Brigham and Women’s Surgeon Encourages E-Prescribing for Opioids

Electronic prescription of opioids is safer and more convenient, says surgeon Atul Gawande

In an article in the Annals of Surgery, Atul Gawande argues that there is an urgent need to expand the use of electronic prescriptions for opioids. According to Surescripts, e-prescribing controlled substances can prevent prescription duplication and forging, reduce dosing errors, improve patient adherence, and simplify the prescription process for both providers and patients.

Under the current system, surgeons frequently supply a large excess of pills. According to a 2017 study, 72% of narcotics prescribed for some of the most common outpatient procedures end up going unused, and three-quarters of patients hold onto these excess pills rather than disposing of them. Gawande points out that surgeons often intentionally overprescribe to meet the needs of 99% of patients, because “patients stranded with an insufficient supply for their pain have no straightforward way to get a refill without a written prescription.” He argues that e-prescribing “would make it easier for surgeons to write smaller prescriptions that meet the needs of 80% of patients, knowing they could remotely order an additional supply if a patient needed it.”

The state of New York has already proven that large-scale expansion of e-prescribing for opioids is feasible. In March 2016, New York announced stringent opioid prescription regulations which require the use of electronic prescriptions. In just one year, the number of New York providers with e-prescribing capabilities jumped from fewer than 2% to more than 47%.

Read more here. Epic community members are already starting to integrate with their states’ prescription databases to track opioid prescriptions. Community members can read about MetroHealth’s success here.