ESHB 2876 Rule Compliance Algorithm for UW
Patients with:
Chronic non-cancer, non-terminal/hospice
pain longer than 3 months duration
Document: Diagnosis, Risk Screens, Treatment Plan

Establish pain diagnosis and treatment plan
At initiation of opioid therapy



Screen for risks: history of substance abuse,
psychiatric conditions, anxiety, sedative/alcohol use,
receipt of opioid >1 provider, repeat ED visits
seeking opiods, sleep apnea, pregnancy, falls,
allergies/intolerances
Counsel patient on risk and benefits of opioid therapy
Use written controlled substance treatment agreement



Update problem list with 338.29 Chronic Pain
EPIC Chronic Pain Care SmartSet (#713)
ORCA
Opioid Risk Tool (ORT) available in UW Provider
http://depts.washington.edu/anesth/education/pai
n/index.shtmlToolkit
Give Patient:
Benefits & Risk of Treatment with Opioids
(#3989)
https://healthonline.washington.edu/show
_details.asp?item=3989
Controlled Substance Written Treatment
Agreement form (UH2127)
https://know1.mcis.washington.edu/Document
/forms/forms_images/UH2127.pdf
Track function, pain, mood
and aberrant behavior
If mean oral morphine equivalent dose (MED)
≥120mg/day
Seek consultation or
(q 2yrs) ≥ 12 hrs of CME on pain treatment
UW ECHO Telepain consultations
http://depts.washington.edu/anesth/care/pai
n/echo/index.shtml
UW Pain Champions Program
http://depts.washington.edu/anesth/educati
on/forms/pain/UW-Pain-ChampionsOverview.pdf
Use:
 UW Pain Tracker
 Periodic check of PMP/EDIE
http://www.wapmp.org/practitioner/pharmacist/
http://www.ediecareplan.com/EDIE_Full_Service.pdf
 Risk stratified UDT Algorithm
http://depts.washington.edu/anesth/education/forms/
pain/UW-UDTinterpretationAlgorithm.pdf
MED calculator available at:
http://agencymeddirectors.wa.gov/mobile.html
AMDG free 4 hour CME to familiarize yourself with the rules
http://www.agencymeddirectors.wa.gov/opioiddosing.asp#CME