By Michael Burger, Senior Consultant

Prescription drug monitoring programs (PDMPs) were created in 2002 as a tool to help address the growing problems of prescription drug abuse and diversion. PDMPs are independent, state-run databases of controlled substance prescriptions from the range of dispensers. Data include quantities of and to whom controlled substance medications have been dispensed. All states, except Missouri, have a PDMP. Despite their promise, PDMPs are data silos and lack interoperability. (For more information, see the article in the April HIT Perspectives.)

States are increasing requirements to check the PDMP before a prescription is written or dispensed. State and federal policymakers also have begun to recognize that it’s time to make PDMPs more interoperable and useful in fighting the war against substance abuse.

Here are six things EHR vendors can do to get ready for integration with PDMPs.

1. Keep current with growing mandates. EHR vendors should be aware of rapidly emerging state and federal PDMP activities and regulations to ensure their products are compliant. By being proactive, vendors reduce the risk of being caught short and potentially losing revenue and market share. A challenge for prescribers is that PDMP access is typically via a standalone web portal, not a built-in feature of the EHR work flow. As demand for easier access grows due to regulatory requirements, EHRs should soon begin to be interoperable with individual states’ PDMP databases to both meet customer demand and regulatory compliance
2. Know who’s in charge. Because PDMPs are state sponsored, a variety of state agencies are responsible for their administration. EHR vendors need to know who’s in charge in the states where their products are used so they can keep abreast of the evolving regulatory requirements.
3.  What about the PMIX? Instead of the transactions and data exchange standards normally used by EHRs, PDMPs use the Prescription Drug Monitoring Program Information Exchange (PMIX). PMIX is a national, interoperable architecture that supports the sharing of PDMP data by various “hubs.” EHR vendors need to be mindful of how their products will integrate with the PMIX architecture and related standards until the federal government promulgates a national interoperability standard, which won’t happen anytime soon.
4. Keep up with harmonization efforts. There are inherent differences in PDMPs from state to state, including when and how they may be accessed and the use of PMIX to share data. Recognizing these differences and the challenges they present, the federal government has initiated standards and harmonization efforts through the S&I Framework (see the web page for more information).
5.  Check business agreements. As EHRs need to connect with PDMPs and share data, vendors may need to create or revisit business agreements with individual PDMPs and data hubs. They should address data collection, use, privacy, disclosure, storage and other aspects of PDMP data exchange.
6. Don’t forget about EPCS. Electronic prescribing of controlled substances can be a useful tool to help prescribers identify potential substance abuse and doctor shopping — before the PDMP is checked and prescriptions are written electronically through the EHR. Medication history often will provide valuable information about previous controlled substance prescriptions paid for by insurance as well as where they were filled. This makes EHRs a powerful, value-add tool, which physicians and policymakers can get behind.

Point-of-Care Partners can help you keep up with current events regarding PDMP, including state mandates and what needs to be done to integrate EHRs and PDMPs. For starters, check out our regulatory resource center, which makes it easy for you to stay current with state and federal regulatory actions.