EHR Tools for Acute Pain Management Vanessa Hennes

EHR Tools for Acute Pain Management { Vanessa Hennes, Pharm. D Clinical Pharmacist Analyst Rady Children’s Hospital – Inpatient Pharmacy

EHR Tool Kit Ambulatory/Discharge Acute Pain Order Set Ambulatory BPA for concurrent opioid & benzodiazepine prescriptions AVS Handout for patients prescribed an opioid Inpatient Acute Pain Protocol Emergency Care Plans Live demo following case studies

Ambulatory Order Set Search by order set name, or search any pain medication Found in Orders Activity, as well as Medication Reconciliation

Ambulatory Order Set Clean, stream-lined build Offers a step-wise approach to pain management Supportive care medications built into each panel where appropriate

(1) Choose appropriate pain therapy approach. (2) Select Primary Pain Medication Class. (3) Choose medication & form. Adjust any defaults if needed (dose, duration, special instructions, etc. ) (4) Add breakthrough medications as necessary. (5) Order supportive care medications as appropriate. (6) Option to add antiemetics as appropriate.

No combination analgesic-opioid products. Tramadol only appears for patients 13 years or older Naloxone suggested for patients meeting certain criteria who might be at higher risk of respiratory depression.

Opioid/Benzodiazepine BPA Triggered when prescribing an opioid if the patient has any active prescriptions for an opioid and/or benzodiazepine If provider chooses to keep the new prescription, they must select an acknowledge reason

Opioid Patient Education Handout (1) Automatically prints with Inpatient and Outpatient AVS when an opioid is prescribed (2) Available in English & Spanish

Inpatient Acute Pain Management Protocol Search by order set name, or search any pain medication Found in Orders Activity, as well as Medication Reconciliation

Inpatient Acute Pain Management Protocol Similar build structure to Ambulatory Order Set Includes non-pharmacologic pain management, consult orders and all necessary supportive care medications

(1) Choose appropriate pain therapy approach. (2) Select Primary Pain Medication Class. (3) Choose medication & form. Adjust any defaults if needed (dose, duration, special instructions, etc. ) (4) Add breakthrough medications as necessary. (5) Order supportive care medications as appropriate. (6) Option to add antiemetics as appropriate.

No combination analgesic-opioid products. Standard naloxone orders for all patients with active opioid orders.

Emergency Care Plan

Feedback & Questions The Pain/Opioid Task Force welcomes any feedback you have regarding the build discussed. We are always looking to improve EHR tools and workflows. Please send feedback to Vanessa Hennes vhennes@rchsd. org Dr. Jeannie Huang jshuang@ucsd. edu