Pain Management Support Program

Enhancing Pain Management by providing specialists monitoring and managing controlled substances

Challenges Pain Specialists Face

With more than 200 million prescriptions for opioid medications being written every year, it’s hard to escape the notion that physicians are being targeted for creating the opioid epidemic the nation is facing; Physicians are carrying the brunt of the challenge. Some of the challenges they face include:

  • Not knowing a complete list of the medications your patients are taking currently
  • Keeping up with State and Federal regulations, a lot more documentation is required, and compliance steps need to be followed when prescribing controlled substances.
  • Documenting outcome/score of ORT and COMM, risk status, and checking to make sure patients are providing timely urine samples is time consuming.
  • Getting prior authorization for a medication requires that physicians show that the documentation is in place.
  • Following up with patients takes time and adds work to already busy staff, putting a strain on the practice’s resources and adds cost to the practice.
  • Finding time in the day to follow up with patients is challenging for staff and physicians.
  • Practices are struggling to find additional time to contact patients after office hours.
  • Practices are struggling to ensure patients adhere to policies and regulations put forth by their physician. 

The Pain Management Support Program (PMSP)

PMSP was developed by a pain specialist who wanted to address the challenges to his practice. It was designed to ensure that a patient’s medication regimen is followed and avoids problems patients may face using a controlled substance including patient medication pick-up habits.  This includes looking for red flags in the federal database such as increased dispensing of controlled substances, multiple pharmacies, and doctor shopping. 

PMSP is led by a team of PharmDs that conducts screenings for current opioid misuse, illicit drug use, and abuse.  The PMSP team determines compliance with treatment regimens and UDS frequency, and assists the practice with scheduling UDS appointments to include:

  • Proactive program for all your patients to ensure medication compliance and risk evaluation.
  • Engagement call check-in to see how the patient is doing.
  • Conduct opioid abuse risk assessments using the ORT and COMM annually.
  • Review of UDS for regularities and irregularities.
  • Schedule the UDS, when appropriate.
  • Review Prescription PDMP for red flags/irregularities.
  • Provide medication reconciliation and counseling with the patient.

How Does It Benefit The Practice?

  • Takes the burden off physicians and staff and ensures compliance with all State and Federal regulations as it pertains to opioid therapy.
  • Reduces the amount of time clinicians need to spend on the phone or spend with patients to do these checks.
  • Gives physician(s) peace of mind knowing that they are following all regulations and have a program that is helping their patients.

                          Ensures documentation is maintained and current in the practice’s E.H.R.

                          Provides audit protection because the documentation meets State and Federal requirements.

  • Provides an extension of the staff at a higher quality level than using MAs. By using a clinical pharmacist to communicate with patients you know your patients’ medications are being managed at the highest quality level.
  • Ensures that the patient medication regimens are followed that include:

                       Patient medication pick-up habits.

                       Looking for red flags in the federal database such as increased dispensing of controlled substances

                      Potential use of multiple pharmacies.

                      Physician abuse (doctor shopping).

 

  • Gives patients the ability to discuss their medications in greater detail with a medication expert.
  • Physicians have more information about their patients

Patient Workflow - Step One

Step One: Pre-Patient Contact Activities

PharmD reviews the previous month’s notes in the patient’s chart and obtains an overall sense of the patient’s status:

  • Reviews the drug list and all controlled substances.
  • Looks at the PDMP under scanned documents to confirm that the medications were dispensed or if there are any irregularities.
  • Reviews the last UDS and compares to the drug list and confirms anticipated positives and notates any irregularities.
  • Looks for completed ORT for new patients.
  • Confirms COMM was completed once per year (unless there is a change) for patients.
  • Creates appointment for the call under the appropriate provider.

Patient Workflow – Steps Two and Three

Step Two: Patient Outreach

1.PharmD establishes contact with patient and builds rapport and trust

2.Patient Arrival:

  • If the ORT is missing, PharmD completes ORT
  • If the COMM is missing, PharmD notates missing COMM that need to be completed at the next check-in call.
  • If the urine sample was not dropped off, PharmD schedules the UDS for the patient before their next appointment with the provider.
  1. Complete the UDS Checklist note and includes:
  • Call start and stop time.
  • Summary of findings.

Step Three: Post-Patient Activities

  • Pharmacist creates the note in the EHR.
  • Pharmacist updates patient status on a spreadsheet, records time spent, and initials when note is completed.
  • Pharmacist speaks to mid-level for final report of each patient that day.

What does this mean for your patients?

  • Your patients feel more in control of their healthcare and the practice is actively involved in their care.
 
  • Reduces patient stress because they know their physician is closely monitoring them.
 
  • Patients have continual communications about their medication usage.
 
  • Patients have a medication expert they can talk with about their medications and how to manage them.

The PMSP Difference

 Without PMSP

• Complete and frequent medication reconciliation
(every quarter on average)

• Takes The Burden Off Practice Physician And Staff.

• Ensures compliance with all state

and federal regulations.

• Gives physician peace of mind knowing that they are

 following all regulations and additional audit protection.

• Ensures documentation is maintained and current in the practice’s E.H.R.

• Provides an extension of the staff at a higher quality level.

• Ensuresthat the patient medication regimens are followed.

• Gives patients the ability to discuss their medications in greater detail.

• Physicians have more information about their patients.

 

Without PMSP

• Limited medication reconciliation

 

• Staff and physician must follow up with patients.

• It is up to staff and physician to review and meet all state and federal regulations.

• Practice must monitor itself to ensure documentation integrity.

 

• Uses valuable staff and physician time.

• Clinicians must follow up and monitor patient medication regimens.

• Patients have no access to medication expert.

 
 
 
 
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