, Boston has a very good data infrastructure just in the state itself.

I mean, Massachusetts has a very good. Mechanism for sharing data. They've had it for years. Great leadership there. And actually that was gonna lead me to my next question, but the other thing that I, I think it shows is Matt is A-C-M-I-O. You have to make the magic happen for all these different things to work together.

So you behind the scenes, this is not quite as easy, is just, oh yeah. Turn that dial. Okay. We're done. We're good. Yeah. The team looks at you like, you want me to do what? Yeah. Yeah. It'll be fine. But, but this gets to the heart bill of what this committee can do, right. Because there's no sense in reinventing the wheel across every state for every institution at all times.

Like, we should share that information. We should act as one voice and share that playbook and literally created that playbook of, and you mentioned it earlier for CIOs and CMIOs. Written by CIOs and CIOs for other colleagues to say, here's how we did it. Here's how we recommend doing it. And not only that, but here are the people we did it with, including the people from Epic and Cerner and maybe some PDMP people.

And so that's the whole concept. And granted, we're only partway down the journey, but the P-D-M-P-E-P-C-S, these are direct examples and chapters right out of the playbook to say, don't go it alone. Learn from those of us who have scars and let us connect all together. Share that. And if something really isn't right, let's try to change it through the advocacy and the education committees as well and get the word out through Bill and others.

I'm flipping through this CIO playbook if people aren't familiar with this, this is fantastic. It, it really is a step by step from forming a committee around opioid stewardship to creating a dashboard has real world examples from health systems, how they did it. But that leads me to the question of the differences, which is I look at this playbook and I go, okay, you, you three are from, well-funded health systems.

I mean, we can always argue what is well-funded at this point. 'cause we're all under financial constraints, but you're fairly large health systems. Let's assume I'm in. Columbia, Missouri, and I'm a one hospital system. Am I following this playbook? Is there enough stuff in here and that I can do this without a a significant budget?

I'll take a first shot at that. There should be, I. And part of the issue here is to try to break down those barriers and to give some resources and make them available. And we're actually toying with the idea, and I'll float this out to you, bill floating the idea of this curbside consult. Like, Hey, if you are at a community hospital and you are going it alone, reach out to us and let's see if we can help out and get you in touch with the Epic Opioid Army or Meditechs person or Cerners person, or.

From Impravada, we'll help out for EPCS or whatever, whatever that connection might be, and get colleagues, CIOs and CMIOs to help out those out there that are trying to recreate this, um, for themselves and, and spin this up. And so my, I don't think it's necessarily only, sure funding is an issue, but sometimes it's just, it's the actual, like, can I get a template for this and, and that's what I can use it, or can you get me in touch with my own vendor?

To talk through and, and use this, you know, blueprint rather than starting from scratch. And I'll, I'll let you know, Matt, you struggle this, you, you have a lot of community hospitals in your ranks that are doing this too. So I'll turn it back to you guys, but I think at the resounding answer is absolutely, I think we can help with this.

Yeah. Bill, you've done many of these and, and across not just opioid issues, but lots of healthcare issues. The idea that we are unique in some way. Or that, you know, Scott's team is doing something incredibly innovative in the halls of medicine is probably far less than the 99.9% of what we do every day for the US healthcare system, which is to turn patients.

Health around in the same way? Well, actually, probably not in the same way. And that is part of the problem. And that is part of what I think as an informatics team, we can try to help normalize, which is that care ought to be delivered in the same way at a very high level across the United States. And the way to do that is our EMR and, and so much of that is our struggle on a day-to-day basis.

Opioids are just part of that very small group. Where we would like to deliver the same messaging, the same way to wire the EMR up the same delivery system so that if Scott were to come down and get privileges and walk into one of the hospitals here in, in Charlotte, he would see the same look and feel and be able to take care of patients in exactly the same way as I would if I were to walk up and, and roll into the halls of Boston there.

So it's a challenge that we struggle, whether we're talking about low risk chest pain or whether we're talking about. Imaging for headaches or any of the other things that we've tried as a nation to tackle and do it in a better way, at a lower cost and a more efficient manner that that gives patients the comfort, safety to, to know that they're being cared for.

And so it's tough, but that is why we go to work every day. I'll jump into, I think it's always, we're all three ER doctors, so we think very pragmatically. I think it's good to think a couple practical examples and understand sometimes things do like APDM integration might be very technical, it might be costly require.

