This project was supported by Grant No. 2014-PM-BX-K001 awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, and the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.

Tracking PDMP Enhancement:

The Best Practice Checklist

March 3, 2017

Prepared by

The Prescription Drug Monitoring Program Training and Technical Assistance Center

The Heller School for Social Policy and Management

Prepared for

The Bureau of Justice Assistance

2 Tracking PDMP Enhancement: The Best Practice Checklist

Brandeis University PDMP TTAC 2

Tracking PDMP Enhancement:

The Best Practice Checklist

Overview

Prescription drug monitoring programs (PDMPs) are now operational in Guam, the District of Columbia,

and all states but Missouri, and established but not yet operational in St. Louis County.1 Over the past

decade, with support from federal grants, many PDMPs have enhanced their programs to make

prescription data more accurate, timely, relevant, and accessible. During this process a number of best

and promising practices have been identified, and continue to be identified, many of which PDMPs have

adopted to optimize operations and increase their impact. This report documents the development of

the PDMP best practice checklist, a tool for tracking the adoption of practices over time by PDMPs, both

individually and collectively. It also describes findings on the adoption of practices from the first

comprehensive assessment of PDMPs to include most of the checklist items, carried out in 2016.2 This

provides a baseline snapshot of the extent of states implementation of practices from which progress in

optimizing PDMPs can be measured by future assessments.3 States can also use the checklist as a self-

assessment tool when planning further enhancements. The checklist itself will undergo modification as

promising PDMP practices continue to be discovered, developed and evaluated.

Origins and Purpose of the Checklist

The best practice checklist (henceforth, the checklist) first appeared as an appendix to a 2012 white

paper on PDMP best practices commissioned by the Pew Charitable Trusts, where it was offered for

consideration by PDMP administrators and other stakeholders as a draft tool for tracking progress in

PDMP enhancement.4 It is also appended to this report, see Appendix A. This demonstration checklist

presented practices in tabular form, divided into sections corresponding to major PDMP functions (e.g.,

data collection, analysis, and reporting) and operations (e.g., ensuring data quality, maximizing

utilization, securing funding). The checklist items, that is, the practices themselves, were identified

during the preparation of the white paper, and represented the then-available published evidence,

expert opinion, and states experience on what policies and procedures would most likely enhance

PDMPs. Each practice in the demonstration checklist is described in the white paper, along with its

rationale and the known extent of its adoption by states in 2012. The checklist included columns in

which respondents could indicate the current status of each practice: planned, in progress, or

achieved (see Appendix A).

Evidence continues to be collected on how practices contribute to PDMP effectiveness, and PDMPs

continue to discover new promising practices and revise existing practices. The checklist items in the

1 See http://fox2now.com/2016/05/31/st-louis-establishes-prescription-drug-monitoring-program/

2 Methods and findings from the TTAC biannual PDMP assessments (2010, 2012, 2104, 2016) are described in the

technical assistance guide Enhancing PDMPs: A Comparison of Changes 2010-2016 at http://www.pdmpassist.org/pdf/state_survey_comparisons_TAG_final_20161208_3.pdf. 3 Historical trends in the adoption of some key best practices are described in Enhancing PDMPs: A Comparison of

Changes, 2010-2016, see footnote 2. 4 See PDMP Center of Excellence, Brandeis University and The Pew Charitable Trusts, Prescription Drug

Monitoring Programs: An Assessment of the Evidence for Best Practices, 2012, Appendix C, pp. 92-4, http://www.pdmpassist.org/pdf/COE_documents/Add_to_TTAC/Brandeis_PDMP_Report.pdf.

http://fox2now.com/2016/05/31/st-louis-establishes-prescription-drug-monitoring-program/http://www.pdmpassist.org/pdf/state_survey_comparisons_TAG_final_20161208_3.pdfhttp://www.pdmpassist.org/pdf/COE_documents/Add_to_TTAC/Brandeis_PDMP_Report.pdf

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Brandeis University PDMP TTAC 3

appendix to the 2012 white paper were consequently offered as candidate best practices, to be

reviewed as further evidence accumulated and innovation took place. This remains the case for many of

the checklist items that were included in the 2016 state assessment and that constitute the subject of

this report: they are subject to revision as evidence and experience accrue that bear on how practices

actually work (or not) to enhance PDMPs. Therefore, the term best practice checklist should not be

construed to imply that all the practices in the checklist are necessarily unimprovable or universally

applicable to all PDMPs; nor should the checklist items be considered exhaustive of the universe of

possible best practices. Rather, the checklist should be considered a living document a continually

evolving assessment tool which itself can be improved in light of further evidence, experience in the

field, and feedback from states.

Use and Further Development

In 2013, the checklist was fielded as part of a PDMP self-assessment prior to site visits convened by the

Association for State and Territorial Health Officials (ASTHO) to provide technical assistance to the

Oklahoma and Ohio PDMPs. As in the 2012 demonstration version, the checklist included columns to

indicate the current status of each practice (planned, in progress, achieved), but also included

columns for providing details on practice implementation and any barriers to its adoption, and for

showing the estimated number of PDMPs which had implemented the practice. A final section allowed

respondents to list any innovative or other relevant practices not included in in the checklist. The

checklist was successfully completed by both the Oklahoma and Ohio PDMPs prior to the site visits,

helping to identify specific needs for technical assistance. These site visits in effect provided an

opportunity to field test the checklist, which underwent some modifications in response to feedback

from the Oklahoma and Ohio PDMP staffs.

The practices in the checklist were also the subject of two webinars on PDMP best practices conducted

by the PDMP Training and Technical Assistance Center in late 2015 and early 2016.5 Webinar

participants - PDMP administrators and other stakeholders - were invited to provide their insights on

best practices, including details on implementing a practice in their state, whether a particular practice

merited inclusion in the checklist, and what new or overlooked practices might be added to it. This

feedback was taken into account in subsequent iterations of the checklist, which led to the addition of

some practices and deletion of others. The version of the checklist reflecting feedback from these

webinars, and which is the source for the checklist items included in the TTAC 2016 state assessment, is

provided in Appendix B. It includes columns in which respondents can provide feedback on a practice,

describe any barriers to its adoption, and indicate the priority of the practice for implementation.

The most recent application of the checklist was for a technical assistance site visit in September of 2016

with the Illinois PDMP, convened by ASTHO. As noted above, the checklist items were included in the

2016 TTAC assessment of PDMPs, which Illinois completed prior to the site visit. This allowed TTAC staff

to compile a snapshot of the Illinois PDMPs current implementation of the checklist practices, thus

highlighting possible areas for program enhancement related to practices and policies not yet

implemented, or in need of further development. The checklist, although embedded in the larger 2016

assessment, thus served to guide the provision of technical assistance aimed at optimizing the Illinois

PDMP.

5 Webinars are recorded at https://pdmpassist.wistia.com/medias/9dtw4r8zao and

https://pdmpassist.wistia.com/medias/k4i9r10idd.

https://pdmpassist.wistia.com/medias/9dtw4r8zaohttps://pdmpassist.wistia.com/medias/k4i9r10idd

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Brandeis University PDMP TTAC 4

Tabulation of Findings, 2016 Assessment

Data reported in the tables below are the percent of 2016 TTAC assessment respondents who reported

having impl