Alaska’s Prescription Drug Monitoring Program (PDMP) is underutilized—only 82 percent of potential prescribers are registered. The Alaska Department of Health and Social Services will use grant funds to assist in assessing the levels of awareness of the PDMP among health-care practitioners; identifying statewide trends in controlled substance prescribing; increasing provider self-awareness of prescribing habits; expanding the data collected by increasing usage of the PDMP; and recommending policy changes to prevent opioid overuse, misuse, abuse, and overdose. The current PDMP program will be enhanced by adding a prescriber report card function to track prescribing habits.
The Arkansas Department of Health seeks to convene an action group, the Prescription Drug Overdose (PDO) Advisory Council, to encourage and support cross-system planning and collaboration to reduce the incidence of morbidity and mortality related to opioid overdose. The approach will include integrating prescription drug monitoring program (PDMP) data with all identified data sets, developing composite tables that combine indicators across data sources, providing training and education to opioid prescribers, assessing the impact of specific policy changes to the PDMP, and creating the Opioid Misuse Action Group to provide feedback on the data sets. The Arkansas Department of Health will also implement the Dose of Reality educational campaign to combat opioid abuse.
The University of California, Davis (UC Davis) will work with the California Department of Justice and other partners to perform a rigorous evaluation of California’s new law mandating use of its prescription drug monitoring program. The evaluation will focus on effects of mandated PDMP use on prescribing patterns and health outcomes, including potential unintended consequences. UC Davis will work with the Northern California High Intensity Drug Trafficking Area (HIDTA) to establish a foundational relationship between public health and law enforcement agencies. In particular, UC Davis will focus on exploring new data sources from law enforcement agencies to share with public health agencies about opioid supply and overdose. The goal is to develop protocols to predict opioid overdose and share information about supply disruptions with emergency departments, first responders, and other key agencies. UC Davis will also explore protocols for communicating directly with local emergency services directors.
The Ventura County Health Care Agency–Ventura County Behavioral Health Department, the Ventura County Sheriff’s Office, the Ventura County Public Health Department, the Ventura County Emergency Medical Services Agency, and the Ventura County Ambulatory Care Department will convene the County Opioid Abuse Suppression Taskforce (COAST) to improve the quality, consistency, sharing, and integration of local and state prescription drug monitoring program (PDMP) data to monitor community-level conditions/outcomes and target/coordinate resources to increase impact in response to the opioid abuse epidemic. Funds will also be used to complete, document, and disseminate an evaluation of state and local prescriber trends by scope of practice and to deploy the ESRI ArcGIS Opioid Epidemic Solution. EVALCORP Research and Consulting will serve as the research partner for the proposed project.
The Connecticut Prescription Monitoring Program (PMP), in partnership with other state agencies, will merge the Office of the Chief Medical Examiner (OCME) and the state forensic laboratory system with the Connecticut Prescription Monitoring and Reporting System (CPMRS) to allow prescribers and pharmacists to identify patients who have died and reduce inappropriate dispensing; create a new module to allow law enforcement users access to both death data and toxicology information within the CPMRS to assist in their investigations; and conduct educational campaigns to introduce these new features and the benefits that would expand the ability of prescribers, pharmacists, and law enforcement to avoid and deter controlled substance misuse or diversion.
The Florida Department of Health will enhance the Florida Prescription Drug Monitoring Program (PDMP) system, known as E-FORCSE (Electronic-Florida Online Reporting of Controlled Substance Evaluation Program), by employing an epidemiologist to provide data analysis to inform and guide health-care practitioners and policymakers and expanding existing outreach and education. E-FORCSE will also fund integration of PDMP information into clinical workflow by providing mini-grants to small physician practices and independent pharmacies.
The Idaho Department of Health and Welfare (IDHW) will build a sustainable data infrastructure to ensure timely collection, analysis, and dissemination of opioid data. In addition, an action researcher will establish a suspected drug-induced death mortality review team. The data will be shared with Idaho’s strategic planning workgroup and other stakeholders. To address vulnerable populations, IDHW will work with the Idaho Office of Drug Policy to distribute naloxone in communities across Idaho. To educate prescribers in rural Idaho on substance abuse treatment and safe prescribing, IDHW will work with the University of Idaho to extend its Project ECHO program, an evidence-based, technology-enabled collaborative learning model that builds a clinician’s knowledge and ability to treat complex conditions. To evaluate Idaho’s efforts in educating prescribers on safe prescribing and prescription drug monitoring program (PDMP) utilization, IDHW will contract with a third-party evaluator.
The Illinois Department of Human Services will, in collaboration with the University of Illinois at Chicago, develop a comprehensive training program that will provide academic detailing, automated connection education, and prescription monitoring program (PMP) website usage education. Working with its vendor, Logicoy, Inc., the grantee will help the Illinois PMP connect to 78 hospital, clinic, or pharmacy electronic health record (EHR) systems, thus reducing the access time from minutes to seconds, which is critical during trauma situations. Finally, in collaboration with the Illinois Department of Public Health, the PMP will expand the unsolicited alert system by increasing the types of alerts sent to hospitals and medical providers.
