The first statewide EDDS program in the nation was launched in Maryland in 2022. CESAR was awarded a grant by the State of Maryland’s Office of Overdose Response. MD-EDDS is now working with 20 hospitals across the state. Hospitals were selected so that all areas of the state are represented. Participating hospitals provide de-identified extracts of patients’ electronic health records (EHRs) and can participate in expanded urine drug screening and targeted urinalysis studies to learn more about the drugs to which their patients have been exposed.

 

Map with markers showing locations of Maryland EDDS sites

 

EHR Data Extraction: The EHR extracts contain a limited data set of information on patient urine drug test results, chief complaints, diagnostic codes, and basic demographic information. The EHR data are used to track quarterly trends in the urinalysis results for all drugs included in the hospital's standard panel thus providing trends and patterns in the drugs to which Emergency Department (ED) overdose patients have been exposed.

Targeted Urinalyses: In FY2023, 14 hospitals participated in a fentanyl dipstick sub study to assess patient exposure to fentanyl in hospitals that did not include fentanyl in their standard test panels. Results from this study were used by local legislators and advocates to support the Josh Siems Act. The Act was passed during the 2023 legislative session and now requires all hospitals in Maryland to include fentanyl when urine drug screens are conducted as a part of standard diagnostic procedures.

Expanded Urine Screening: In FY2024, all hospitals participating in MD-EDDS will have the opportunity to provide up to 100 de-identified patient urine specimens to the EDDS collaborating lab for re-testing for an expanded panel, including synthetic opioids and xylazine. The expanded re-testing of a sample of patients’ de-identified urine specimens enables MD-EDDS to identify drugs involved in local ED cases that might be added to each hospital’s testing protocols.

MD-EDDS findings are disseminated on CESAR’s website and can be used to help inform patient treatment and to update testing protocols. EDDS is also a key part of the State’s drug surveillance system.

Definition for Inclusion of ED Visits in MD-EDDS analyses: 
Definition for Inclusion in MD-EDDS analyses: Any ED visit involving a patient aged 18 years or older with a complaint of overdose and/or an ICD-10-CM code T36-T50 initial encounter diagnosis code of poisoning with accidental (unintentional), intentional self-harm, or undetermined intent recorded for the visit.  

Table 1: MD-EDDS Hospitals

Western Maryland [Download Charts]    
Meritus Medical Center Hagerstown 2019-2023
UPMC Cumberland 2018-2023
Southern Maryland [Download Charts]    
UM Charles Regional Medical Center  La Plata 2019-2023
Central Maryland [Download Charts]    
UM Baltimore Washington Medical Center Baltimore 2016-2023
UM Medical Center Baltimore  2016-2023
UM Medical Center, Midtown Baltimore     2016-2023
UM Upper Chesapeake Med Center Bel Air Mar 2020-2023
UM Harford Memorial Hospital Havre de Grace Mar 2020-2023
UM St. Joseph Medical Center Towson 2016-2023
Grace Medical Center, LifeBridge Health Baltimore  2016-2023
Sinai Hospital of Baltimore, LifeBridge Health Baltimore     2016-2023
Northwest Hospital Center, LifeBridge Health Randallstown 2018-2023
Capital Region [Download Charts]    
UM Bowie Health Center Bowie Jun 2021-2023
UM Capital Region Medical Center Largo Jun 2021-2023
UM Laurel Medical Center Laurel Jun 2021-2023
Eastern Shore [Download Charts]    
UM Shore Medical Center Cambridge Cambridge 2022-2023
UM Shore Medical Center Chestertown Chestertown 2019-2023
UM Shore Emergency Center Queenstown 2019-2023
UM Shore Medical Center Easton 2019-2023
TidalHealth Peninsula Regional Hospital Salisbury 2018-2023

Source: CESAR August 2023

 

Additional Findings:

 

The Data-Informed Overdose Risk Mitigation (DORM) 2022 Annual Report is produced by the State of Maryland's Office of Overdose Response. MD-EDDS research is a significant component of the latest report (2022) published in September 2023. The MD-EDDS contribution begins at "Hospital Level Data" on page 33.

 

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