A White House-appointed commission tasked with addressing the country’s opioid addiction crisis wants state and federal prescription drug monitoring programs (PDMPs) to be completely interoperable in less than 12 months.
After calling on President Donald Trump to formally declare the opioid epidemic a national emergency, the Commission on Combating Drug Addiction and the Opioid Crisis, led by New Jersey Governor Chris Christie, outlined recommendations in a draft report released on Monday, several of which hinged on improving IT systems.
In addition to providing “federal funding and technical support” to enhance interstate data sharing among PDMPs, the Commission urged the White House to direct the Department of Veterans Affairs and the Department of Health and Human Services to lead an effort in which state and federal PDMPs would be able to share data by July 1, 2018.
Although the report notes that 49 states have PDMPs “but not nearly a majority of those are sharing their information,” according to the National Alliance for Model State Drug Laws, 24 states share PDMP data with other state PDMPs as well as authorized users. Another 16 states plus the District of Columbia share data with other state PDMPs exclusively. Just four states have no interstate data-sharing arrangement in place.
But state models vary widely. Those that do share PDMP data often focus on exchanging information with neighboring states.
Noting that PDMPs are used by both law enforcement and healthcare providers, the commission added that systems need to be easier for providers to use, but stopped short of mandating providers check the databases before prescribing painkillers. While some organizations have called for mandatory PDMP participation from providers, some have argued that integrating PDMP data into hospital EHRs would make it more appealing to providers.
Last month Michigan said it was using $2.1 million in state and federal funding to integrate its state PDMP into hospital EHR systems around the state.
Changes to privacy laws
The commission also advocated for changes to existing privacy laws so patient information pertaining to substance abuse can be easily shared among providers. The report pointed specifically to 42 CFR Part 2, which requires addiction treatment specialists to get written consent from patients before sharing information with other healthcare providers.
Earlier this year, HHS finalized changes to the Part 2 regulation that modified some of the requirements around patient consent. Under the updated regulation, patients can authorize a more general disclosure—rather than a specific provider—allowing patients to benefit from integrated health systems.
Arguing current privacy laws “limit the ability to use electrotonic health records to their full potential,” the commission called for reforms that would better align substance abuse privacy laws with HIPAA, with a specific nod to the Overdose Prevention and Patient Safety Act/Jessie’s Law, introduced last year by Sen. Joe Manchin (D-Wyoming).
Future recommendations involve data analytics
Several other recommendations with health IT implications are expected in the commission’s final report, due to the president on Oct. 1.
“Big data analytics” will play a significant role in the group’s final recommendations in order to “devise targeted prevention messages that employ cutting-edge methods of marketing and communications.” The final report will also propose a CDC-run “behavioral health surveillance system” that tracks substance abuse disorders along with comorbidities, and address the need for targeted analytics to improve quality and assist law enforcement.