SCPMG’s Systematic Approach to Fighting the Opioid Epidemic

Joel Hyatt, MD, emeritus assistant regional medical director for Community Health Initiatives for the Southern California Permanente Medical Group (SCPMG), joined New Hampshire Attorney General Joseph Foster on an Institute for Healthcare Improvement panel entitled, “The Opioid Crisis: How Health Care and the Community Can Act.”

Dr. Hyatt has been a leader in safe opioid prescribing for the Kaiser Permanente Southern California region, the LA County SafeMedLA Coalition, and the California Health Care Foundation. Speaking on the IHI panel in April, he says the Kaiser Permanente Southern California Region has achieved major reduction with its early and systematic approach, noting that it “looks simple but was not easy.”

SCPMG discovered in late 2009 through regular drug utilization monitoring that opioids were the region’s most frequently prescribed drug and moved quickly to organize a response that evolved over time.

Perhaps most successful was adding warnings and hard stops to the electronic medical record, empowering pharmacists with “corresponding responsibility” to call out high doses or quantities, and providing physicians with lists of patients who had been prescribed opioids with recommendations and advice, including tapering guidelines.

Over six years, SCPMG has significantly lowered opioid prescribing overall, including less prescribing of brand-name drugs.
Attorney General Foster says the epidemic use of opioids is the biggest public health and law enforcement issue in New Hampshire.

Foster says the state’s concerted efforts to reduce supply and demand include requiring physicians to query the state’s prescription drug monitoring program, allowing pharmacies to take back unused opioids, treating drug overdoses as crime scenes to allow evidence to be collected and drug dealers prosecuted, and launching an investigation into the marketing of opioids by pharmaceutical companies to determine if they are making false claims to physicians.

Download the entire presentation.

Visit the IHI website to listen to an audio of the full presentation.