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Improving Opioid Prescribing

In light of a governor’s mandate, The Ripples Group initiated a comprehensive stakeholder engagement strategy to inform the launch of a new Prescription Monitoring Program (PMP) and propel the state to national leadership in the fight to reduce opioid abuse. 

A state’s department of health charged The Ripples Group with developing a comprehensive approach to updating the state’s prescription monitoring program (PMP).  Recent statutory changes required a complete overhaul of the existing program including replacing all IT systems and changing how the program coordinated with the medical community and other stakeholders. Starting with initial stakeholder engagement sessions, our team has been involved in all critical aspects of implementation including vendor contract negotiations, IT development sessions, program change management, stakeholder engagement, system testing, and coordination across the implementation teams. The Ripples Group worked closely with Department of Health leadership to make the PMP a success.


Ripples structured new ways to engage with stakeholders and use their expertise to inform the program redesign.  Under previous leadership, the program had drifted away from stakeholder involvement which undercut the program’s effectiveness and utility to the medical community.  Our team developed a three-pronged approach creating a stakeholder group to inform policy and program design, creating a user group to inform system implementation, and starting widespread outreach to the community. Outreach centers on reaching out directly to medical societies and health institutions as well as pharmacies, law enforcement, licensing boards, and others.  The program now maintains an open dialogue across many channels to support ongoing improvement. 


To manage the successful systems launch, Ripples supported leadership in nearly every angle of the implementation. Based on the major upgrades the state needed, the Ripples team leveraged previous experience to write comprehensive requirements, which enabled a dramatic leap forward in the system design and quality. The Ripples Group also encouraged the program to leverage their new relationship with stakeholders to allow stakeholders to participate in User Acceptance Testing (UAT). The stakeholder testing proved to be invaluable to inform the go-live planning and program’s change management to become a customer service focused organization.


In parallel to system testing, Ripples developed a comprehensive go-live plan that included a high-level engagement strategy all the way down to a minute-by-minute playbook in the hours leading up to go-live. The high-level engagement strategy was focused on educating stakeholders on why the system was important, how they register, and how they use it. The strategy leveraged daily live webinars, ongoing continuing education coursed (doctors, dentists, pharmacists, etc.), tutorial videos, and email communication. The engagement strategy enabled not only a successful go-live, but transformed the image of the program and quadrupled the utilization rates of the system.


Overall, the Ripples team helped define the critical path to go-live that informed leadership decisions and supported priority setting by the development teams. Through this guidance and management, Ripples kept the PMP Program Team on schedule, meeting its commitments, and making informed business decisions.


Ripples is now engaged in continuing its work on the PMP by supporting program development, organizational redesign, continued system enhancements and testing, stakeholder engagement, and coordination of system integration opportunities with EMRs and dentist & pharmacy IT systems.  The program is on a defined path to further integrate the PMP into clinical and pharmacy workflows, continually improving utilization and effectiveness.    


Highlights include:

-        Comprehensive stakeholder engagement strategy to develop a clear vision and approach to the program,

         working closely with medical societies, hospitals, and pharmacies

-        Launching a new web-based application that medical and pharmacy staff could use to see filled schedule II

         through V prescriptions from across the state

-        Implementing a new data collection service for all pharmacies in the state to report filled prescriptions

-        Improving the intersection with medical licensing boards and law enforcement

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