Opioid Wizard: Advancing identification and engagement in opioid use disorder care
Author: Eric Wright
As part of a national initiative to improve care for patients with opioid use disorder (OUD), Geisinger Enterprise Pharmacy contributed to the development and evaluation of Opioid Wizard — a clinical decision support tool embedded in the electronic health record. Designed to assist clinicians in identifying patients with OUD and guiding them toward evidence-based treatment options, the tool reflects a collaborative effort to enhance clinical decision-making and improve patient outcomes.
The project was conducted through a multi-site research collaboration funded by the National Institute on Drug Abuse, involving researchers and clinicians from several major health systems. Geisinger’s Center for Pharmacy Innovation and Outcomes led key aspects of the initiative, including tool design, implementation and evaluation. The project highlights the role of pharmacy in advancing clinical informatics and contributing to national strategies for substance use treatment.
“This project demonstrates how pharmacy can lead innovation in clinical decision support,” said Eric Wright, PharmD, MPH, professor and system director of CPIO.
“While adoption in practice was variable, Opioid Wizard helped us better identify patients at risk and laid the groundwork for future improvements in care delivery.”
Opioid Wizard integrates risk models and point-of-care decision aids to support clinicians in recognizing OUD and initiating appropriate care pathways. The tool was designed to be accessible in routine workflows, allowing providers to assess risk and make informed decisions during patient encounters. A randomized controlled trial published in JAMA Internal Medicine reported modest but statistically significant improvements in naloxone prescribing and referrals to treatment for OUD.¹ These findings underscore the potential of embedded decision support tools to influence clinical behavior and improve access to care.
In addition to quantitative outcomes, the initiative included a qualitative study of patient perspectives conducted at Geisinger and Essentia Health by researchers Drs. Katrina Romagnoli and Tony Olson. This work informed the development of 6 validated patient archetypes, representing diverse experiences and engagement patterns with opioid-related care. The study, published in BMJ Open, highlighted real-world barriers and motivators that influence patient decisions and provided actionable insights for future intervention design.² These archetypes are now being used to inform the design of future tools and outreach strategies so that patient needs and preferences are considered in the development of care models.
“Understanding patient perspectives was essential,” said lead author Tony Olson, PharmD, PhD, Enterprise Pharmacy leader and co-investigator. “The archetypes helped us see the real-world barriers and motivators that shape how patients engage with treatment — and that insight is already influencing how we design future interventions.”
The project also emphasized the importance of understanding communication dynamics between patients and primary care clinicians. Findings from the qualitative study revealed that perceptions of empathy, trust and clarity significantly influenced patient engagement with treatment recommendations. These insights are being used to guide training and support for clinicians working with patients affected by substance use disorders.
The Opioid Wizard initiative demonstrates Geisinger’s commitment to collaborative, patient-informed innovation. By combining data-driven tools with qualitative research, the project contributes to a more responsive and effective model of care for people with OUD. The integration of pharmacy leadership in both the technical and clinical aspects of the project reinforces the value of interdisciplinary collaboration in addressing complex public health challenges.
Geisinger’s participation in this national effort reflects its ongoing investment in innovation, research and continuous improvement in substance use treatment.
The insights gained from this project continue to inform the development of future tools and approaches aimed at improving care delivery, supporting clinicians and enhancing outcomes for patients with opioid-related conditions.
Relevant publications
- Rossom RC, Crain LA, Wright EA, Olson AW, … Romagnoli K, … Tusing L et al. Clinical Decision Support System for Primary care of Opioid Use Disorder: A Randomized Clinical Trial. JAMA Intern Med. 2025;185;(9):1079-1089. doi:10.1001/jamainternmed.2025.2535
- Olson AW, Bucaloiu A, Allen CI, Tusing LD, Henzler-Buckingham HA, Gregor CM, Freitag LA, Hooker SA, Rossom RC, Solberg LI, Wright EA, Haller IV, Romagnoli KM. ‘Do they care?’: a qualitative examination of patient perspectives on primary care clinician communication related to opioids in the USA. BMJ Open 2025;15:e090462. doi:10.1136/bmjopen-2024-090462
