title: Usability of the Massachusetts Prescription Drug Monitoring Program in the Emergency Department: A Mixed-methods Study.
abstract: OBJECTIVE
  Prescription drug monitoring programs (PDMPs) are underutilized, despite evidence showing that they may reduce the epidemic of opioid-related addiction, diversion, and overdose. We evaluated the usability of the Massachusetts (MA) PDMP by emergency medicine providers (EPs), as a system's usability may affect how often it is used.
  
  
  METHODS
  This was a mixed-methods study of 17 EPs. We compared the time and number of clicks required to review one patient's record in the PDMP to three other commonly performed computer-based tasks in the emergency department (ED: ordering a computed tomography [CT] scan, writing a prescription, and searching a medication history service integrated within the electronic medical record [EMR]). We performed semistructured interviews and analyzed participant comments and responses regarding their experience using the MA PDMP.
  
  
  RESULTS
  The PDMP task took a longer time to complete (mean = 4.22 minutes) and greater number of mouse clicks to complete (mean = 50.3 clicks) than the three other tasks (CT-pulmonary embolism = 1.42 minutes, 24.8 clicks; prescription = 1.30 minutes, 19.5 clicks; SureScripts = 1.45 minutes, 9.5 clicks). Qualitative analysis yielded four main themes about PDMP usability, three negative and one positive: 1) difficulty accessing the PDMP, 2) cumbersome acquiring patient medication history information within the PDMP, 3) nonintuitive display of patient medication history information within the PDMP, and 4) overall perceived value of the PDMP despite an inefficient interface.
  
  
  CONCLUSIONS
  The complicated processes of gaining access to, logging in, and using the MA PDMP are barriers to preventing its more frequent use. All states should evaluate the PDMP usability in multiple practice settings including the ED and work to improve provider enrollment, login procedures, patient information input, prescription data display, and ultimately, PDMP data integration into EMRs.
authors.affiliation: Harvard Affiliated Emergency Medicine Residency, Boston, MA.|Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.|Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Sabrina J
authors.initials: SJ
authors.lastname: Poon
authors.affiliation: Harvard Affiliated Emergency Medicine Residency, Boston, MA.|Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.|Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Margaret B
authors.initials: MB
authors.lastname: Greenwood-Ericksen
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Gish
authors.affiliation: Clinical and Quality Analysis, Partners Healthcare, Wellesley, MA.
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Neri
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.|Department of Emergency Medicine, Harvard Medical School, Boston, MA.
authors.forename: Sukhjit S
authors.initials: SS
authors.lastname: Takhar
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.|Department of Emergency Medicine, Harvard Medical School, Boston, MA.
authors.forename: Scott G
authors.initials: SG
authors.lastname: Weiner
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.|Department of Emergency Medicine, Harvard Medical School, Boston, MA.
authors.forename: Jeremiah D
authors.initials: JD
authors.lastname: Schuur
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.|Department of Emergency Medicine, Harvard Medical School, Boston, MA.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Landman
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D016208:Databases, Factual / Q000706:statistics & numerical data*; D004635:Emergency Medicine; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D009293:Opioid-Related Disorders / Q000517:prevention & control*; D055553:Prescription Drugs / Q000008:administration & dosage* / Q000627:therapeutic use; D014584:User-Computer Interface
chemical_list: D000701:Analgesics, Opioid; D055553:Prescription Drugs