Tuesday, June 28, 2016

Beginnings.



When I began doing this work, in early 2013, there were just over two dozen states with a Prescription Monitoring Program (PMP) issuing a report of a patient’s prescription history of controlled drugs. Of those that did exist, none of them could network with each other.

It began for me with ‘clearing’ patients; pulling a PMP going back two years and checking it for inconsistencies or doctor shopping. I then contacted the facility where their MRI or X-Ray had been generated to verify its validity. I had to explain what I was doing and why, and was often refused, until I made clear I had a HIPAA (
http://www.hhs.gov/hipaa ) release form, signed and ready to fax.
In short order, it became apparent that some of these perspective patients had perfectly legitimate medical problems, the test records to back them up, and were still going from clinic to clinic, seeking multiple prescriptions for the same condition. This ‘doctor shopping’  could still easily occur even after they had been cleared and accepted.
( https://en.wikipedia.org/wiki/Doctor_shopping )

A ‘pain contract’ was implemented, between the doctor and patient, to let patients know this was both illegal and not to be tolerated by the clinic, or doctor of note. This agreement allowed for real pain management, rather than just the dispersal of pills. The use of non-emergency pain medication for other conditions (surgeries, dental work, broken bones) required a release form be signed by the patient and added to their file, complete with a new confirmation of these records. Patients agreed to random drug tests, both to prove they were not using illicit substances and to prove their prescribed medications were in their blood stream.

We began to pull a PMP for each patient, just before each follow-up appointment.
Today, I believe that 48 of 50 states now have a PMP program, and from here in Louisiana, we can access the PMP files of Mississippi, Arkansas, South Carolina and Connecticut.
( http://www.deadiversion.usdoj.gov/faq/rx_monitor.htm )
 
An organization called Shatterproof (
http://www.shatterproof.org ) has begun working both to de-stigmatize addiction and subsequent treatment, and has released their own report on the use of PMPs to prevent addiction, going so far as to ask Congress to mandate the use for them by doctors prescribing opioid pain medication.
While I am unsure how that would work, I am unable to offer them support at this time, although I believe that this is a necessary path down which we all must eventually go.
 
I will, in future posts, describe the methodology with which we have achieved years of success in treating patients, kept clinics safe from many who would seek drugs illegally, done our due diligence in reporting those cases, and earned a reputation for both of these things.

As the founder of A Clinic Secure, a New Orleans based Patient Monitoring and Diversion Prevention consulting firm, it is my goal to both limit the exposure of society to illegally sourced prescription drugs, and to offer protective services to the thousands of doctors who prescribe these medicines in good faith, with no other goal than limiting the suffering of those in need of them. In the end, it is the legitimate patients who must come first.

David Percival
Patient Monitoring & Diversion Prevention ~ New Orleans, LA
Member Academy of Integrative Pain Management
( http://www.aapainmanage.org/ )

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