Possible Updates to Process Documentation Page

[gregoryawhite]

• Is this still true? “The initial focus is on Epic and Cerner EHR platforms.” And “Both Epic and Cerner will be capable of supporting the provision of the following information:“ Do we want to mention specific EHRs, and if so, do we want to include Cerner?

• Not sure if this section is still relevant, “Opioid Abuse Risk Assessment”. 2022 Recommendation 7 now suggests providers “evaluate benefits and risks with patients”, and the value set is “Opioid treatment assessment procedure” Also, the 2022 Guideline avoids recommending tapering. Hence this recommendation language is outdated “optimize other therapies and work with patients to taper opioids to lower dosages or to taper opioids”

• With the 2022 Guideline applying to pain generally, not clear that the first bullet 5.3.3. "Patient is being prescribed opioid medications for subacute or chronic pain" is still applicable. Consider changing this statement to "Patient is being prescribed opioid medications for pain". Also, consider adding other bullets for these conditions: "Patient is 18 years old or older", "Patient is diagnosed with sickle cell disease", and "Patient is receiving active cancer treatment". Descriptions of the logic implementing these conditions can be found in the semi-structured artifacts for the "opioid review useful" and "active cancer treatment" subroutines.

• The description for chronic pain in 5.3.3.1 is an older definition of chronic pain. For 2022 artifacts, prescriptions of opioids for 28 days or longer are used to identify both chronic pain (over 3 months) and subacute pain (1- 3 months) per subroutine 4.

• Opioid-tolerant vs. Opioid-naive – is this section still relevant? We have an opioid naïve subroutine that defines opioid naïve as not having an opioid prescription in the past 90 days. Not sure it aligns with the opioid naïve section of the Process Documentation that reads – “Therefore, the team decided to base recommendations on the MME calculation and to avoid categorizing patients as opioid tolerant or naïve.” Suggest this section is reviewed for possible updates.