Prescription Drug Monitoring Program Integration in the Electronic Health Record

项目摘要 处方药监测计划（PDMP）是国家管理的处方药的电子注册。 受控物质处方分配数据，并由临床医生用于告知处方决策， 滥用药物。PDMP现在在每个州和哥伦比亚特区都有运作，是一项核心战略 对阿片类药物过量流行病的反应。越来越多的文献表明， 减少高风险阿片类药物处方和阿片类药物相关过量，特别是在要求在 某些临床情况。然而，临床医生之间的使用情况各不相同，因为获得药物往往需要 中断临床工作流程或患者护理遭遇。为了促进更多的Pesticide使用，多个州 正在投资于促进Pandemic集成到其他健康信息技术（HIT）中的技术 电子健康记录（EHR）。为了加速整合，俄勒冈州卫生部 管理局正在补贴整个俄勒冈州的医疗保健系统的电子健康记录集成。俄勒冈州健康与 科学大学（OHSU），该州最大的医疗保健系统之一，将成为第一个医疗保健系统之一。 系统在其EHR应用程序（Epic™）中进行Pestrian集成。OHSU目前正在整合PSTO 在六个月的时间内，在十二个门诊初级保健医疗诊所（四个诊所开始 每两个月）。本提案的目的是评估Pandora集成对提供商使用的影响 和行为规范。我们通过两个具体目标来实现这一目标：（1）确定 （2）评估PSEEHR集成对供应商PSEEHR使用的影响 管制药物处方。我们将使用观察性阶梯楔形设计，数据来自 OHSU EHR和该州的PAPER计划。我们利用OHSU诊所的交错实施， 评估PIMEHR集成对PIMEHR提供者使用（目标1）和处方行为的影响 (Aim 2）。该项目产生的数据将为全国各地的PINDIA融合工作提供信息，并支持 一项更大的研究提案，旨在研究该倡议对阿片类药物处方和阿片类药物相关过量的影响 结果。

PROJECT SUMMARY Prescription Drug Monitoring Programs (PDMPs) are state administered electronic registries of controlled-substance prescription dispensing data and are used by clinicians to inform prescribing decisions for medications of abuse. Now operating in every state and the District of Columbia, PDMPs are a central strategy in the nation’s response to the opioid overdose epidemic. A growing literature suggests that state PDMPs reduce high-risk opioid prescribing and opioid-related overdoses, particularly in states that mandate use in certain clinical situation. However, PDMP use varies among clinicians because access often entails interrupting the clinical workflow or patient care encounter. To promote increased PDMP use, multiple states are investing in technology that facilitates PDMP integration in other health information technology (HIT) platforms such as the electronic health record (EHR). In an effort to accelerate integration, the Oregon Health Authority is subsidizing PDMP EHR integration for healthcare systems across Oregon. Oregon Health & Science University (OHSU), one the largest healthcare systems in the state, will be one of the first healthcare systems to undergo PDMP integration within its EHR application (Epic™). OHSU is currently integrating PDMP access across twelve ambulatory primary care medicine clinics over a six-month period (four clinics starting every two months). The objective of this proposal is to evaluate the effect of PDMP integration on provider use and prescribing behavior. We accomplish this objective with two Specific Aims: (1) Determine the effect of PDMP EHR integration on provider PDMP use and, (2) Evaluate the effects of PDMP EHR integration on controlled substance prescribing. We will use an observational stepped-wedge design with data derived from OHSU EHR and the state’s PDMP program. We exploit the staggered implementation across OHSU clinics to estimate the effects of PDMP EHR integration on provider use of the PDMP (Aim 1) and prescribing behavior (Aim 2). Data generated from this project will inform PDMP integration efforts across the country and support a larger research proposal to study the effects that initiative on opioid prescribing and opioid-related overdose outcomes.