Prescribing Practices: Prescription Monitoring Program

The Minnesota Prescription Monitoring Program (PMP) was established to promote public health and safety by detecting diversion and misuse of prescriptions for controlled substances as defined in Minnesota Statutes Section 152.126.  Pharmacies and prescribers who dispense Schedule II-V substances submit prescription data into the PMP. 

As of July 1, 2017 enrollment into the PMP is mandated for all prescribing providers including physicians, nurse practitioners, physician assistants, and dentists.  The Minnesota mandated use currently states that all prescribers who are a part of an Opioid Treatment Programs (OTP) must query the PMP every 90 days when treating a patient with an Opioid Use Disorder. 

In 2017, the PMP is working on enhancements to the PMP including, but not limited to:

• Monitoring the implementation of mandated enrollment: quarterly reports will be collected to compare the number of new licensees to new enrollees; reports are given to each of the licensing boards to encourage enrollment
• Enhanced user interfaces: adding data fields to make it easier to view the patient’s entire care team, or all providers who have prescribed medications for one person
• Additional proactive reports: running additional “controlled substance insight alerts” that identify patients who may be misusing prescription opioids and/or may be prescribed opioids outside of the state guidelines

Some considerations in the current PMP statute:

• For active investigations, law enforcement is allowed to request a patient’s prescribing history.
• For active investigations, the Restricted Recipient (RR) Program is allowed to request a patient’s prescribing history. 

Before mandated enrollment, many prescribers were not enrolled in the PMP in Minnesota. In 2014, approximately 14% of prescribers were enrolled in the PMP, and approximately 52% were enrolled in 2017. A study published in Pain Med in 2012 shows that when a prescriber queries the PMP, it changes their decision 50% of the time. Some clinics have optimized the use of delegates, made the PMP query a part of pre-visit planning or rooming procedure, and/or set up PMP query alerts in their electronic health record (EHR).

Currently, there are a few pilots underway for integrating the PMP into the electronic medical record (EMR).  Most states who have already implemented mandated use legislation recommend first integrating the PMP into the EMR.  In other words, an unfunded mandate to use the PMP will be more successful when it is easy to use it.  PMP integration into an EMR requires up-front costs to build information technology infrastructure or use a translation service, and ongoing costs to enroll prescribers.

For more information about PMP registration, reports and statistics, and frequently asked questions, visit Minnesota Prescription Monitoring Program.

For more information about eight strategies to maximize the efficiency of the Prescription Monitoring Program (PMP) recommendations, please review The PEW Charitable Trusts Prescription Drug Monitoring Programs Report. 

Please visit the Opioid Dashboard for more information on opioid overdose death, nonfatal overdose, use, misuse, substance use disorder, prescribing practices, supply, diversion, harm reduction, co-occurring conditions, and social determinants of health.