In a CHCF-funded study, the San Francisco Department of Public Health implemented detailing techniques and cut opioid-related emergency department visits by nearly half among patients who were co-prescribed naloxone.
The firms below are available to provide academic detailing and strategies for identifying and remedying outlier prescribers in a health system. If you have any questions, please contact Challen Clarke.
- Services: Community-level provider outreach, education, and academic detailing
- More information: healthmanagement.com
Health Management Associates (HMA) and the Community Care of North Carolina (CCNC) pharmacy enhanced services network have partnered together to provide an approach that leverages the existing relationships, expertise, and infrastructure of community-based pharmacists and physicians with expertise in treating opioid use disorder.
The group engages providers who are prescribing outside of Centers for Disease Control and Prevention guideline-based norms, including those in harder to reach areas, using a tiered approach aimed at impacting overall prescribing patterns.
- The first tier involves engaging community-based pharmacists with outlier prescribers.
- The second tier engages local physicians who are opioid experts if the pharmacists are not able to create lasting change.
- The final tier, should the first two fail to produce results, involves bringing in national experts and taking a team-based approach to education.
HMA has experience in identifying and developing educational resources for outlier prescribers. The firm has more than 200 consultants, many of whom have held senior positions in health plans, managed and accountable care organizations, provider systems, and state and federal agencies.
- Services: Consulting for providers and health plans on prescribing patterns
- More information: manatt.com
Manatt Health recognizes the importance of addressing prescribing, especially as regulatory scrutiny increases. The firm will work with health plans and providers to launch a comprehensive process to address risky prescribing patterns.
Manatt works with major health plans across the country as a legal adviser, management consultant, and policy expert. Its approach to tackling prescriber patterns includes analyzing data to identify outlier prescribers and the truly problematic instances. Prescribers are segmented based on patterns and motivations; the firm then develops and deploys educational and outreach resources for each segment with the support of a contract sales organization. Strategies may include one-on-one academic detailing, group education, and in-person or virtual outreach. Progress is tracked against goals.
Manatt has also published extensively on the opioid epidemic, keeping it up to date on the clinical, regulatory, and policy dimensions of the issue. The team also has a significant data analysis capacity that it can use to glean valuable insights from claims data to help guide decisionmaking.
- Services: Free clinician-to-clinician telephone consultation service
- More information: ucsf.edu
The Substance Use Warmline (SUW) of the Clinician Consultation Center (CCC) (based in the Department of Family and Community Medicine at the University of California San Francisco–Zuckerberg San Francisco General Hospital) offers free telephone consultations for clinicians and prescribers.
The SUW is a free clinician-to-clinician telephone consultation service to provide education and directly support clinicians in implementing opioid safety and addiction treatment. The SUW multidisciplinary team of dedicated substance use, HIV, and hepatitis experts and educators includes addiction medicine-certified physicians, clinical pharmacists, and advanced practice nurses.
Key components of SUW consultations include developing individualized strategies to identify patients at risk, advising on safer opioid and benzodiazepine prescribing, facilitating realistic medication changes, implementing overdose prevention strategies, connecting patients with opioid and substance treatment programs, implementing MAT, and discussing complex comorbidities and social supports, with the goal of developing alternative treatment plans for their patients. SUW consultations are both case-specific consultations and general discussions. All consultations will be confidential for both the prescriber and patient per HIPAA standards.
A unique strength of the SUW is that its consultants provide colleague-to-colleague individualized case consultation as needed by the treating clinician. The process is nonjudgmental and goal-directed. The SUW is available Monday through Friday, 8 AM to 5 PM (PT).