Coding that might be difficult for one hospital compared to another, depending on the state, depending on the number of states, depending on EHR, another infrastructure as Matt's talked about, and so you could qualify that out. It's like, that is too expensive or too much for us to handle. Or maybe we can get help with the committee going to bat for us saying, look, this needs to be more standardized, but there might be other things that are just

I just need examples of knowing where to go and look and simple interventions. You can stack rank them by impact and also by how much of a long pull it is simply doing. Order set maintenance and establishing part of your committee to go through and review discharge instructions, review default settings.

I mean, if we went through and just changed all the default settings from dispense 30, oxycodone to dispense eight or 10 as a default. To make everything PRN until the order has to change it or to X, Y, and Z. Right. There are certain interventions. Have you gone through as ACIO or A-C-M-I-O or a committee and reviewed what your patients are actually getting for instructions?

Right. Does, does the post-surgical instruction sheet say expect pain? A small, you just had your knee, you know, operated on. You expect some pain. That's okay. Here's what to expect. Here's how to deal with it. Here's a standing dose of Tylenol, if you can take it or of NSAIDs if you can take it. Here's what physical therapy and stretching is all about.

Here's a number to call. For breakthrough pain, consider blah, blah, blah. If you haven't gone through and just read some of the instructions that you yourself would get as a patient at your own facility, it's shocking. 'cause some of these things have been there for 15 years and it says, pain's the fifth vital sign.

If you're experiencing pain, take 10 milligrams of oxycodone until you can't wake up. It's you. You really have to go through and review these things, and some of that's technical, but some of it is just blocking and tackling and knowing where to look and getting templates for help. A great place to start Again, I, I keep coming back to the CIO playbook, creating an opioid stewardship committee.

We talked about that. Creating a dashboard provider, our patient education and change management. So if people are looking for, okay, how do I find out what other health systems are doing and how they stack rank 'em? This is a great place to start. Order set Maintenance and Care Pathways EPCS, electronic Prescribing and controlled substances, prescription drug monitoring programs, pd, DMPs, patient education.

And one of the ones I find interesting, community outreach and collaboration. This is not a problem that we solve in a vacuum. I mean, and there's a lot of really interesting examples in here of community outreach and working with. Some of the other organizations in the community. So as you guys hear those various things, I, I assume that's a good place for anyone to start form a committee, do that, order set maintenance, look at these various things, determine which ones you can do, uh, right out of the box.

Does that make sense? As a good starting place for a hospital system in Columbia, Missouri? Yeah, it does. Yeah. Through academic centers. Integration I talked about before was not po it was like actually literally years of meetings and integration and all this difficulty to get it. And now we've paved that path and so the, the hope is that going forward for other systems, it will be a lot easier to do that.

All this, these best practice advisories, these order sets, this education, we've muddled through it. So my hope is that a, a smaller hospital would be able to just take the playbook and run with it. Fantastic. Let me close with this. What are some of the goals? We're looking at a significant increase through the pandemic and hopefully we can see the other side of the pandemic soon, but we get to the other side of this.

What are some of the goals? What are some of the hopes, not only for the task force, but with regard to our progress? With regard to the. Bill, you said it upfront. Are we gonna get back to normal? Uh, to some degree we're are hoping that with a, a higher rate of vaccination in the US and diminished cases and our hospitals being unburdened, that we will get a little bit back to normal and people will be able to get back into the office and back into their counselors for care in a face-to-face manner.

And I think that's critical. I dunno when that will happen. It's obviously different in different areas of the country. Vaccination rates are different in different areas of the country, so we're hopeful for a return to normal. Yeah, I think first of all, opiate prescribing, as Sean alluded to before, was a huge issue.

Initially, we were clearly over-prescribing and we were giving too many high doses, long acting opioids, et cetera, and I think we've really been successful for the past 20 years at finally reigning that in. In fact, we might have overshot , but you know, it's something that we're kind of reducing this iatrogenic cause of opioid addiction, which I think is good.

Now's the hard part, right? We need to figure out why people are using drugs in society and how we can treat it. And the, the primary way to do that is to really medicalize it. It's just, it's a disease, right? It's, it's a diagnosable disease. It's a treatable disease. There shouldn't be stigma around. It's just something that.

Best practice advisory for when you come in with sepsis. And we have a best practice advisory for when you come in after a overdose. And we have modalities to treat both of those. So as we start to normalize it and make it that, you know, we, we screen patients and we ask them that just along with their travel history, we are able to humanize it and to, to not treat it differently.

