Prescribers get access to out-of-state drug info

Doctors in Massachusetts will soon have their first-ever access to information from bordering states about prescriptions for painkillers and other addictive drugs, gaining a new tool to combat drug abuse.

The state Department of Public Health recently arranged to participate in a multistate system, linking prescription monitoring programs in dozens of states. This will make it harder for people misusing drugs to cross state lines to obtain prescriptions without detection.

When a prescription for a controlled substance is written or filled, that information goes into the state's Prescription Monitoring Program, commonly called the PMP. Some 200,000 prescriptions are recorded each week in Massachusetts.

Medical professionals — doctors, dentists, podiatrists, pharmacists, nurse practitioners, and physician assistants — can consult the database to find out if a patient is obtaining drugs from multiple prescibers or pharmacies, a sign of misuse. But the Massachusetts database has been providing information only about prescriptions within the state.

"In a geographically small state, people cross borders all the time," said Dr. Dennis M. Dimitri, president of the Massachusetts Medical Society. "If you are practicing on the border of Rhode Island or New Hampshire, you don't know if patients are getting a prescription from a doctor just a few miles away."

To remedy that problem, the state health department signed up to participate in the PMP InterConnect of the National Association of Boards of Pharmacy. The program allows data sharing among states' prescription monitoring programs, despite differences in technology and regulations. Massachusetts will become part of the InterConnect after the online connection has been made, in about a month or two.

Carmen A. Catizone, the association's executive director, said that in the past, each state had to sign separate agreements with every other state in order to share data. That system, he said, "never really worked." The association of pharmacy boards developed the PMS InterConnect to streamline the process: Once a state signs an agreement with the association, it has access to all participating states' data. The association provides the service for free.

"A practitioner or someone in Massachusetts law enforcement seeking information on a patient or prescriber can simply access the Massachusetts PMP, and in a matter of seconds information for all other states participating is fed right back to them," Catizone said.

Rhode Island and Connecticut are already participating. New York and Maine recently signed agreements with the PMP InterConnect, according to Catizone. New Hampshire has been in discussions about joining, but Vermont has not, he said.

PMP InterConnect started in 2011 with data exchanged between Indiana and Ohio. Today, 30 states use the system, and an additional five, including Massachusetts, are expected to go live soon, Catizone said.

The agreement was welcomed in Rhode Island, where most residents live within a half-hour's drive of Massachusetts. Rhode Island has already been sharing data with its other neighbor, Connecticut.

"It will make a big difference with us," said Dr. James V. McDonald, chief administrative officer of the Rhode Island Board of Medical Licensure and Discipline. "If we have a patient in Rhode Island, we don't know what they do in Massachusetts, and vice versa."

The interstate linkage is among several improvements to the prescription database that Massachusetts expects to put into effect by next summer. The state recently hired a contractor to develop and implement software that will make the database easier to use and will link it to electronic medical records.

The state awarded a five-year, $6.2 million contract to Appriss, a Kentucky software company that manages prescription monitoring programs in 22 other states, including Connecticut and Rhode Island.

Improving the prescription monitoring program was one of 12 strategies recommended by Governor Charlie Baker's Opioid Working Group, an advisory panel that called prescription monitoring "an underutilized resource." Last year, more than 1,200 people died from fatal opioid overdoses in Massachusetts.

Marylou Sudders, secretary of health and human services and the working group's chairwoman, said in a statement that improving the prescription database "has been a clear priority of this administration. . . . . A well-designed PMP is a critical prevention tool that will help prescribers and pharmacists ensure the proper use of these drugs."

Dimitri, the medical society president, said the improvements will be welcome. "I'm very familiar with how clunky and difficult it is to get the information you need," said Dimitri, a Worcester family doctor. "It takes, like, 11 clicks to get from where you started to where you need to be. Oftentimes, there were issues with inaccuracies in the way patients were listed."

State law requires Massachusetts prescribers to consult the database before writing a controlled-substance prescription for a new patient, or the first such prescription for any patient. The Legislature is weighing whether to require doctors and others to consult it every time they prescribe. The medical society would prefer to wait and see how the new system works before instituting a new mandate, Dimitri said.

Earlier this month, the state Department of Public Health opened the Prescription Monitoring Program to doctors in training — residents and interns at teaching hospitals. These doctors have limited licenses. They are allowed to prescribe controlled substances but, until this change, could not search the database.