“Poisonings are the leading cause of unintentional injury and death in the United States. The death rate from unintentional poisoning, particularly drug overdose involving opioids, has continually increased over the past 22 decades,” wrote Mollie Cummins, Guilherme Del Fiol, et al. in a recent article in the Journal of the American Medical Informatics Association (JAMIA), the association’s peer-reviewed journal for biomedical and health informatics. “The growing epidemic of poisoning, which includes drug overdoses, is apparent in US emergency departments (EDs). The rate of opioid-related ED use more than doubled between 2009 and 2016.”
In 2017, poison control centers (PCCs) registered more than 650,000 cases of unintentional poisoning and drug overdoses. In addition, the Centers for Disease Control and Prevention (CDC) reported 70,237 drug overdose deaths—a troubling new record for the United States.
In order to mitigate that trend, researchers at the University of Utah, the Utah Health Information Network (UHIN), and Intermountain Healthcare successfully implemented and launched a standards-based health information exchange (HIE) at the Utah PCC.
A significant number of calls to a poison control center are forwarded to a healthcare facility, such as an emergency department, making the PCC a link between the patient and the provider. These providers often offer recommendations for poison treatment.
“US PCCs play a critical role in both emergency treatment and surveillance of poison exposures. These largely publicly funded call centers are primarily staffed by registered nurses and pharmacists with specialized education in toxicology. They assess poison exposures via telephone and provide specific advice to callers, whether the caller is the patient, a bystander, or a health care provider,” wrote the researchers in the JAMIA article.
Despite their critical role, PCCs are under-utilized.
“US PCCs have an immediate need to innovate the process by which they collaborate with health care providers, especially EDs, in order to improve efficiency and optimize patient outcomes. Previously, PCC participation in standards-based HIE was not possible due to proprietary software not compliant with HIE standards, a lack of informatics tools, and the need to integrate HIE processes into the workflow of PCCs.”
With their project, the authors wanted to help “enable a standards-based HIE process and software infrastructure to improve poison control communication with EDs.”
“By developing short-term and long-term processes for exchanging poisoning-related information, we make poisoning-related information move in support of patient care,” wrote the authors. “By moving data with the patient to support care transitions and ongoing collaborative care, we shift the focus of information management from provider to patient.”
Due to HIPAA privacy rules, any patient data exchange has to comply with the appropriate safeguards to protect the privacy of personal health information. While privacy rules are important, of course, time is frequently not on the side of the patient in the case of acute poisoning or a potentially lethal drug overdose. Quick and efficient data exchange can save lives. “This shift from unshared, provider-centric data to patient-centered information exchange is critically important for the management of poison exposures, but relevant to all provider-to-provider care transitions and collaborations,” the researchers concluded.
