The Wisconsin Prescription Drug Monitoring Program. WI PDMP Timeline. PDMP Overview. What is a PDMP? PDMPs Across the Nation. Wisconsin.

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1 The Wisconsin Prescription Drug Monitoring Program Wisconsin Nurses Association Jail Health Care Conference May 21, 2018 WI PDMP Timeline PDMP Overview January 2013 WI PDMP operational April 2017 WI epdmp operational changes October 2017 WI epdmp Public Statistics Dashboard launched January 2017 WI epdmp launched January 2018 Continued WI epdmp enhancement October 2013 WI PDMP joins PMP InterConnect 4 What is a PDMP? PDMPs Across the Nation Pharmacies and other dispensers of monitored prescription drugs submit data Data is added to a statewide database 1)Authorized users access PDMP data to verify prescription information National 49 states have PDMP Varying levels of use requirement and allowable access Wisconsin First established in 2013 Wis. Stat WI epdmp connected to PDMPs in 15 other states including MN, IL, MI and IN Nationally recognized PDMP 1

2 Wisconsin s PDMP Authorized Users WI epdmp Department of Safety and Professional Services WI epdmp Credentialing and Licensing Controlled Substance Board Related Boards: Medical Examining Board, Pharmacy Board, Board of Nursing, Optometry, Podiatry Division of Legal Services and Compliance Enhanced system launched January 2017 Over 2,000 dispenser submitters Over 46,000 healthcare users Data for controlled substances in schedule II V dispensed in Wisconsin Over 9 million records submitted each year Clinical Decision Support Prescribers Delegates Pharmacists Delegates Registered Nurses Individuals who treat substance abuse Prescribing Practice Assessment Prescribers Medical Coordinators Investigations Law Enforcement Employees Government Employees Medical Examiners 1)Public Health Analysis Researchers (de identified) Public Statistics Individuals Who Treat Substance Abuse DSPS License types Clinical Substance Abuse Counselor 132 Substance Abuse Counselor 131 Substance Abuse Counselor In Training 130 DSPS License with specialty designation Advanced Practice Social Worker 121 Independent Social Worker 122 Licensed Clinical Social Worker 123 Licensed Marriage and Family Therapist 124 Licensed Professional Counselor 125 Marriage and Family Therapist Training License 228 Professional Counselor Training License 226 Social Worker 120 Clinical Healthcare Tool Interdisciplinary Communication Tool Prescribing Practice Assessment Tool Public Health Tool WI epdmp Components Patient Prescription Histories Prescribing, Treatment, Dispensing Decision Support Law Enforcement Alerts Law Enforcement Investigations Prescriber Metrics Report Medical Coordinator Access Interactive Statistics Dashboard Dispensing Data Trends (State and County Level) 2015 Act 266 Effective April 2017 H.O.P.E. Agenda Legislation Dispensers required to submit to the PDMP by the end of the next business day (previously 7 days) Prescribers required to review PDMP prior to prescribing a monitored prescription drug Medical Coordinator access to PDMP Law enforcement and prosecutorial units allowed to request PDMP data without a court order Healthcare Users Daily Patient Queries December 2016: 4,800 queries/day August 28, 2017: 32,855 queries Monthly Patient Queries January 2017: 101,000 queries January 2018: 640,200 queries 2

3 Direct EHR Integration Creating An Account Registered Nurse Advanced Practice Nurse Prescriber Substance Abuse Counselor Register at: Account Type: Healthcare Professional Using your WI License Number Delegate Account Created by: existing Healthcare Professional user May be associated with more than one Healthcare Professional user Enhanced Patient Report Healthcare Decision Support Patient Report Search Patient Matching Pick List 3

