Electronic Clinical Decision Support Tools: Safer Patient Care for Opioid Prescribing
Using the Centers for Disease Control and Prevention (CDC)’s Opioid Prescribing Electronic Clinical Decision Support (CDS) tools can save time and promote safer opioid prescribing for patients in the context of managing chronic pain.
“Clinical decision support starts from the EHR up.”
Electronic clinical decision support (CDS) tools are integrated into some electronic health records (EHR) and other similar systems. Some CDS tools can provide prompts and reminders to assist users, including healthcare professionals, clinical teams, patients, and administrators, in implementing evidence-based clinical guideline recommendations during patient care or service delivery. CDS tools can provide accurate and timely information to help advise clinical decision-making within the patient encounter, and the data from the EHR can be used, for example, to analyze organizational practices and progress.
“EHR has the potential to serve as an educational tool, a tool to keep clinicians up to date, and to make sure they are practicing at the highest standard.”
Recommendations from the CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016 (“2016 CDC Guideline”)* have been translated into electronic pain management CDS software tools to support safer opioid prescribing.
Among other tasks, CDC’s Opioid Prescribing CDS tools can:
- Present nonpharmacologic and nonopioid pharmacologic therapy considerations
- Assess risk and promote naloxone prescribing
- Perform calculations of morphine milligram equivalents (MME) to determine the lowest effective dose
Integrating the 2016 CDC Guideline recommendations* into electronic CDS tools can help equip health systems with the resources they need to quickly assess when it is appropriate to initiate opioid use for the treatment of chronic pain and how to safely maintain or discontinue use in patients who are currently on long-term opioid therapy.
Health systems, including academic medical centers, pilot tested these CDS tools. Participating health systems included Duke Health, Houston Methodist, Montefiore Medical Center, Stormont Vail Health, and Yale New Haven Health. Learn more about their experiences in Health System Success.
Integrating Into Your EHR
These tools are supported by most EHR vendors. They can be implemented into the EHRs for small practices to large health systems. Work with your EHR vendor to determine how to incorporate these tools and the level of effort required to support them.
To learn more about integrating the CDS tools into your health practice or system’s EHR, please review the Office of the National Coordinator for Health Information Technology (ONC)/CDC Health Information Technology: Integration Framework.
Overall, using CDS tools can increase the quality of care and enhance health outcomes.1
* Once the 2022 CDC Clinical Practice Guidelines for Prescribing Opioids are released, CDC and ONC will revise these tools as needed.
1. Clinical Decision Support. HealthIT.gov. https://www.healthit.gov/topic/safety/clinical-decision-support
- About CDC’s 2016 Opioid Prescribing Guideline
- Electronic Clinical Decision Support (CDS) Tools that Support the Implementation of the CDC Guideline for Prescribing Opioids for Chronic Pain
- HealthIT.gov: Clinical Decision Support
- Osheroff J, Teich J, Levick D, Saldana L, Velasco F, Sittig D, Rogers K, Jenders R. Improving Outcomes with Clinical Decision Support: An Implementer’s Guide, Second Edition. Boca Raton, FL.: HIMSS Publishing; 2012
- Clinical Decision Support: More Than Just ‘Alerts’ Tipsheet (Centers for Medicare & Medicaid Services)
- CDC Center for Surveillance, Epidemiology, and Laboratory Services
- CDC Public Health Informatics Office
- CDS Hooks website
- Opioid Prescribing Support Implementation Guide
- CDC MME CQL Calculator
- CQL Logic Website – Opioid Prescribing Support Guide
- Office of the National Coordinator for Health Information Technology/CDC Health Information Technology: Integration Framework
For more information on adapting clinical guidelines for the digital age, visit: https://www.cdc.gov/csels/phio/clinical-guidelines/index.html