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PDMP Laws in Different States


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I was hoping to get some wisdom from some of you in different states.  In Texas we are required to check the PDMP before prescribing any narcotics.  I currently work in pain management and this is an issue, but has been seen as a necessary step.  We have been trying to work with our EMR on seeing if we can save the PDMP into the EMR.  The reason why we are doing this is that we have caught the database not updating/logging our searches.  As you know if it is not documented it did not happen.  We were advised by our professional society to make sure a copy is in the EMR to prove we did pull the report.  This has cost us labor hours (to scan it back into the system) as well as paper cost to cover our butts.  This is why we want our EMR to allow a save button so we can simply save and sign it to the chart.  During a call with them they stated in some states that it is not legal to print the PDMP or save it to the chart.  One example is Kansas and I cannot find any rule that says it cannot be printed or put in the chart, but that the advisory committee for K-Tracs (Kansas PDMP) recommends it not go in the chart.   I am looking to see if some of us in other states know if this information is correct as it does not appear so in Kansas.  I currently have a call out to K-Tracs but because of COVID they are saying it is taking them longer than usual to respond.  Does everyone else just pull the report and hope it tracks your inquiry like it is suppose to?  I think the information given by our EMR is not the total truth concerning saving and printing the PDMP, but I wanted to ask the brain trust here and see if what they are saying is true.  Their argument is they need a product that can be sold in every state, even if it is at the expense of a needed feature in another state.

PDMP print and save.xlsx

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In Michigan we used to have our "delegates" the MAs print and save the PDMP to the chart before every visit.  Then I would look at it. I think they would scan it into the chart without printing.  Like you pointed out this takes a lot of labor. I am not aware of any law that forbids you from entering this in the chart, but I never looked to see if it's legal either. 

About a year ago our EMR vendor now has a button I click on that automatically brings up the PDMP.  We use E-clinical works. I no longer save it in the chart.  I have logged in through the state and it does log my inquiry.  Our EMR also saves that I checked it. I have not noticed  This has saved us a ton of labor for our MAs. 

We are required to check the PDMP before prescribed a controlled substance, but we did that well before it was law. 

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The rule about it not being saved to the chart is bizarre.  It’s used for clinical decision making, why wouldn’t it?  In Illinois they want you incorporate it into your emr.  Unfortunately cprs is still Stone Age so I just click the button saying I did it.  You already attest that you listened to their lungs and heart, why can’t you just say you did it in your note?

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I am in Texas and we used Epic. Our Epic team baked a "Check PDMP" button into the EHR and, if you wrote a scheduled drug and tried to close the chart a popup opened that asked if you wanted to check the PDMP or had you checked it using an outside source (like my personal PDMP account). That check was saved as part of the record.

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We have a specific chart note titled PDMP. 

It has a hyperlink to the state site.

On the state site - we are given an inquiry number every time we enter a patient name and DOB. 

You cut and paste the inquiry number into the patient's chart PDMP chart note. 

We also cut and paste the rx history into the chart in the same note.

The inquiry number is proof of date, time and who logged in to get the info.

No issues, but we are federal.

We don't print and scan anything like that - cut and paste or snipping tool or screen shot.

We can search our note hx for PMDP and it will highlight so you can see if one has been done in past year - current guideline for ongoing use of control. We tend to do them on all new patients now as well. Lots of little "oops I forgot to tell you about that" moments have come up.

 

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In MN.

Our Epic has a button for it, and we have a built-in prompt to check PDMP when we prescribe narcotics. It pulls the information into the Epic screen (does not go to external website) but I don’t know how or if that is logged in Epic. Well I guess everything is logged in Epic. I do know that it translates to the website. When I’ve initiated a search from the website and checked my search history, it clearly shows searches that originated in Epic.

We aren’t required to check the database. It’s just highly suggested.

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Thank you for the comments.  Unfortunately Appriss is the one that keeps track of our inquiries and I have found that they do not always log the inquiry.  We have showed them proof of this and initially they blew me off.  After about two weeks the reopened the ticket I initially opened (that they closed the same day) and stated there was a "known issue."  Naturally if I am in pain management and I relying on them to cover my butt with the state, this does make a me a little nervous when relying on them to log my inquiries.  I also like to have the actual report scanned into the EMR to prove what I put in the dictation.  I have had several patients put in as a nick name or middle name when their name does not match what we wrote on their script or in the EMR.  (Ex. real name is Leslie but they go by Dale on PMP, or names are shortened from Marylin to Mary, etc......). I have also had some pharmacies go in and edit the PMP or put the wrong drug/prescriber on the PMP.  This was brought to the attention of the PMP advisory board to which the pharmacy board and Appriss did not want to take responsibility.  So naturally I would rather make sure there is a copy in the EMR that cannot be changed.  I would appreciate if anyone else knows if their state prohibits them from printing or scanning into the chart.  Like some of you have said it does not make sense if you do not have this supporting documentation for your medical decision making.  I was  hoping some of you could say "yes I know we can't print or scan and this is why....."

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3 hours ago, NeoTrion said:

 I was  hoping some of you could say "yes I know we can't print or scan and this is why....."

I would treat it like a "HIPAA says..." statement.  That is, almost certainly some combination of intentional falsehood, accidental falsehood, and laziness on the part of the person making the statement.

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Rev Ronin, that is what I was thinking as well.  The closest I can find to a "no that it can't be done" is a recommendation for a committee.   Thus far I have not been able to get anyone to call me back on this that is on these committees or on the various medical boards.  In fairness COVID may be causing some of this communication difficulty.

 

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