BOCA RATON, FLA. – Researchers at the National Institute on Drug Abuse are conferring on concise, standard screening questions that psychiatrists, primary care physicians, and other clinicians can use to identify patients with substance use disorders.
As part of the Affordable Care Act, the agency is devising a standard core set of screening questions to identify patients with drug, alcohol, and/or tobacco use disorders.
The screen will be incorporated into a national electronic health record system, Dr. Robert W. Lindblad said at the meeting.
The aim is to develop a concise set of questions for quick identification in primary care settings, as well as a larger number of more comprehensive questions for screening and treatment in substance disorder treatment settings. "Our efforts here go beyond identification but also to characterize, treat, and/or refer," he said.
"Some of your early feedback is: You cannot look at drugs if you are not looking at alcohol also. Then you have to ask about tobacco also. Being able to ask about all three areas is important," said Dr. Lindblad, a contractor for the National Institute on Drug Abuse (NIDA) and chief medical officer of Emmes Corp. in Rockville, Md.
Researchers began this initiative by looking at existing systems. "There wasn’t really anything out there for us," Dr. Lindblad said. "The VA has a great system, Kaiser has a great system, but the VA and Kaiser systems don’t talk to each other." So researchers started development of "common data elements" that any electronic health record system could incorporate, he said.
"Regarding common data elements ... we are probably creating a lot of these," said Robert Gore-Langton, Ph.D., an Emmes employee who manages the NIDA Clinical Trials Network Data and Statistics Center 2.
Screening questions are likely to address mental health, addiction history and status, addiction treatment history and status, family and social support, and legal and criminal status.
A person attending the meeting asked whether patients will complete questionnaires online before an appointment or in a physician’s office. "That is still unclear," Dr. Gore-Langton replied. "It will probably be filled out before patients see the doctor, maybe on a tablet. It will be the same as information on forms patients fill out in an office [historically], but done electronically."
If patients answer no to all core screening questions, they will be finished. If they respond yes to one or more questions, it will prompt the system to ask subsequent queries.
Emmes Corp. is a NIDA Clinical Trial Network Clinical Coordinating Center.