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Idaho Board of Pharmacy
Prescription Monitoring Program
Objectives
§ Outline the purpose and scope of the Idaho Prescription Monitoring Program (PMP)
§ Explain how to gain access and general
information about the PMP § Learn about Gateway and NarxCare
Prescription Monitoring Program
§ Established in 1997
§ Board of Pharmacy Rule 204
§ Uniform Controlled Substances Statutes § §37-2726 § §37-2730A
Rule IDAPA 27.01.01.204
“Specified data on controlled substances to be reported by
end of the next business day by all entities that dispense controlled substances in or into Idaho and prescribers that
dispense controlled substances to humans. Data on controlled substance prescription drug samples does not
need to be reported.”
(1) All controlled substances dispensed for humans shall be filed with the board…
(2) The board shall create, operate and maintain a controlled substances prescriptions database containing the information…
I.C. 37-2726
Methadone/Narcotic Treatment Program (NTP)
Clinics
Do not report to the PMP 42 CFR Confidentiality
(1) The board shall maintain a program to track the prescriptions for controlled substances that are filed with the board under section 37-2726, Idaho Code, for the purpose of assisting in identifying illegal activity related to the dispensing of controlled substances and for the purpose of assisting the board in providing information to patients, practitioners and pharmacists to assist in avoiding inappropriate use of controlled substances. The tracking program and any data created thereby shall be administered by the board.
I.C. 37-2730A
Rule IDAPA 27.01.01.204.01(a)(b)(c)
01. Online Access to PMP. Online access to the Board’s PMP is limited to licensed prescribers and pharmacists, or their delegates, for treatment purposes. To obtain online access, a prescriber or pharmacist, or their delegate must: a. Complete and submit a registration application and a written agreement to adhere to the access restrictions and limitations established by law; b. Obtain Board approval for access; and c. Be issued a user account, login name, and password.
Who can Request information I.C. 37-2726(2)
§ (a) Individuals employed by the boards
§ (b) Peace officers employed by federal, state and local
law enforcement enforcing law regulating controlled substances § (c) Authorized individuals under the direction of the
department of health and welfare
§ (d) A practitioner, licensed in Idaho or another state, having authority to prescribe controlled substances, or a delegate under the practitioner’s supervision, to the extent the information relates specifically to a current patient of the practitioner to whom the practitioner is prescribing or considering prescribing any controlled substance; § (e) A pharmacist, licensed in Idaho or another state,
having authority to dispense controlled substances, or a delegate under the pharmacist’s supervision, to the extent the information relates specifically to a current patient to whom that pharmacist is dispensing or considering dispensing any controlled substance, or providing pharmaceutical care as defined in the Idaho pharmacy act
§ (f) An individual who is the recipient of a controlled substance prescription or that individual’s attorney § (g) Upon the lawful order of a court of competent
jurisdiction. § (h) Prosecuting attorneys, deputy prosecuting attorneys
and special prosecutors of a county or city and special assistant attorneys general from the office of the attorney general § (i) A medical examiner or coroner who is an officer of or
employed by a state or local government, for determining a cause of death or for performing other duties authorized by law.
Sharing Data
37-2730A(4) Nothing herein shall prevent a pharmacist or practitioner from furnishing
another pharmacist or practitioner information obtained pursuant to and in
compliance with this chapter.
Delegates
§ 37-2726(6) § The board shall limit to four (4) the number of delegates
that a practitioner or pharmacist may permit to access the database under the practitioner or pharmacist’s supervision.
§ 37-2726(12) § …, "delegate" means a nurse, medical or office
assistant, or registered pharmacy technician who is designated by a supervising practitioner or pharmacist to access the database according to the provisions of this section and who must register with the state board of pharmacy for such access.
Registration
Click on “Create an Account”
https://idaho.pmpaware.net
Red Flags
§ Patient has insurance but requests to pay with cash § Patient travels a long distance to the prescriber
or pharmacy or, § Traveling with several others with similar
prescriptions
§ Patterns of early refills or statements suggesting abuse § Prescription appears altered or missing
key requirements of a valid prescription § Prescriptions are for highly abused
“cocktails” Example; combination of opiate, benzodiazepine, and muscle relaxant
Profile Requests from
65% Practitioners
30% Pharmacists
3% Law Enforcement
>1% Licensing Boards
>1% Other
State Programs 50 States have operational programs
1 Territory (Guam) and the District of Columbia
Map obtained from: Prescription Drug Monitoring Program Training and Technical Assistance Center. http://www.pdmpassist.org/content/pdmp-maps-and-tables
PMP Interconnect with Idaho
Alaska Massachusetts North Dakota Arizona Michigan Ohio Arkansas Minnesota Oklahoma Colorado Mississippi Rhode Island Illinois Montana South Carolina Indiana Nevada Texas Kansas New Mexico Utah
21 States
State PMP Regulations
Prescription Drug Monitoring Program Training and Technical Assistance Center http://www.pdmpassist.org/ National Alliance for Model State Drug Laws http://www.namsdl.org/
CDC Grant Idaho Department of Health and Welfare Division of Public Health
Idaho Board of Pharmacy Prescription Monitoring Program
PMP Gateway and NARxCheck Idaho Healthcare integration
What is Gateway?
§ PMP Gateway enables access to PDMP data integrated with the EHR workflow and § Is a multi-state query system to access a majority
of state and local PDMPs § Enables prescriber requests to be sent
automatically to all allowed PDMPs § PDMP Prescription History is accessible within
the prescriber workflow § The basic report or preferred NarxCarereport,
with data-analyzed insights are available
Requesting Health IT System
<XML> Patient Reques
t
Gateway
Secure, Encrypted channel
Requesting Health IT System
PMP Gateway Provides PMP Data Back to Requestor
<XML> Response
Secure, encrypted channel
PMP Data
Doctor/Pharmacist views report within Electronic Medical/Pharmacy
Records
NarxCare
§ Aggregates two years of prescription data § Number of prescribers § Morphine milligram equivalents (MME) § Overlapping prescriptions § Number of pharmacies
§ Presents the information in a visual platform § Scores from 000-999 § Narcotics, sedatives and stimulants § Higher scores = higher risks
NarxCare Report
Idaho Office of Drug Policy
Idaho Board of Pharmacy
Prescriber Report Cards
PDMP Prescriber Report § Patients > 1 Opioid Rx § Opioid Rx § Top 3 drugs § MME § Patient opioid treatment duration § Total MME § Medication Prescribing § PDMP Usage § Patient Exceeding Multiple
Provider threshold § > 5 different prescribers/1 month
§ Dangerous Combo Therapy
Idaho State Board of Pharmacy http://bop.idaho.gov/index.html
Idaho PMP AWARxE
https://idaho.pmpaware.net/login
Teresa Anderson 208-334-2356
Ellen Mitchell 208-334-2356
