![]() ProHealth used these resources to develop their own set of “Best practice guidelines” focusing on utilizing the initial visit to screen and evaluate patients, give patient education on the risks and benefits of therapy and obtain informed consent prior to prescribing. The critical need to treat for functional outcomes and not total cessation of pain was a key component of the guidelines. REMS began in April 2011, as a program using pharmaceutical industry funding for development and educational dissemination of safe opioid prescribing practices. Food and Drug Administration (FDA) Risk Evaluation and Mitigation Strategy (REMS). The 2012 publication of the Federation of State Medical Examiner Boards titled “Responsible Opioid Prescribing, A Clinicians Guide” proved to be an invaluable guide. Sensitive to these issues, ProHealth looked to resources already developed for guidance. Respect for autonomous practice and trust between medical leaders and providers, like the trust between providers and patients, is valued. Strict policy mandates were rejected as non-starters for providers who must work with the complex and diverse needs of individual patients. With background collected from its assessment, and knowing the scope of the challenge, ProHealth worked to make writing opioid prescriptions for chronic pain a safer, more consistent experience for provider and patient. Scientific evidence for safe and effective treatment for chronic pain is still being developed, and in its absence, providers walk a tightrope of under prescribing, exposing patients to the debility of untreated pain, or overprescribing, risking adverse effects, diversion of drugs, and in extreme cases, death. It is abundantly clear that a simple solution for the problem of chronic pain control was evasive. ![]() Analysis of the data indicated an absence of uniform procedure for prescribing opioids. The survey revealed doctor-to-doctor variance in rates of prescribing. By using a survey that explained to providers that data gathered was explicitly for informative purposes, ProHealth gained a clear view of the prescribing habits of their providers. ![]() Todd Staub warned that overprescribing, “Would soon surface as a nationwide problem.” Assessing prescribing habitsĪpproaching the issue scientifically, ProHealth analyzed how providers were dealing with controlled substances. ![]() Presciently, then ProHealth Physicians Chairman Dr. Although none of the accused doctors were with ProHealth Physicians, these events prompted analysis of practices related to opioids. Growing awarenessĮarly in 2012, ProHealth took note of several Connecticut physician arrests for criminal overprescribing. ProHealth physicians have been at the forefront of safer, more effective prescribing. This complex epidemic facing the United States is front of mind for family practitioners. Morbidity and mortality from use of the drug has seen an equal surge. That said, the number of prescriptions written by physicians and advanced practitioners for the two most common prescription opioid painkillers, oxycodone and hydrocodone, has spiked from seventy-six million in 1991 to 207 million in 2013. No single factor alone caused the dramatic rise in opioid use in America over the last two decades. gov/initiatives/Comprehensive-Primary-Care-Initiative The Comprehensive Primary Care initiative is the kind of common-sense investment in health care we need.ProHealth Physicians, part of Optum, is a physician-led health group caring for more than 345,000 patients with 350 primary and specialty care providers at 85 locations in Connecticut. Additional information is available online at. The Comprehensive Primary Care initiative is a four-year project administered by the Center for Medicare and Medicaid Innovation, which was created by the Affordable Care Act to test innovative payment and service delivery models that have the potential to reduce program expenditures while preserving or enhancing the quality of care. Marilyn Tavenner, acting administrator of the centers.
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