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Sentinel opioid prescribing measures


The DHS Opioid Prescribing Work Group (OPWG) developed seven prescribing measures by analyzing Minnesota Medicaid and MinnesotaCare prescription claims data. In developing the sentinel measures, the OPWG also considered other national indicators such as those developed by Healthcare Effectiveness and Data Information Set (HEDIS). 

The seven sentinel measures are intended to assess individual clinicians’ opioid prescribing patterns in the acute, post-acute and chronic pain phases by comparing them to the prescribing rates of their same specialty peers. The measures also serve as indicators to support the quality improvement arm of the program. DHS acknowledges that the meausures do not fully illustrate a clinician’s overall practice, patient panel or alignment to community standards. Rather, the measures are a tool to help DHS identify clinicians who may need additional data or support. 

Additional information related to the sentinel measures include:

Measure definitions

Measure 1: Percent of patients prescribed an index opioid prescription.

Measure 2: Percent of index opioid prescriptions exceeding the recommended dose; 

  • greater than 100 morphine milligram equivalence for medical specialties; 
  • greater than 200 morphine milligram equivalence for surgical specialties.

Measure 3: Percent of prescriptions exceeding 700 cumulative morphine milligram equivalence during the acute and post-acute pain period. 

Measure 4: Percent of patients with chronic opioid analgesic therapy.

Measure 5: Percent of patients on chronic opioid analgesic therapy exceeding 90 morphine milligram equivalence per day (high-dose chronic opioid analgesic therapy). 

Measure 6: Percent of patients receiving elevated-dose chronic opioid analgesic therapy (greater than 50 morphine milligram equivalence per day) who received concomitant benzodiazepine prescriptions. 

Measure 7: Percent of patients on chronic opioid analgesic therapy who receive opioids from multiple providers.

Measure overviews

The following overviews describe each of the four measures that have quality improvement requirements. 

Review the Measure 2 Overview (medical specialties) 

Review the Measure 2 Overview (surgical specialties)

Review the Measure 3 Overview

Review the Measure 5 Overview

Review the Measure 6 Overview 

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