Program Overview

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 program now includes representatives from:

ARNP United of Washington State
Washington State Dental Association
Washington Academy of Physician Assistants

The BPBT program promotes safe prescribing in two ways:

Better Prescribing, Better Treatment Reports: Each quarter, the WSMA sends prescribers in the state an opioid prescribing feedback report. Using data from the state prescription monitoring program, 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. Now expanded to include the acute benzodiazepine/sedative prescribing reports and acute buprenorphine prescribing reports.
1:1 Coaching Program: The WSMA offers 1:1 coaching services with Nathan Schlicher, MD, JD, on improving systems in primary care clinics to deliver more evidence-based pain care and opioid management.

Better Prescribing, Better Treatment Reports

Results driven

Better Prescribing, Better Treatment's data-driven and data-sharing approach is working. The initiative, now encompassing 17,000+ prescribers with 64 hospitals, health systems, and medical groups in the state, has reduced opioid prescriptions above guidelines by 58% since 2018.

Acute opioid prescribing reports

We are excited to be expanding the number of prescribers being reached with these reports and partnering with professional associations. Get answers to your questions about report development and impact or actionable next steps in the Washington State Opioid Reports FAQ.

Acute benzodiazepine/sedative prescribing reports

Given the success in addressing the acute opioid epidemic with the BPBT acute opioid prescribing reports, we are expanding to work on the challenges of sedative misuse. More information about safe prescribing and available educational resources can be found here.

Acute buprenorphine prescribing reports

Staying true to the program name, Better Prescribing, Better Treatment, the program is expanding to include opioid use disorder treatment. Now is the time to consider screening for opioid use disorder and provide access to treatment, click here to learn more.

1:1 Coaching Program

If you are interested in individual coaching or a resource for your clinic, the WSMA can assist with resources and physician speakers for your team. Please contact Alyssa Crawford at alyssa@wsma.org for more information.

Contact Us

Contact the physician lead, Nathan Schlicher, MD, JD, at nathan_schlicher@teamhealth.com for clinical guidance on the Better Prescribing, Better Treatment Prescribing Reports. For other questions or concerns, contact Alyssa Crawford (alyssa@wsma.org).

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.

Opioid News

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Call for Feedback on Draft OUD Treatment Guidelines from Bree Collaborative

Opioids

Shared_Content/News/Membership_Memo/2024/october-11/call-for-feedback-on-draft-oud-treatment-guidelines-from-bree-collaborative

<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/october/bree-collaborative-logo-645x425px.png" class="pull-right" alt="Dr. Robert Bree Collaborative logo" /></div> <h5>Oct. 11, 2024</h5> <h2>Call for Feedback on Draft OUD Treatment Guidelines from Bree Collaborative</h2> <p>The Dr. Robert Bree Collaborative is accepting public comment on its draft <a href="https://www.qualityhealth.org/bree/wp-content/uploads/sites/8/2024/09/Revised-OUD-Treatment-Report-24-public-comment-FINAL.pdf" target="_blank" rel="noreferrer">Treatment for Opioid Use Disorder Report and Guidelines 2024</a>. In partnership with the Washington Society of Addiction Medicine, the WSMA supports updating the guidelines to reflect current clinical practice and patient care in the era of fentanyl.</p> <p>Some of the updated guidelines include encouraging practitioners to:</p> <ul> <li>Become educated on the latest evidence-based guidelines.</li> <li>Universally screen in primary care at least annually for substance use disorders including opioid use disorder using a validated instrument (see NIDA Screening and Assessment Tools) following the United States Preventative Task Force recommendations. Physicians and practitioners not in primary care settings should also routinely screen for substance use disorders using validated instruments.</li> <li>If a patient screens positive, or independently brings up concerns about their opioid use, ask about frequency, amount, and route of opioid use, perform comprehensive assessment, and discuss medications for opioid use disorder.</li> </ul> <p>A complete list of the updated guidelines is available on pages 9-11 of the report.</p> <p>Once completed, the guidelines will be submitted to the Legislature and may be the foundation of future legislation. We encourage WSMA members to review and provide feedback on the draft report and guidelines before the deadline on Thursday, Oct. 24 at 11:59 p.m.. All comments will be presented anonymously and reviewed at the November work group meeting.</p> </div>

