PRIMUM: Using Data and Technology to Reduce Opioid Prescriptions

Too often, health providers have difficulty assessing a patient’s history with controlled substances – either they cannot share patient health records across facilities, or critical information is buried deep within a patient’s health record. PRIMUM alert system solves this. It prevents high-risk prescriptions for opioids and benzodiazepines from being written in the first place.


PRIMUM flags evidence-based risk factors for misuse, substance use disorders, and diversion that are present in a patient’s electronic health record. In its first two years of “live” use, PRIMUM identified risk factors in one in four patients. Ultimately, this prevented nearly 23,000 high-risk prescriptions for controlled substances across our system. After PRIMUM identifies the signs of a substance use disorder, physicians have the option to refer patients to other providers within Atrium Health’s network – including addiction and behavioral health specialists.

"We designed PRIMUM not just for Atrium Health, but for other health professionals as well. The tool is extremely versatile - it can integrate easily within many different electronic health records and care settings. If more hospital systems adopted PRIMUM, it would dramatically reduce the number of opioid prescriptions given to high risk patients. This could turn the tide of the U.S. opioid crisis over time."

-Joseph Hsu, MD, Vice Chair of Quality, Atrium Health Musculoskeletal Institute

PRIMUM gets “smarter” the more it’s used, as it references a growing body of patient records. The CDC has recognized PRIMUM as an effective tool to operationalize its guidelines for prescription opioids for chronic pain, with the potential to be deployed by many other health providers.

In addition to PRIMUM, we’re also using our centralized electronic health records to develop an innovative “opioid dashboard,” which allows medical directors to identify trends in prescribing habits across different locations and specialties. Armed with this information, we can quickly address problems within our system where rates of opioid prescriptions exceed the average.

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