July 3, 2012

Pilot Programs Could Result in More Real-Time
Access to Prescribing Histories

Washington, D.C.Pharmacists and other health care providers will have real-time access to prescription drug use data with two new pilot projects launched by the U.S. Department of Health and Human Services (HHS).

The pilot projects, conducted by HHS's Office of the National Coordinator for Health Information Technology (ONC) in Indiana and Ohio, are to gauge the effects of expanding and improving access to prescription drug monitoring programs (PDMPs) as a method to reduce prescription drug abuse.

While PDMPs are either available or coming on line in 49 states, HHS maintains they are not used enough and suggests that better real-time access could remedy that.

"Technology plays a critical role in our comprehensive efforts to address our nation's prescription drug abuse epidemic," said Gil Kerlikowske, director of National Drug Control Policy (ONDCP). "Together with education, proper disposal practices, and enforcement, improving existing prescription monitoring programs is a priority for this administration. We hope these innovative pilots will help usher in an era of 'PDMPs 2.0' across the nation to improve real time data sharing among, increase interoperability of data among states, and expand the number of people using these important tools."

In Indiana, the pilot project will look at how immediate access to a patient's controlled substance prescription history affects prescribing in emergency departments. HHS pointed out that EDs are responsible for almost a fourth of all controlled substance prescriptions in some states.

The Ohio pilot project will look at how clinical decision making is affected by having a drug risk indicator in the electronic health record.

At this point, states differ greatly in the use and easy availability of PDMPs. According to an HHS report, the "Action Plan for Improving Access to Prescription Drug Monitoring Programs through Health Information Technology," authorized users in many states have direct access to the online system and can generate reports within seconds or minutes. In states that also allow fax requests, responses can take 1 to 2 days because requester information must be authenticated. For other states with exclusively manual systems using the U.S. mail, a response can take 2 weeks.

Other ways in which states vary is the ability to access PDMP data without logging on to a separate system, and the ability to send secure messages to pharmacists and other providers about patients who may be obtaining prescriptions at multiple locations.

The ONC is seeking to resolve the discrepancies through the pilot sites and other programs.

In one of those, the National Association of Boards of Pharmacy have been working with state prescription monitoring program administrators to develop PMP InterConnect to facilitate the transfer of PDMP data across state lines. Connecticut, Indiana, Kansas, Mississippi, North Dakota, Ohio, South Carolina, Virginia, and West Virginia have all signed memoranda of understanding as a first step in participating, according to HHS.

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