3-minute case study: Smart, seamless opioid prescribing
By Alison Pereto | November 18, 2019
Darren K. George, D.O. at Lakeside Physicians, a Community Health Systems (CHS) practice in Granbury, Texas, appreciated the utility of his state's Prescription Drug Monitoring Program (PDMP). The electronic database helped him assess whether a controlled substance might be the best fit for a patient, and let him know what other providers had already prescribed. But the process of using the PDMP — an entirely separate system from the electronic health record — took an arduous five to seven minutes per patient.
A few nurses at CHS had access to the PDMP, so George would sometimes ask them to run the search in order to allow him to keep his attention on the patient. But of course, finding a nurse added another minute to the process.
George knew Texas legislation landing in the spring of 2020 would require him to check the PDMP every time he wrote a prescription for any controlled substance. While he agreed with the reasoning, he knew there had to be better execution.
“When the pharmacy board stood up to the PDMP, that helped dramatically," says George. “But it's still difficult."
The solution Early in 2019, Lakeside Physicians' EHR provider offered an integration; instead of logging into a separate system, physicians could now access the PDMP right from the EHR. Since the providers were already familiar with the EHR, learning the new addition was “highly intuitive," according to George. “Now, we simply press the button, and within about ten seconds, we're able to see the information we need." A huge improvement over the prior systems. The short-term benefits were immediate: more face time with patients, and more time in the schedule, period. Furthermore, with the PDMP a part of the EHR, the final step of recording that the provider had visited the PDMP was obsolete.
The PDMP integration was “one of the biggest wins that we've had," says George. “Our providers have raved about it."
Physicians who look up five to seven patients a day in the PDMP are getting back nearly an hour in their day. George equates the change to “real cost savings and real wRVUs."
“That time can be turned around and used for a variety of things," says George. “Either you can see a couple more patients, or the providers can get home with their families a little sooner."
When the new legislation takes effect in March, physicians will be required to check the PDMP far more often, so the integration will save even more time — and perhaps make it easier to notice and adjust prescribing patterns, and even identify possible instances of drug seeking.
“Providers are so busy taking care of patients, and doing what they do every day, that it's hard to simultaneously keep up," says George. “My goal for our 3,200 providers is to make them as efficient as humanly possible, so that they're spending less time documenting and more time with the patients and at home with their family. I'm a big, big, big fan of the integration."
Alison Pereto is a senior writer for athenahealth's Knowledge Hub.