New Jersey Innovation Institute (NJII), a New Jersey Institute of Technology (NJIT) corporation, has joined in a new state-funded effort to combat the national opioid epidemic's impact on New Jersey.
With support from a $6 million grant by the New Jersey Department of Health (NJDOH) and New Jersey Department of Human Services (NJDHS), the institute has announced it will help lead the statewide "Promoting Interoperability for New Jersey Substance Use Disorder Providers" initiative -- a program designed to bolster the state's health information technology infrastructure and incentivize a greater number of its substance use disorder (SUD) medical professionals to transition from traditional paper-based medical records to electronic health record (EHR) technology.
The new program specifically aims to address the persistent issue of opioid overprescribing that has contributed to the escalating epidemic by enhancing the management and communication of prescription opioid-related patient health records between behavioral health professionals, primary care physicians and hospitals through the state's health data exchange system, called the New Jersey Health Information Network (NJHIN).
NJII will partner with the New Jersey Association of Mental Health and Addiction Agencies (NJAMHAA) to implement the rollout of the initiative, officially introduced by the NJDOH and NJDHS in April.
"The opioid epidemic has created devastating needs, one of which is the need to bridge the islands of health information that currently exist between our substance abuse doctors and the rest of the state's health providers," said Tomas Gregorio, senior vice president of NJII's Healthcare Division. "One major challenge during this epidemic has been the inadvertent overprescribing from doctors who may not know a patient has just been prescribed opioid medication and is trying to get more.
"Our goal with this initiative is to help these providers get connected ... they are on islands right now and we want to put in the bridges."
According to data published by NJCares.gov, dispensations of prescription opioids in New Jersey -- such as morphine, oxycodone and fentanyl -- totaled more than 4,800,000 in 2017. The National Institute on Drug Abuse reported that there were 1,969 drug overdose deaths involving opioids across the state that year -- a rate of 22 deaths per 100,000 persons, which is 50 percent higher than the national rate. The state estimates that more than 3,000 individuals have died due to overdoses in 2018, with the greatest increase in cases attributed to potent synthetic opioids, such as fentanyl and its analogs.
"Substance use disorder providers are underequipped to care for these patients without a holistic view of population health in their community and a better understanding of what happens after patients leave their doctors," said Van Ly, senior program director at NJII's Garden Practice Transformation Network. "Providers that are encountering a patient with an overdose history for the first time cannot readily access this information using filing cabinets and paper... it can only be done on electronic systems, which may offer clinical decision support and vital health data to help them customize care plans based on a patient's history."
"Currently, some of our state's providers have computerized infrastructure for record-keeping of these prescriptions but no interconnectivity with other providers, while many others do not have any kind of electronic system at all," said Gregorio. "This initiative will introduce electronic health record technology to a large number of behavioral health professionals in New Jersey for the first time, most of whom have been some of the least funded and have the most need."
According to a 2018 survey by NJAMHAA, approximately 60 percent of SUD providers in New Jersey have reported that they require new EHR platforms or system upgrades.
Bridging this technology gap and "building sound data systems and strengthening system wide infrastructure for the addictions community" was identified as one of four key strategies outlined in Gov. Phil Murphy's $100 million 2019 budget to tackle New Jersey's opioid crisis, which he publicly announced at Cooper University Medical Center in Camden, New Jersey, in January 2019.
"The opioid epidemic continues to devastate families and communities across our state," said Gov. Murphy in his address. "As we combat this crisis, it is critical that we use data-driven, evidence-based strategies to support individuals suffering from addiction and help them get on the path to recovery."
Ly says those SUD providers that have historically lacked resources needed to maintain modern health record systems will now be able to receive incentive-based funding to deploy or upgrade electronic health record technology and connect with other providers through the NJHIN, as well as state-run drug abuse monitoring databases like the New Jersey Prescription Monitoring Program and the New Jersey Substance Abuse Monitoring System.
"Right now, a big part is getting providers connected to the state's prescription monitoring program because there is a current lack of EHR interoperability in the database, specifically among the SUD community," said Ly. "This funding will primarily go to participating providers to reimburse them and train them on these systems based on every step they take toward connectivity. NJII will ensure they get the funding for their efforts."
According to Ly, the program is currently designed to support SUD providers at up to 120 health care facilities across the state that are seeking to implement new or updated EHR technology through 2021. The institute has already received participation agreements from 35 health care organizations after holding the program's first public webinar event for applicants May 1, co-hosted with NJAMHAA, NJDH and NJDHS. NJII has plans to co-host similar webinars each month for SUD providers until the program reaches its enrollment limit.
"I think this is just the beginning," said Ly. "I am looking forward to getting under the hood of this issue from a provider perspective because they are often the first responders. I also want to see the number of patients being positively impacted by connecting these facilities, and we may begin to get that data once we solidify enrollment by the end of the year."
"Over the next two years, we should start to see much more active communication between the behavioral health specialists, the hometown doctors and the state's hospitals," said Gregorio. "Most important, we hope to see a drastic reduction in overdoses and costly hospital emergency admissions as a result."
The New Jersey Innovation Institute (NJII) is an NJIT corporation that applies the intellectual and technological resources of New Jersey's public polytechnic university to challenges identified by industry partners. Through its Innovation Labs (iLabs), NJII brings NJIT expertise to key economic sectors, including healthcare delivery systems, bio-pharmaceutical production, civil infrastructure, defense and homeland security, and financial services.