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Objective: COVID-19, coinciding with the opioid epidemic in the United States, has had significant impacts on health-care utilization. While mixed, early analyses signaled a potential resurgence in opioid use following the pandemic. The primary study objective was to assess the association of the COVID-19 pandemic with opioid utilization among Health First Colorado (Colorado's Medicaid Program) members and a non-Medicaid managed care cohort who did not have a diagnosis of cancer or sickle cell disease. Patients and Methods: Using an interrupted time series and segmented regression analysis, this population-level study assessed the association of the COVID-19 pandemic on prescribed utilization of long- and short-acting opioid analgesics among Health First Colorado members and a random sample of non-Medicaid managed care members. Pharmacy claims data for both cohorts were assessed between October 1, 2018, and September 30, 2021, with April 2020 identified as the interruption of interest. We evaluated the following monthly opioid use measures separately for short-acting and long-acting opioids: number of members filling an opioid, total fills, and total days supplied. Results: Short- and long-acting opioid utilization was significantly decreasing among Health First Colorado members in the 18 months prior to the start of COVID-19. After the onset of the pandemic, utilization stabilized and slopes were not significantly different from zero. Among the non-Medicaid managed care cohort, short- and long-acting opioid utilization significantly decreased in the 18 months leading up to the onset of the pandemic. After the onset of the pandemic, utilization of long-acting opioids stabilized, while utilization of short-acting opioids significantly increased. Conclusion: While we observed an increase in opioid utilization measures post-pandemic in the non-Medicaid managed care cohort, a similar increase was not observed in Health First Colorado members suggesting that thoughtful opioid policies put in place pre-pandemic may have been effective at controlling potential inappropriate opioid utilization.
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OBJECTIVE: We report the influence of Sprint electronic health record (EHR) training and optimization on clinician time spent in the EHR. MATERIALS AND METHODS: We studied the Sprint process in one academic internal medicine practice with 26 providers. Program offerings included individualized training sessions, and the ability to clean up, fix, or build new EHR tools during the 2-week intervention. EHR usage log data were available for 24 clinicians, and the average clinical full-time equivalent was 0.44. We used a quasi-experimental study design with an interrupted time series specification, with 8 months of pre- and 12 months of post-intervention data to evaluate clinician time spent in the EHR. RESULTS: We discovered a greater than 6 h per day reduction in clinician time spent in the EHR at the clinic level. At the individual clinician level, we demonstrated a time savings of 20 min per clinician per day among those who attended at least 2 training sessions. DISCUSSION: We can promote EHR time savings for clinicians who engage in robust EHR training and optimization programs. To date, programs have shown a positive correlation between participation and subjective EHR satisfaction, efficiency, or time saved. The impact of EHR training and optimization on objective time savings remains elusive. By measuring time in the EHR, this study contributes to an ongoing conversation about the resources and programs needed to decrease clinician EHR time. CONCLUSIONS: We have demonstrated that Sprint is associated with time savings for clinicians for up to 6 months. We suggest that an investment in EHR optimization and training can pay dividends in clinician time saved.
