Using Surescripts National Record Locator Service (NRLS) to Combat Opioid Abuse

1 Copyright © 2015 by Surescripts, LLC. All rights reserved.
Copyright © 2017 by Surescripts, LLC. All rights reserved.
Using Surescripts NRLS to
Combat OpioidAbuse
HIMSS Interoperability Showcase
February 2017

Mary’s Story
Mary Sanderson is a 21 year old female student at Boston College. Prior to her recent move to Boston,
she lived at home with her parents in Providence, RI where she visited her PCP and her OBGYN on a
regular basis. Shortly after her move to Boston, Mary sought care at an urgent care center (MEDITECH)
for severe abdominal pain. The urgent care provider prescribed her some pain medications to help
relieve her pain. Mary was feeling the stress of college life and, over the next year, visited multiple
urgent care centers (Surescripts Location Summary CDA) seeking out pain medications to help her
cope. She returns to her parents’ home in Providence one summer and obtains additional pain
medications from her former PCP (NextGen) where she complains of a severe headache. Mary then
presents to a new PCP, Dr. Massoud, (eClinicalWorks) complaining of abdominal pain. Dr. Massoud is
able to query (Surescripts) NRLS for external records, including visit summaries from her urgent care
visit for abdominal discomfort and her PCP visit for headache, along with the Surescripts Location
Summary CDA indicating multiple historical visits to urgent care facilities in the Boston area. Dr.
Massoud suspects an opioid abuse issue and refers Mary to a care coordinator (Netsmart). The care
coordinator creates a care plan for Mary and refers her to a pain management specialist (Epic). The
pain management specialist treats Mary and closes the loop with the care coordinator.
**All names used are just as example, not a real patient or situation**

Mary visits an Urgent Care while at college in Boston, MA
complaining of abdominal pain
The Urgent Care
provider is using the
MEDITECH EHR and
has no insight into
Mary’s past history.
Mary is prescribed
Morphine for her severe
abdominal pain and
discharged.

Mary visits her parents in Providence, RI over the summer
and sees her old PCP complaining of a severe headache
The PCP is using the
NextGen EHR and
has no insight into
Mary’s past history.
Mary is prescribed
Vicodin for her severe
headache and
discharged.

Mary returns to Boston, MAand presents to a new PCP
complaining of pain and constipation
The new PCP, Dr.
Massoud, is using the
eClinicalWorks EHR.
Dr. Massoud uses her
eCW EHR to query
the Surescripts
National Record
Locator Service
(NRLS) to discover
historical visit
information.

Surescripts NRLS locates multiple visits that Mary has
recently had and provides that information to Dr. Massoud
NRLS finds visits to multiple urgent cares and ERs in CA, FL,
RI and MA within the last year.
NRLS retrieves and
provides various
documents to Dr.
Massoud in her eCW
EHR.
• CDAs from the
MEDITECH and
NextGen locations
• NRLS creates a
Location Summary
CDA with a list of
locations found
leveraging
ePrescribing data

Dr. Massoud uses the NRLS, MEDITECH and NextGen CDAs
to conclude that Mary is exhibiting Opioid abuse behavior
Dr. Massoud sees that Mary has frequently visited ERs and urgent cares
and has been prescribed multiple Opioids from various providers. Dr.
Massoud prescribes Naloxone and refers Mary to a care coordination
program to determine the best program to manage her pain and Opioid use

Mary presents to the care coordinator using the Netsmart
EHR to manage her Opioid use
The care coordinator reviews the referral documentation sent
from the eClinicalWorks EMR via XDR and also queries
Surescripts NRLS to confirm Mary’s Opioid abuse
NRLS retrieves and
provides the documents
from the MEDITECH and
NextGen visits as well as
the NRLS Location
Summary CDA
The care coordinator
documents a treatment
plan and refers Mary to a
pain management
specialist to manage her
underlying pain condition

Mary presents to the pain management specialist using the
Epic EHR where she is treated for her chronic pain and
tapered off her Opioid use
Using Surescripts NRLS,
the pain management
specialist is able to get a
complete picture of
Mary’s health from visit
locations across the
nation, without relying on
Mary to remember and
disclose every visit, in
order to treat her chronic
pain and taper her off of
Opioids
The pain management specialist reviews the referral
documentation via XDR from the Netsmart EMR and also
queries Surescripts NRLS to retrieve other documents

Using Surescripts National Record Locator Service (NRLS) to Combat Opioid Abuse

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