- Most users of Wisconsin’s EHR-integrated prescription drug monitoring program (PDMP) are not taking full advantage of all features of the PDMP system, according to a recent user survey by the Wisconsin Department of Safety and Professional Services Controlled Substances Board.
Wisconsin first deployed its PDMP in 2014 and launched additional enhancements in 2017 designed to address prescription drug abuse, misuse, and diversion through clinical decision support, prescribing practice assessment, communication between care settings, and public health surveillance.
Prescribers in the state have been required to check the PDMP before prescribing medications for controlled substances since April 2017.
According to survey responses from more than 6,000 users, about half of Wisconsin physicians, advanced practice nurse prescribers, pharmacists, physician assistants, dentists, and other clinicians currently use the state PDMP.
Overall, most users are satisfied with the PDMP.
“Seventy-seven percent of respondents reported overall satisfaction with the WI ePDMP, providing responses of either ‘Satisfied’ or ‘Very Satisfied,’” wrote report authors. “Eleven percent reported being ‘Neither Satisfied nor Dissatisfied,’ and 8 percent reported being ‘Dissatisfied’ or ‘Very Dissatisfied’ with the WI ePDMP.”
Satisfaction rates are higher among users who access the PDMP via EHR integration, with about 45 percent of EHR integration users reportedly being “very satisfied” with the database compared to 40 percent of users accessing the PDMP through the WI ePDMP website.
“EHR integration allows the user single sign on access to the WI ePDMP from within a patient record, eliminating the need for a user to log in and manually populate the patient search criteria for a patient query,” clarified report authors.
“However, certain WI ePDMP features, such as interstate queries, prescriber self-assessment metrics reports, delegate management, and account management require direct sign-in via the WI ePDMP website,” authors continued.
Over thirty-three percent of survey respondents who access the PDMP through their EHR systems reported they do not access the PDMP through the website to use additional features. However, about the same amount — thirty percent — of survey respondents who use access the PDMP through an EHR system stated they access the PDMP through the website link to use additional features up to 3 times per week.
Twelve percent access additional PDMP features between one and three times per month, while 24 percent access them less than once a month.
“This indicates that the primary focus of those accessing the WI ePDMP is to view patient reports and that there is an opportunity to educate users about the additional beneficial features of the WI ePDMP system,” wrote report authors.
While use of all PMDP features is lacking among providers, the majority of survey respondents reported PDMP functionality is easy or very easy to use.
This high usability rating indicates both the single sign-on EHR integration and PDMP online log-in contribute minimal administrative burden to the provider workday.
In addition to enabling access to more complete patient health data, survey results indicated the PDMP is influencing the behavior of healthcare professionals.
Forty-four percent of survey respondents reported that they spoke with a patient about controlled substance use after reviewing information available in the PDMP.
Furthermore, 37 percent of respondents indicated they denied or modified a patient’s prescription as a result of accessing information within the database, while up to 21 percent of respondents reported referring a patient for substance abuse treatment, behavioral health treatment, or pain management after viewing PDMP data.
“In some cases, the PDMP presented unexpected information about a patient’s controlled substance prescription history or prescribers, and 34 percent of respondents indicated that the PDMP report confirmed that patients had prescription information that had not been disclosed,” stated report authors.
“The most common action, however, reported by nearly 50 percent of respondents, was that the PDMP confirmed that patients were not misusing prescriptions,” authors continued.
These findings emphasize the value of EHR-integrated PDMP data and verifies that equipping healthcare professionals with more comprehensive patient health information can have a significant impact on patient care delivery.