Integrating electronic health records with prescription drug monitoring programs (PDMPs) would optimize the latter by making it easier for doctors to check those databases for opioid misuse by patients, a pair of Yale doctors write in a new post for the Health Care Blog.
Opioid abuse claimed almost 20,000 American lives last year alone. The blog post, written by Joshua Elder, an emergency physician and clinical scholar at Yale University, and Gail D’Onofrio, a professor and chair of the department of emergency medicine at the Yale University School of Medicine, notes that checking with PDMPs changes prescribing behavior that results in fewer or no opioid medications being prescribed; in one study from 2010, they point out, there was a 41 percent change in prescribing by emergency doctors that reviewed the PDMP.
However, Elder and D'Onofrio say, requiring physicians to review a PDMP before prescribing certain drugs or particular amounts of drugs as required by a number of states is burdensome. For instance, they say, databases require access through a separate portal outside the EHR that requires a repeated authorization. What's more, their use is time-consuming and the database can lack pertinent patient information. As a result, some physicians only look to the EHR for clues regarding overprescribing of opioids, which is incomplete and doesn’t catch “doctor-shoppers” using different EHRs.
To that end, they argue that if the PDMP access was integrated into the EHR, the process would be more efficient. For example, they say, in Indiana, where such integration has occurred, 58 percent of prescribers reduced the number of opioid prescriptions and the quantity of pills prescribed.
“This solution is not a panacea but could be a part of a multi-pronged effort developed to fight this problem," Elder and D'Onofrio write. "It’s about time we start using the technology that already works and exists to fight this epidemic."
To learn more: