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Weighing in on the Opioid Crisis

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Posted March 21, 2018

The opioid epidemic is perhaps the most insidious and complicated health issue we as a nation face today. It truly is a crisis, for the number of opioid drug overdose deaths continues to climb year over year. According to the Minnesota Department of Health, the number of opioid-overdose deaths in Minnesota was up 9.2 percent from 2015 to 2016. The issue is urgent.

Roon Makhtal, a senior in the Health Services Management (HSM) major, has taken a deep dive into researching and understanding the opioid crisis through an internship she began with the Minnesota Department of Health in the summer of 2017. Working in the Office of Health Information Technology with her mentor Kari Guida, Makhtal was assigned to research the crisis and its spread throughout the state. Her objective was to determine what role electronic health information (prescriptions and documentation) could play in mitigating the opioid crisis. But halfway through her internship, Makhtal was surprised by an even bigger responsibility.

“The Minnesota e-Health Advisory got a request for a set of recommendations from Governor Dayton about how to cope with the opioid crisis in Minnesota,” Makhtal says. “No one in my department expected that request from the Governor, but since it became an official thing, we suddenly had a lot more work to do.”

So much more work, in fact, that Makhtal was asked to stay on staff beyond her 400-hour summer internship to be part of the project team drafting recommendations for the Governor. With the title of Student Paraprofessional Senior, she eagerly accepted the responsibility.

E-Prescribing as Part of the Solution

A key component in understanding how the opioid epidemic works involves electronic prescribing, or e-prescribing. Think of e-prescribing as a way to create digital records of patient health as well as a secure system for sending prescriptions directly from providers to retail pharmacies, without risk of tampering or fraud. According to Surescripts National Health Information Network, only 20 percent of providers nationwide currently are set up for e-prescribing controlled substances, while 88 percent of retail pharmacies are enabled to receive e-prescribing. It’s this lack of e-prescribing adoption in providers that limits professionals like Makhtal at the Minnesota Department of Health in getting a grasp on the scope of the epidemic.

“There’s not a lot of specific data on how many doctors are prescribing opioids or how many drugs have been dispensed,” Makhtal says. “So, the Minnesota e-Health Advisory Committee is recommending that Governor Dayton provide resources to fully implement and ensure compliance with the current e-prescribing mandate.”

She goes on: “Everyone at the Minnesota Department of Health is lasered-in on this issue, but I don’t know if there are proven ways to solve the crisis. I read some research saying the magnitude of the crisis is really unlike anything we’ve ever seen before, so getting out of it will be extremely difficult. No one can say if there’s a surefire solution, but we have to start somewhere.”

Another recommendation that Makhtal has worked on for the Governor involves the possibility of funding for health care providers that cannot afford the technological upgrades necessary to be enabled for e-prescribing and using the prescription monitoring program. Her research involved sending surveys to health care organizations across the state of Minnesota, gathering information about why some doctors aren’t using prescription monitoring programs.

“We’ll just have to wait and see if the Governor takes action on any of the recommendations we put forth,” Makhtal says.

And while it’s a lot of work to research and draft those recommendations, she couldn’t be happier that she’s been given the opportunity to work on this important project. Says Makhtal, “There are some days when I read and work on really depressing research, but overall I’m really loving it. I hope we have an impact.”

Feeling Prepared to Take on Big Projects

Makhtal feels honored to have had the opportunity to intern for the Minnesota Department of Health, then to eventually contribute to opioid crisis recommendations for the Governor. She says that she’s lucky to have been chosen for the internship in the first place, but the fact is that she was well-equipped to take on the work due to her coursework in the HSM program.

“My HSM classes have been really helpful, and I can tell that the instructors are preparing us to be leaders, managers, and executives in the health care industry,” Makhtal says. “We’re able to learn about a vast number of issues. For example, in my Health Care Law & Ethics course I got experience working around the opioid issue.”

Her internship mentor, Kari Guida, Senior Health Informatician at the Minnesota Department of Health, says this of Makhtal: “Roon has been a great asset to the Opioids and e-Health Project. Her systematic research on state and national activities allowed us to develop a framework of how e-health can be used to prevent and respond to opioid misuse and overdose. This work is cutting-edge and will influence our efforts greatly over the next 18 months.”

Makhtal is interested in pursuing a career in either public health or health care administration, and she has a special interest in working with communities suffering from health disparities. In the meantime, she will finish her work on the recommendations for the Minnesota Department of Health and graduate with a degree in health services management and a minor in public health in May of 2018. Of the internship, Makhtal says, “It’s probably been my favorite part of the HSM program. My classes were a good building block, and the internship was an amazing learning experience. I never thought I would be working on recommendations for Governor Dayton. It’s been so important to me.”

Source: University of Minnesota

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