prescription monitoring

[e3w24r]

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Hello all, am new here. This is a bit random, sorry if this is the wrong forum but I have a system that I think could stop a lot of stuff like rx forgery, stolen pads, doctor shopping, etc. on hard drugs.

To see it put into action, who would I need to contact? Would it be the pharmacists themselves, the doctors, the DEA, the relevant state prescirption monitoring program, or some other body? A bit confused on who controls what. Thanks.

 

[BidingMyTime]

Hello all, am new here. This is a bit random, sorry if this is the wrong forum but I have a system that I think could stop a lot of stuff like rx forgery, stolen pads, doctor shopping, etc. on hard drugs.

To see it put into action, who would I need to contact? Would it be the pharmacists themselves, the doctors, the DEA, the relevant state prescirption monitoring program, or some other body? A bit confused on who controls what. Thanks.

I have a hard time believing that your system would add anything to the systems already in place, but if its that good, then I would say market it to all the sources you mentioned. The more people/places you get to try out your system and have positive feedback from it, the more likely that it will become widely accepted.

 

[e3w24r]

*

 

[VA Hopeful Dr]

I have written a simple software based solution, it's already finished. There are 2 pieces of software. The first is run by the doctor. So when a patient comes in and needs 30 hydrocodone pills, they input the controlled drug they wish to prescribe, the patient's name, and quantity of that drug (and maybe other stuff like DEA #'s or other things I'm unaware of). Their software then generates a number that is not readable to humans based on that info (for example, 4r8934r984398r4983rj8349rj4938rj9834j). Then they can call/fax/email that number in to the pharmacy themselves, print it on a Rx or whatever. THe pharmacy fills scripts based on this number alone. No verfiable number, no script.

Once the pharmacy receives that number, they then input it to their part of the software, which then determines/verifies the patient's name, the drug they need, the quantity (possibly other info too). Each pharmacy software can be linked to other pharmacies to prevent doctor shopping, or be linked to a central database (ie "prescription monitoring program", but thus far I doubt this works well because it's allegedly already in place). The pharmacists then gives the patient what they need. This number is based on various algorhythms and will not be easy to forge, and that same math protects a lot of other sensitive info in the real world.

To recap, patient goes to doctor, doctor gives patient non human readable number, patient brings it to pharmacy, pharmacy gives patient medicine (if number checks out).

In this system, no stolen rx pads, no multi county doctor shoppers, no callign in bogus scripts, nothing. Even if the doctor's PC were compromised there are logging systems which would alert anytime a script is filled based on their software. This is the same concept used to prevent software piracy, verify login credentials, and much more. No system is 100% secure, but this one would have much higher success rates than the current, it doesn't cost a lot to implement.

The software is finished, it's written in C++ (that means it's not a slow, insecure webapp like most software) and works well. Profit would be nice, but my sheer hate for pain pills is why I did it. You factor in that with dealing with countless know it all doctors and pharmacists, and I'm not sure if it'd be worth it. Your answer, bidingmytime, shows that this is not centrally controlled by anyone and making all those groups come together and agree on something, well, you'd have to be a patient person to do that : ) I'll probably just make it open source and put it out there hoping someone gets use from it.

As a doctor, that sounds like a fairly significant pain in the ass for a problem that I generally don't care enough about to tolerate said pain in the ass.

 

[e3w24r]

Thanks for your honest feedback doc.

I'll post the proof of concept software in the coming days, it runs on Win XP/7/8 and is easy to run.

if u like it, use it, if not then forget it : ) It would stop many problems though.

 

[zelman]

#1 Open source will compromise security.
#2 Massachusetts has a state law against prescriptions "in code". This is to prevent things like an MD writing an Rx for "acne regimen #1" so that only their buddy who owns a pharmacy can fill it. You should check with someone versed in pharmacy law as to whether or not your plan would be legal in most states.

 

[e3w24r]

.

 

[zelman]

The only way to make this happen universally would be if the DEA made it a requirement. They are the only ones who do not care about the burden it will place on doctors pharmacists and patients.

 

[Dr Wario]

For all the negative responses you have gotten, I have to say that I greatly appreciate the fact that you are trying. I have a frequent internal debate with myself concerning if we should implement greater security in the dispensing of controlled substances or just let it all go and allow people to go wild. I would be somewhat opposed to an idea such as yours simply because it is going in the direction of even more government control and privacy violation. At the same time, however, I am really really sick of the junkies.

If anything though, I do hope your work does not go to waste, though I would imagine if anything like this were implemented, it would be just another part of a global EMR.

 

[zelman]

Don't take my comments as a lack of support. I would love this. The current PMP situation is a joke. I'm just saying it will be tough to institute this legislatively because of AMA and NCPA lobbies.

