The prescription monitoring programs (PMPs) throughout the country are probably the single most innovative help in years to law enforcement trying to deal with pharmaceutical diversion issues. Although some of the states’ systems are not as friendly to law enforcement access, those that are provide a wealth of easily accessible information for potential prosecutions.
Prescription Databases
However, until now, the one thing that has been lacking in all of these PMPs has been the data being produced and stored in our veterans’ hospital prescription database. The announcement was made that by April 2013, state PMPs will be able to access the pharmaceutical history kept at Veterans Affairs (VA) hospitals or have it dumped into their databases.
I have no idea what the actual numbers are that are being kept in the VA databases, but my guess is that they are rather voluminous. There is no question that a considerable number of “doctor shoppers” and other prescription drug seekers have gone unprosecuted due to state and local law enforcement not having the entire prescription profile of the possible offender. This new move by the VA will likely fill the large gap that exists now.
Of course, the addition of these databases will also assist countless health professionals who access their state PMP every day in an attempt to provide the best possible health care for their patients. They, too, will now have a more accurate view of the patient in front of them—and can make even better decisions when it comes to the prescribing or dispensing of controlled substances.
Health Care Fraud
When I testified for Ohio’s PMP many years ago, I stressed the fact that the program would also reduce health care fraud. Adding the VA information to the state PMP databases will also potentially reduce health care fraud in both state and private health care programs and the VA itself. This is, of course, if law enforcement and regulators are aggressive in rooting out these folks with this additional tool.
Some of you may remember the old way we obtained prescription drug profiles: through facsimile programs and good old shoe leather! This seems archaic compared with today’s almost instantaneous computerized response from our PMP programs. No doubt, our efforts in those days, although well intentioned, fell sorely short as far as being efficient.
Automated Reporting
Ohio’s program, called the Ohio Automated Rx Reporting System, like those of many states near us, is incredibly efficient. Our investigators send in their request, which comes to their supervisor, who approves or disapproves the request. Once approved, the information almost immediately becomes available to the investigator. If supervisors are at their computers when the request is made and promptly approve the request, the whole transaction can take less than 5 seconds.
This is a far cry from waiting hours and sometimes days before pharmacies could respond to your requests by fax. The other issue was that many of the fax machines if co-located in a grocery store went to the grocery office—the location of the only fax machine in the building! I never understood this—it was as if the pharmacy couldn’t be trusted with a fax machine or there were no money for 2 fax machines, even though the pharmacy faxes very well may have contained private patient information. I assume that situation is a very rare occurrence today, although fax machines seem to be destined to be a thing of the past soon, along with our daily newspapers.
I am not sure who is responsible for this decision to add the VA database into state PMPs, but I certainly applaud it. I often criticize the federal government for its bureaucracy and inability to make decisions. But in this situation, although it has taken a few years, the decision will have a positive impact in one of the most prolific drug problems in the United States. Ultimately, this will have a positive impact on legitimate patients, and may just save a few addicts’ lives in the process—both a good thing.