How to Integrate a Prescription Drug Monitoring Program into the EHR

Executing a prescription drug monitoring program (PDMP) EHR integration only takes a number of steps.

Every time a prescriber writes a prescription, she taps a prescription drug monitoring program (PDMP) if it is available at her health organization. This platform gives prescribers a complete understanding of a patient’s full prescription drug history within the EHR workflow and has been a key tool in combatting the opioid epidemic.

The PDMP assembles pharmacy and patient data through a more extensive, state-run electronic database about controlled substances and prescription drugs from the Drug Enforcement Agency (DEA). PDMPs help prescribers keep track of patients who are at high risk of becoming opioid-dependent.

The platform is currently available in all states, excluding Missouri.

These tools help streamline a key prescribing workflow for clinicians and other medical personnel who may prescribe a prescription drug, experts say. Prior to EHR integration, providers experience burden because of how long the query process was in the past.

“Typically, the ER doctors would have to stop working what they're doing in the EHR, log into the state's registry, put in all the patient information, wait for a return to come back in, and then look at it,” Steven Heilman, senior vice president and chief health innovation officer at Norton Healthcare in Kentucky, said in an interview with EHRIntelligence.

“That could take anywhere from five to 10 minutes, typically, depending on how much time the provider took to put everything in.”

But while integrating the PDMP is becoming a common practice, there remains room for increased PDMP integration throughout health organizations.

According to a June 2020 JAMA Network Open research article, hospitals located in areas with high rates of opioid prescribing were less likely to have an EHR-integrated PDMP. Only 10.8 percent of hospitals located within counties with high prescribing rates had PDMP EHR-integration.

Connecting a PDMP to an EHR system might sound difficult, but there are specific vendors and tools that streamline the process in a few easy steps.

Request and fill out key documents

First, the health organization’s authorized health IT leader must visit a PDMP provider’s Integration Request Form and complete all required documents.

These documents include:

  • Integration request forms
  • Licenses for use
  • Potential PDMP portal or gateway license agreements

Once those final two documents are completed and submitted, the PDMP vendor reviews the documents for the next integration steps.

Setting the groundwork

Most top EHR vendors already have the development process completed to integrate the PDMP data into the workflow.

After the PDMP vendor reviews and accepts the documents, the vendor creates credentials for the healthcare organization. This can take up to five business days. Once created, the state’s PDMP administrator will approve the request and send over the credentials to either the health organization or the EHR vendor, depending on the EHR vendor’s typical PDMP integration process.

After communicating with the EHR vendor, the rollout process can begin. However, suppose the EHR vendor cannot integrate the PDMP. In that case, the health organization can go through the PDMP vendor and its sales engineer to receive API documentation, testing materials, and technical support.

Although there are minimal steps until the integration begins, the physical integration process can take up to several months, depending on the vendor’s engagement level or a pre-existing project backlog.

EHR-integrated streamlined workflow

Once the vendor successfully connects the PDMP to the EHR system, the user shouldn’t have to exit the workflow to visit the outside PDMP website.

Prior to the integration, the user would have had to enter her username and password, navigate the patient request, enter the patient name and date of birth, determine the dates to query, and then hit search.

“Having the tool integrated into the EHR helped with the workflow for clinicians,” Heilman said. “We’re now able to look the information up without having to log out of the EHR, log into the state's website, then log into multiple registries because we're on the southern border of Indiana as well to look up a patient's previous habits and their database history in the PDMP.”

Following integration, the clinician can utilize the streamlined practice to query and process tasks without initiating multiple clicks. The practice includes:

  • An automatic query that initiates when the patient schedules an appointment; the PDMP information automatically updates when the patient arrives for the appointment
  • The patient’s demographic information passing from the EHR to the state PDMP to execute the query
  • The PDMP creating a risk factor for the patient, transfers it back into the EHR system, and links it into the patient’s EHR for more detailed information on the patient’s past prescribing history

With all the information passed directly from the EHR to the PDMP database, providers encounter fewer proxy issues, Heilman said. Since integration, the prescription numbers at Norton Healthcare fell more than 51 percent from last year, which is a good sign for the growing opioid problem.

“A lot of our providers were writing for 120-day supplies and we knock those down to 90 or less,” Heilman continued. “We've seen a significant reduction with everything that we've done. Whether it’s modifying order sets, educating per clinician, or making ease of access to the PDMP. We've also seen the number of clicks have gone down dramatically within the last year.”

Post-launch technical support

Following the go-live, if a user has issues regarding data access, the provider’s internal IT desk can most likely fix the situation. However, if the tool is non-operational, the provider can submit a request form through the PDMP vendor to fix the issue.

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