Combating the Opioid Crisis with PerfectServe-Enabled Communication

Bon Secours Mercy Health is one of the 20 largest healthcare systems in the United States, serving communities across seven states and Ireland. Through partnerships and by investing in innovative processes, technology, and products, Bon Secours Mercy Health continually strives to improve healthcare quality while reducing costs and addressing healthcare issues facing entire communities. Two areas of focus include enhancing access to behavioral health services and fighting opioid dependency.

Challenges

Bon Secours Mercy Health serves many communities that have been significantly impacted by the opioid epidemic, with some areas seeing an average annual overdose death rate that doubles the national average. In the summer of 2016 alone, Cincinnati experienced an unprecedented 174 heroin overdoses in a six-day time period. In each year that followed, approximately 5,000 Ohioans died from overdoses.

After reviving and stabilizing patients, emergency department nurses were trying to coordinate rehabilitation treatment to prevent repeat overdoses, but had difficulty connecting with community based treatment providers. Patients regularly left the ED when stable without successfully enrolling in a treatment program.

Solution

Bon Secours Mercy Health implemented a multi-pronged approach including opioid prescribing practices, acute withdrawal protocols, efficient access to Prescription Drug Monitoring Program (PDMP) databases, Narcan (naloxone) availability, early treatment referrals, and partnership with area addiction treatment facilities—a pioneering collaborative with technology at the heart of the program.

Fourteen private, church, university, and VA-based facilities were connected to the health system through special read-only EHR access and advanced clinical communication. Treatment centers built on-call schedules within PerfectServe’s Clinical Collaboration platform, which used intelligent routing to ensure that ED staff received timely responses— resulting in an average response time of just four minutes.

Implementation

Typically, once a patient is revived, clinicians have a finite window for treatment before the patient drops out or loses motivation. Since delays often result in subsequent overdose and death, the program began by changing the treatment paradigm to an on-demand model.

Bon Secours Mercy Health extended use of the PerfectServe Clinical Collaboration platform to their community-based treatment program partners. All 14 treatment facilities instituted 24/7 call schedules to facilitate smooth patient acceptance and hand-off. Dynamic Intelligent Routing®, PerfectServe’s proprietary rules engine, was used to connect clinicians with on-call providers quickly via one HIPAA-compliant smartphone app.

Secure access to EHRs by the receiving provider reduced the average time to perform patient intake, which further expedited the transfer process.

Results

Bon Secours Mercy Health achieved rapid rehabilitation referral through accurate and immediate communication between the ED clinical team and community-based treatment facilities. The program has recorded the following results:

• 4-minute average response time for patient acceptance by community treatment centers
• 50% increase in the number of people receiving treatment
• 36% decrease in overdose ED visits
• 34% decrease in opioid-related deaths
• 33% decrease in medic runs

Conclusion

Bon Secours Mercy Health’s Addiction Treatment Collaborative has dramatically reduced the number of opioid-related overdose deaths through a comprehensive approach that includes rapid referral of overdose patients to drug addiction treatment, which improves rehabilitation success rates.

Rapid communication with treatment centers through PerfectServe, combined with faster patient intake through EHR access, reduced the enrollment timeline from 4-6 weeks to mere hours, significantly improving the likelihood that patients received needed therapy.

Bon Secours Mercy Health serviced Butler, Claremont, and Hamilton Counties with this program—the only three counties in Ohio to see a decrease in opioid-related overdose deaths in 2018.