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How can physicians, already struggling to keep up with mounting regulations and larger patient loads, use PDMPs in more effective and efficient ways?
Until about a year and a half ago, the use of prescription drug monitoring programs (PDMPs) was optional for many physicians, but many states now require physicians to check these databases before prescribing controlled substances, such as opioids, to patients.
So how can physicians, already struggling to keep up with mounting regulations and larger patient loads, use these databases in more effective and efficient ways?
During her presentation at CBI’s Prescription Drug Monitoring Programs conference in Baltimore on February 7, presenter Pooja Babbrah, senior consultant and practice lead, PBM services, Point-of-Care Partners management consulting firm, shared best practices for incorporating PDMP data into provider work flow, based on lessons learned from pilot studies conducted between 2012 and 2016.
#1. Incorporate PDMP data into EHRs-automatically. Traditionally, said Babbrah, PDMP data have been outside of the prescriber work flow. In other words, if providers want to access the data on a PDMP, they have to review the PDMP database separately from their EHR work flow. This has been “a huge barrier” to use, said Babbrah.
Ideally, she said, PDMP data for providers would be “automatically” available to physicians in the EHR, and physicians wouldn’t have to type or search for the information as a separate part of their work flow.
Unfortunately, a common theme from presenters throughout the Prescription Drug Monitoring Programs conference (and something that Babbrah acknowledged) is that this seamless integration of PDMP data into the EHR is no easy task, and vendors face big legal and technical hurdles in this area.
#2. Incorporate PDMP data into EHRs-in a user-friendly manner. In addition to considering how to best integrate PDMP data into EHRs, it’s also important to consider how best to incorporate PDMP data into clinical decision making, said Babbrah.
Pilot projects showed that providing clinicians with a summary of PDMP data, rather than raw data, made a big difference to physicians and helped them more efficiently use the data in relation to patient care, she said.
As best practice, she said, that data should be received from the PDMP in a user-friendly report, such as a chart, risk score, etc. (something the physician can easily see and understand).
In addition, data received from the PDMP should be automatically stored in the patient records (if state regulations allow it), said Babbrah.
#3. Incorporate an access and standards-based approach. Pilots in 2015 and 2016 started looking at standardization in PDMP data and information flow, said Babbrah, noting that the fact that each state utilizes a different PDMP and has its own set of rules and regulations related to data further complicates this problem. “We’re still in our infancy in a lot of this from the EHR vendor perspective” but having standards will be a huge push in getting things moving, she said.
Further complicating matters when it comes to facilitating information flow between PDMP and EHR are access rules related to which clinical team members can legally access protected health information. “From an EHR perspective, what you need to realize is there’s a lot of functionality that goes into an EHR based on roles,” said Babbrah.