South Dakota Prescription Drug Monitoring Program (SD PDMP) SD Academy of Physician Assistants Summer/Fall CME Conference September 6, 2012 Ron Huether, RPh, SD PDMP Kari Shanard Koenders, RPh, PDMP Director Learning Objectives Describe the extent of the current problem of diversion and illicit use of controlled substances. Describe the process of registering for On Line Access to the PDMP database. Discuss potential uses of PDMP patient profiles by prescribers. 1
SD PDMP This program has been established to improve patient care and to reduce diversion of dangerous drugs. Patient profiles from the PDMP database may be used by prescribers to supplement an evaluation of a patient, to confirm a patient s drug history, or to document compliance with a therapeutic regimen. Reports may be generated to aide prescribers, dispensers, and law enforcement in preventing illicit use of controlled drugs. State PDMPs VT WA OR NV CA MT ID WY UT CO AZ NM ND MN SD NY WI MI PA NE* IA OH IL IN WV VA KS KY MO NC TN OK AR SC MS AL GA ME NH MA RI CT NJ DE MD States with operational PDMPs AK TX LA FL States with enacted PDMP legislation, but program not yet operational HI *The operation of Nebraska s Prescription Monitoring Program is currently being facilitated through the state s Health Information Initiative. Participation by patients, physicians, and other health care providers is voluntary. 2012 The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 215 Lincoln Ave. Suite 201, Santa Fe, NM. 87501 This information was compiled using legal databases, state agency websites and direct communications with state PDMP representatives. 2
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Drug Induced Deaths From 2010 National Drug Control Strategy 4
Emergency Department (ED) Visits Involving the Nonmedical Use of Selected Narcotic Pain Relievers: 2004 to 2008* DAWN REPORT June 18, 2010 5
11 Goals of Prescription Monitoring Appropriate pain management Education and information Early intervention and prevention Investigations and enforcement Protection of confidentiality 6
Advantages of using PDMP Data in Evaluation High level of detail, including formulation, prescriber, and dispenser identifications Timeliness better than most other sources Statistical power (large enough numbers to detect small changes) Linkage of patient and provider data Lower cost Uses for Prescribers Prescription history of a current or a new patient Check for addiction or undertreated pain Check for misuse, multiple prescribers Check for drug interactions or other harm Use reports for compliance with pain contracts Prescription history of transactions linked to a DEA number Check for fraudulent scripts 7
Data Accuracy Another concern is the accuracy of the data. Will the information provided by the PMP be accurate? What if some of the information provided isn t for the client the information is requested for? Name Matching will help with this issue. Basically it searches and pulls together names that are similar in case someone is for example using John Smith and Johnny Smith. Software algorithms help do this. There may be up to a 10 day delay from the time the prescription is dispensed by the pharmacy until it is available in the database. Confidentiality/Security There are exceptions under HIPAA that allow PMPs to collect this information without patient consent There are stiff penalties for inappropriate access or disclosure of PMP information A thorough authentication process is required to register to get reports so that only those authorized have access to the data Appropriate security measures are put in place for physical access, hardware, and software Auditing is in place for all data requests 8
Provider/Pharmacist Access www.hidinc.com/sdpmp Provider/Pharmacist Access 9
Confirmation Email South Dakota Prescription Monitoring Program (PDMP) This email confirms that the South Dakota Board of Pharmacy has approved your request to access the South Dakota Prescription Drug Monitoring Database. If you are a physician, your user name is your DEA number (e.g. DE1234567). If you are a pharmacist, your user name is your state license number prefixed with SDRPH (e.g. SDRPH1234). You will receive a second e mail, within four hours with your temporary password, your account personal identification number (PIN), and the steps to follow to log on to the system. The authorized vendor supporting the department for South Dakota PDMP is Health Information Designs, LLC (HID). Please contact the HID Helpdesk for technical questions about the South Dakota PDMP. You can reach the HID Helpdesk Monday through Friday from 8:00 a.m. to 5:00 p.m., Central Time. Contact them by phone at 877 719 3122, or by e mail at sdpdmp info@hidinc.com. Confirmation Email This e mail confirms you are APPROVED by the South Dakota Board of Pharmacy to access the South Dakota Prescription Drug Monitoring Program (SD PDMP) database. It also contains your temporary password, your PIN, and the steps you must follow to log on to the system. Your temporary password is: Kei9taehae Your PIN is: 7222 Perform the following steps to log on to the South Dakota PDMP and establish your new password: 1. Open an Internet browser and type the following address: www.hidinc.com/sdpmp 2. Click the "Healthcare Provider" link located on the left menu. 3. Click the "Provider's Query Site" link located on the left menu. A logon window is displayed. 4. Type your user name (provided in a previous e mail) in the "User Name" field. 5. Type the temporary password (provided in this e mail) in the "Password" field. 6. Click "OK." 7. If this is your first log on to the PDMP, a message displays that your password has expired and must be changed. Click the "Change now" link at the top left corner of the RxSentry home page. 8. Type your temporary password in the "Current Password" field. 9. Type your new password in the "New Password" field. 10. Type your new password again in the "Confirm New Password" field. 11. Click "Submit." A message displays indicating that your password change was successful, and the RxSentry home page is displayed. NOTE: Your PIN is required if you contact the help desk to request assistance with a lost password or encounter any other type of account access difficulties. It is recommended that you store your PIN in a secure and easily retrievable location. If you do not know your PIN when you call the help desk, you will be required to re apply for access to the SD PDMP. 10
Provider/Pharmacist Query Provider/Pharmacist Query 11
Provider/Pharmacist Query Provider/Pharmacist Query 12
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Provider Consultation Q: Are health care providers restricted from consulting with other providers about a patient s condition without the patient s written authorization? A: No. Consulting with another health care provider about a patient is within the HIPAA Privacy Rule s definition of treatment and, therefore, is permissible. In addition, a health care provider (or other covered entity) is expressly permitted to disclose protected health information about an individual to a health care provider for that provider s treatment of the individual. See 45 CFR 164.506. Answer furnished by : Important Numbers Your PIN # required for assistance 877 719 3122 number you call for assistance 15 minutes: how long the query stays on the screen 14 days: how long the query is in the query status 180 days, your password will expire 14
SD PDMP Statistics Prescriptions in database 2011 (July Dec 2011) 411,326 2012 (YTD August 31, 2012) 707,133 Most prescribed substances (YTD August 31, 2012) Rxs Quantity Hydrocodone/APAP 191,284 10,738,270 Zolpidem 66,599 2,121,011 Lorazepam 55,891 2,638,801 Clonazepam 48,567 2,995,129 Alprazolam 34,614 2,209,068 SD PDMP Statistics Patient Facts (1/1/12 8/31/12) Patients using 10 or more prescribers: 141 Patients using 6 or more pharmacies: 105 15
SD PDMP Statistics Approved for on line access (9/4/12) Physicians 358 Pharmacists 431 PA 97 CNP 70 Dentists 39 Other 12 Contact Information Web site www.pharmacy.sd.gov Phone 605 362 2737 Fax 605 362 2738 Email kari.shanard koenders@state.sd.us or sdpdmp@state.sd.us Technical Assistance from Health Information Design sdpdmp info@hidinc.com 877 719 3122 16
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