To understand the breadth of the opioid crises in America, consider West Virginia with a population of just 1.8 million. In only six years, between 2007 to 2012, almost 800 million doses of the pain pills hydrocodone and oxycodone were legally shipped to the state. That comes out to 433 pills for every man, woman, and child in West Virginia prescribed by doctors.
In 2017, 50,000 of the more than 70,000 people in the U.S. who died from drug overdose were killed by opioids, according to the “Tracking Federal Funding to Combat the Opioid Crises” report issued in March 2019 by the Bipartisan Policy Center (BPC). The BPC included an analysis of 57 opioid epidemic federal programs and their impact in five states – Arizona, Louisiana, New Hampshire, Ohio, and Tennessee. Among the findings:
- Each of the five states had a coordinating body to facilitate data sharing.
- The states developed outpatient treatment solutions to enhance the treatment network.
- Federal funding flowed to the areas within each state with the highest deaths, with rural counties receiving lower funding levels.
- Output data in the states from federal programs are preliminary and more attention to prevention, treatment, and recovery data is needed to evaluate the effectiveness of federal funding.
- Medicaid expansion is essential in the five states to providing behavioral health solutions for opioid addiction.
- Opioid addiction is a significant social detriment of health (SDoH). Because of this SDoH threat, there are focused behavioral health and public policy initiatives underway to combat what Kaiser Permanente asserts “could be the worst drug crises in American History.”
The Regenstrief Institute (TRI), with a mission to create better pathways to health, just announced one such initiative. At a forum, it recently held (June 2019) to consider data solutions to the opioid crises it announced: “funding opportunities for researchers to help unlock the potential of the Indiana Addiction Data Commons (IADC).” Awardees will be selected based on the potential to advance research focused on the addiction crisis, prospective ability to generate extramural funding, and fit of research questions and approach with current IADC data sets. The pilot funding will strongly consider to junior faculty in the state; the deadline for submission is August 1, 2019.
The TRI IADC was built on the premise that researchers and healthcare professionals need more than the information available from electronic health records. Additional sources of data such as information from policy, criminal justice, treatment resources, environmental factors, and demographics provide insight for solutions. Some of the data sources TRI has cultivated, including:
- Indiana Network for Patient Care: Is one of the largest health information exchanges in the country with data shared by more than 100 hospitals, health networks, and insurance payers.
- Local Health Data Warehouses: The Regenstrief Data Core has business agreements with Eskenazi Health and Indiana University (IU) for approved research applications.
- Polis Center: This arrangement provides collaboration, engagement, research, and technology projects through “spatially-enabled” datasets to develop healthier and more resilient communities.
- Indiana Business Research Center: The IBRC has been working since 1925 to collect, organize, and find meaning in the social and economic characteristics of the state.
- State of Indiana Management Performance Hub: MPH serves as a connector of entities and sectors seeking to apply data to opportunities for improvement in the state.
- Healthcare Cost and Utilization Project: This data set is generated by the Indiana State Department of Health to analyze hospital discharge data, such as payer, diagnosis code, total number of patients, days of hospital stay, charges, and other information.
The effective use of data, such as the TRI’s IADC is key to finding evidence-based solutions to the opioid crises. For example, TRI offers an in depth platform to help researchers to comb through unstructured data and physician notes to uncover statistically significant indicators that have not been previously realized. Such work is funded through the IU addiction Grand Challenge, could, for example, using SDoH indicators could a track to expand opioid-related research.
Large insurers are also stepping up with solutions. Both the Blue Cross Blue Shield Association (BCBSA) and Kaiser Permanente KP) have leveraged their data insights to reduce prescription opioid use by 12-40 percent. Such progress cannot be accomplished quickly enough. According to the BPC report, behavioral health policy experts believe “the end of the epidemic is not yet in sight.”