But can we say by making information access, leveraging technology easier for those on the front lines, did we save a life? If we can say that, then all the hours that have been put in this will have been worth it. So it's all about, for the task force is leveraging technology to get information to treat and to prevent opioid addiction.

And it's that simple and that difficult. I'll add to that and back up that point. I think we need to acknowledge as it professionals that it drives behavior and there's a lot of power to that. I don't think we can save one life. I. Lives, and we need to step up as leaders, both on the provider side and on the industry side, and acknowledge that position of power and influence and use it and learn from each other.

The blueprints, and again, I. We we're giving you a place to chime Opioid Action Center where you can go collectively to share that knowledge, to gain knowledge, to interact and, and work together on this, but understand that we can empirically speaking, stack rank the interventions that we think have the most impact.

And you can do this today bit by bit. You can establish a committee, look at a dashboard. Put some EPCS and PDMP in play and do some change management and make an impact starting tomorrow. And we fully feel that you can get lost in a whole lot of things with the opioid epidemic, but focus on it and what it can do to change behavior and it will work.

I. Part of me wants to ask the question. There has to be ACIO who's listening to this saying, this isn't my purview. I'm not a physician. I am, whatever. Why do you want me to step up and lead? What? What do you say to that person? Well, it's your daughter. It's your life, it's your family. You're a patient too, and you have the power to affect change.

This is why you're ACIO at a hospital and not a gaming company or a bank. This is our mission and we work together. And so this is one of those places where CIOs and CMIOs, clinical leadership, operational leadership, and IT leadership, all share like passion. We're gonna be thinking about this at two in the morning when we're on a night shift, and we're gonna respond to your request for help.

And we're gonna get you in touch with Scott and Matt who've created that PDMP connection. And then we're gonna get you on with the Epic Opioid Army and say, make this connection for our friend here who, who needs that to happen? You'll save. So you wanna save lives. You're in the mission. Get involved.

Yeah. I love Bill, can I add something to that? So you're talking to three people on this call that are Boston based folks. The name Bill. It brings back the thought of excellence and goat, if you will, right? So you are lending your time and talent right now as the Bill Russell Healthcare IT podcast guru, and there are hopefully other listeners that have other time and talent and treasure that they can lend because we will save lives because of folks like you.

Appreciate it. Bruce, I'm gonna give you the last word. How can people get involved and how can they tap into this group? All right, so disclaimer, I'm also head of fundraising, so I'm gonna save that for the very end. But what they would do is to reach out to one of the folks this call, they could reach out to Chime, specifically, ask Susan Aldrich, who is, she's herding all US cats on a literally a daily basis.

I mean, just raise your hand and we'll find a place for you. The other way you can help is we have raised money three years ago that was supposed to last a year. It lasted three. 'cause we have been very careful to only spend the donated money on moving the mission forward, not dinners and plane flights and all the nonsense.

So we're gonna be doing another fundraising kicking off in October for the next two years. And if anyone has a passion or has a checkbook and or has a company that is excited by this mission, please let us know and we'll be happy to. Deploy your to try to save some lives. Appreciate that. Gentlemen, I wanna thank you.

And by the way, bill Russell, for those who don't know, was a basketball player, you have to be from Boston to know that. 'cause I've had people say to me, its like, how we do not know that I seriously, I don't know how you don't know that. But they, you know, they as far back as they go as Larry Bird, but a lot of 'em are talking about

John, millennials. Yeah. Young, young listeners. They're tough. They, they just don't know the history. They go to search for me on the internet and they say, who's this basketball player? I don't know. He won a few championships. He arguably one of the best ever. Gentlemen, thank you for your time. I appreciate your work.

I appreciate all the things that the Chime Opioid Task Force is doing, and if I can support in any way, just let me know. Thanks for having us, bill. Appreciate it. Thank you. Thanks, bill. What a great discussion. If you know of someone that might benefit from our channel from these kinds of discussions, please forward them a note.

Perhaps your team, your staff. I know if I were ACIO today, I would have every one of my team members listening to this show. It's it's conference level value every week. They can subscribe on our website this week, health.com, or they can go wherever you listen to podcasts. Apple, Google. I. Overcast, which is what I use, uh, Spotify, Stitcher, you name it.

We're out there. They can find us. Go ahead, subscribe today. Send a note to someone and have them subscribe as well. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. Those are VMware, Hillrom, Starbridge advisors, Aruba and McAfee.

Thanks for listening. That's all for now.