Prescription Drug Monitoring Program Integration in the Electronic Health Record

项目总结 处方药监测计划(PDMP)是国家管理的电子登记 受控物质处方配药数据，并由临床医生用于通知 滥用药物。现在，PDMP在每个州和哥伦比亚特区都有业务，是一项核心战略 在国家对阿片类药物过量流行的反应中。越来越多的文献表明，州pdmp 减少高风险阿片类药物处方和阿片类药物相关过量，特别是在强制使用阿片类药物的州 某些临床症状。然而，PDMP的使用因临床医生的不同而不同，因为访问通常需要 中断临床工作流程或患者护理会面。为了促进更多的PDMP使用，多个州 正在投资于促进PDMP与其他医疗信息技术(HIT)集成的技术 电子健康记录(EHR)等平台。为了加快一体化进程，俄勒冈州卫生局 当局正在为俄勒冈州各地医疗保健系统的PDMP EHR集成提供补贴。俄勒冈州健康与健康公司 科学大学(OHSU)是该州最大的医疗保健系统之一，将是第一批医疗保健系统之一 系统将在其电子病历应用程序(EPIC™)中进行PDMP集成。OHSU目前正在集成PDMP 在六个月内访问12家门诊初级保健医疗诊所(从4家诊所开始 每两个月)。本提案的目标是评估PDMP集成对提供商使用的影响 开出行为处方。我们实现这一目标有两个具体目的：(1)确定 PDMP EHR集成对提供商PDMP使用的影响，以及(2)评估PDMP EHR集成对以下方面的影响 开出受控药物处方。我们将使用观测台阶式楔形设计，数据来源于 OHSU EHR和该州的PDMP计划。我们利用OHSU诊所的交错实施来 评估PDMP EHR整合对提供商使用PDMP(目标1)和处方行为的影响 (目标2)。该项目产生的数据将为全国各地的PDMP整合工作提供信息，并支持 更大的研究方案，研究这一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.