Prescription Drug Monitoring Program Integration in the Electronic Health Record (Oregon)

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Integrating prescription drug monitoring programs into existing electronic health record systems may improve provider use and accessibility, reduce high-risk opioid prescribing practices, and improve opioid-related overdose outcomes.

Project Details - Ongoing

Summary:

Prescription drug monitoring programs (PDMPs) are State-administered electronic registries of prescription dispensing data for controlled substances and are used by clinicians to inform prescribing decisions. Although PDMPs are widely considered a critical tool in the Nation’s response to the opioid overdose epidemic, PDMP use varies widely among providers due to various logistical barriers. In many cases, accessing the PDMP requires the provider to open a new browser page, enter their credentials, and execute a patient-specific query. This disrupts the clinical workflow and may cause delays in patient care encounters.

To address this issue, researchers at Oregon State University and Oregon Health & Science University (OHSU) will evaluate integration of the PDMP within the OHSU electronic health record (EHR) system and examine the impact of integration on PDMP utilization and opioid prescribing patterns.

The specific aims of the research are as follows:

  • Determine the effect of PDMP EHR integration on provider PDMP use.
  • Evaluate the effects of PDMP EHR integration on controlled substance prescribing. 

To achieve the first aim, the research team will review PDMP utilization data from 12 ambulatory primary care clinics in the OHSU system, before and after PDMP integration. The study will employ a closed cohort design to minimize bias from changes in staffing, ensuring that the same providers in each clinic are tracked throughout the study period. To achieve the second aim, the research team will analyze PDMP dispensing data and EHR-derived prescription order data to evaluate changes in overall opioid prescribing. The research team will also evaluate high-risk prescribing patterns by comparing the dispensing data generated by OHSU providers using an integrated PDMP system versus external non-OHSU providers from a comparable health system that has yet to integrate their EHR systems.

The findings of this research will inform a larger, multistate research project to evaluate the effect of PDMP-EHR integration on clinical outcomes as well as identify factors that influence the efficacy of integrated PDMP-EHR systems.