NORWALK, Conn. — Forty-four people across the nation die each day from overdosing on prescription painkillers, or opioids, according to the Centers for Disease Control and Prevention. Xerox is working with MO HealthNet, the state's Medicaid division, to address the prescription drug abuse epidemic through the implementation of technology that provides real-time data and alerts to ensure that opioids are prescribed and used safely and effectively.
Xerox's prescription clinical authorization tool gives physicians and pharmacists real-time insight into recent prescriptions received and filled by a patient. As a pharmacist fills a prescription, the tool investigates whether the patient has recently received another opioid. If so, the pharmacist receives a notification that prior authorization is required to verify the medication is correctly prescribed and necessary for the treatment plan. Xerox software then streamlines the prior authorization process by managing coordination between the patient's physician, MO HealthNet and the pharmacist. The increased communication between these groups helps manage a patient's opioid dosage over a set period of time.
With this program, MO HealthNet has dramatically reduced the number of patients receiving more than the Food and Drug Administration's recommended dose of opioids. Vicodin use, for example, dropped more than 30 percent, while Percocet dropped 16 percent from January 2012 to January 2015.
"Missouri does not have a statewide, electronic prescription drug monitoring program, so physicians and pharmacists have limited visibility into other medications a patient has received," said Janelle Sheen, Pharm.D., pharmacy solutions director, Government Healthcare Solutions, Xerox. "We help eliminate that blind spot by providing data and alerts that reduce doctor and pharmacy hopping while improving the coordination of care."
Xerox also utilizes medical claims data via MO HealthNet to send out notification letters to physicians of patients who may be receiving prescriptions from other providers. Since September 2013, 300 providers received notification about 1,491 patients who appeared to be over-utilizing opioids without a supporting diagnosis. The letter provides indicators of drug abuse, along with the patient's profile and a recommendation that the doctor reevaluate the patient's treatment plan. Within six months, there was a 73.9 percent reduction in the number of target patients flagged for overutilization. MO HealthNet also saw a savings of more than $44,000 in intervention-related drug expenditures during the six-month post-intervention period.
"There are legitimate reasons why a person may require opioids to manage their pain, but unfortunately this type of medication is often abused for a variety of reasons from dependency to diversion for profit," said Steve Calloway, director of pharmacy, MO HealthNet. "The solution Xerox provides helps us ensure our members have access to the prescriptions they need while preventing adverse events associated with opioid abuse, ultimately saving lives and improving health outcomes."
Xerox has worked with MO HealthNet for more than 10 years and has more than 40 years of experience working with government health agencies to enhance the efficiency of health programs and help ensure the health of citizens. Xerox healthcare solutions meet HIPAA requirements to protect patient privacy.
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