Several queries have been developed to help you use your EMR to create registries of patients who use opioids. They will allow you to identify patients:
- Who have one or more current prescriptions for opioid use
- Currently available for TELUS PS, Accuro, and OSCAR EMRs
- Who have concurrent prescriptions for both opioid and benzodiazepine use
- Currently available for TELUS PS, ACCURO, and OSCAR EMRs
- Who have one or more current prescriptions for opioid use with high morphine equivalent (MEQ)
- Currently available for OSCAR EMR
- In development for TELUS PS and ACCURO EMRs
Creating this list is a first step in developing a program to manage opioid prescriptions in your team.
|Technical Details of the Query Criteria|
|Additional EMR Resources|
|More Resources to Support Opioid Stewardship and Pain Management|
|NOTE: All queries are tested and validated prior to release. However, changes that take place after the queries are released may affect how accurate they are. Such changes could include EMR software updates, new medications, and changes to standard clinical definitions. They may result in false positives, that is, patients being flagged who do not have the specified condition. They may also result in false negatives, that is, patients not being flagged who do have the condition. Queries are also limited by the quality of your EMR data. Please exercise judgement when using them, as they are meant to support and complement a chart review, not to replace it.|
|ALERT -- TELUS USERS: As of the most recent update from Telus, the opioid queries built by the Algorithm Project team are no longer completing properly. Thanks to the collective action of the Algorithm Project team, the issue has been escalated within Telus and will be tracked by the EMR Communities of Practice for speedy resolution. Thanks for your patience|
Technical details of the Query Criteria
(click image to see larger version) Note: This is just one component of the vast amount of work being done in the province on dealing with the issues associated with opioid use. More information will be added to this post when it becomes available. To learn more about opioid prescribing in the province, visit Health Quality Ontario's post on Opioid Prescribing in Ontario.
Step 1. Import the query into your EMR. Right now, you can only do this if you have TELUS PS Suite, Accuro by QHR Technologies, or OSCAR. You will likely need the help of your QIDSS, IT staff or anyone who usually works with your EMR to do this.
- For PSS, download the .srx files using the links below, and import them into your EMR.
- opioid prescription,
- concurrent opioid and benzodiazepine prescriptions
- in development: high-MEQ opioid prescription
- For Accuro, download the queries from the Publisher (within your EMR).
- Queries available: opioid prescription (“AFHTO Opioid Frontend Search”); concurrent opioid and benzodiazepine prescriptions ("AFHTO Opioids and Benzos Frontend Search v1.")
- Query in development: high-MEQ opioid prescription
- For OSCAR, open the .txt files using the links below; copy and paste the code to your EMR.
Step 2. Run the query in your EMR. Again, you might need the help of your QIDSS, IT staff or other person who usually runs queries in your EMR. Running the query will produce a list of patients prescribed an opioid. The query gets you STARTED in building a registry but doesn’t do the whole job for you. Need help? Contact firstname.lastname@example.org.
Additional EMR Resources
Opioid Management Toolkit for TELUS PS
The Opioid Management Toolbar is now available for live use. To use the toolbar, download it to your local system, unzip the contents, and install the custom forms, searches, and reminders. The toolbar was developed to support safe opioid management based upon 2017 guidelines. It displays the MEQs for each patient, includes screening tools with reminders that change colour when overdue, provides summary and visit forms, and also includes tools to help manage opioid prescribing such as opioid switching and tapering tools, handouts, and links to resources. A demonstration video is also available to provide an overview and help get you started.
More Resources to Support Opioid Stewardship and Pain Management
Looking for resources to assist you and your team better understand pain management?
- Check out AFHTO's post on Supports for Management of Pain and Addiction. Here you will find information and links to supports from some of our partner organizations to help navigate the pain management landscape.
- Take a look at the resources from the Strategies for Opioid De-Implementation in Primary Care KTE Workshop that took place in Toronto and Kingston June 11, 2018. There you'll find slides, handouts, and links to more tools.