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Project POINT optimizes outcomes using REDCap

Like many other states, Indiana has felt the staggering effects of opioid misuse within its cities and towns; the Spring 2018 issue of the Indiana Business Review reports an increase of over 500% in overdose deaths between 2003 and 2018, and estimates related economic damages at $43.3 billion dollars and climbing. Dr. Krista M. Brucker’s experiences with overdose patients in the Eskenazi Health Emergency Department, coupled with statistics like these, prompted her to ask how the medical community might do more.

In 2015, Brucker started Project POINT (Planned Outreach, Intervention, Naloxone, and Treatment), which seeks to improve outcomes for these patients. The program targets patients who survive opioid overdose and come to a hospital emergency department for treatment. She explains that the healthcare system, at present, “makes it very hard to get help and very easy to slip back into active disease;” Brucker seeks to mobilize the medical community to connect patients to care after they leave the emergency department. Project POINT is committed to using peer supports (people with lived experience of addiction) to meet patients where they are and help them take the next few steps toward recovery.

REDcap cut through all that. It lets you keep, organize, and output the data you want for any specific request and leave the rest behind to be used later

Project POINT began when doctors began counting the number of overdoses they saw in the emergency department. They didn’t have a good way to track, sort, or quickly de-identify them in order to use the data for quality improvement work. REDcap, an easy-to-use research database tool, offers the project a quick interface for creating custom forms, sorting information, and making reports with all the inputs the doctors need. For a project like POINT, electronic medical records contain too much data they don’t need, and not enough about social determinants like personal history of incarceration and childhood trauma. Brucker explains, “REDcap cut through all that. It lets you keep, organize, and output the data you want for any specific request and leave the rest behind to be used later,” while also giving the people working on the project timely access to the information they need in the moment. REDcap’s interface allows the doctors “to dig quickly into well-organized data and show hospital, local, and state leadership how bad the problem was and how much of a difference some small-scale pilot work could make.”

While other diseases have had lots of money and infrastructure poured into them in order to decrease incidence, people with opioid use disorder are frequently asked to do better and try harder. Brucker notes that it is, rather, “like every other disease...a combination of genetics, brain biochemistry, zip code, access to food, shelter, education, and healthcare, family and hyper-local environment as well as large-scale public policy.” Countering notions that opioid use disorder is a moral failure, Brucker asserts its status as a disease and tasks the medical community and general public with pushing the systems we interact with--from schools and churches to employers and congress--to improve access to treatment.