10/11/2024 12:00:00 AM

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ScalaNW Program Provides ER Physicians Support for Opioid Use Treatment

Opioids

Shared_Content/News/Membership_Memo/2024/june-14/scalanw-program-provides-er-physicians-support-for-opioid-use-treatment

<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/june/buprenorphine-butrans10mcg-645px.jpg" class="pull-right" alt="Buprenorphine-Butrans 10 mcg packets" /></div> <h5>June 14, 2024</h5> <h2>ScalaNW Program Provides ER Physicians Support for Opioid Use Treatment</h2> <p>Despite the success of medications for opioid use disorder like methadone and buprenorphine, less than 9% of overdose-related emergency room visits result in a prescription for MOUD. A new program from the state Health Care Authority, introduced this month, aims to bring that number up by equipping emergency room clinicians with tools to treat patients for opioid use disorder and connect them to community-based care.</p> <p>MOUD have been underprescribed in the ER for a reason: Before 2023, the U.S. Drug Enforcement Administration required clinicians to complete special training to prescribe certain medications for OUD. These requirements were removed at the end of 2022. Now that the medications are easier to prescribe, clinicians and hospital systems can standardize treatment protocols and consistently get medication to ER patients with OUD.</p> <p>The new Health Care Authority program, ScalaNW, is a bridge program with tools to close the gap between emergency initiation of MOUD and the ongoing, outpatient clinical care they needed to keep patients on medication long-term. The program gives acute care physicians and practitioners a direct link to evidence-based clinical support and provides hospital systems with 24/7 scheduling services to make it easier to initiate medications for opioid use disorder. ScalaNW is endorsed by the WSMA, the Washington Chapter of the American College of Emergency Physicians, and the Washington Hospital Association.</p> <p>The program website, <a href="https://scalanw.org/">ScalaNW.org</a>, offers evidence-backed protocols for clinicians to determine how and when to provide MOUD and collaborates with the University of Washington Psychiatry Consultation Line to offer 24/7 live clinical support. ScalaNW also works with the Washington Recovery Helpline to provide 24/7 scheduling that allows follow-up appointments to be made before ER discharge.</p> </div>

6/14/2024 12:00:00 AM

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Opportunity to Help Improve the Safe Medication Return System

Opioids

Shared_Content/News/Membership_Memo/2024/april-26/opportunity-to-help-improve-the-safe-medication-return-system

<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2024/april/pill-bottle-illustration-shutterstock-645x425.jpg" class="pull-right" alt="pill bottle illustration" /></div> <h5>April 26, 2024</h5>  <h2>Opportunity to Help Improve the Safe Medication Return System</h2> <p> <em>Survey will be available until May 15</em> </p> <p>Safe Medication Return at the Washington State Department of Health has launched an awareness survey of physicians, health care professionals, law enforcement staff, veterinarians, and pharmacists. Your input will help the department assess awareness, attitudes, and use of safe medication return services and benefits and inform the department's report to the Legislature. Take the five-minute survey <a href="https://redcap.link/SafeMedReturn_professionals">here</a>. Please share the survey with other physicians and health care professionals.</p> <p>The department is offering a similar survey to the public. Please share the <a href="https://redcap.link/SafeMedReturn">public survey</a> widely within Washington state to help improve the system for our communities. Both the public and professional surveys will be available until May 15.</p> <p>If you have questions about either survey, contact the department at <a href="mailto:SafeMedReturn@doh.wa.gov">SafeMedReturn@doh.wa.gov</a> or 360.236.4698.</p> </div>

4/26/2024 12:00:00 AM

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