An evaluation to determine if a patient is opioid naive is not possible when a EHR system does not support queries for past medications by date range.
| Opioid analgesics with ambulatory misuse potential prescription in past 90 days excluding the last 24 hours? | No | Look for an existing prescription (order) for opioid that is in the value set for opioid with ambulatory misuse potential authored within the past 90 days (excluding the last 24 hours) |
Opioid analgesics with ambulatory misuse potential | MedicationRequest | MedicationRequest.medication, MedicationRequest.category, and MedicationRequest.authoredOn |
| Opioid analgesics with ambulatory misuse potential reported as being taken excluding the last 24 hours?* | No | Look for evidence of active medication on the medication list that is in the value set for opioid with ambulatory care misuse potential (excluding the last 24 hours) |
Opioid analgesics with ambulatory misuse potential | MedicationStatement | MedicationStatement.medication, MedicationStatement.status, and MedicationStatement.effective |
| Opioid analgesics with ambulatory misuse potential dispensing event in past 90 days excluding the last 24 hours?* | No | Look for evidence of a dispensing event for medication that is in the value set for opioid with ambulatory use potential occurring within the past 90 days (excluding the last 24 hours) |
Opioid analgesics with ambulatory misuse potential | MedicationDispense | MedicationDispense.medication, MedicationDispense.status, and MedicationDispense.whenHandedOver |
| * Future consideration: Current algorithm addresses only orders (prescriptions). 1 - Implement one global configuration point to set all past medication queries at each particular site: “Can the implementing EHR support queries for past medications by date range? Yes or No”. An evaluation to determine if a patient is opioid naive is not possible when a EHR system does not support queries for past medications by date range. 2 - orders use RxNorm, but medication lists and dispensed medication will require an NDC value set and/or local mapping of NDC to RxNorm to enable this element |