Care Transformation Center Blog

How Geisinger is responding to the opioid crisis and cutting ED visits in the process

by Rob Lazerow, Rebecca Tyrrell, and Gillian Michaelson

Drug overdoses are now the leading cause of accidental death in the US. In 2016 alone, fatal drug overdoses (63,632) surpassed the number of individuals who died during the HIV/AIDS epidemic at its peak in 1995 (43,000) and U.S. military deaths in the Vietnam War (58,000). At this point, opioid abuse and addiction have had devastating consequences on communities nationwide.

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As frontline providers of care and pillars of their communities, hospitals and health systems are poised to expand their role in mitigating the harms of the crisis. Some progressive organizations have already developed interventions that successfully prevent new addiction or expand access to addiction treatment.

For example, Geisinger Health System in Danville, PA initiated a system-wide response to the opioid epidemic. One aspect of this response included training pharmacists who were already embedded in primary care clinics to become pain management and addiction specialists. Geisinger piloted the program by training 9 out of 58 embedded pharmacists. After just a year, the pharmacists were able to manage 1,233 patients with chronic, non-cancer pain and reduce ED visits by 20%.

Here are two major reasons Geisinger's approach was successful as an early response strategy:

1. Pharmacists were trained to prevent new cases of addiction, treat existing ones, and more effectively manage patients’ pain

Instead of targeting just prevention or treatment, Geisinger maximized the immediate impact of their intervention by training staff to both prevent new cases of addiction and treat existing cases--while still managing patients' chronic pain.

Across the year, trained pharmacists significantly decreased the opioid dosage amounts of their managed patient population. Additionally, the trained pharmacists increased the use of methadone, a common form of medication-assisted treatment (MAT) for opioid addiction, among their patients by approximately 20% compared to non-pharmacist managed patients.

This tactic worked especially well for Geisinger because the clinical needs in the regions where they operate span across prevention, pain management, and addiction treatment.

For more information on the specific clinical needs in your region, use our new analytic tool: The Opioid Population Profiler

2. Geisinger maximized the use of existing clinical experts

Rather than make a large scale investment, Geisinger chose to train and empower already embedded clinical pharmacists. This decision allowed the system to expedite the roll out of the program in a financially sustainable manner.

Many other hospitals and health systems serve markets that face a significant gap in treatment options, but lack sufficient staff and specialized capacity to meet local demand. In this circumstance, leaders should first evaluate options for capitalizing on the relative abundance of opioid-related funding available from city, state, or federal governments—as well as local philanthropies.

The opioid crisis is a community challenge and, just as hospitals and health systems can help the community more broadly through greater engagement and education, the community can help the health system fund the development of new clinical capabilities.

 

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Use this new tool to guide the construction of your comprehensive opioid response strategy.

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Learn more: Get 8 steps for deploying clinical pharmacists in outpatient clinics

Clinical pharmacists are uniquely skilled at identifying and correcting medication issues. In response, many health systems are deploying pharmacists in ambulatory care settings.

Check out our infographic to learn eight steps for how to deploy clinical pharmacists in outpatient clinics.

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