Better Prescribing, Better Treatment

The Better Prescribing, Better Treatment (BPBT) program is a peer-to-peer, clinician-driven quality improvement program that promotes safe, appropriate prescribing to curb opioid misuse and overdose. The program was developed in partnership with the Washington State Hospital Association and the state Health Care Authority in lieu of proposals seeking to implement mandatory prior authorization for all opioid prescriptions. At the same time, the legislature was considering a blunt statutory 7-day pill limit that would have been problematic for appropriate patient care and potentially result in disciplinary action for well-meaning clinicians.

BPBT was launched to focus on quality improvement rather than punitive regulatory oversight. This effort has protected the medical profession from further problematic legislative and/or regulatory interference, while significantly improving opioid prescribing behaviors and resulting patient care and outcomes.

BPBT is a component of the state opioid response plan, and is a collaboration between the Washington State Medical Association, Washington State Hospital Association, Washington State Department of Health, and the Washington State Health Care Authority.

The BPBT program promotes safe prescribing in two ways:

• Washington State Opioid Prescribing Reports: Each quarter, the WSMA sends prescribers in the state an opioid prescribing feedback report. Using data from the state prescription monitoring program (PMP), the report shows how their opioid prescribing practices compare to others in their hospital, health system, or medical group, as well as within their specialty. To participate, prescribers are opted-in by their organization's CMO.
• Opioid Management Coaching Program: In partnership with the University of Washington Six Building Blocks program, the WSMA offers coaching services on improving systems in primary care clinics to deliver more evidence-based chronic pain care and opioid management. Contact monica@wsma.org for more information.

Washington State Opioid Prescribing Reports

Results driven

Better Prescribing, Better Treatment's data-driven and data-sharing approach is working. The initiative, now encompassing 11,000+ prescribers with 60 hospitals, health systems, and medical groups in the state. Collectively, reducing opioid prescriptions above guidelines by 46% since 2018.

To opt In

We are happy to announce that medical groups and individuals can enroll to receive this quarterly reports, even if you do not have an approved CQIP plan with the state.

To enroll your organization, hospital, and health system CMOs can email melinao@wsha.org and medical group CMOs can email monica@wsma.org. You will be asked to sign a confidentiality agreement and provide an updated list of the prescribers in your organization every quarter.

Frequently asked questions and next steps

Get answers to your questions about report development and impact, or actionable next steps in the Washington State Opioid Reports FAQ. Contact the physician lead, Nathan Schlicher, MD, at nathan_schlicher@teamhealth.org, for clinical guidance on the Washington State Opioid Prescribing Reports. Contact the program manager, Monica Salgaonkar, MHA at monica@wsma.org, to join or find out more about the opioid management coaching program.

Opioid Management Coaching Program

Utilizing the UW Six Building Blocks Framework, there are a variety of ways we can offer support in opioid improvement work:

Opioid Management Resources

• May 2020 Webinar on the Washington State Opioid Reports
  Learn more about the Washington State Opioid Prescribing Reports program and the Six Building Blocks program. This webinar was originally broadcasted on May 15, 2020. Webinar presenters were Dr. Nathan Schlicher, BPBT physician lead; Jeb Shepard, WSMA director of policy and regulatory affairs; Dr. Laura-Mae Baldwin, UW Family Medicine and the Six Building Blocks program; and Dr. Michael Parchman, Kaiser Permanente Health Research Institute and the Six Building Blocks program.
• Complying with State Opioid Regulations through Improved Prescribing Practices – WSMA members only—sign-in required
  WSMA's free one-hour on-demand webinar can help clinicians understand how to comply with the new requirements. Completion of the webinar will fulfill the new state requirement for continuing medical education on opioid prescribing. This activity has been approved for AMA PRA Category 1 Credit™. After completing the activity, learners should be able to:
  • Review the Washington state opioid prescribing requirement.
  • Outline strategies to comply with specific requirements of opioid prescribing rules.
  • Detail additional resources available for up-to-date evidence-based information on opioid prescribing.
• UW Six Building Blocks
• Self-Service How-to Guide for the Six Building Blocks Program
• WSU Interprofessional Team-Based Opioid Education
• Washington State Opioid Rules and Best Practices - developed by UW
  We aim to ensure our healthcare professionals who prescribe opioids for pain for any indications are doing so safely and according to state rules and best practices for pain management. This module is consistent with an emerging national consensus by the CDC, FDA, and professional pain societies regarding best practice guidelines for Healthcare professionals for management of patients receiving opioid prescriptions regardless of formulation or type of pain.
• Pain and Opioid Consult Hotline for Clinicians
  A resource developed by UW Medicine and funded by the state. It aims to provide answers and help Washington State clinicians with opioid questions and concerns about patients under their care.