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Hospitals target opioids, mental health: State's biggest health systems fashion cooperative effort

DULUTH — Thirteen Minnesota health systems — including Duluth-based Essentia Health — are joining forces to take on two of the state's most vexing health issues: opioid addiction and mental health care.

"They are tremendous societal and health problems that all of us were already working on, but none of us felt that we could come to the solutions within our communities by ourselves," said Dr. David Herman, CEO of Essentia.

The health systems, which also include the Mayo Clinic, HealthPartners and Allina Health, collectively serve four out of every five patients in the state, according to a news release from the Institute for Clinical Systems Improvement, a Minneapolis-based nonprofit that's coordinating the effort.

The newly formed cooperative, in the works for a year, is going under the name Minnesota Health Collaborative. It extends the work of the 25-year-old institute, which long has supplied best-practices guidelines for the state's providers, said Herman, who sits on the institute's board. But it has them addressing a couple of particularly dicey areas.

"The opioid crisis is a very complex problem with many pieces to it," said Dr. Claire Neely, the institute's chief medical officer. "There are many things that need to be done and some of them frankly need to be discovered."

The plan is for the health providers to learn from each other what approaches work best and then implement those approaches statewide as rapidly as possible, Neely said.

"I've worked in health care a long time, and it can take 10 to 15 years for a change to occur," said Neely, who formerly practiced as a pediatrician. "We're trying to work on a much faster timeline than that."

Opioid overdoses now take more lives in the U.S. than motor vehicle accidents, and opioid prescriptions have been blamed for much of the epidemic's origin. In 2015, 681 opioid prescriptions were written for every 1,000 Minnesotans, according to the Minnesota Department of Health.

But the number of opioid prescriptions has declined in Minnesota, Neely said, and so has the number of deaths.

The collaborative is working to build on that, she said, with "calls to action," recommending specific policies for health providers. The first of those was issued in early December and advises limits on prescribing opioids for acute pain. A similar call will be issued regarding prescribing opioids for post-operative patients.

Within the year, more opioid guidelines will be issued, as well as guidelines regarding mental health, Neely said.

The collaborative is looking at how to better include behavioral health services as part of primary care, she said. It's also focusing on what happens to patients who are in a mental health crisis when they come to the emergency room.

"Sometimes patients have to remain in the emergency department for days," Neely said. "They're looking at ... how do we make things better in the emergency department?"

The collaborative's recommendations are non-binding, but both Neely and Herman said they believe they'll be well-received. They started on the initiative of the people at the top of the organizations, they noted.

"There's a lot of busy people that are around that table," Herman said. "These are things that are important enough ... that they're certainly very worthy of our time and attention, and difficult enough that we have a higher level of confidence by us working together."

It's even more important for the people in the front lines of the crises, Herman said.

"They have long seen the need to work on these two things," he said. "(They) have long been frustrated that things don't come together quickly enough or don't have the time and attention that they feel they deserve."

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