Prescription drug monitoring system soon to go live

Network will link Kansas doctors and pharmacists to digital patient histories

0 | Health Care Delivery, HIE-HIT

Pharmacist Sally Heilman (left), intern Alexa Hon and pharmacist Mark Smith process incoming prescriptions at Orchards Drug, 1410 Kasold Drive in Lawrence. Beginning early next year, Kansas doctors and pharmacists will be linked to a prescription drug monitoring system known as K-TRACS.

Pharmacist Sally Heilman (left), intern Alexa Hon and pharmacist Mark Smith process incoming prescriptions at Orchards Drug, 1410 Kasold Drive in Lawrence. Beginning early next year, Kansas doctors and pharmacists will be linked to a prescription drug monitoring system known as K-TRACS.

— As part of a growing national effort to prevent prescription drug abuse, the Kansas State Board of Pharmacy will soon launch a computerized monitoring program designed to give doctors and pharmacists near-instant access to patient drug histories.

“This is part of a national push that’s been going on for a few years,” said Christina Morris, director of the monitoring program. “Kansas’ legislation was enacted in 2008, but the funding didn’t come through until September of 2009. We selected a vendor, and we got our regulations in place last September.”

The Web-based monitoring system chosen by the board is called RxSentry, a product of Health Information Designs, which is headquartered in Auburn, Ala.

The company also provides drug utilization services to the Kansas Health Policy Authority and prescription monitoring services to government agencies in 10 states.

K-TRACS

If all goes as planned, in February prescribers and dispensers will begin forwarding information to the database, which will be called Kansas Tracking and Reporting of Controlled Substances or K-TRACS.

Physicians and pharmacists will be able to retrieve information from the database in April 2011.

Law enforcement access to the database will be subject to formal, written requests.

At first, physicians and pharmacies will be required to forward information on a weekly basis. After Jan. 1, 2013, they will be required to submit information daily.

“This is about trying to prevent the misuse and abuse of prescription drugs, to improve pain management and to give prescribers and dispensers more accurate information,” Morris said.

The pharmacy board, she said, will send notices to pharmacies and physicians when their patients are found to meet “certain thresholds such as seeing five or more physicians or five or more dispensers in a six-month period.”

Seeing many doctors and/or pharmacists in a short time is considered a red flag for possible prescription drug abuse.

Those notified will be asked to confirm whether they wrote or filled the prescriptions and to discuss the notice with the patient.

Max Heidrick, a Beloit pharmacist and a member of the pharmacy board’s monitoring program advisory board, said the database will likely benefit physicians more than pharmacists.

“If we’re filling an inordinate number of prescriptions that involve controlled substances, we’re already monitored by our wholesalers,” Heidrick said. “I think this will be a great tool for us, but really it’s the physician who runs into a lot of suggestive medicine, people saying ‘This is what works for me.’

“In other states where they’re doing this already – like in Ohio and Kentucky – 80 percent of the people using it (to tap patient records) are physicians,” he said.

Kansas is one of 43 states with laws that allow the monitoring of drug prescriptions. In 34 states, systems are already up and running.

“I kind of feel like there are 34 states ahead of us,” Heidrick said. “But it’s taken us this long to come up with the funding.”

The program is being underwritten by a pair of $400,000 grants from the U.S. Department of Justice and more than $130,000 from the federal Substance Abuse and Mental Health Services Administration.

Two people will be hired at the pharmacy board to help run the program, Morris said. And the board has moved into a larger space to accommodate the new workers.

More drug deaths

According to the Kansas Department of Health and Environment, deaths attributed to overdoses known to have involved prescription drugs have increased from 22 in 1999 to 113 in 2007.

The agency’s report said “preliminary numbers” point to 124 prescription drug deaths in 2009.

In Kansas, since 2001, deaths involving prescription drugs have outnumbered those involving heroin, cocaine and tranquilizers.

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Christina Morris of the Kansas State Board of Pharmacy.

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Morris said the plan is for Kansas to join other states in compacts designed to give physicians and pharmacists in nearby states access to each other’s databases. That could happen as soon as next year.

It’s troubling, she said, that neither Missouri nor Nebraska has a prescription drug monitoring program.

“I see that as a problem,” Morris said, “but, federally, there’s going to be a big push to get programs going in all the states. I’ve already had some calls from Nebraska.”

Oklahoma, she said, already requires daily reporting.

In Colorado, the information is submitted on a bi-monthly basis.

In other states, civil liberties groups have raised concerns about the monitoring programs’ potential for violating patient privacy.

In Kansas, Morris said, anyone caught accessing information they are not authorized to see will be subject to prosecution and fines.

“It’s considered a felony,” Morris said.

Most of the state’s pharmacists already have access to the prescription histories of patients who have health insurance, said Mike Larkin, executive director of the Kansas Pharmacists Association.

“If, for example, you have Blue Cross Blue Shield, your pharmacist can already look to see what prescriptions you’ve had filled – assuming you used your insurance to pay for them,” Larkin said. "So from our perspective, a lot of this information is already available, but we know it’s something that needs to happen. Where it’s really going to make a difference is in the emergency room when a physician gets someone who appears to have overdosed on something and they have no idea what and for whatever reason, the patient can’t tell them.”