Working Together to Reduce Prescription Drug Abuse and Overdose Deaths

3. General Practice Initiative:  Expand safe prescribing initiative to targeted, major Provider Groups/Delivery Systems across      LA County.

Safe Prescribing Medical Practice Action Team (MPAT)

a.  78 of 78 EDs in LA County continue to follow AAEM Safe Prescribing guidelines and distribute LAC patient handout or              equivalent.
b.  All 78 EDs with >90% CURES registration for providers and all institute Policy for use with opioid prescribing.
c.  15 EDs implement EDIE within 18 months.

ED Initiative Work Group
Urgent Care Initiative Work Group
Medical/Dental Initiative Work Group
Provider Group/Delivery System/Health Plan Network Work Group

a.  Identify a core group of Provider Groups/Delivery Systems (primary care, dentistry, etc.) who commit/pledge to the

     Safe Prescribing effort.
          -  Target Groups/Systems: HealthCare Partners, AltaMed, SCPMG, LAC DHS, Facey/Providence, Eldorado,                        CCALAC, UCLA, Molina, and IPAs (through Health Plans), LA Dental Society.
b.  Participating Provider Groups/Delivery Systems adopt and implement safe prescribing practices consistent with the

     CDC Opioid Guidelines and/or Oregon Guidelines.  Each will implement a core set of specific activities/processes that

     support safe prescribing, e.g., required educational program/academic detailing; regular measurement and reporting;

     provider lists and feedback; peer review/pre-authorization; active decision support at time of prescribing; workflow  

     protocols; eConsultation from pain management/addiction medicine; others to be determined.
c.  All providers register with CURES and follow policy of use with opioid prescribing by their Provider Group/Delivery            System.
d.  Collaborate/Coordinate with pharmacy practice (pharmacists’ “corresponding responsibility”).
e.  All participating Health Plans support and sponsor Safe Opioid Prescribing Initiatives involving provider networks,              including manage communications across networks; and each Plan will implement and/or enhance a core set of    

     specific activities/processes that support safe prescribing, including monitoring and reporting prescribing patterns over      time.

a.  Identify at least 50-75 Urgent Care Centers (independent and with major provider groups/delivery systems) that      

     commit/pledge to Safe Prescribing effort.
b.  All participating Urgent Care/Provider Groups adopt and put into practice the AAEM safe prescribing guidelines and           distribute the LA County patient handout or equivalent.
c.  All participating Urgent Care/Provider Groups with >90% CURES registration for providers and all institute a policy             for use with opioid prescribing.

1. Strengthen the ED Initiative following AAEM guidelines and patient information communications.

         -  Coordinate with EDIE (Emergency Department Information Exchange) implementation for information exchange.

2. Expand the adoption and implementation of the AAEM guidelines and patient information communications to Urgent Care Centers.

3. Expand safe prescribing initiative to targeted, major Provider Groups/Delivery Systems.

1. ED Initiative: Strengthen the ED Initiative following AAEM guidelines and patient information communications.

Activate the medical (and dental) community to support evidence-based pain management and safe opioid prescribing to reduce opioid over-prescribing, misuse, abuse, and diversion.

2. Urgent Care Initiative:  Expand to Urgent Care Centers the adoption and implementation of the AAEM guidelines and patient      information communications.

Leads:  Maureen McCollough, MD and Katie Ward, MD