Why don't patients have access to their PMP results?

[BenJammin]

I tried contacting the Texas PMP about getting access to my PMP results and I could not get anyone to give me a report of what shows up and who has accessed it. Curious that the TSBP will soon require pharmacists to access it before they fill controlled substance prescriptions. If the government is supposed to protect me from unreasonable searches and seizures, shouldn't that information be given to me?

Random thought on a stormy Sunday.

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[JustFillIt]

I tried contacting the Texas PMP about getting access to my PMP results and I could not get anyone to give me a report of what shows up and who has accessed it. Curious that the TSBP will soon require pharmacists to access it before they fill controlled substance prescriptions. If the government is supposed to protect me from unreasonable searches and seizures, shouldn't that information be given to me?

Random thought on a stormy Sunday.

My guess... they are not so worried about you knowing what is on it, rather they are more cautious about you knowing who accessed it. That’s called opening Pandora’s box.

 

[Litha]

Can't you just look yourself up on the PMP? I have done it, many pharmacists I know have done it. It's how I tested my login initially to know what to look for.

 

[BenJammin]

Of course I can look myself up but why should it be a secret who looked me up? Wouldn't you be concerned if a pharmacist who isn't in any way affiliated with your prescriptions is looking at your PMP results?

 

[zelman]

Of course I can look myself up but why should it be a secret who looked me up? Wouldn't you be concerned if a pharmacist who isn't in any way affiliated with your prescriptions is looking at your PMP results?

Mobsters can’t just call the FBI and ask who has checked their rap sheet recently. The PMP was created for non-clinical reasons.

 

[BenJammin]

Mobsters have HIPAA rights too

 

[CetiAlphaFive]

I tried contacting the Texas PMP about getting access to my PMP results and I could not get anyone to give me a report of what shows up and who has accessed it. Curious that the TSBP will soon require pharmacists to access it before they fill controlled substance prescriptions. If the government is supposed to protect me from unreasonable searches and seizures, shouldn't that information be given to me?
Random thought on a stormy Sunday.

Isn't that work contracted out to a private company?

Also, I wonder if a health system that would fire you for looking at your own chart would fire you for looking at your own PMP file

 

[JustFillIt]

Can't you just look yourself up on the PMP? I have done it, many pharmacists I know have done it. It's how I tested my login initially to know what to look for.

No you can not.. I think the rules are fairly consistent across state lines. The rules are essentially the same as HIPPA - you can not access the report unless you have a clear clinical/professional reason to access it. Curiosity does not satisfy this rule.

 

[RxPreceptor]

Why so drug addicts can better learn how to cheat the system by knowing the search parameters better/data included/omitted/extent of tracking/history/etc.?

 

[BidingMyTime]

No you can not.. I think the rules are fairly consistent across state lines. The rules are essentially the same as HIPPA - you can not access the report unless you have a clear clinical/professional reason to access it. Curiosity does not satisfy this rule.

HIPPA also gives the right for someone to know who has accessed their data. I agree with the OP, he should have the right to know who has accessed his data (and to challenge, if he thinks there was no lawful reason for them to access his data. This seems pretty clear cut, and the reason people are fired all the time for accessing "celebrity's" data.

As for looking up one's own data...it may be against one's employment rules, and technically against HIPPA. But legally, there is no case, since presumably nobody is going to sue themselves (maybe if split personalities?) for looking up their own data.

Edited to fix typos.

 

[owlegrad]

You have the right to your own health information. Companies may be able to fire you for looking at your own chart but if you request the chart information from the appropriate channels you will get it.

Or is my understanding of how that works wrong? Any patient can request copies of their chart, right?

Personally I have never understood the problem with accessing your own chart to begin with. It's your PHI. How can you violate HIPAA by looking at your own PHI? Seems like it is more of a violation of company policy than a privacy issue.

 

[owlegrad]

I tried contacting the Texas PMP about getting access to my PMP results and I could not get anyone to give me a report of what shows up and who has accessed it. Curious that the TSBP will soon require pharmacists to access it before they fill controlled substance prescriptions. If the government is supposed to protect me from unreasonable searches and seizures, shouldn't that information be given to me?

Random thought on a stormy Sunday.

I am not totally sure how I feel about patient's being allowed to know what is on the report, except that they should be given a chance to contest incorrect information but it does seem like they should know who accessed it. After all how can they know if someone is accessing it without reason/permission?

 

[owlegrad]

Mobsters can’t just call the FBI and ask who has checked their rap sheet recently. The PMP was created for non-clinical reasons.

In Soviet Union you could go to the KGB and ask to see your record with them. Oddly though I am told no one ever did that, I can't imagine why not. Just a random fun fact.

