PRESCRIPTION DRUG MONITORING PROGRAMS. The role of technology in combatting the prescription opioid epidemic

Transcription

1 PRESCRIPTION DRUG MONITORING PROGRAMS The role of technology in combatting the prescription opioid epidemic

2 ABSTRACT Government can leverage industryleading technology providers to create effective platform solutions that complement their efforts to understand, monitor, analyze, and help combat the prescription opioid epidemic. However, no single-threaded approach including technology can solve the multifaceted opioid problem on its own. Innovative technology that harnesses big data to analyze and track activity can, play a valuable role in helping to combat the nation s prescription opioid epidemic. Government will need to engage and coordinate with many key players, decisionmakers, and influencers. There is widespread recognition that the best technical approach should include: A collaborative mindset that encourages connectivity across multiple agencies, jurisdictions, and subject matter experts to help unify government s response and coordinate activities The ability to bridge diverse data silos and effectively analyze information in order to identify and localize warning signs, prescription trends, and indications of fraud and abuse The vision to leverage the best technology and world-class providers to deliver predictive analytical capabilities to identify potential future problems and direct government resources accordingly. 2

3 BACKGROUND The prescription opioid epidemic is a prominent topic across every level of government that impacts all facets of our society. This epidemic has its roots in the late 1990s as pharmaceutical companies dramatically increased the production of these medications to help address a variety of physical conditions with limited scientific evidence as to their addictive properties. 1 Most recently, reports from states such as West Virginia heighten the prevalence of opioids available to healthcare providers, with one town of 3,000 residents receiving more than 21 million pills in a five-year period. 2 With more than 2 million Americans addicted to opioids, this crisis has a personal and economic impact that is estimated to cost the United States over $78 billion annually in healthcare, lost productivity, addiction treatment, and criminal justice involvement. 3 4 Over the past five years, states have passed legislation promoting the use of Prescription Drug Monitoring Program (PDMP) solutions. While there are a number of private companies that may provide this service, a majority of states have legacy PDMP solutions provided by one company. The primary capabilities typically addressed by these legacy technologies have been the consolidation of prescription data and reporting capabilities back to providers. While this approach has provided historical value, it has not been effective at unifying key pillars such as law enforcement, education, and treatment options. 1 Morone, N. E. & Weiner, D. K. Pain as the fifth vital sign: exposing the vital need for pain education. Clin Ther 35, , doi: /j.clinthera (2013). 2 Mole, Beth. Drug companies submerged WV in opioids: One town of 3,000 got 21 million pills. (January 30, 2018). 3 Florence CS, Zhou C, Luo F, Xu L. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States. Med Care. 2016;54(10): doi: /mlr (2013). 4 Center for Behavioral Health Statistics and Quality National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration (2016). 3

4 THE NIC APPROACH 5 As the nation s most experienced NIC has been working with various understanding new answers to this provider of digital government states since 2011 to PDMP epidemic. The unique, innovative services for federal, state, and local solutions. In 2017, NIC successfully features of this system were governments, NIC understands launched its flagship custom solution recognized at the federal level that few initiatives carry as much in Wisconsin the Enhanced as part of the testimony before importance to the greater good Prescription Drug Monitoring the Senate Committee on Health, of our society as the reduction of Program the only such system Education, Labor, and Pensions. 5 addiction and deaths caused from acknowledged by 2017 Center for overdoses of prescription opioids. Most recently, the Information Digital Government Experience Technology & Innovation NIC works with 36 states to provide Award for offering citizens Foundation ( ITIF) showcased the technology framework that more integrated, anticipatory and the NIC Controlled Substance consolidates agency data and personalized electronic services. Monitoring and Prevention solution extends government services to NIC intentionally looked beyond the as part of their Government Digital more than 140 million citizens, 43 traditional capabilities encompassed Transformation Exchange, a first in percent of the entire U.S. population. in other PDMP solutions and the nation partnership to accelerate Additionally, the Company provides included unique capabilities to adoption of new technologies and government services to millions ensure data could be shared in digital government platforms by more through its work with federal real-time with key agencies and empowering collaboration across agencies and municipalities. academic institutions focused on government entities. https: //w w w.help.senate.gov /hearings /the-front-lines-of-the-opioid-crisis-perspectives-from-states-communities-and-providers 4

5 RXGOV TM : A COMPREHENSIVE PLATFORM SOLUTION Increasingly, state government needs PDMP solutions that can coordinate resources across multiple entities such as law enforcement, health and human services, family care, and others to provide a complete response to this epidemic. NIC took the best of its flagship system in Wisconsin, coupled with newly purchased technology, to create RxGov. The RxGov platform is a proven public health tool with robust monitoring and analysis to help leaders make better informed decisions and change clinical outcomes. This modular Platform as a Service (PaaS) solution provides complete, end-to-end data transparency, with no data loss in near real-time. This is an important factor as more states more to 24- hour reporting requirements. Many states have various timing triggers as part of the PDMP regulations. 6 In addition, the platform provides actionable data. Existing legacy systems today often only meet simplistic reporting compliance functionality. But, shouldn t the data that is entered as required also be harnessed to provide information to help stem the tide of the rise in prescription opioid addiction? Not only is RxGov data transparent and traceable, it is provided through robust reporting capabilities and unique data visualization functionality. This allows anonymized and de-identified data sets that represent prescribing volumes, trends, and geo-location to facilitate deeper research into best-practice solutions. One example is the visual representation of the concentration of opioid prescriptions at the county level. The system also includes a unique patient-matching algorithm that matches a person s full name, nicknames, maiden names, former addresses, etc. into a single patient record. This comprehensive view of the patient is an important factor in halting patient doctor shopping, the practice of using different aliases to get prescriptions from multiple doctors in a short time period. The system also provides prescribers and other healthcare professionals a means to review patients -controlled substance history and to assess their own prescribing information. Law enforcement agencies can review prescriber and patient reports and submit patient alerts to notify prescribers of events such as attempted overdose of patients. And, one of the main benefits of RxGov for healthcare providers is that it is embedded seamlessly CONTINUED 5

