How to Make PMP a Seamless Part of Your Day - TRIARQ Health

Thousands of lives are lost to opioid addiction each year, and that has to change. Prescription monitoring programs (PMP) make physicians aware of possible abuse or diversion, giving them insight on when to prescribe controlled substances — and it’s easier than you might think.

The Center for Disease Control (CDC) estimates that roughly 38 people died from prescription opioid abuse per day in 2019, amounting for a total of just under 14,000 deaths. In an effort to combat the opioid epidemic, states have created database hubs that facilitate prescription oversight and alert prescribers to possible opioid abuse or diversion.

These hubs are often known as prescription monitoring programs (PMP) or prescription drug monitoring programs (PDMP), and they are a valuable tool in the fight against opioid addiction. Implemented in all 50 states as well as the District of Columbia and all other American territories as of 2018, PMP hubs have become commonplace amongst medical practices and pharmacies, but the way they are structured varies from state to state.

These variations significantly impact how medical professionals leverage PMP insights, and while the most effective streamline PMP usage, inefficient regulations can complicate physician workflows. With the right tools, though, physicians can make PDMP integration a seamless part of their practice.

Here’s a deeper look into what PMP programs are, how they help physicians make the best decisions for their patients, and a case study of an effective PMP program Michigan has started that reduces participant costs.

PDMP Overview

What Is a PDMP?

PDMPs use a three-step process to give providers insight into their patients’ prescription use:

1. Input. When a provider prescribes a controlled substance, it is entered into the PDMP database after being filled by the pharmacy. The frequency with which pharmacies enter their filled prescriptions varies both by state and by pharmacy, though, making real-time entry essential for accurate data and for providers to rightly assess their patients’ prescription use.
2. Access. Before ever seeing the patient, a provider may log in to the database and view a clear history of each time that the patient was prescribed the substance in question. That way, signs of potential abuse such as early filling or visits to multiple providers can be detected, and providers can decide how best to respond.
3. Insight. Built-in analytics platforms can be leveraged to give providers insights into their own prescription frequencies, and regulators may also view trends to see where controlled substances are prescribed the most. This helps providers find alternatives to regularly prescribed substances and shows governing bodies how they can best serve the patients that use them.

While compiled data has been mixed regarding the degree of benefit that PDMPs provide, it is clear that the overall results of these programs are changes in prescribing behaviors, reductions in visits to multiple providers, and, most importantly, improvements in patient health.

Using PMPs in Independent Medical Practices

Although PMPs have proven to be a helpful tool in raising physician awareness and reducing opioid abuse, improper usage can hinder their effectiveness. There are at least three factors that determine how much benefit PMPs yield, namely:

• Real-time entry. While some PMPs use platforms that update pharmaceutical entries within five minutes, others only require pharmacies to enter their prescriptions as little as once a month. This can leave providers with obsolete data, making prompt updates an essential part of the process.
• Active management. Regulators can make the most of PMPs by viewing demographic data so that they can establish appropriate ways to address a drug epidemic and can even send proactive reports to authorized users regarding patients at higher risk of abuse. Accurate data equips authorities with the insights they need to curb opioid abuse, and PMPs make that possible.
• Universal use. More providers using PMP data means that more prescription abuse can be identified and prevented, but it only works when as many providers as possible are on board. Involving multiple healthcare professionals has been instrumental toward that end, as physician’s assistants and nurse practitioners may enroll in PMPs too.

When used correctly, PMPs can provide a current, proactive means of identifying potential controlled substance abuse that all authorized providers can access. However, when barriers arise that hinder proper use, the tool’s effectiveness suffers.

PDMP and EMR Integration

To obtain the maximum benefit from these programs, medical practices must have a simple, cost-effective means of integrating PMP access into their daily workflow. The cost of PMP enrollment varies from state to state, as some require providers to pay for PMP access, while some PMP vendors may charge a subscription fee for access to their database, which states may or may not cover. Moreover, some states make PMP enrollment optional, while others make it mandatory. Still others offer subsidies to cover the costs to providers that enroll, while some offer lifetime free enrollment.

On top of financial cost, providers that access PMP databases must navigate away from their EMR window to log in, which hinders productivity and deters PMP use. Providers already have a very heavy workload, and logging into a separate system multiple times per day is yet another barrier that keeps doctors from providing adequate patient care.

A simple solution exists to this problem, as management services organizations like TRIARQ have developed QEMR software with built-in PMP integration. That way, providers can navigate directly to a PMP database and immediately view their patients’ prescription history, making abuse detection easier than ever before.

Case Study: PMP Michigan

One notable example of a state that has embraced PMPs as a way to curb opioid abuse is Michigan. The PMP Michigan program is known as the Michigan Automated Prescription System (MAPS), and the state currently subsidizes it to make it free for all enrolled providers. This subsidy has lasted well over a year past its originally intended expiration date, and there appears to be no clear end in sight. Coupled with updated software and an EMR system capable of PMP integration that TRIARQ offers, providers may use PMP tools to the full extent of their capabilities.