 

[Sabril]

Not related to this but I went to a CE last month. The presenter who was on the board of pharmacy told of a story of a girl (I think a pharmacist) looking up the PDMP of her boyfriend's ex for like 5 times over the course of a month or so for dirt while not dispensing anything for that person. The board found out and she was fined like $15k, made to take classes and faced lawsuit from the other person.

 

[owlegrad]

Not related to this but I went to a CE last month. The presenter who was on the board of pharmacy told of a story of a girl (I think a pharmacist) looking up the PDMP of her boyfriend's ex for like 5 times over the course of a month or so for dirt while not dispensing anything for that person. The board found out and she was fined like $15k, made to take classes and faced lawsuit from the other person.

I wonder how they found out.

 

[BenJammin]

I am not totally sure how I feel about patient's being allowed to know what is on the report, except that they should be given a chance to contest incorrect information but it does seem like they should know who accessed it. After all how can they know if someone is accessing it without reason/permission?

What information on the PMP report is too sensitive for a patient to see? They know where they've filled, what doctor they see, etc. My thought is that if the state is requiring you give up your medication history before a prescription is filled then why is the history of access not appropriate to give to a patient? Why the secrecy? I don't see why I should be denied the right to see who has accessed my information.

 

[lord999]

In Soviet Union you could go to the KGB and ask to see your record with them. Oddly though I am told no one ever did that, I can't imagine why not. Just a random fun fact.

The Lives of Others - Wikipedia

en.wikipedia.org

And as far as access, I was actually on the panel for SAMSA when we worked on this initially. I was vehemently opposed to the idea of pharmacy handing out those reports to patients, not because I am against patients accessing their own data (in fact, I'm usually pro for that), I was opposed to making it the front-line pharmacists' responsibility to address discrepancies or have to prove to the system that the record was validly accessed for a patient inquiry. I had enough headaches as a practicing pharmacist dealing with RTS situations with druggies, I wasn't going to make spurious reports or data correction the pharmacist problem. That motion carried as if the patient wants to know their prescription history, that is valid for the pharmacy, but no pharmacy has independent authorization to speak for all state fills for a patient except the state themselves.

Actually, all PDMP's will disclose to a patient, but that has to be handled at the state level according to their system of record requirements (and fill out the release of information matters to the state's satisfaction). The local pharmacy though is NOT authorized to give out that information to non-practitioners as patients are not in a need-to-know position for that context. Refer them to the the state PDMP coordinator for those matters. TX does do it that way, and I would not entertain these requests at the pharmacy level.

 

[lord999]

What information on the PMP report is too sensitive for a patient to see? They know where they've filled, what doctor they see, etc. My thought is that if the state is requiring you give up your medication history before a prescription is filled then why is the history of access not appropriate to give to a patient? Why the secrecy? I don't see why I should be denied the right to see who has accessed my information.

Let me rephrase your question, would you mind a walk-in with a demand to see their information? Do you want to address those discrepancies by calling the other pharmacies and providers even if they were not your fills? Want to keep a log of system access and release of information requests? I would assume no.

Of course, you are actually obligated to report on what you dispensed for which physician for that patient in most states. It's not the secrecy, we just didn't want to make it your problem as the issues with interparty (interpharmacy) permissions and of just the dumb logistics of it made the pharmacists on the panel making those decisions opt hard against having a pharmacy do this rather than a state?

 

[johnpharm01]

Can't you just look yourself up on the PMP? I have done it, many pharmacists I know have done it. It's how I tested my login initially to know what to look for.

This is why I hate being a pharmacist. It should be pharmacy common sense to not to look up anyone but who you are filling a prescription for (or other professional duty). To top it off, the pmps I have used make you check a box with a statement to that effect if you didn't know it already. Yet here is a pharmacist apparently suggesting to look yourself up and justifies it because others have.

Op can get the information just follow the process. I requested my medical records from my provider and received them. i suggest everyone do this. It was enlightening my provider had falsified my record and i would never had known it unless I saw the record. During my appointment, my provider spent time talking shop talk (I was a patient at my place of employment). It changed my opinion of that provider.

 

[CetiAlphaFive]

HIPPA also gives the right for someone to know who has accessed their data. I agree with the OP, he should have the right to know who has accessed his data (and to challenge, if he thinks there was no lawful reason for them to access his data. This seems pretty clear cut, and the reason people are fired all the time for accessing "celebrity's" data.

As for looking up one's own data...it may be against one's employment rules, and technically against HIPPA. But legally, there is no case, since presumably nobody is going to sue themselves (maybe if split personalities?) for looking up their own data.

Edited to fix typos.

They could theoretically lose access to PMP. if PMP is required to dispense controls in retail, they'd lose the ability to dispense controls.

 

[BenJammin]

Let me rephrase your question, would you mind a walk-in with a demand to see their information? Do you want to address those discrepancies by calling the other pharmacies and providers even if they were not your fills? Want to keep a log of system access and release of information requests? I would assume no.

