Thursday, August 2, 2012

New PDMP in Texas: Right Direction, Still Work To Do

Texas has moved to the next phase of its implementatin of new PDMP technology and there is a lot to like about the new iteration. 

Up until now, prescribers in Texas had to manually request data from the PDMP that would arrive via mail days after the request.  The new system, now being rolled out to almost 90,000 practitioners in the state, is an online tool from which data can be accessed in minutes. 

Combine this with the reporting requirement that went into effect last September (pharmacies must report scripts to the database within 7 days), and this starts to look like a model PDMP program.  The full release is expected by month's end and will include pharmacists and other prescribers not included in this current phase of implementation. 

One weak point, however.  While reporting is mandatory, there is no requirement that physicians prescribing drugs must check the database at all.  This part of the program is voluntary.  Dr. Chris Schade, past President of the Texas Pain Society and a beta tester of the new PDMP, summed up the physicians' view: "What doctors don't want is an unfunded mandate requiring them to use the monitoring program." 

This is fundamentally about patient safety.  Are the pre-surgical verification steps outlined by JCAHO an "unfunded mandate"?  What about the commonly expected best practice of physicians washing their hands between patients?  These are things we do in the healthcare community to protect patients, physicians, and other stakeholders from the unintended consequences of case delivery.  I can't understand how that logic trail doesn't extend to prescribing opioids. 

Texas doctors, or appropriate physician-extenders, should be required (as they are in Kentucky, for example) to check the PDM database prior to writing a script for a schedule II narcotic. 

I know that will cost the docs money.  But if they don't do it, it might cost lives. 

On Twitter @PRIUM1

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