Having a clear view of a patient’s prescription history is one of the most important tools a doctor can have during the opioid crisis. That’s why we recently integrated our EHR with the Michigan Automated Prescription System (MAPS) at Chippewa County War Memorial Hospital.
The MEDITECH Prescription Drug Monitoring Program button, or PDMP, launches the physician directly into the Michigan MAPS website, enabling them to get this information without having to leave the EHR or alter their workflow.
The easy access to drug histories gives the doctors the ability to make informed decisions about prescribing opioids and safely manage patient drug use. The information is being pulled and put in the doctor’s hands right when they need it, whether prescribing a new drug and/or discussing care with the patient. They immediately are given the opportunity to change the prescription plan or provide the patient with additional counseling and education in real time.
How Michigan is reducing opioid prescriptions
By integrating PDMP, War Memorial meets current mandates set by the state of Michigan and puts us ahead of the federal PDMP requirement, which goes into effect in 2020, in addressing the opioid crisis.
According to a report published in March, the number of overdose deaths in Michigan increased by 30 percent between 2013 and 2015, with the largest number of drug-related overdose deaths occurring among men ages 26-35 and men ages 46-55.
By utilizing MAPS, our state is able to track all drugs listed under Schedules II through V by the federal government for each prescriber.
MAPS also reports the overall number of prescriptions in the state annually and after years of steady increases, Michigan’s rate of opioid prescriptions recently fell by 7.1 percent from 2015 to 2017, falling below the 20 million mark for the first time since 2011. Opioid prescriptions also dropped by 10.7 percent during that time, according to the state Dept. of Licensing and Regulatory Affairs (LARA), so we think it is making a difference.
The state feels these improvements are a direct result of providing more education and training for prescribers. The inclusion of the NarxCare platform within MAPS is credited with this decrease as well. This platform provides substance abuse prevention and management tools for prescribers, including an overdose risk score that predicts the potential for overdose death.
Using these tools, our doctors readily understand the possible risks for patients and can take steps to reduce them, lowering overall opioid prescriptions and reducing the potential harm to patients.
Doing the right thing for patients, prescribers, and our organization
From the Information Systems perspective, integrating PDMP was an extremely simple process. It was essentially an update to our existing EHR that gives our providers one-click access to the information they need.
This new integration did require some changes on the clinical side – current regulations require each prescriber to access the MAPS file directly, instead of delegating this action to a staff member.
If accessing MAPS directly through the website, and not through the MEDITECH link, a staff member is allowed to prepare it for provider review. It was a bit of a challenge to get some providers to start using the new link, as they were used to having this information prepared and given to them via a different workflow.
We were able to take advantage of a built-in benefit to promote the use of the PDMP button: The patient’s care record automatically logs/records the use of the PDMP button, confirming that the provider reviewed MAPS for the patient.
This accomplishes the requirement that physicians document every time they review MAPS activity prior to writing a controlled prescription. We promoted the PDMP button as a time-saver and efficient documentation tool, as well as a launch point.
Our goal is to deliver safe and appropriate care to our patients, and the PDMP launch point allows us to do both a little more efficiently.
More importantly for clinicians, the patient’s care record is updated automatically with the prescribing information. This saves time for our providers because they don’t have to complete a separate process to confirm that they have reviewed the PDMP record. The automatic EHR update also makes it easier for them to review the discharge process and ensure that each patient is getting the appropriate prescription before they leave the hospital.
Ultimately, that’s what PDMP integration is all about: Doing the right thing by our patients and delivering the appropriate, quality care.
Learn more about MEDITECH Expanse’s integrated Opioid Stewardship Toolkit that supports efforts to identify high-risk patients and reduce opioid-related harm.