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2 New Jersey Prescription Monitoring Program (NJPMP) James Mielo, Administrator, NJPMP New Jersey Division of Consumer Affairs 2

3 The Challenge of Staying Relevant 3

4 2000- We need more pain medication. People are hurting. Pills are the answer. Changing Policy We need less pain medications. People are dying. Pills are the cause. 4

5 Changing IT Landscape 2012 Pharmacy chains denied intranet access 2015 Pharmacy chains piloting access integration 5

6 Evolving Lifestyles I live on my computer. My computer lives on me. 6

7 What path should you take? 7

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9 Why Mobile Phones? Ease of use. Widespread adoption. Intimate for the user. Access independent of other company IT infrastructure. Access during non-traditional business hours. Ability to communicate to users in the event of emergencies when other infrastructure may not be available. 9

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15 Was it difficult to do? No. Advantages: PMP concept is fairly simple which lends itself to easy app design. Diversity of current apps provides a wide spectrum of solutions available to developers. Hurdles: Approval required by owner of mobile platform prior to posting in app store. Beta testing prior to release required use of different phone types not easily accessible by state employees. 15

16 Contact Information New Jersey Prescription Monitoring Program James Mielo R.Ph., Administrator (973)

17 OpioidCalc: New York City Department of Health s Mobile App to Support Safe Opioid Prescribing Jessica Kattan, MD, MPH Director Primary Care Integration Unit Bureau of Alcohol and Drug Use Prevention, Care and Treatment New York City Department of Health and Mental Hygiene For: TTAC Webinar August 17, 2015

18 The problem Overdose from opioid analgesics is a public health crisis nationally and in New York City (NYC) In NYC, opioid analgesic overdose deaths increased by 256% during More than one New Yorker died every other day from opioid analgesic overdose in 2013 Fatal and non-fatal overdose are associated with opioid prescribing patterns E.g., high-dose prescriptions

19 What are high-dose opioid prescriptions? Defined as 100 morphine milligram equivalents (MME) MME is the strength of an opioid relative to morphine MME used as common unit of comparison Example: 30mg oxycodone x 1 pill = 45 MME 30mg oxycodone x 3 pills = 135 MME

20 Risks associated with high-dose opioid prescriptions Opioid dosages 100 MME per day increase overdose risk by nine times compared with dosages between 0 20 MME NYC Department of Health and Mental Hygiene (DOHMH) recommends 100 MME as a threshold for caution and patient reassessment But prescribers are not typically trained to calculate MME

21 Information technology to the rescue! We identified an opportunity to develop a mobile app for smartphones to calculate MME and help prescribers reduce overdose risk

22 Methods Need for this technology confirmed via internet search of existing similar tools App developed using interdisciplinary team Information technology specialists, epidemiologists, physicians, pharmacists Beta tested with NYC physicians

23 Results: Creation of OpioidCalc Calculates total MME per day, based on type of opioid analgesic, strength, and quantity Alert indicates increased overdose risk if 100 MME Quick works in seconds Free for ios and Android Required ~1,000 hours of staff time to develop

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25 Promotion of OpioidCalc Banner ads on internet sites for NYC clinicians Newsletters blasts Website postings Meetings and conferences Public health detailing campaign in Bronx, NY

26 OpioidCalc uptake Released June 17, 2014 Cumulative downloads to date = 3,244 United States and international

27 Conclusions NYC DOHMH successfully developed an app to support safe prescribing of opioids Additional promotion needed Local prescribing data will be monitored for changes in high-dose prescribing patterns Information technology should be part of a multi-pronged public health response to address the opioid analgesic public health crisis

28 NYC DOHMH Thank you Vibhuti Arya (St. John s University College of Pharmacy) Stephen Giannotti Ellenie Tuazon Marissa Kaplan-Dobbs Denise Paone Hillary Kunins Centers for Disease Control and Prevention Funding support

29 Questions

30 Telephone: (781) Website: