Multi-Site Testing of an Opioid Prescribing Electronic Clinical Quality Measure Following Elective Primary Total Hip and/or Total Knee Arthroplasties.

As the United States faces the third wave of the ongoing opioid epidemic, development of measures which report on prolonged opioid prescribing (POP) rates, specifically following orthopedic surgeries, are needed to better understand and improve prescribing practices at the clinician group level. Brigham and Women's Hospital (BWH) has been contracted by the Centers for Medicare and Medicaid Services (CMS) to create a novel electronic clinical quality measure (eCQM) to quantify the prolonged opioid prescribing rate of opioid episodes lasting > 42 days in patients aged 18+ years following elective primary total hip arthroplasties (THA) and/or total knee arthroplasties (TKA) for use in the Merit-Based Incentive Payment System (MIPS). When this measure was tested on two geographically distinct sites, it was found that the THA rate was 3.80% and 16.07% at sites 1 and 2, respectively, and that the TKA rate is 7.65% and 24.15% at sites 1 and 2, respectively. This manuscript reports on the testing of this eCQM between these two sites, highlighting differences in state and organizational level policies regarding opioid prescribing and documentation practices.