Drastic Times Call for Drastic Measures: The Opioid Epidemic and the Electronic Health Record

The over-prescription of medication has reached epidemic proportions. While politicians give speeches and draft legislature to address the opioid epidemic, the improper use of prescription medication impacts our society in many ways. For example, when a patient presents with a cold virus and is prescribed an antibiotic “just in case,” not only does the antibiotic cost the patient money, but it will have no effect on the cold virus. On a larger scale, these unnecessary antibiotics may encourage the evolution of antibiotic-resistant superbugs.

Most medical practices in America have adopted some sort of electronic health record system, but Americans have resisted a national electronic health record database, citing valid concerns about privacy and government overreach. However, Rumball-Smith et al., argue in JAMA that if carefully implemented and used wisely, the electronic health record (EHR) could address systematic problems when it comes to prescription drugs and “be a powerful vehicle for measurement and intervention around low-value care.”

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So why not implement a national database for electronic health records?

The main advantage of this system is also the biggest threat – the ability to track information down the to the individual level presents an opportunity to intervene. But at what cost to privacy? A national EHR could show if a patient was soliciting pain medication from multiple doctors and flag that patient’s record. Or, if a large facility, comprised of many doctors and medical staff, was prescribing antibiotics at a much higher rate than other similar facilities, this could indicate a need for better education on proper antibiotic use. In addition to safety and high-quality care, patients rank privacy and right of access among their top expectations from their medical carers. There are many concerns to be addressed: Who owns the data? Who has access to it? Who can enter and edit the information? How much control does the patient have? If patterns of misuse do emerge, who has jurisdiction to address or pursue them?

In our modern world, we both hope and expect that technology will solve the problems of our daily lives, both big and small. Younger generations may be more willing to having their private and personal data online, lowering the barriers to creation of a national EHR. Alternatively, distrust in the government could grow to a point where such a database could never be feasible. It will be interesting to see how dire these medical “epidemics” may become before we turn to technology and national data collection to help solve them, even at the risk of personal privacy.
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Laurie Breen

Laurie Breen is a freelance writer well-versed in research communications and grant writing. She received her Bachelors Degree in Psychology from Smith College and has worked previously at the University of Queensland's Centre for Clinical Research in Brisbane, Australia. Her favorite conversational topic is "antibiotic-resistant bacteria," making her a big hit at parties.