The Next Generation of Controlled Substance Prescription History Reports for the Healthcare Professional

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NARxCHECK: 2nd Generation PMP ReportsCarl Flansbaum, RPh.

– Director of Client Relationships and Government Affairs, Appriss– Former State PMP Director; 20+ years as a licensed Pharmacist

Dr. James E. “Jim” Huizenga– Emergency Medical Physician– Creator of NARxCHECK

Dr. Bruce G. Jones– Emergency Department Medical Director, Doctors Hospital, Columbus, OH– NARxCHECK user

PMP Request Report: ProcessState PMP Web Portal Through a Healthcare Entity IntegrationLog into PMP using username / password N/ANavigate to PMP Request Report Page N/AEnter required information (Name, DOB at a minimum)

Manual or automated “trigger”

Review PMP Report Review PMP Report

PMP Request Report

Patient Controlled Substance Prescription History

PMP Request Report: Default FormatPatientPatient Record Details (Name, Address, DOB, etc.)

PrescriptionsDRUG QUANTITY DAYS SUPPLY DATE FILLED RX # PRESCRIBER PHARMACY REFILLS PAYMENT TYPE

OXYCODONE 30MG 90 30 3/21/2016 012581 ABC123 PHARM025 0 INSURANCE

ALPRAZOLAM 1MG 60 30 3/15/2016 328623 CDF1578 PHARM324 2 PRIVATE

HYDROCODON-ACETAMINOPHN 10-325 30 10 3/15/2016 328597 CDF1578 PHARM324 0 PRIVATE

OXYCODONE 30MG 90 30 2/28/2016 012001 ABC123 PHARM025 0 INSURANCE

PrescribersABC123 Dr. Earl Jones 123 Main Street, Your Town, GA 123456 555-123-8945

CDF1578 Dr. Cathy Simpson 1257 1st Ave, Not Your Town, SC 23547 555-458-8945

DispensersPHARM025 Bob’s Drug Store 2548 2ND Street, Your Town, GA 123456 555-123-8978

PHARM324 DRUGS FOR LESS 1600 Evergreen Hwy, Not Your Town, SC 23547 555-459-1325

PMP Request Report: NARxCHECK Report

NARxCHECK History

• 2010 Landscape– Focus on prescription drug abuse epidemic increasing– PMP programs getting better and more numerous across

the country but access is difficult– NARxCHECK project conceived to address issues

of usability• Risk scoring• Enhanced visualization• Automated access

NARx Score

• Developed to create risk awareness– Not abuse awareness

• Based on the concept of comparative scoring– Example

• 25,000 MME in 1 year– A lot or not?

» 96th percentile

• End result is somewhat analogous to a credit score

NARx Score

• Ranges from 000-999– Narcotics, sedatives , and stimulants

• Scores increase as risk factors increase• Last digit is the number of active prescriptions• Distribution– < 200 = 75%– > 500 = 5%– > 650 = 1%

NARx Score

• Preliminary data using Ohio DOH 2014 unintentional overdose death

NARx Report

• Focus is on data visualization– Patterns of use matter (maybe matter most?)

• Providers• Overlapping prescriptions• MME

– Guides provider awareness to the types of risk that present

Examples - patients with similar risk

Same data seen through a NARxCHECK Report

NARxCHECK Report

ED Environment

• Opiate use/abuse• ERs are busy place• Time– Old PMP vs NarxCheck

Importance

• Knowledge helps improve care• Valuable information– High, medium, low– Suboxone

High Numbers

• Recognize addiction (potential)

• Dose up for fractures/etc

• Intervene vs ignore

Low Numbers

• Adjust dose/no dose?

• Be more alert for occult critical condition

• More quickly treat (back pain, toothache, etc)

QUESTIONS?

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