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The Department of Veterans Affairs (VA) is continually pursuing methods of tackling the opioid crisis facing the nation. VA recognized that the vast pools of information within state Prescription Drug Monitoring Databases (PDMPs) could be leveraged to avoid harmful drug interactions and increase oversight of controlled drugs across states. However, until last November, this critical information was fragmented behind outdated interfaces, hampering clinicians’ ability to efficiently deliver high quality care. After months of preparation and a pilot phase, VA launched its new State PDMP solution nationally. This solution marks a major milestone for VA’s implementation of MISSION Act Section 134, which directs VA to participate in a network of state PDMPs. By expanding relations with state databases of controlled substance prescriptions, VA improves the quality of care and can capture geographic trends that inform care. VA’s new PDMP interface and exchange enhances the existing manual PDMP process, allowing VA to more seamlessly participate in the national network of State-based prescription drug monitoring programs. The Office of Information and Technology (OIT) worked shoulder-to-shoulder with the Veterans Health Administration’s (VHA) PDMP Office to craft a nationwide network with an intuitive interface that meets clinicians’ need for accurate, easy-to-understand information.

Scott Pawlikowski, MD, Deputy Chief Medical Officer and VISN 12 Primary Care Lead, says he is enthusiastic about the new solution’s ability to improve the Veteran healthcare experience: “PDMPs are a crucial tool that we use to ensure the utmost vigilance and safety for high-risk medications. This new exchange interface makes VHA trusted partners with state PDMP databases, saving time during data entry. All of this integration really helps us monitor prescriptions across state lines and gives us a better overall picture of every Veteran.”

Prior to national rollout of OIT’s PDMP solution, VHA clinicians who handle information in the Computerized Patient Record System (CPRS) had to log in to a separate program each time they needed to check a state PDMP. Each state’s PDMP required a separate login process which often timed out on providers, requiring them to restart the process. OIT’s technical innovation was to forge data sharing agreements with state PDMPs and make CPRS the single-entry point for clinicians.

Map of the United States showing a representation of pharmacies connected to the Prescription Drug Monitoring Databases system.

By networking dozens of separate PDMPs into a single interface, healthcare providers have more efficient access to crucial information, as well as a bigger pool of data to cross-reference. Now, Veterans who have prescriptions in separate state PDMPs, can be assured that if they relocate or travel, clinicians in other participating states can query the system, and receive the Veteran’s complete and comprehensive controlled substance prescription history.

“Under the MISSION Act, OIT was remarkably quick to help us create a data exchange with human-centered design principles. OIT was keenly attentive to the particulars that practitioners like me needed and we are already seeing time saved in the field” Dr. Pawlikowski said.

After piloting the solution at two VA Medical Centers with over 500 healthcare providers and licensed delegates, the national rollout has already involved more than 50,000 healthcare providers and licensed delegates across 42 states and territories. OIT continues to work with national and state partners to expand the PDMP exchange to all states and add new user-requested features.

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