4 Alerts, Demographics and Map Morphine Milligram Equivalent Chart Dispensing History PDMP Dispensing History Pharmacies must report by the end of the next business day Monitored Prescription Drugs only Schedules II V Dispensed by a pharmacy or dispensing practitioner, not inpatient or directly administered Methadone and Suboxone pharmacy dispensed, not OTP dispensed WI epdmp Alerts Data Driven Alerts Data Driven Law Enforcement Prescriber Led WI epdmp uses sophisticated data analytics to assess a patient's controlled substance prescription history 1. Multiple Prescribers or Pharmacies 5 or more in the last 90 days 2. High Current Daily Dose of Opioids Exceeds 90 morphine milligram equivalent (MME) 3. Concurrent Benzodiazepine and Opioid Active prescriptions for both drugs 4. Long Term Opioid Therapy with Multiple Prescribers 1 opioid or more from 2 or more prescribers for more than 90 days 5. Multiple Same Day Prescriptions Same controlled substance drug from multiple prescribers or pharmacies onthe same day 6. Early Refill Filled 2 or more days earlier than expected 4

5 WI epdmp Alerts Law Enforcement Alerts Law Enforcement Alerts Suspected Violation of Controlled Substances Act Suspected Narcotic Related Death Suspected Opioid Related Overdose (Non Fatal) Report of Stolen Controlled Substance Prescription Alert Detail 1. Name 2. Date of Birth 3. Type of Event (dropdown) 4. Date of Event 5. Additional Detail 6. Prescription Detail (if available) Communication of Law Enforcement Alerts Notice: Prescriber(s) Healthcare User View Law Enforcement Alerts Alert Icon: Prescriber(s) Alert Banner: Patient History Alert Detail: Patient History Prescriber Led Alerts Prescriber Led Alerts Prescriber Led Alerts Treatment Agreement Violation of Treatment Agreement Overdose Event 5

6 Patients Panel Prescriber Features Prescriber Metrics Report Prescriber Metrics Report Medical Coordinator Role Created pursuant to 2015 Wisconsin Act 266 Non patient identifiable information to a person who: Medically coordinates, directs, or supervises a practitioner Establishes standard operating procedures for a practitioner Evaluates the job performance of a practitioner Performs quality assessment and improvement activities, including outcomes evaluation or developing clinical guidelines Law Enforcement and Medical Examiner Access 6

7 Law Enforcement PDMP Access Law Enforcement PDMP Access Prior to April 2017 April 1, 2017 Law enforcement agencies and prosecutorial units could only obtain PDMP data with a court order 2015 Act 266 became effective Removed requirement for court order Attestation document required for each request: PDMP data requested is reasonably related to an active and specific investigation or prosecution or monitoring patient as part of a drug court Patient Report Access Released after review and approval by DSPS staff (2 3 business days) Same view as healthcare user, except Prescriber Led Alerts are not displayed Records about schedule II V controlled substance prescriptions dispensed in Wisconsin Information should correspond to original records kept by prescribers and dispensers Potentially useful information to help guide investigations of drug diversion or overdose Not evidence and should not be used in isolation to make any determinations about a patient, prescriber, or dispenser Types Of Reports Individual/Patient Name (alias) Date of Birth Law Enforcement Attestation Agency Letterhead (Signed,.pdf) Name, DOB of subject, or Household address, or Name, DEA# of prescriber Household Address Prescriber DEA Number Required Documentation for Each Request Date range for PDMP data requested Explanation of how the information requested is reasonably related to an active and specific investigation, citations of violations being investigated, case number Specific justification required for household WI epdmp Statistics Dashboard WI PDMP Statistics 7

8 Statewide Dispensing Trends Data Driven Alerts 2017 Alert Type Decrease Q1 to Q4 45,000 40,000 35,000 30,000 High Opioid Daily Dose 22% Concurrent Benzodiazepine and Opioid 16% Long Term Opioid Therapy 19% Multiple Prescribers Or Pharmacies 24% Early Refill 17% Multiple Same Day Prescriptions 50% 25,000 20,000 15,000 10,000 5,000 High Opioid Daily Dose Concurrent Benzodiazepine and Opioid Long Term Opioid Therapy Multiple Prescribers Or Pharmacies Early Refill Multiple Same Day Prescriptions Q1 Q2 Q3 Q4 Questions For More Information Sarah Bradley Deputy Director Website: 8