Good morning! There are numerous organizations that recommend assessing a patient's status as opioid naïve or tolerant prior to opioid administration. (ex: WAKE UP Campaign, HRET ADE Prevention Change Package, ISMP TMSBP 12, TJC SEA 49, Opioid ADE Prevention Gap Analysis Minnesota Hospital Association.) We also know that performing an assessment of opioid naïve or tolerant status is complex and prone to knowledge based error by multiple disciplines. (ex: Results of the Opioid Knowledge Assessment from the PA Hospital Engagement Network Adverse Drug Event Collaboration.) Our institution is currently upgrading our Knowledge Based Care content (clinical practice guidelines) and we are pushing to build this type of assessment into a primary flowsheet. Lots of questions have arisen that may end up having to place this initiative on hold. Have you had success implementing a formal opioid naïve versus tolerant assessment program into your EHR? Who performs the opioid naïve versus tolerant assessment in your facility? What is the information used for? Is it used as actionable information or just simply documented and forgotten? Have you been able to deploy this screening tool to change behavior in a medication use process? Have you been able to use your EHR system to help drive this as a forced function? Are you experiencing any problems with patients erroneously documented as the wrong dichotomous category? Thank you for your thoughts on any component of this complex topic! Our facility uses Sunrise Clinical Manager Allscripts as our EHR. Sincerely,
Jason Perry, PharmD, BCPS, LHRM, CPh - Medication Safety Officer