The University of Kentucky Research Foundation, on behalf of the Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health (DPH), will (1) develop an algorithm-based mechanism to identify high-volume, high-risk opioid prescribing specialty groups within a health-care system to provide actionable information to health-care leadership to initiate targeted education; (2) develop an algorithm to identify inpatients whose specific principal diagnoses increase the likelihood that they will receive opioid prescriptions upon discharge and during follow-up care; and (3) develop diagnosis-specific patient education materials to facilitate a health-care system intervention for inpatients with these diagnoses. The results will be disseminated by developing reports, peer-reviewed manuscripts, and a repository of developed and tested patient- and prescriber-oriented educational materials to facilitate replication in other health-care systems and settings.
St. Mary’s County Health Department in Maryland will work with other community agencies to expand the data that are used to support the Opioid Intervention Team. The utilization of Overdose Detection Mapping Application Program (ODMAP), Prescription Drug Monitoring Program (PDMP), and first responder data will be increased. In addition, the agency will increase the multidisciplinary engagements with community organizations and neighboring jurisdictions and increase recovery support services and educational opportunities for prescribers and patients.
The New Hampshire Prescription Drug Monitoring Program (PDMP) is committed to reducing misuse, abuse, and diversion of prescription controlled substances through the following goals: expand the implementation of information sharing between state PDMPs, improve the quality and accuracy of PDMP data, integrate and examine the effectiveness of PDMP utilization, examine the effectiveness of prescriber- and pharmacist-mandated enrollment of PDMPs, and develop training for practitioners and users of the PDMP. The PDMP will work with members of the Advisory Council to examine through data collection the effectiveness of the prescriber mandate to query the PDMP.
The New Jersey Department of Law and Public Safety will develop clinical alerts and unsolicited reports to alert prescribers of potential doctor/pharmacy shoppers, excessive dosages, and dangerous drug combinations and establish a pharmacy inspection program to audit for prescription drug monitoring program (PDMP) compliance and prompt training and education upon identification of practice deficiencies.
The Reno Police Department, in partnership with the Washoe County Health Department and other community partners, will implement evidence-based practices in the field of tobacco prevention by launching a mass-reach health communication campaign with the goal of changing the social norms surrounding prescribed opioids. This program will also follow up with individuals/families who have experienced a suspected overdose and provide information regarding resources such as how to seek a substance abuse evaluation and/or counseling, medication-assisted treatment (MAT) and other treatment, and where to obtain naloxone. Finally, the program will launch a prescriber education campaign.
The Philadelphia Department of Public Health Opioid Data Working Group will develop a comprehensive opioid epidemic data report to establish a baseline and monitor the epidemic, use data matched across departments to identify barriers and opportunities, establish use of real-time data such as the Overdose Detection Mapping Application Program (ODMAP) and hospital syndromic data to support a rapid response plan to surges in overdose, and establish an overdose death review team that will review, in depth, a smaller number of fatal opioid-related overdose cases to identify factors, including system-level failures, that may have contributed to the fatalities.
The Montgomery County, Texas, District Attorney’s Office will take the lead with a multiagency collaboration to comprehensively tackle issues surrounding prescription opioid abuse in the county. A preventive and proactive data-driven approach will be adopted to identify doctor shoppers, “pill mill” doctors, problematic pharmacies, and prescription opioid addicts. The goal is to hold doctors and pharmacies accountable and to prosecute doctor shoppers who divert prescription opioids to streets for profit. The two primary components of the project include a pre-crime unit and a Prescriber Outreach and Education Program.
Washington’s prescription opioid death rate for calendar year 2015, 5.5 per 100,000, was much higher than in 1999, 2.7 per 100,000. The proposed data-driven response project, led by the Washington Department of Health, is to reduce opioid misuse and overdose fatalities in Washington by providing quarterly prescription drug monitoring program (PDMP) data to health-care facility chief medical officers (CMOs). The data provided will be based on key PDMP indicators that will identify potential outlier prescribers compared with current guidelines from both the Washington State Agency Medical Directors Group (AMDG) Interagency Guideline for Prescribing Opioids for Pain and the Centers for Disease Control and Prevention (CDC) prescribing guidelines. CMOs have the authority to engage with their prescribers in the development of proactive prescribing quality improvement (QI) interventions and to encourage provider use of the PDMP for clinical decision making. Development of QI interventions at the facility level will ensure effectiveness for the specific facility that can be closely monitored and amended as needed.
The Washington Department of Health will hire a prescription drug monitoring program (PDMP) onboarding coordinator (management analyst) who will perform outreach and education, and provide onboarding assistance to facilities interested in integrating the PDMP query into their electronic health record (EHR) systems. Washington’s Emergency Department Information Exchange (EDIE) is a care management tool that has been largely successful in integrating PDMP data into its reports. By supporting more EHR-PDMP integration, it is expected that more health-care organizations will uptake the technology and fully adopt the Agency Medical Directors Group (AMDG) Interagency Guideline for Prescribing Opioids for Pain. The Prescription Monitoring Program at the Washington State Department of Health will work with stakeholders, other state agencies, and health-care providers to develop metrics and measures to be included in provider feedback reports sent to prescribers to inform them of their own prescribing practices and how their practices relate to other prescribers of similar licensure and specialty.
The Wisconsin Department of Safety and Professional Services will enhance the Wisconsin Prescription Drug Monitoring Program (WI ePDMP) by convening user groups to identify and prioritize future enhancements to the WI ePDMP system. The Wisconsin Department of Safety and Professional Services will work to develop and deploy enhancements to meet user needs for a clinical decision support tool, a prescribing practice assessment tool, an interdisciplinary communication tool, and a public health tool.