Tracking & monitoring patient careImplement proactive population management before, during, and between clinic visits of all patients on long-term opioid therapy.
Why is this important?
Identifying who is on long-term opioid therapy for their chronic pain is important for three reasons: 1) this is an “at-risk” population so identifying who they are provides both an opportunity to risk-stratify them and also produce reports about them so that they don’t “fall between the cracks” of a busy primary care clinic; 2) a population tracking system can be used to identify care gaps between scheduled visits and conduct follow-up with those patients; and 3) population tracking provides an opportunity to track if efforts to improve care are successful.
- Produce a report of current patients on long-term opioid therapy
- Identify data and measures needed for pre-visit planning and monitoring success