The Nebraska Health Information Initiative, which operates a statewide health information exchange, is ramping up to be the first state to require the tracking of all filled prescriptions, including opioids. The program is expected to go live in January.

The HIE has contracted with electronic prescribing software vendor DrFirst to capture prescription data and deliver it to the state’s Prescription Drug Monitoring Program that launched in January. The goal is to give pharmacists and other providers a more complete picture of a patient’s medication history and aid in identifying opioid abuse issues and intervening. The program also aims to identify the diversion of opioids and other medications to others.

Interventions could include dosage tapering, alternate therapies or a treatment program. The Nebraska initiative was facilitated via legislation that State Senator Sara Howard supported in the legislature.

“Having lost my sister as a result of a prescription drug overdose, it’s heart-warming to consider the tremendous impact the state’s prescription drug monitoring program will have on the lives of hundreds of thousands of Nebraska families,” Howard says. “By making narcotic details available to every doctor and pharmacist, providers can identify patients who are potentially at risk of abuse or doctor-shopping for medication.”

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A total of 49 states conduct some degree of prescription monitoring, but Nebraska soon will be the first to close the loop with all prescriptions, says Deb Bass, CEO at Nebraska Health Information Initiative (NHII).

Under the program, DrFirst collects dispensed prescription information and sends it to the state’s Prescription Drug Monitoring Program, known as PDMP, which all prescribers and dispensers in the state can query at the point of care, including the 552 pharmacies and about 400 mail-order companies. This year, PDMP also started tracking prescriptions for controlled substances, including opioids.

To get the program rolling, PDMP and DrFirst had to engage the pharmacies and mail order companies and teach them how to report all of their prescriptions. Most of the task wasn’t technically hard work, Bass says, but involved a lot of support, primarily by telephone, to explain how to download apps to send a data file of filled prescriptions to PDMP, and some pharmacies weren’t happy with the exercise.

“Pharmacists are very busy individuals and they saw this as a distraction,” Bass recalls. In the end, resistance to change was low and Nebraska has a 100 percent compliance rate for prescription reporting while some other states would be happy with hitting 80 percent, she adds.