PCMS_Philadelphia_Medicine_Spring2018 - 30

p h i l a m e d s o c .org

FEATURE

A Faster, Easier Way to Access the
Prescription Drug Monitoring Program
By Eric Corkhill, President & Chief Revenue Officer at Prescription Advisory Systems & Technology

Six years ago, Dr. Skip Leeds was
frustrated with his PDMP reports. Dr. Leeds,
an Assistant Professor of Family Medicine at
Wright State University Boonshoft School
of Medicine and staff MD at Wright State
Physicians, had lost both friends and family
to drug addiction. He wanted to make use
of the valuable information contained in
his patient's PDMP reports, however, the
time and effort to access and understand
the PDMP report meant he was able to
look at only a fraction of his patients. He
knew the scope of the Opioid addiction
problem was bigger than the population
he was able to review.
Dr. Leeds turned to a lifelong friend who
happened to be a career software developer
and the two of them created Prescription
Advisory Systems & Technology (PastRx), a
company solely committed to making PDMP
data easier to both access and understand.
Dr. Leed's fear was correct and six years
later it's hard to go a day without being
confronted with another announcement or
article with frightening statistics regarding
the Opioid epidemic:
* 64,000 drug overdose deaths in 2016
* Leading cause of death for people under
50 years of age
* National Public Health Crisis
As with any crisis, there is lots of blame to
go around. Some accuse the pharma industry
and the early flawed research regarding the
non-addictive nature of opioids. Others point
to the CDC and Joint Commission labeling
30 Philadelphia Medicine : Spring 2018

pain as the "fifth vital sign" which established
an "alleviate all pain" approach to patient
care. There have even been economic factors
at work with CMS's Value Based Purchasing
incentives/penalties reinforcing eliminating
pain as an element of their HCAHPS patient
satisfaction survey process.
And yes...we still have some doctors who
routinely over-prescribed opioids without
proper review of controlled substance history,
unintentionally addicting a new generation
to opioids or cheaper street drugs. However,
this discussion isn't another analysis of how
we got here, but rather where and how we
move forward.
Federal and State Actions
Despite press headlines, much of the
Federal response has been limited to political
posturing and far too little money for
diagnosing and preventing addiction. Three
cheers for doctor or first responder who
was able to pull a patient back from the
precipice with Naloxone. Wonderful that
we are getting additional funding for more
Suboxone treatment centers to manage an
addicted population. But where is the money
to help doctors identify problem patients
before they are hopelessly addicted? Money
for this side of the equation truly fits the
adage of "an ounce of prevention is worth
a pound of cure."
State PDMP Programs
The National Board of Pharmacy and
state legislators have weighed in with both
money and a tool. Every state has now rolled

out a Prescription Drug Monitoring Program
(PDMP) to help identify problem patients
(and problem doctors and pharmacies) before
needing lifesaving heroics. States are now
making it easier to share prescription data
across their borders with neighboring states.
PDMP challenges
PDMP reports are packed with vital
information about a patient's controlled
substance history. What are the patient's
active narcotic prescriptions, when were
they prescribed, what is the combined
impact (MME level) of multiple opioids,
who prescribed or distributed them, where,
when, etc.? However, there are two primary
problems in using a PDMP report - getting
to it and uncovering what's in it.
In order to access a report, a doctor
has to launch the state's PDMP browser
and manually enter their user name and
password, and then enter the required
patient information. This process is many
times repeated one patient at a time. This
manual process takes precious time and
is performed outside of the normal EHR
workflow making it both disruptive and
unproductive.
But once a prescriber has access to the
report, they don't have the time to thoroughly
understand what's in it. PDMP controlled
substance history is presented in a nongraphical, dense columnar representation.
This causes most doctors to simply glance
at the list of active narcotics and skip over
substantive and valuable data.

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