What do you think was the number one cause of accidental deaths in the United States in 2016?

A common answer is car accidents, which used to be the number one cause of accidental deaths back in the day. In fact, the number of accidental car deaths reached its peak in 1980 with more than 55,000 deaths—but with modernizing vehicle safety standards, that number is steadily decreasing.

Given the increasing number of mass shootings in the news, your next guess might be gun violence. However, although devastating, it’s still not the number one cause.

According the National Safety Council (NSC), the number one drug class on that list is opioids. Opioids, which covers a long list of drugs including codeine, methadone, oxycodone and fentanyl, are commonly prescribed in North American for post-surgery pain or chronic illness. Unfortunately, these drugs are highly addictive. Once addicted to these pain killers—and after the prescription runs dry—many addicted patients also turn to illegal means to obtain them, or to illegal drugs like heroin.

According to the Center for Disease Control (CDC), more than 1,000 people per day are treated in emergency rooms for misusing prescription opioids. And approximately 91 American adults die each day of an opioid overdose.

Why are opioids commonly over-prescribed?

If opioids are such a problem, why do doctors continue to prescribe them to their patients—knowing that the risk of addiction and abuse is high?

Many organizations have pointed to the pharmaceutical industry as a scapegoat, with the notion that companies incentivize and pressure doctors to prescribe certain medicines to increase profits. Others have pointed to the doctors, and the idea that they receive kickbacks from the aforementioned pharma companies.

Dr. Deborah Clements, in an article from the Chicago Tribune, indicated that doctors were previously criticized for not helping their patients enough with pain, and perhaps have been overcompensating with these dangerous prescriptions. Another theory considered by Dr. Clements is that insurance companies often don’t offer alternative treatments for pain, such as acupuncture and massage therapy. Because many patients need something to get back to work, back to raising their families or simply back to everyday life, opioids are often seen as the only option—even though, according to the CDC, these types of medicines are not appropriate for minor ailments and should not be prescribed for more than a three-day period.

Whatever the root cause, the fact remains that many people are prescribed opioids and many are dying of overdose and addiction as a result.

What other data elements could you use to help identify the root cause of this problem that is killing so many people?

Some tests you may consider running are checks for reasonableness like:

  • Are there specific doctors who prescribe certain drugs significantly more than others?
  • Are there regional areas where overdoses are more prevalent?
  • Are specific drug manufacturers being over prescribed more frequently than others?
  • Does the diagnostic code correspond with the procedure code?
  • Is there something unusual in the inventory analysis of pharmacies?

Your biggest obstacle at this point is that you may not have complete and full access to your own data, let alone, the data of other agencies and third parties. For any initiative like this to work, you must have data sharing arrangements in place with state/local healthcare entities, hospital systems, pharmacies, electronic medical record providers, doctor’s offices, insurance companies and possibly even law enforcement.

Healthcare GRC professionals need to get involved in solving this health crisis by starting to ask the questions—for you hold the key to important answers locked in your data.

What could possibly make you more sought-after than saving lives?

ACL Inspirations

ACL Inspirations

For more analytical ideas specific to the healthcare industry, check out ACL Inspirations, a pre-built, public library of risk scenarios and tests collected from ACL initiatives worldwide.

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