1.0.0 Opioid Prescribing Support Implementation Guide

1.1.0 Introduction

This implementation guide provides resources and discussion in support of applying the Centers for Disease Control and Prevention (CDC) Opioid Prescribing Guidelines:

CDC guideline for prescribing opioids for chronic pain

This implementation guide was developed as part of the Clinical Quality Framework Initiative, a public-private public-private partnership sponsored by the Centers for Medicare & Medicaid Services (CMS) and the U.S. Office of the National Coordinator for Health Information Technology (ONC) to identify, develop, and harmonize standards for clinical decision support and electronic clinical quality measurement.

This project is a joint effort by the Centers for Disease Control and Prevention (CDC) and the Office of the National Coordinator for Health IT (ONC) focused on improving processes for the development of standardized, shareable, computable decision support artifacts using the CDC Opioid Prescribing Guideline as a model case.

1.2.0 Scope

This implementation guide includes support for the following guideline recommendations:

1.2.1 Rationale for Initial Focus

Prior review by Yale Center for Medical Informatics had identified these recommendations as the most implementable using the Guideline Implementability Appraisal (GLIA) form. MME will be quite challenging to implement, but also is expected to provide significant value to healthcare organizations due to the complexity of the logic which would make it difficult to re-implement on an institution-by-institution basis.

Recommendation #4 (starting on short-acting opioids) is difficult to implement because identifying new opioid prescriptions for chronic pain is challenging (specifically, such therapy often starts out with an intention to treat acute pain). Recommendation #11 (opioid-benzo interaction checking) is difficult to implement due to overlap with existing drug-drug interaction checking software and the lack of further specificity in the guidelines (e.g., for specific drug combinations over a certain dosage and for specific populations such as the elderly).

1.3.0 Getting Started

Follow the documentation link in the IG menu for an overview and introduction to the documentation for the guide.

For clinical informaticists interested in how the behavior for the artifacts was determined, refer to the Process Documentation.

For an overview of how the artifacts are represented in the FHIR Clinical Reasoning resources, refer to the Integration Documentation.

For a detailed description of how to implement the functionality with CDS Hooks calling into a FHIR Clinical Reasoning server, refer to the Implementation Documentation.