 

[Ackj]

If instead of generating an encryption key, it would directly transmit the data securely to the pharmacy system, which would decrypt it, it would be cool. With widespread acceptance, it would essentially be mandatory e-Rx for controls, no worry about getting handed a forgery. Direct transmission from doctor to pharmacist.

The only way to make it not an additional burden on the workflow would be to have it integrated with the doctor and pharmacist e-rx systems though. I don't think they would want to take their existing system's output, enter into your system, pharmacy receives output, then inputs into pharmacy system.

 

[zelman]

If instead of generating an encryption key, it would directly transmit the data securely to the pharmacy system, which would decrypt it, it would be cool. With widespread acceptance, it would essentially be mandatory e-Rx for controls, no worry about getting handed a forgery. Direct transmission from doctor to pharmacist.

The only way to make it not an additional burden on the workflow would be to have it integrated with the doctor and pharmacist e-rx systems though. I don't think they would want to take their existing system's output, enter into your system, pharmacy receives output, then inputs into pharmacy system.

If it's transmitted electronically, how is this superior to current e-prescribing?

 

[xml2]

What's your background, dude? Are you a pharmacist? Sounds like a cool software you created.

I have written a simple software based solution, it's already finished. There are 2 pieces of software. The first is run by the doctor. So when a patient comes in and needs 30 hydrocodone pills, they input the controlled drug they wish to prescribe, the patient's name, and quantity of that drug (and maybe other stuff like DEA #'s or other things I'm unaware of). Their software then generates a number that is not readable to humans based on that info (for example, 4r8934r984398r4983rj8349rj4938rj9834j). Then they can call/fax/email that number in to the pharmacy themselves, print it on a Rx or whatever. THe pharmacy fills scripts based on this number alone. No verfiable number, no script.

Once the pharmacy receives that number, they then input it to their part of the software, which then determines/verifies the patient's name, the drug they need, the quantity (possibly other info too). Each pharmacy software can be linked to other pharmacies to prevent doctor shopping, or be linked to a central database (ie "prescription monitoring program", but thus far I doubt this works well because it's allegedly already in place). The pharmacists then gives the patient what they need. This number is based on various algorhythms and will not be easy to forge, and that same math protects a lot of other sensitive info in the real world.

To recap, patient goes to doctor, doctor gives patient non human readable number, patient brings it to pharmacy, pharmacy gives patient medicine (if number checks out).

In this system, no stolen rx pads, no multi county doctor shoppers, no callign in bogus scripts, nothing. Even if the doctor's PC were compromised there are logging systems which would alert anytime a script is filled based on their software. This is the same concept used to prevent software piracy, verify login credentials, and much more. No system is 100% secure, but this one would have much higher success rates than the current, it doesn't cost a lot to implement.

The software is finished, it's written in C++ (that means it's not a slow, insecure webapp like most software) and works well. Profit would be nice, but my sheer hate for pain pills is why I did it. You factor in that with dealing with countless know it all doctors and pharmacists, and I'm not sure if it'd be worth it. Your answer, bidingmytime, shows that this is not centrally controlled by anyone and making all those groups come together and agree on something, well, you'd have to be a patient person to do that : ) I'll probably just make it open source and put it out there hoping someone gets use from it.

 

[e3w24r]

.

 

[zelman]

Not farmiliar w/E-Rx system, but had a brief look on wikipedia ...

... All someone needs to do is get one pharmacist to click a link, they get login credentials for that cheap, outsourced crappy CVS management software, then manipulate it look like 100 scripts for Oxycontin need to be ready for pickup in 10 different locations.

That was on Wikipedia? Clearly you have no idea what you're talking about.

And dismissing a burden as being insignificant because it is 30-60 seconds? There are states where purchasing a fax machine is optional by law for pharmacies. A stupid $20 machine (plus toner and whatever) is too much of a burden for lobbying groups to allow it. You CANNOT sell this as a benefit to doctor or pharmacy groups. The only people who will be on board are law enforcement. I'm giving you good advice when I say getting the DEA on board is the best way to make this happen. They do not have constituents to whom they are responsible.

 

[owlegrad]

That was on Wikipedia? Clearly you have no idea what you're talking about.

I am glad someone said it. Clearly that person has no clue what they are talking about.

 

[eagles22]

The problem is unless every pharmacy and doctor is using this program, then it's useless. There will still be written or called in rxs. It's like screening all lines at the airport but 1. The criminals will see how to get around the system.

To be honest, pharmacies benefit from filling fakes and most doctors are too busy to give a **** about using a special system to send the rx unless it's legally mandated. It'll take exactly 1 patient saying "I want to go to that pharmacy next to that grocery store by the gas station. You know which one I'm talking about?" for the doc to be fed up and just write an rx. How does he know that nondescript pharmacy will take an unreadable code? He's not going to risk having to deal with this patient again to re-write it.