11/26/2012. Implementation of Florida s PDMP. Disclosure

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1 Implementation of Florida s PDMP Rebecca R. Poston Program Manager December 1, 2012 Disclosure I have no vested interest in or affiliation with any corporate organizations offering financial support or grant money for this continuing education program, or any affiliation with any organization whose philosophy could potentially bias my presentation. 1

2 OBJECTIVES Provide overview of Florida s Prescription Drug Monitoring Program regulations Discuss data reporting requirements Demonstrate health care practitioner registration Demonstrate health care practitioner Query~ Patient Advisory Report Discuss outcomes BACKGROUND The purpose of the PDMP is to provide information collected in the database to health care practitioners to guide their clinical decisions in prescribing and dispensing these highly-abused prescription drugs. 2

3 DEFINITIONS Section (1), F.S.: A dispenser means a pharmacy, a dispensing pharmacist, or a dispensing health care practitioner. A health care practitioner means any practitioner who is subject to licensure or regulation by the department under chapters 458, 459, 461, 462, 464, 465, or 466, F.S. DEFINITIONS CONTINUED Section (1), F.S.: Administer means the direct application of a controlled substance, whether by injection, inhalation, ingestion, or any other means, to the body of a person or animal. REPORTING REQUIREMENTS Pharmacy and dispensing practitioners must report within 7 days of dispensing a controlled substance in schedules II, III and IV to an individual Mandatory reporting began September 1, 2011 E-FORCSE requested dispensers report retroactive data from December 1, 2010 >53 MILLION records in database. 3

4 REPORTED INFORMATION Patient Demographics Date of Birth Gender Prescriber Demographics DEA Number NPI Number State License Number Pharmacy DEA Number Rx Number Date written, date filled Refill Number Drug Name Strength Dosage Form Quantity Payment Type CS INFORMATION NOT REPORTED If administered directly to a patient during that particular treatment session; If administered to a patient receiving care in a hospital or emergency room, nursing home, ambulatory surgical center, hospice, intermediate care facility for developmentally disabled; If administered or dispensed in the health care system of the Department of Corrections; If administered or dispensed to a patient less than 16 years of age; If dispensed one-time 72-hour re-supply to a patient; If prescribed by a health care practitioner; or If prescribed or dispensed by a health care practitioner in a DOD/VA facility. PENALTY FOR NON-COMPLIANCE A health care practitioner who willfully and knowingly fails to report the dispensing of a controlled substance as required by section , F.S., commits a first degree misdemeanor. 4

5 AUTHORITY TO ACCESS THE DATABASE Section (7)(b), F.S.: A pharmacy, prescriber, or dispenser shall have access to information in the prescription drug monitoring program s database which relates to a patient of that pharmacy, prescriber, or dispenser for the purpose of reviewing the patient s controlled substance prescription history. PUBLIC RECORD EXEMPTION Section , F.S., any person who willfully and knowingly violates this section of law by sharing confidential protected health information commits a felony of the third degree. ACCESSING THE RxSENTRY SITE RxSentry site: 5

6 Requesting an account Creating query requests Viewing query request status Generating reports Viewing patient records 6

7 LOGGING ON TO FL RxSENTRY User Name: newacct Password: welcome 7

8 Patient Advisory Report Request QUERY SITE Click Query Site Type in User ID Type in Password Click OK License # PDMP Menu 8

9 PRACTITIONER DISCLAIMER PRACTITIONER QUERY SCREEN PRACTITIONER PATIENT SELECTION 9

10 VIEW QUERY STATUS Approved/Queued- the query has been approved and is processing Approved/Done- the query has been approved, processed, and is available for viewing PATIENT ADVISORY REPORT 10

11 VIEW PATIENT ADVISORY REPORTS Open open the report for viewing and printing (if desired) Save save the report to a specific location for viewing and printing (if desired) at a later time. Cancel 11

12 PERFORMANCE MEASURES Outcome: Reduction of the rate of inappropriate use of prescription drugs through education and safety efforts Measure: The number of licensed prescribers, dispensers, and individuals authorized to conduct investigations that were trained in the use of the state's PDMP system. Controlled Substance Prescriptions Reported by Dispensers Number of Pharmacies / Dispensers who have reported to the PDMP 6,391 Number of prescription records reported to the PDMP 55,041,371 NUMBER OF PDMP REGISTERED USERS Healthcare Practitioners 18,385 Law Enforcement Officers 546 TOTAL 18,931 12

13 NUMBER OF PATIENT ADVISORY REPORT REQUESTS= 2.5 MILLION PERFORMANCE MEASURES Measure: The number of coroner reports that indicate controlled substance prescription drug use as the primary or contributing cause of death. 1 13

14 PERFORMANCE MEASURES Outcome: Reduction of the quantity of pharmaceutical controlled substances obtained by individuals attempting to engage in fraud and deceit. Measure: The number of individuals obtaining controlled substance prescriptions from X or more prescribers and X or more pharmacies in a 90 day period. 2 14

15 DOH RULEMAKING Rule 64K-1, Florida Administrative Code Rule Promulgation 64K Indicators of Controlled Substance Abuse System Enhancements Update User Profile 15

16 SYSTEM ENHANCEMENTS Interstate Data Exchange States Number of Prescriptions Issued by Florida Prescribers 2009 Alabama 116,000 Louisiana 16,000 North Carolina 48,000 South Carolina 28,000 Arizona 14,000 Vermont 1,700 Total 223,700 Future System Enhancements Integration into Clinical Workflows 16

17 Future System Enhancements Integration into Electronic Health Record Primary Care Practice Future System Enhancements Real Time Data Reporting Presentation Summary Reviewed Florida s Prescription Drug Monitoring Program regulations Discussed data reporting requirements Demonstrated health care practitioner registration Demonstrated health care practitioner Query~ Patient Advisory Report Discussed performance measures and program outcomes 17

18 Conclusion Physicians and pharmacists have queried 53 million records more than 2.3 million times to improve clinical decision making, help reduce diversion and abuse of controlled substances and to assist in curbing the prescription drug abuse epidemic in Florida. PDMP must become a routine part of every clinical practice not because it s mandated, but because it makes good clinical sense. Future of PDMP includes building integration into existing workflow and technology, interoperability of data between states, strengthening partnerships, and identifying sustainable funding. Questions How often does a pharmacy need to upload a or report dispensing information to the PDMP? a. 10 days b. 15 days c. 7 days d. Real time Questions True or False I am required to view my patient s specific controlled substance history prior to dispensing a controlled substance. 18

19 Questions What is the penalty for a health care practitioner that does not report their Schedule II-IV controlled substance dispensing data? a. Felony b. Misdemeanor Questions What is the penalty for disclosure of confidential information in the E-FORCSE database? a. Felony b. Misdemeanor Need Technical Assistance? Contact Health Information Designs, Inc. for Technical Support & Assistance: Phone: Website: 8:00 am 5:00 pm EST 19

20 Need Program Assistance? Contact E-FORCSE Program Staff for non-technical assistance Phone: Website: Rebecca Poston, Program Manager Erika Marshall, Program Operations Administrator and Outreach Director QUESTIONS? References 1. Medical Examiner s Commission, Drugs Identified in Deceased Persons by Florida Medical Examiners, 2011 Report, Florida Department of Law Enforcement available at Report_Final.aspx 2. Florida Department of Health, Prescription Drug Monitoring Program Annual Report 2012 available at on December 1,

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