The number of deaths in the U.S. related to prescription drug overdose has reached epidemic proportions, according to the Centers for Disease Control and Prevention (CDC). This emerging epidemic has led to the advent of prescription drug monitoring programs (PDMPs) — statewide electronic databases that collect data on controlled substances dispensed in the state.
Health care providers can use PDMPs to identify and intervene in cases of potential prescription drug abuse, but many are not using them. In most states, less than 20 percent of the authorized physicians utilize the PDMP in their state, according to the Action Plan for Improving Access to Prescription Drug Monitoring Programs through Health Information Technology. The Action Plan was formulated by the Prescription Drug Abuse and Health Information Technology (HIT) Work Group in 2011 as a follow-up to the Enhancing Access to PDMPs Project that stemmed from the White House Roundtable on Health IT and Prescription Drug Abuse in June 2011, according to a press release from the U.S. Department of Health & Human Services.
The problem is that in many cases, access to PDMPs does not fit in well with existing workflows. This means that all the useful information being collected by PDMPs is currently “trapped” and not getting where it needs to be in time for intervention.
As a result of the work group’s efforts, the ONC launched 2 pilot programs that will take place in Indiana and Ohio to measure the effects of expanding and improving access to PDMPs.
The Indiana pilot will demonstrate how emergency department staff can receive a patient’s controlled substance prescription history directly through the Regenstrief Medical Record System (RMRS), a care management system used by Wishard Health Services, a community health system in Indianapolis, and other hospitals.
The Ohio pilot project will test the impact of having a drug risk indicator in the electronic health record and how that affects clinical decision making.
The pilot projects fit in with the goal of the Action Plan, which is not to create any new systems, but to leverage existing — and emerging — health IT to generate more value from the PDMPs already in place. The aim, as noted in the Action Plan, is to enable “a ‘machine to machine’ communication that does not necessitate action by the provider,” so existing workflows are not disrupted.
This type of non-disruptive health data access would be applauded by health IT experts like Patrick Howard, who recently lamented one aspect of the state of New York’s decision to approve the Internet System for Tracking Over-Prescribing Act (I-Stop). This system, said Howard, will disrupt workflows for physicians and pharmacists by requiring them to access health data via a database that is completely separate from the systems used in their existing practice.