Prescription Monitoring Information Exchange (PMIX) Prescription Drug Monitoring Program 2010 West Regional Meeting Chris Baumgartner Program Coordinator ASPMP
Why PMIX? The BJA/IJIS PMP Committee Prescription Monitoring Information Exchange Project Status State Considerations and Planning Discussion/Q&A Contents
The Need Abusers/diverters not constrained by state borders Common requirement from PMP users is to see data from additional states Controlled substances dispensed within a state prescribed throughout the country
Kentucky - Out of State Rx s 2009
Why PMIX? 50+ State / territory programs States have different problems, resources and approaches States have proven track record for collecting and providing data Implement a national-level PMP data sharing solution with state-level control
The Florida Example
The Florida Example
BJA/IJIS PMP Committee
BJA IJIS PMP Committee State Members Danna Droz Ohio Daniel Eccher Maine Dave Hopkins Kentucky (Co- Chair) Donna Jordan Alabama Ralph Orr Virginia Xaviel Soto Connecticut
BJA IJIS PMP Committee Vendor Members Steve Bruck Watson Escarment Eric Jakstadt BruckEdwards, Inc. (Co-Chair) RelayHealth Trusted Federal Systems Sarvanan Mani Infinite Solutions Liz Pearson URL Integration Shan Ramachandran Optimum Technology Winfield Wagner Patriot Data Solutions Group
BJA IJIS PMP Committee Federal Advisors Ruby Qazilbash BJA Rebecca Rose BJA Chris Traver BJA Bonnie Konopka DEA Terry Zobeck ONDCP Nick Reuter SAMHSA
BJA IJIS PMP Committee Affiliate and Partner Advisors John Eadie Brandeis PDMP COE Jim Giglio ASPMP Sherry Green NAMSDL Cynthia Gunderson Indian Health Service Bill Lockwood ASAP
BJA IJIS PMP Committee Project Manager Scott Serich IJIS Institute
PMIX Project Status
PMIX Primary Goal Implement a standardized, secure, scalable approach for the exchange of electronic PDMP data among states Utilize PMIX Hub to provide focal point for common design and execution
NIEM The National Information Exchange Model (NIEM) is designed to foster a common vocabulary as part of an inter-enterprise architecture to support seamless information exchange. Identify information sharing requirements Develop standards, common lexicon and on-line repository of information exchange package documents to support information sharing Provide technical tools to support development, discovery, dissemination and re-use of exchange documents Provide training, technical assistance and implementation support services for enterprise-wide information exchange
BJA/IJIS PMIX Phase 2 Successfully demonstrated a pilot point-to-point exchange of PMP information between California and Nevada on May 31, 2007 Created initial set of reference documents describing a standard data model for the exchange
BJA/IJIS PMIX Phase 3 PMIX Hub Server installed at Ohio BOP Information Exchange Package Document (IEPD) for exchange model completed Initial definition of Hub Server specifications Interface Control Document Cost Recovery Model Demonstration of request and response through PMIX Hub using test data completed September 24, 2009
BJA/IJIS PMIX Phase 3 Extension Objectives Upgrade PMIX Hub Server to support exchange of actual PDMP data Design/implement security standard Two levels of encryption Update Interface Control Document Implement production pilot exchange of data between Kentucky, Ohio and other states Facilitate establishment of PMIX Users Group
BJA/IJIS PMIX Phase 3 Extension Status MOU for exchange of real data in place between KY and OH Project kickoff conference call conducted March 15, 2010 Security design contract proposals received April 2, 2010 States/vendors working on PMIX interface software States/vendors modifying PDMPs to support production data exchange
State Considerations and Planning
Business Considerations Confirm state statutes/regulations allow for PMP information exchange Document demand to help justify PMIX participation to legislators and state officials Plan for Memorandums of Understanding (test data/actual data) Review cost model and PMIX reference documents to support development and operational cost estimates Utilize BJA Grants to support participation
Design Considerations Access via Web Services (Internet) All state PMP PHI data will remain encrypted while passing through the Hub. No state data stored at the Hub Each state controls their exchange parameters Exchange state partners Allowable exchange entities (e.g.; prescriber types, law enforcement, etc.) Report format (e.g.; allow records to be sorted in with other states; or presented as stand-alone report)
Design Considerations (cont.) Graphical user interface to your PDMP Allow selection of states for requesting data Requesting state authenticates users Requires PDMP system logic to create requests to Hub and process responses from Hub Including displaying data to end user Web services to control Internet access between PMP and Hub Security; two levels of encryption Request/response message encryption (SSL) PHI data/report encryption (PKI)
What s Required to Test? States may require an MOU with each state with whom test data will be shared States must agree on payload content; which fields will be required and optional in the requests to the disclosing state responses from the disclosing state States can test now!
What s Required to Test? (cont.) PMIX code changes to state PDMP system User interface enabling requests for data from other states Build the XML request Invoke the appropriate Hub Web service State PDMP Web service to receive [and briefly store] the responses from multiple disclosing states User interface to display data from multiple states
What s Required to Test? (cont.) Development of test data with exchange partner state(s) Establishment of state PDMP Hub administrator account with Ohio State Board of Pharmacy (PMIX Hub administrator) Coordination of exchange partner HUB authorizations with exchange partner state(s) Coordination of PMIX Hub test time with Ohio State Board of Pharmacy
What s Required to Exchange Real Data? Identify partner states Develop MOU with partner state(s) to exchange real data Consider recruiting target users for small pilot Additional PMIX code changes Hub interface changes per new ICD (e.g., error handling) Encrypt patient data payloads per Hub security design standard
Cost Model Designed to help forecast PMIX Hub life cycle costs; and can also be used to assist states with planning and budgeting their hardware, software and staff costs for PMIX participation Assumes participating states will support PMIX Hub costs Establish annual base fee for participating states Base fee will decline as more states participate Establish annual usage fee based on number of prescribers within each state
Interstate Compact National Advisory Panel convened by Council of State Governments Explore use of interstate compact to promote PDMP data sharing Goal: To provide a framework for state administered prescription drug monitoring programs to securely share data to improve public health and safety.
Interstate Compact (cont.) Phase I development of compact statutory language targeted for late spring 2010 Initial draft completed February 23, 2010 Seeking federal sponsorship and funding (BJA, SAMHSA) Phase II promotion and education for state legislators and officials throughout 2010. Enactment starting during 2011 legislative sessions Phase III transition and operation upon meeting enactment threshold of six states
Interstate Compact (cont.) Interstate compact would address: Governance and structure Authorized use and access to data Technology and security Funding Interstate Commission Powers and duties Organization and operation Rulemaking functions Oversight, enforcement, dispute resolution Financing Withdrawal and dissolution
Questions/Discussion