Friday, January 30, 2015

Closing the In-state PMP Loop

By Doug Brockway
January 30, 2015

A key weakness with Prescription Monitoring Programs, PMPs, is they do not capture and immediately make use of the act of writing a prescription. There is no PMP record of a prescription as it is written.  With PMPs data are only collected by the pharmacist for prescriptions filled.  The pharmacy often has a week, usually more time, to enter the data.

As a result a PMP cannot detect potential diversion prior to dispensing.  One doctor hears you have back difficulties, the next is told that your shoulder hurts.  Each can write you a prescription without knowing of the other’s action. You can see doctor after doctor for at least a week before anyone notices. 

If in your state the pharmacist has more than a week to submit information on a prescription the window for mischief is wider. Sometimes the doctor shopping is done by an individual trying to satisfy an addiction or generate some cash.  More insidiously are the diversions done by coordinated groups intent on the resale of prescription pain killers to the innocent and the unsuspecting.

As noted elsewhere, PMPs are not notable for their user experience.  They cause significant delay in process when only used for look-up purposes by doctors.  What is needed is a very efficient-for-the-user method to capture prescriptions, in real time, and feed that data to a central data base, presumably a PMP, for use in closing the in-state PMP loop. 

This either means wholesale re-write/replacement of PMPs or the use of a “surround strategy;” putting a superior data collection capability, a “wrapper” around the existing systems[1].  If this is done then PMPs will be far more suitable to our goals of opiate abuse prevention than they are now.

[1] Capabilities of this sort, CMS-tested, are available:

No comments:

Post a Comment