February 2017
Have a WISHIN story you'd like to share? Let us know. 
Welcome WISHIN Pulse Participants!
Save the Date!
Wednesday, March 22nd
Free Webinar Presented by WISHIN: 

Beyond the PDMP: 
Integrating with WISHIN to Make a Bigger Impact on Drug Abuse

Discover how WISHIN can help you:
  • Integrate PDMP access into your EHR
  • Comply with HOPE Agenda legislation
  • Put prescription history into context
  • See a more complete picture of patient health
"Avoiding the cost of a single admission or readmission certainly helps WISHIN pay for itself"
Client Spotlight: Community Care

One of WISHIN's newest clients to go live, Community Care Inc., is a Managed Care Organization that serves members in the PACE (Program for All Inclusive Care for the Elderly), Family Care Partnership, and Family Care programs.  All of the programs serve members who are either frail elderly, physically disabled or intellectually disabled.  Community Care has sites in 14 counties in Wisconsin. 

Cathy Rapp, Clinical Services Officer at Community Care, oversees the clinical nurses, rehab clinicians, dieticians, and the home care, dental and behavioral health departments. In just over a month of using WISHIN Pulse, Ms. Rapp and her staff have already found WISHIN to be a valuable tool for their daily work. Ms. Rapp shares her experience with WISHIN Pulse below.

What about WISHIN interested or appealed to Community Care and encouraged you to sign up?  

Our care teams are responsible for coordinating long-term and acute care services for our members.  The prospect of real-time access to member information was exciting because it would allow streamlined access to key health care information such as immunization, hospitalization and ED visit data.

What does your staff say about WISHIN Pulse?  How have you incorporated it into your workflow?
This has happened very seamlessly. The application is very easy to navigate, and the information is so valuable that teams immediately began accessing it.  It has streamlined many of our processes.

Can you share any success stories from Community Care's use of WISHIN Pulse?
We had a member who [returned] to their residence after a hospital stay.  On arrival she continued to look very ill.  We had labs drawn at her residence but because the staff had just completed their WISHIN education, they were able to view labs from the hospital that had not been available at the time of her discharge.  These included urine and sputum cultures.  The RN and MD were able to determine that she had both a urinary tract infection and pneumonia, were able to start treatment right away and avoided a readmission. Avoiding the cost of a single admission or readmission certainly helps WISHIN pay for itself. The teams continue to use WISHIN regularly and it has been very helpful to ensure smooth care transitions. 

I have numerous staff members tell me about how helpful it's been to have access to hospital discharge information, medication lists and immunization data....all in one place.  It saves them time that would have been spent contacting physician offices and allows them to make more timely post-hospital visits.  We know that post-hospital medication reconciliation is critical to preventing readmissions and timely post-hospital visits are key to this.
For more information on how WISHIN Pulse can help prevent readmissions at your organization give us a call at (608) 274-1820 or send an email to wishin.support@wishin.org
Across the State and Country, Researchers Look for Best Methods to Prevent Opioid Abuse 
The battle against opioid addiction and abuse has remained in the news both nationally and locally as the medical community investigates origins of the epidemic and how to safely control and put an end to it. WISHIN remains positioned to aid- in the fight as a source of Prescription Drug Monitoring Program (PDMP) and clinical data across health systems.
WQOW News in Eau Claire reported on the redesigned PDMP and the Heroin, Opiate, Prevention, and Education (HOPE) Agenda that includes a law with new requirements for providers prescribing opioids coming into effect April 1st.

In the story Dr. Paul Horvath, medical director of emergency care at Mayo Clinic Health System, emphasizes that the requirements of the new law aren't meant to stop narcotic prescriptions altogether, but rather improve the decision-making around prescribing.
"The goal here is not to cut anybody off...it is not to stop anybody from getting the drugs they need. It is a tool designed to get prescribers information we need to prescribe safely."

Safer prescribing brought WISHIN and the Wisconsin Department of Safety and Professional Services together to collaborate in 2014 to implement the first integration of a state PDMP into a health information exchange (HIE) in the nation. By providing the PDMP data along with the rest of a patient's clinical data, WISHIN allows a prescribing provider to see the whole picture of a patient's health. That way, as Dr. Horvath notes, patients who experienced a recent traumatic injury can receive the pain medication they need while those exhibiting symptoms of addiction without an injury or health event necessitating narcotics or opioids in their clinical history can be redirected to alternative forms of pain management or a treatment program.

In La Crosse, WKBT reported on a study by the state's Controlled Substances Board that found opioid prescriptions had dropped nearly 12 percent in 2016. WISHIN is proud to have played a role in reducing unnecessary opioid prescriptions by making the PDMP easier to use for health systems such as Aurora (see the December 2016 edition of Connections ).

Unfortunately the trend of babies born with drug addictions is headed in the opposite direction. The Wisconsin State Journal reports, "Wisconsin is seeing a surge in babies born dependent on opioids or other addictive drugs, a condition called neonatal abstinence syndrome, or NAS."

The Journal adds that the state had 598 babies with NAS in 2015, up from 142 in 2006, according to the state Department of Health Services. The rate more than quadrupled during that time, from 2.0 cases per 1,000 births to 8.9 cases per 1,000 births.

The increase in Wisconsin mirrors national trends. The New York Times shared similar findings in December, noting that rural areas seem to be predominantly affected. 

"One has to appreciate that behind every incidence of neonatal abstinence syndrome, which is relatively easy to recognize and relatively easy to treat," says Dr. Anne Johnston, an associate professor of pediatrics at the University of Vermont, "There's a case of a mother dependent on opioids, and that's complex to treat."

A study by the New England Journal of Medicine found that a patient's future opioid use can be highly dependent on the prescribing patterns of the physician they encounter in an emergency room. The study, shared by  The New York Times, examines the relationship between prescribing and long-term opioid use particularly in older adults who pose unique challenges in pain management decisions. The article also investigates the prescribing habits of physicians. The lead author of the study, Dr. Michael L. Barnett, an assistant professor of health policy and management at Harvard T.H. Chan School of Public Health, considered his own habits recently when prescribing pain medication to a patient.

"I felt I had no choice but to give her a short prescription of opioids to get through the weekend, just to be functional," he recalled. "I told her about the risks of constipation and sleepiness. But I didn't tell her about dependence and addiction. And that's one lesson from this paper. Doctors don't even know what they're doing is a habit. We have to decide to interrupt ourselves, like picking up a backpack with your other arm: 'Oh, I need to tell this patient about another risk with this medication.'"
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Wisconsin Statewide Health Information Network | Company | (608) 274-1820 | wishin@wishin.org | www.wishin.org | PO Box 259038 | Madison, WI 53725-9038