Objective
We leveraged existing data from a single electronic health care system in the southeastern United States to demonstrate the feasibility of measuring quality indicators for the hospital-based care of opioid-exposed newborns using existing data infrastructure. Additionally, we identified other key variables related to the care of opioid-exposed maternal-infant dyads.
Patients and Methods
Using a predefined population of opioid-exposed infants from an Epic electronic health record, we developed criteria for the identification of quality indicators and other variables from the clinical data recorded during the birth hospitalization and the perinatal period. Informed by existing literature and the study team’s clinical expertise, we used a combination of structured and unstructured data elements.
Results
Out of 36 hospital quality indicators identified as important and feasible by an expert panel using a Delphi approach, we were able to extract the necessary elements to assess 8 indicators: Infant assessment for signs of withdrawal begins before 12 hours of life, the infant was provided breastmilk at any point during the birth hospitalization unless contraindicated by infectious disease or relapse in the past 30 days, a certified lactation consultant was consulted during the birth hospitalization, the primary medication used to treat infant opioid withdrawal was an opioid, the infant was observed for at least 24 hours after weaning off medications prior to discharge, percent of opioid-exposed infants who were treated with pharmacotherapy, duration of pharmacotherapy in days (i.e., length of treatment), and the duration of the birth hospitalization in days (i.e., length of stay).
Conclusions
Health care systems can utilize the published algorithms to assist in leveraging existing EHR data to assess quality of care for opioid-exposed newborns.
GitHub URL: https://github.com/The-Wei-Lab/clinical_indicators_for_opioid_exposed_in...
PheKB URL: https://phekb.org/phenotype/opioid-exposed-infant-clinical-indicators