Of course, you are actually obligated to report on what you dispensed for which physician for that patient in most states. It's not the secrecy, we just didn't want to make it your problem as the issues with interparty (interpharmacy) permissions and of just the dumb logistics of it made the pharmacists on the panel making those decisions opt hard against having a pharmacy do this rather than a state?

Would I mind? Not really. If there is a discrepancy then that's between those pharmacies reporting fills and the patient. I play no role in that. As for the system access log, every time our pharmacists use the PMP in Texas it logs the patient who was searched and the user who initiated the search. That's the log I'm interested in. Why should that be secretive?

 

[JustFillIt]

So... Now let’s cut to the real juicy drama... why do you want to see your pmp so bad?

 

[BenJammin]

Nothing juicy about my PMP results. I'd like to know who has seen it and when.

 

[VA77]

I tried to get access to my pmp records and who had run a query on them and was asked who, what, when, where, etc. Felt like a criminal asking for my own records and was even told that I shouldn't execute a query on myself. This was all from a state agency.

 

[Litha]

Of course I can look myself up but why should it be a secret who looked me up? Wouldn't you be concerned if a pharmacist who isn't in any way affiliated with your prescriptions is looking at your PMP results?

Great point, I hadn't thought of the reverse.

No you can not.. I think the rules are fairly consistent across state lines. The rules are essentially the same as HIPPA - you can not access the report unless you have a clear clinical/professional reason to access it. Curiosity does not satisfy this rule.

It literally says in my state's rules regarding the PMP, "An individual who is the recipient of a dispensed controlled substance entered into the database may access records that pertain to that individual"

Since the PMP is a separate system, affiliated with but not part of the state BOP, it is not illegal or a violation of HIPAA. I would not look up my own file at a pharmacy or health system without going through the proper channels, but the PMP is separate.

 

[RxPreceptor]

Yes, let's make it so people already on boat loads of chronic benzodiazepines can constantly be worried about checking & excessively monitoring self records of who looked @ files @ what location, when, & why...this will like totally bode well & be super convenient for RPhs to accommodate especially when these types of people will want to examine records on a ****'ing daily (multiple times) basis.

We already have these people call pharmacies multiple times/day to see if MD sent in an Rx...it's part of drug seeking behavior/chasing the dragon, sometimes just as pleasurable to partake in the process of acquiring a drug as actually ingesting it

 

[JustFillIt]

Great point, I hadn't thought of the reverse.



It literally says in my state's rules regarding the PMP, "An individual who is the recipient of a dispensed controlled substance entered into the database may access records that pertain to that individual"

Since the PMP is a separate system, affiliated with but not part of the state BOP, it is not illegal or a violation of HIPAA. I would not look up my own file at a pharmacy or health system without going through the proper channels, but the PMP is separate.

Hmm I dunno.. I have always treated it like phi that should only be accessed for professional reasons.

If there is a clause to allow people to access their own pmp then I would be careful to follow that pathway and not take matters into my own hands.

 

[CetiAlphaFive]

Now wait a minute.
The individual pharmacist is a covered entity as far as HIPAA is concerned

 

[BenJammin]

Yes, let's make it so people already on boat loads of chronic benzodiazepines can constantly be worried about checking & excessively monitoring self records of who looked @ files @ what location, when, & why...this will like totally bode well & be super convenient for RPhs to accommodate especially when these types of people will want to examine records on a ****'ing daily (multiple times) basis.

We already have these people call pharmacies multiple times/day to see if MD sent in an Rx...it's part of drug seeking behavior/chasing the dragon, sometimes just as pleasurable to partake in the process of acquiring a drug as actually ingesting it

Well the PMP results wouldn't happen at the pharmacy level, it would come from the company that runs it. I get your point but even then, I don't think it's convincing enough to deny a patient the right to know who is looking at their medical history.

 

[CetiAlphaFive]

I'd love for Dr. Shoppers, addicts, and occasionally organized criminals to be able to see that I was the one that denied them their fix and then look up my personal address online because it's apparently logical for states to post licensees personal addresses online. What could go wrong?

Why are you worried about this? You can shoot them with a gun.

 

[RxPreceptor]

I don't think healthcare professionals should have ANY MORE reasons to be stalked by patients for simply doing his/her job and following protocol/policy. Patients having intelligence as far as who exactly denied something just makes things that much easier for him/her to know which MD & Pharmacy (hell even the shift of which RPh) to shop for....yeah let's totally cater to potential drug addicts even more.

Hey, while were at it, how about we start telling people our shift hours & exact work week schedules & hell how about our full names, DOB, license number, who to contact to register complaints against RPhs, and social security number just for good measure? Eyes rolling so far in the back of my head I've temporarily gone blind.

