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New Wisconsin PDMP receives up to 35,000 daily queries

The Wisconsin Enhanced Prescription Drug Monitoring Program, implemented in the state since last year, features data analysis capabilities, as well as a customizable platform.

As the spotlight gets brighter on abuse of opioids and other prescription drugs, hospital clinicians and pharmacists may find themselves spending more time using prescription drug monitoring programs backed by machine learning technology.

Healthcare organizations in Wisconsin offer a good example of what's coming.

The state of Wisconsin worked with NIC Inc. -- an information service provider for local, state and federal governments -- to develop a new PDMP that could accommodate an increased number of users, as well as additional reporting and data analysis. The Wisconsin Enhanced Prescription Drug Monitoring Program was implemented last year.

Andrea Magermans, managing director of the Wisconsin PDMP, said the number of queries from clinicians, hospital pharmacists and local police departments has increased from fewer than 5,000 per day to up to 35,000 per day since implementing the Wisconsin Enhanced PDMP. She said the state has also seen decreases in opioid prescriptions and the number of alerts for doctor shopping; she credited the new PDMP for contributing to those results.

"We're happy with what we're seeing but definitely want to see those trends continue," she said.

Wisconsin PDMP users like data-driven alerts, customizable platform

The state conducted a user survey and over 75% of users who responded to the survey stated they were "satisfied" or "very satisfied" with the Wisconsin PDMP.

"The more valuable alerts, according to the users, are the data-driven alerts, analytics-driven alerts that look at the patient's prescription history and do an analysis of it to look for dangerous drug combinations or high levels of opioid doses and bring that valuable information to the immediate attention of the users," Magermans said.

The most valuable aspect of the Wisconsin PDMP is its flexibility, Magermans added. The state used feedback from PDMP users and implemented some of their requested enhancements, which she believes made developing and using the platform a better experience for the users.

We're happy with what we're seeing but definitely want to see those trends continue.
Andrea MagermansPDMP managing director, state of Wisconsin

"The fact that it's customizable has been the best part of it," she said.

Magermans said the main impetus for adopting a new Wisconsin PDMP was to meet new requirements established by the state. Before legislation changed in April 2017, the state had not required healthcare providers to review the PDMP before prescribing controlled substances. Now, legislation requires providers to take such action.

Magermans said the state's former PDMP offered by Health Information Designs couldn't support the increase in the volume of users, such as providers and police, who must now submit information regarding suspected opioid overdoses or reports of stolen prescriptions to the Wisconsin PDMP.

"There were going to be some requirements that no other PDMP would have been able to support and our previous platform would not have been able to support," Magermans said.

Magermans said the state chose to work with NIC to find a new PDMP that could facilitate a larger volume of users, as well as provide data analytics.

Wisconsin work leads to enhancements

After working with Wisconsin to develop a new PDMP platform catered to the state's needs, NIC acquired the RxOrbit suite of technology assets from Maryland-based Leap Orbit and combined the new technology assets with the best functionality of the systems NIC currently manages, including Wisconsin's.

The newly named product, RxGov, uses machine learning and a patient-matching algorithm that matches full names, nicknames, maiden names and more into a single record to help prevent doctor shopping. The platform integrates with EHRs, doesn't require a separate login portal and features extensive reporting functionality, said Doug Rogers, NIC senior vice president of business development.

The PDMP is also cloud-based on the Microsoft Azure cloud platform, which Rogers said was an intentional step for several key reasons, including security.

"Given that this system is managing and hosting very sensitive and critical information, we wanted to make sure we provided it in a structure that was protected and intrinsically secure," Rogers said. "Our ability to leverage the Microsoft Azure platform to do this provides those capabilities to make sure this is completely protected."

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