Advocating for mandatory e-prescribing and nationwide data sharing, a representative from Oklahoma says technology and data are critical first steps to reining in the opioid epidemic.
Requiring physicians to electronically prescribe controlled substances and input prescription data into EHRs would “cut down drastically on the amount of opioids given to patients,” Rep. Markwayne Mullin, R-Oklahoma, wrote in an op-ed for The Hill. Those requirements are part of H.R. 3528, the Every Prescription Conveyed Securely (EPCS) Act, that he introduced with Katherine Clark, D-Massachusetts last month.
Mullin said the bill would “work in tandem” with PDMPs across the country by “creating a uniform, reliable and nationwide electronic record of each patient’s past prescriptions.” However, many state PDMPs are not currently integrated with EHRs.
In draft recommendations released last month, a White House-appointed opioid commission recommended that state and federal PDMPs be completely interoperable by July 1, 2018.
At the same time, one public health attorney is calling for more research about how variations between state PDMP programs impact opioid reductions or lead to unintended outcomes. So far, studies show PDMPs don't always reduce opioid-related deaths, although recent research shows states that mandated PDMP participation reduced opioid prescriptions by as much as 85%.
“It is assumed commonly, for example, that PDMPs provide actionable data to the prescribing clinician, who uses it to make better prescribing decisions, and that those decisions lead to reduced overdose death,” Corey Davis, deputy director and staff attorney at the Network for Public Health Law and professor with the Brody School of Medicine at East Carolina University wrote in the medical journal Addiction. “While this theory appears facially plausible, there is little evidence to support it.”
Instead, he advocated that PDMP date be accessible to health departments that could use the information to assist individuals at risk for an overdose.
Physicians that already feel overregulated may loathe another mandate, but some healthcare leaders have said doctors should embrace e-prescribing to reduce opioid use. Several states, including New York and Connecticut, have passed legislation mandating e-prescribing, but the approach is still relatively underutilized.
At the same time, more states are integrating PDMP data into hospital EHRs. Michigan and Indiana are two states that have committed to combining the two IT systems to make it easier for physicians to access prescription information.