Connecting for Impact: Linking Potential Prescription Drug Monitoring Programs (PDMPs) to Patient Care Using Health IT

Prescription drug monitoring programs (PDMPs) are one of the most promising tools available to address prescription drug misuse, abuse, and diversion. PDMPs are state-run electronic databases that provide critical health information to physicians and other health care providers about an individual’s history of using controlled substance prescriptions. This information can be used to avoid inappropriate prescribing, identify drug-seeking behavior, and allows providers to intervene when there are signs of prescription drug misuse.

Maximizing PDMPs

ONC is committed to making sure this critical information gets to health care providers when and where it is needed most – in the provider’s workflow. Making PDMP information available in health IT systems like EHRs can make it easy for physicians and pharmacists to quickly check a patient’s PDMP report before prescribing or dispensing powerful prescription pain medications. ONC has worked on a range of efforts seeking to ensure that the utility and promise of PDMPs is fully realized.

PDMP & Health IT Integration Initiative

ONC’s PDMP & Health IT Integration Initiative seeks to address an important challenge to integration: no uniform standards exist for PDMPs to share their valuable prescription drug data with health IT systems. Not having these standards makes it harder for providers to use PDMP data when making treatment decisions. The PDMP & Health IT Integration Initiative brought together the PDMP and heath IT communities to address this problem and establish a standardized approach to delivering data stored in the PDMPs to EHRs, pharmacy systems, and health information exchanges (HIEs).

The “Enhancing Access” Project

From 2011-2013, ONC led the Enhancing Access to PDMPs using Health IT project, in collaboration with the Substance Abuse Mental Health Services Administration (SAMHSA), which explored different ways that technology could be used to maximize the potential of PDMPs in a variety of clinical settings.

REAL SOLUTIONS. REAL RESULTS. REAL STORIES.

I have to say that this is probably one of the more genius moves of the 21st century . . . having easy access to [the PDMP] without going to a totally different website and have it pop up instantly has taken a lot of time off of decision making for me.

- Emergency Dept Physician

“Enhancing Access” Pilot Reports

ONC led development of a series of pilots to test different technical solutions ranging from electronic prescribing tools to connecting PDMPs with HIEs. This was done to improve provider access to PDMP data. ONC released white papers which detail pilots’ design and outcomes, and highlight personal anecdotes from health care providers who reflected on the success integration had on their practice.

Phase 1: Six Pilot Studies and Their Impact [PDF - 839 KB]

State	Setting	Pilot Summary
Indiana (IN₁)	Emergency Dept	Automated query to PDMP upon patient admission to ED PDMP data integrated into EHR Read the Full Report [PDF - 549KB]
Indiana (IN₂)	Ambulatory	Unsolicited PDMP reports sent via Direct Read the Full Report [PDF - 638KB]
Michigan (MI)	Ambulatory	Automated query to PDMP to create integrated prescription history and alerts Read the Full Report [PDF - 409KB]
North Dakota (ND)	Pharmacy	Automated query to PDMP using an existing benefits management switch Read the Full Report [PDF - 528KB]
Ohio (OH)Ambulatory	Ambulatory	Automated query to PDMP upon appointment scheduling and patient check-in Patient risk score and a link to PDMP details displayed in EHR Read the Full Report [PDF - 547KB]
Washington (WA)	Opioid Tx program	Hyperlink to PDMP within EHR

Phase 2: Connecting for Impact: Integrating Health IT and PDMPs to Improve Patient Care [PDF - 3 MB]

State	Setting	Pilot Summary
Illinois (IL)	Emergency Dept	Automated query via intermediary and interstate hub to PDMP upon patient admission to ED PDMP data integrated into EHR as a PDF via a Direct message
Indiana (IN)	Emergency Dept	Automated query via HIE to multiple states’ PDMPs upon patient admission to ED Patient risk score and PDMP data integrated into EHR
Kansas (KS)	Providers & Pharmacists	Unsolicited report of at-risk patients sent via Direct to EHR-integrated mailboxes
Michigan (MI)	Ambulatory	Automated query via e-Prescribing software to multiple states’ PDMPs and result integrated in patient’s med history
Nebraska (NE)	Emergency Dept	Automated query via HIE to PDMP upon pt admission to ED Easy access to PDMP with SSO PDMP data integrated into EHR
Oklahoma (OK)	Emergency Dept & Ambulatory	Established PDMP access directly though an HIE Developed a SSO from the EHR through the HIE to the PDMP Alert flag representing the PDMP data
Tennessee (TN)	Pharmacy	Real-time reporting of dispensing controlled substance data to the PDMP using an existing network

Other Available “Enhancing Access” Resources

A number of additional resources and communication materials grew out of the 18-month Enhancing Access effort that might be helpful for those who may want to replicate or build upon the project’s success: [including the press release, fact sheet, and 1pager]

The Road to Connectivity (March 2013): A roadmap on how to connect PDMPs through health IT.
Work Group Recommendations–Final Report [PDF - 3.7 MB] (Aug 2012): Report outlining stakeholder-identified (more than 94 people across 53 organizations) challenges to timely use of PDMP data by clinicians and recommended solutions to address the problem.
Videos (March 2013): Pilot participants from Oklahoma and Indiana detail their states’ battles against prescription drug abuse and recall the advantages of their state’s PDMP including real-time reporting and how they used health IT to connect clinicians to this important database.
Action Plan for Improving Access to PDMPs through Health IT (June 2011): The White House hosted an expert roundtable, with government leaders and stakeholder experts to better understand the challenges and opportunities to leveraging health IT to connect PDMPs. This report outlines key themes and policy recommendations for consideration at the state and congressional level that emerged from that discussion.

Related ONC Resources

EHR Incentive Programs –FAQ 13413 (Dec 2015): CMS FAQ noting that integrating with a PDMP can count as a specialized registry to help meet Meaningful Use requirements.
Health IT Buzz Blog: “Health IT Helping to Fight the Prescription Drug Abuse Epidemic”.
Prescription Drug Monitoring Program Interoperability Standards – A Report to Congress (Sept 2013): a report pursuant to FDASIA 1141 on barriers and recommended solutions for enhancing the interoperability of state PDMPs with other technologies and databases used for detecting and reducing fraud, diversion, and abuse of prescription drugs.