CDS tool use

PCC CDS tool use was defined as clicking within the CDS tool, such as screening for OUD, making a diagnosis, providing a referral, prescribing a medication, printing patient education materials, or prescribing naloxone. The use rates for each PCC for the follow-up period (6 months) were calculated as the proportion of CDS -eligible visits in which the CDS tool was clicked. An CDS -eligible visit was defined as a primary care visit with a patient between 18 and 75 who had either (1) a diagnosis of OUD, (2) an opioid overdose within the prior 6 months, (3) a prescription for a MOUD (buprenorphine, methadone, or IM naltrexone), or (4) high risk for OUD or overdose, determined by a risk prediction algorithm embedded in Epic, defined as a score of 55 or higher (out of 100) at the time of the encounter [36]. The CDS tool is designed for both waivered and non-waivered PCCs, and guides them through screening, diagnosis, and treatment (either referral or prescription). Because overall use rates were low, this variable was dichotomized as whether the PCC ever clicked in the tool (1 = yes; 0 = no) in the 6 months following the training.