6 R XGOV TM : A COMPREHENSIVE PLATFORM SOLUTION CONTINUED within Electronic Health Records of the Microsoft technology ( EHRs). Especially in an emergency foundation. Microsoft recognizes and Health Information Exchange room setting where seconds count the significant social value of this ( HIE) Web Service Integration to determine if healthcare providers solution and is committed to being In addition, a new Public Health are dealing with a prescription drug part of the team to deliver a world- Portal has been created to enable overdose, providers do not have time class, citizen-centric platform on searching and viewing of to check a separate PDMP system. its Azure cloud platform. NIC de-identified data. Data must be streamlined and and Microsoft will be able to easily accessible in order to consolidate this and other predictive improve clinical outcomes. models to more effectively drive These capabilities are in alignment recommendations and alerts to key with many of the recommendations stakeholders across state agencies. raised in the President s Features Commission on Combating Drug High level functions include: Addiction and the Opioid Crisis. Account management Addressing recommendations such Data submission solution increased the percentage as facilitating data sharing across Search of Wisconsin-licensed prescribers states and creating a national early Retrieve and view registered from 15% to 30 % warning system or connecting prescription data Electronic Health Record ( EHR ) Results RxGov was designed to quickly onboard each user group to grow the service portfolio and meet performance goals: Quantifiable improvement in quality, accuracy of the data In Wisconsin, the custom epdmp 50 % increase in the number of agency resources such as the U.S. Customer administration queries performed per month Department of Transportation s Alert management by healthcare users from Emergency Medical Technician Systems integration 3,500 to 7,000 ( EMT) overdose database. Reporting and analytics NIC has partnered with Microsoft to Access and connectivity to deliver the solution as an extension law enforcement resources 6

7 PDMP SERVICES THE NETWORK EFFECT: NIC S STATE GOVERNMENT PARTNERS As a digital government services provider in 36 states encompassing state portals, applications, and secure payment processing NIC has proven capabilities to deploy enterprise-level solutions to multiple governments. NIC s engagement map below illustrates how we understand aggregating data across multiple governments and agencies, which can be leveraged to effectively understand the impact of the prescription opioid crisis across state lines and predict opportunities where interventions could be successful. MARYLAND // COMPLIANCE AND AUDITS In collaboration with the state of Maryland s health information exchange CRISP (Chesapeake Regional Information System for our Patients) Provided compliance and audit capabilities to track for data loss and inaccurate information WISCONSIN // ENHANCED PRESCRIPTION DRUG MONITORING PROGRAM Launched in 2017 Proven, fully featured, flexible PDMP Demonstrable improvement: 50% increase in quieres, quantifiable improvement in quality & accuracy of data, significantly increased adoption Aligned with PDMP industry standards & technologies ASAP 4.2 MONTANA // PRESCRIPTION DRUG REGISTRY Launched in 2012 Proven, fully featured PDMP solution ASAP ,854 patients 9,998,521 prescriptions UTAH // CONTROLLED SUBSTANCE DATABASE NIC worked with agency to develop the data transmitting component of the Utah CSDB Successfully piloted in 2011 that averged 21,000 prescription transfers/month Currently redeveloping systems that collect data from pharmacies and transmit to database ASAP 4.2 7

8 DIGITAL GOVERNMENT EXPERTISE LE VE R AG ING A THOUG HT LE AD E R Additionally, N I C is a nationally recognized thought leader and ha s focused solely on digital government for more than 25 year s. N I C brings this broad k nowledge of digital government to ever y solution we deliver. Provides digital government services in 36 STATES encompassing portals, applications, and payment management Provides digital government services that serve more than 6,000 GOVERNMENT AGENCIES Has led the digital government industry SINCE 1992 Developed and currently maintains more than 13,000 TOTAL APPLICATIONS, many of which involve securely managing PPI, PHI, and payment data. Annually securely completes more than 300 MILLION TRANSACTIONS and securely processes MORE THAN $ 20 BILLION in payment processing on behalf of its government partners. NIC currently manages business-to-government, citizen-to-government, and government-to-government digital services and solutions on behalf of the following: U.S. Department of Agriculture U.S. Library of Congress U.S. Department of the Interior U.S. Department of Transportation And more than half of U.S. state governments 8

9 IN CONCLUSION A UNIFIED APPROACH TO AN EPIDEMIC NIC s RxGov platform provides an advanced PDMP that connects healthcare providers, law enforcement, and state agencies with an additional focus on pushing de-identified data to the research community. The NIC approach is forged from our experience with controlled substance and prescription drug monitoring system (PDMP) implementations in key states, our proven domain expertise with health and human services agencies across the U.S., and NIC s unrivaled experience delivering the core registry and privacy functionality in hundreds of government services. NIC has unique experience in breaking down silos across state governments and helping connectthe-dots across agencies. NIC is able to help impact the prescription opioid crisis by helping connect across agencies such as health, law enforcement, licensing and permitting, and more. Beyond breaking down silos between agencies, government is increasingly responding to citizens desire for more transparency and access. FOR MORE INFORMATION VISIT DOUG ROGERS Senior Vice President, NIC Inc. (913) doug.rogers@egov.com KUNAL TANWAR Modern Government Partner Solutions SLG Industry Team, Microsoft (585) kutanw@microsoft.com 9