Evaluation of Prescription Drug Monitoring Program Integration with Hospital Electronic Health Records by US County-Level Opioid Prescribing Rates

Prescription drug monitoring programs (PDMPs) have become a widely embraced policy solution to the opioid epidemic in the US. PDMPs offer prescribers a comprehensive view of patients’ controlled substance prescription history and can be used to monitor and reduce inappropriate opioid prescribing. However, poor usability and lack of integration with electronic health records (EHRs) have limited their effectiveness. Furthermore, without PDMP integration in EHRs, prescribers are forced to manage multiple disconnected software systems that interrupt clinical workflow, which may exacerbate technology-driven physician burnout and result in prescribers neglecting to check the PDMP before writing opioid prescriptions. Efforts to integrate PDMPs with EHRs may be associated with reduced prescriber burden and improved PDMP effectiveness; however, the extent to which this adoption has occurred remains unknown on a national scale in the US. Extant literature has focused on usability of PDMP systems rather than adoption and integration. PDMP integration rates are particularly important among hospitals, which are major sources of ambulatory care and thus potential opioid prescribing. Furthermore, hospitals in areas with high opioid prescribing rates may gain the most from PDMP integration efforts because physicians are more likely to provide treatment to patients with current or past opioid prescriptions in these regions. In this study, we assessed the level of EHR and PDMP integration in hospitals, comparing hospitals located in US counties with vs without high opioid prescribing rates.