February 19, 2018

In This Issue
AMA Advocacy Conference Highlights High Drug Costs, Regulatory Relief and Coverage Concerns
MMA Board to Address Several Critical Issues at Annual President's Retreat in March
Use EMR System Defaults to Reduce Opioid Prescribing
CMS Projects Health Care Spending to Increase Significantly in Next Decade
Purdue Pharma Announces Cessation of Marketing Oxycontin to Prescribers
Health Access Network Names New Chief Executive Officer
Notes from the American Medical Association
3 Ways to Maximize Employer Diabetes Prevention Tools for Your Patients
Legislative Call This Tuesday, February 20th
Legislative Report: "Conversion therapy" and More
Healthcare Suicide Prevention Protocol Development Training - half day workshop - March 2
28th Annual Winter Conference - Contemporary Topics in Orthopedics - March 16-18
QC2018: Building Communities of Practice through Innovation - Wednesday, April 4, 2018
MMA and Jackson Laboratory Seeking Volunteers to Assist with 2018 Maine Cancer Genomics Initiative Forum
New Free CME on Alzheimer's Risk, Detection, and Management
Peer Navigation Program from Facing Our Risk of Cancer Empowered (FORCE)
Online Learning Opportunities Offering CME Credits - from the Northern New England Practice Transformation Network
Associate Director/Director of Compliance, Privacy, Risk and Legal Affairs for Penobscot Community Health Care in Bangor, Maine
MD/DO - Lewiston, ME
Chief Executive Officer CEO at Greater Portland Health
Outpatient Internal Medicine Physician Bangor, Maine
Relocate to Beautiful Southwestern Maine - Medical Director/Family Practice Physician
Clinical Cardiology Opportunity
Outpatient Only - Internal Medicine with Loan Repayment & Sign-on Bonus
Opportunities at the VA for Volunteer Physicians

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Use EMR System Defaults to Reduce Opioid Prescribing

Researchers at the University of Pennsylvania in Philadelphia noticed a problem with overprescribing of opioids in their emergency departments. Many patients were not talking nearly as many opioid pills as they were being prescribed. As the institution changed its EMR provider, Dr. M. Kit Delgado and others took advantage of a feature in the new system that allowed them to set a default number of recommended doses right in the system. They set the default to half the number of pills generally prescribed in their departments, 10 as opposed to 20. The individual prescriber remained free to prescribe whatever number she or he deemed clinically appropriate.

The effect was dramatic. After 41 weeks, the number of physicians prescribing 20 doses declined from 22.8% to 16.1%. Prescriptions for 10 doses increased from 20.6% to 43.3%. The number of prescribers ordering 11 to 19 doses also decreased, from 33.5% to 20.1%. Dr. Delgado noted that the number of prescriptions for fewer than 10 doses declined, though, as more physicians followed the default recommendation.

The researchers tweaked the system to provide for defaults of different opioid/acetominophen combinations and including options for different numbers of doses. They found that the number of opioid doses being prescribed was cut in half, with patients reporting fewer pills left over after their pain resolved.

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