 

[BenJammin]

Why are you being so dramatic? At least in my state your name and license is a matter of public record. Why isn't the public entitled to that information? More importantly, why isn't the public entitled to know that their privacy is being respected? I would want to know if a CVS in El Paso was interested in my fill history. I would want to know if a Walgreens in Nacogdoches was interested in my fill history. Why should this information be a secret? I have yet to see a compelling reason.

 

[RxPreceptor]

OP - some clarity/insight...providing drug seekers intelligence/means of finding holes in a system; I can not emphasize this enough so I bolded it for you. Not everyone who uses control substances is as rationale/understanding as you; plenty who seize any opportunity to get what he/she desires

My state at least
So, are providers going to be aware of how many times/how often a patient requests self reports on control substances? Does it seem like a wise idea to allow potential drug seekers unlimited access to data gathering without any consequences (other than reporting suspicious activity to PMP)?

If this is some personal little vendetta you have with other RPhs, why don't you just gather some courage & do the adult thing & confront said RPh & ask face to face in a professional manner? Rather than sneakily avoiding confrontation

Will flat out tell patient X, I'm not filling your control substance due to drug seeking behavior history

 

[BenJammin]

Understand that I'm not bringing this up as a patient concerned about my controlled substance history. I've had 1 control filled in the last 5 years and it was because I had my wisdom teeth removed. I couldn't care less about my report. My concern is that the state is now requiring us to look up the fill history of my patients. Doesn't the patient have a right to know what's on that report and who has accessed it?

I feel like it's an easy question to answer. I don't understand the secrecy or the hesitation I sense from some here. What's on the PMP report that a patient doesn't already know? The only thing I can think of is MME and that's only because a layperson more than likely doesn't understand that figure. But fill history, day supply, drug name, authorizing physician, date of dispensing, pharmacy location, etc isn't really a secret is it? On the topic of loopholes, I'm not sure that's a compelling enough reason to deny a patient their fill history.

 

[BidingMyTime]

I'd love for Dr. Shoppers, addicts, and occasionally organized criminals to be able to see that I was the one that denied them their fix and then look up my personal address online because it's apparently logical for states to post licensees personal addresses online. What could go wrong?

Um, unless your state is different, there is no "refused to fill" info on the PDMP. Nor does it contain pharmacists names, at least in IL. The PDMP contains only the name of the pharmacy that filled the drug and the name of the drug/strength/qty/method of payment. I can't image other states are any different from this. How would it even be possible for the PDMP to show the name of the pharmacist that refused to fill an RX, there is no record at all of an RX that wasn't filled.

 

[lord999]

Um, unless your state is different, there is no "refused to fill" info on the PDMP. Nor does it contain pharmacists names, at least in IL. The PDMP contains only the name of the pharmacy that filled the drug and the name of the drug/strength/qty/method of payment. I can't image other states are any different from this. How would it even be possible for the PDMP to show the name of the pharmacist that refused to fill an RX, there is no record at all of an RX that wasn't filled.

If you've seen one PDMP, you've seen one PDMP, there is no uniform dataset anywhere (a regret of SAMSA and someone else). Actually, IL does record whatever your system uses as an authorization, so the PDMP cannot reidentify the pharmacist without help (but can tell if a person was an excessive verifier of problem scripts), but what they do in those instances is ask the company who had that authorization if they need to reidentify whoever did this.

There is a "not completed" status for eRx's that are sent but never filled, but I am unaware of refused myself. That does get tracked for inventory concerns.

 

[RxPreceptor]

Next OP wants government to provide reports of everyone (including IP addresses) for anyone who googles name of OP...including the date, time, location, browser used, search engine used, what said user was wearing, other webpages visible @ said time of search, & rationale. FFS

 

[Zynx]

Just to provide additional support to the original question (which lord already answered), per North Dakota law - "The board may charge a fee to an individual who requests the individual's own information from the central repository."

So yes, any individual can contact and request their own records.

 

[zelman]

Just to provide additional support to the original question (which lord already answered), per North Dakota law - "The board may charge a fee to an individual who requests the individual's own information from the central repository."

So yes, any individual can contact and request their own records.

The tougher part of the original question was seeking a list of disclosures. Have you found any info about that?

 

[Zynx]

The tougher part of the original question was seeking a list of disclosures. Have you found any info about that?

I'm not aware of anything similar - I would imagine subjective to each state, considering that lack of uniformity. You probably get different information provided depending on how each state set up the database.

 

[panicatthepharmacy]

I'd love for Dr. Shoppers, addicts, and occasionally organized criminals to be able to see that I was the one that denied them their fix and then look up my personal address online because it's apparently logical for states to post licensees personal addresses online. What could go wrong?

This is precisely why I use a PO Box for my mailing address on my pharmacy licenses.