By Daniel Cidon, CTO of NextGate
Twitter: @NextGate
Twitter: @dcidon
Established in nearly every state across the nation, prescription drug monitoring programs (PDMPs) are used to track the prescribing, dispensing and use of opioids and other controlled substances. At its core, PDMP databases help providers identify patients at-risk for prescription drug abuse and facilitate opportunities for intervention, medication reconciliation and reduction of controlled substance prescribing.
However, for PDMPs to thrive, the Rx information that is recorded, stored and analyzed must be exceedingly reliable and complete. If we are to curb the nation’s opioid crisis, which is now the fifth leading cause of death in the U.S., the data must be consistently and correctly matched to the right individual for informed decision-making and effective care management.
Accurate patient matching and identification constitutes a PDMP’s internal capacity to connect and analyze prescription data while linking that information externally to an individual’s health record. Currently, there is no universal standard for matching individuals in PDMP data.
Earlier this month, the Office of the National Coordinator for Health Information Technology (ONC) held a one-day symposium on patient matching for PDMPs, which brought together government officials, pharma leaders, health IT developers, standards development groups, and other stakeholders to discuss patient identification challenges and opportunities for accelerating prescription data interoperability. Here are three take-aways:
Patient matching issues are not unique to hospitals and health systems
Just as health systems and hospitals rely on comprehensive health records for better clinical, operational and financial outcomes, PDMPs depend on facilitating a complete picture of a patient’s care history for informed clinical decision-making and interventions.
Patient matching and interoperability are critical aspects for PDMPs, and many continue to struggle with fragmented information and lack of substance use history in an individual’s health record. While states have made PDMPs easier to access and use, the ability to link and share records across multiple pharmacies remains an ongoing challenge. For physician practices located near a neighboring state boarder, the issue becomes even more difficult since the information available about an individual’s “in-state” activity may only represent a fraction of their prescription use.
HIEs can aid patient identification efforts for PDMPs
PDMP integration with state health information exchanges (HIEs) can enable the needed interoperability for a complete and historical record of care. When clinicians and pharmacists can complement their PDMP data with extensive clinical data offered by the HIE, they can make more informed care decisions and apply data-rich insights into one’s treatment plan.
Further, many HIEs, including healtheConnect Alaska, utilize patient identification technologies like an enterprise master patient index (EMPI) to facilitate patient record matching and connect with the state’s PDMP to give providers access to an accurate, comprehensive picture of a patient’s prescription history. The EMPI consolidates records from multiple sources, locations and settings of care into a single view.
Workflow and lack of standardization remain key barriers
When PDMP information is not easily accessible, or seamlessly integrated with state’s HIE, it creates significant workflow issues for prescribers.
Because PDMP data is not readily available in the EHR—and currently not federally required—clinicians must take extra steps to leave the screens in an EHR, log into the PDMP and run a patient search. Utilization of PDMPs is thus slowed and workflow is disrupted.
In addition, information in the PDMP is presented in a disorganized manner, creating a scavenger hunt of sorts for prescribers. The fragmented nature of the data makes it difficult to detect a prescribing issue, posing a risk to both the patient and prescriber.
Further, lack of widely agreed-upon technical standards for prescription data collection to support patient matching and interoperability compounds the issue.
Every day in the United States, nearly 50 people die from an overdose involving prescription opioids. The good news is, PDMPs have not only helped to lower the number of opioids prescribed, they have also lowered the rate of opioid-related inpatient stays and emergency department (ED) visits.
Timely access to accurate, comprehensive patient data is essential for clinicians and prescribers to make informed care decisions and interventions. Better use of information technology to provide high-quality information at the point of treatment is imperative for managing prescription data and combating the opioid epidemic. As longitudinal medical records and robust interoperability become imperative for population health management and value-based care, the need for patient matching and identity management technologies, like EMPI platforms, will become progressively in-demand.
This article was originally published on the NextGate Blog and is republished here with permission.