Chronic Pain Case Management in Opioid Patients: Improving Risk Management and Shifting Prescriber Behavior in a Rural Community Health Center

Abstract

Moderator: Andy Lowe, Director of Program Management Resources, Outer Cape Health Services Presenters: - Barbara K. Prazak, MD, Internal Medicine, Medical Director, Director of Clinical Quality Outer Cape Health Services - Ellen Dennehy, PA-C, Physician Assistant, Family Medicine, Outer Cape Health Services - Tina Rauch, RN, Registered Nurse, Family Medicine, Outer Cape Health Services - Jennifer Eldredge, Medical Assistant, Family Medicine, Outer Cape Health Services Session Description Outer Cape Health Services (OCHS) is an independent, federally-qualified health center with three locations in the outermost towns of Cape Cod, an area hit hard by the opiate epidemic of recent years. After years of updates to the OCHS Controlled Substance Policy and Procedure, Medical Director Dr. Barbara Prazak worked with the Director of Nursing to develop the Chronic Pain Case Management (CPCM) Program, to be implemented March 1, 2016. The CPCM program uses a team-based case management approach to monitoring patients on opioid prescriptions, with systematic tracking of patient data such as PEG scales, MEQ dosing, concurrent use of benzodiazepines, annual agreements, UDS and PMP checks and visit compliance, and regular provider-to-provider case reviews. While the CPCM program supports the primary care prescriber with consistent, data-based risk management and evaluation, it also aims to shift provider behavior and practices in opiate prescribing, towards an approach that is more collaborative, individualized to patients’ needs, and integrated with primary care. Through this breakout session, we will engage with other prescriber teams to learn about other team-based approaches to chronic pain case management, discuss best practices, and begin formulating issues that warrant research.