Award-Winning Wisconsin Enhanced Prescription Drug Monitoring Program Changes Prescribing Culture, Drives Down Opioid and Controlled Substance Prescribing

MADISON, Wis. – There is a vast public health effort underway in Wisconsin. It involves multiple state agencies, municipal partners and federal support. The threat is everywhere, and it isn’t COVID-19. It is opioids.

The opioid epidemic has been raging through the country for years, and Wisconsin has been fighting it with a multi-faceted public health campaign. One key tactic in this effort is to ensure that health care providers have the right information at the right time. That is achieved through the Enhanced Prescription Drug Monitoring Program (ePDMP).

Launched in 2013, the ePDMP is an online database and dashboard that puts patient prescription and overdose information physician’s fingertips. With this real-time awareness of which providers a patient is seeing and what drugs they’re taking, physicians, dentists, and advanced practice nurse prescribers could make better informed decisions about whether to prescribe pain medications.

It is working. Opioid prescribing rates have dropped significantly since their peak in 2015. For example, the number of opioid prescriptions dispensed in the fourth quarter of 2019 was 36%, or over 450,000 prescriptions, lower than those dispensed in the same quarter four years prior. Overall dispensing of monitored prescription drugs was down 25%, or 700,000 fewer prescriptions, over the same time period.

Dr. Timothy Westlake, an emergency room physician who serves on both the Controlled Substances Board and the Wisconsin Medical Examining Board, says doctor shopping—the once-common practice of seeing multiple providers to obtain multiple pain prescriptions—is rare. Program compliance, which is technically legally required, is high, while integration into existing electronic health records, so access is a matter of clicks and not opening a separate screen with an additional login, is growing.

The Department of Safety and Profession Services worked closely with the Wisconsin Controlled Substances Board and the Wisconsin Interactive Network to develop the ePDMP. Dr. Westlake says the team designed the ePDMP with prescribers in mind and the goal was to deliver a useful tool that meaningfully informed prescribing practices.

“It is a really, really useful clinical tool,” Dr. Westlake said. “We have such a good product that the majority of people are going to continue to use it after the mandate is gone. People use it because it’s useful.”

Westlake says the ePDMP is so efficient that once he knows a patient is coming back to him, he can immediately access the person’s opioid history. “Before they can bring the patient back, before they even take their heart rate, I’ve got the ePDMP up,” he says.

The team also ensured that the ePDMP would be flexible enough to adapt to opioid crisis as it evolved over time. And, Westlake adds, because the team emphasized the end user during the design phase, the ePDMP has not only been useful to prescribers. It has also been instrumental in changing, for the better, their attitudes and practices.

“It’s amazing how it has been a key driver to shifting the culture to more judicious and appropriate prescribing,” Westlake said.

The joint effort has earned accolades over the years, including a recent Hermes Creative Award. This international competition for creative professionals recognizes outstanding work in the creative marketing and communications industry. The e PDMP dashboard received a Gold Award in the category of electronic media/social media/interactive media/overall website and government.

In addition to the Hermes Creative award, the ePDMP is a finalist for the American Council for Technology and Industry Advisory Council (ACT-IAC) Igniting Innovation award, which will be selected in August. ACT-IAC is a non-profit public-private partnership dedicated to improving government through the application of information technology.

The awards are important, says DSPS Secretary-designee Dawn Crim, because they help highlight the effectiveness of the tool. “While today’s primary focus is responding to the COVID-19 pandemic, the opioid epidemic remains a crisis for communities throughout Wisconsin,” she said. “The ePDMP is an effective and invaluable part of the statewide effort to curb opioid prescribing, and it is great that this tool is getting recognized for its successful design, implementation and use.”

The ePDMP also has other valuable functionality, including analytics-driven alerts that inform prescribers of certain risk factors, including recent use of multiple prescribers or pharmacies, early refills, or concurrent benzodiazepine and opioid prescriptions. The system also alerts prescribers with law-enforcement information, such as an individual’s opioid-related overdose events or suspected violations of the controlled substances act. The Controlled Substances Board releases ePDMP reports quarterly and annually, and the statistics dashboard allows public health officials and researchers to quickly and efficiently access data about the controlled substances dispensed to Wisconsinites, the use of the ePDMP, and law enforcement trends. The ePDMP is connected to 24 other state PDMPs, including those of bordering states Minnesota, Michigan, Illinois and Iowa.