Nebraska on January 1 became the first state to require pharmacists and pharmacies to report all dispensed prescriptions daily to the state’s prescription drug monitoring program, not just controlled substances.
“A year ago, we implemented the first stage of this law,” says Ashley Newmyer, an injury epidemiologist and director of PDMP enhancements in the Division of Public Health for the Nebraska Department of Health and Human Services, who notes that a previous law went into effect on January 1, 2017, mandating that all dispensed controlled substances be submitted on a daily basis to the PDMP.
However, starting January 1, Nebraska decided to “take it a step further” requiring the reporting of all dispensed prescriptions to the PDMP, according to Newmyer, who adds that the state is taking a “broader public health approach” designed to improve patient safety by “allowing medical providers to conduct medication reviews” using information in the database to ensure drugs are used for medically appropriate purposes.
Felicia Quintana-Zinn, prescription drug overdose prevention epidemiologist, says the goal is to be preventative. “We want to try to prevent as many deaths as we possibly can before it actually becomes a crisis,” comments Quintana-Zinn, who notes that Nebraska’s drug overdose death rate has increased over the last decade—6.9 overdose deaths for every 100,000 people in 2016, up from 3.6 in 2004.
Nebraska’s PDMP is housed in the statewide health information exchange platform—called the Nebraska Health Information Initiative (NeHII)—and is managed in collaboration with the state’s Department of Health and Human Services.
NeHII leverages e-prescribing and medication management vendor DrFirst to collect dispensed prescription details and make them available through the PDMP to Nebraska’s prescribers and dispensers, including each of the state’s 552 pharmacies and approximately 400 mail-order companies.
The PDMP is “available at no cost to all prescribers and dispensers and their delegates,” says Deb Bass, CEO of NeHII, which she contends serves as a “robust medication history tool” for all dispensed prescriptions with the “ability to catch potential red flags” of drug misuse.
According to Bass, DrFirst customized the system to be able to accept all of the dispensed prescription information from the pharmacies in the state of Nebraska. The PDMP medication history is also available to be queried within the HIE, she adds.
“In the health information exchange, we have to get consumers’ consent to participate—so they can opt out, though our opt-out rate is only about 2.3 percent,” Bass concludes. “When an individual opts out of the HIE, then the provider can look at the PDMP where they cannot opt out. The PDMP is mandated participation.”
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