Dr. Schneider called a “very valuable” source of information that now only Medicaid possesses. Because many pa- tients go on and off Medicaid, however, it may provide only a portion of their health history and could be missing im- portant information. “Since it is initially claims-based, there may be timing issues where recent information that could change the care needed by the patient may not be available.”
Nor is it clear how practices can eas-
ily sift through the large amounts of data on complex patients that will likely accumulate. Administrative inefficien- cies such as separate logins for separate tasks, for example, threaten to interrupt workflow and take extra time away from patient care, Dr. Schneider added. But it’s the proposed requirement for physicians to obtain and keep patient consent, he says, that could pose the more significant administrative burden
for practices if not done right. TMA also raised concerns about potential liability risks for physicians if they are unable to comply with the consent process. In late October, TMA asked HHSC to clarify and simplify the process — in particular the draft electronic Terms of Use Agreement and consent attestation forms doctors would have to agree to before accessing the portal — to help participating physi- cians comply. At press time, HHSC had not finalized the consent process or the forms, and TMA was working with the agency to improve them. HHSC also indicated to TMA that physicians would not be required to es- tablish a Medicaid-specific consent pro- cess, and physicians could obtain con- sent from Medicaid patients the same way they do for all other patients with- out any new forms. Dr. Terk says the state has a long his-
tory of prioritizing patient privacy, and physicians share those concerns. “Certainly, a person’s medical history is sensitive and private information, and providing access to it raises concerns that are indeed valid. Breaches of sensi- tive online data happen all too common- ly, and people are harmed by that. But if the burden to access the information is too high, then the [portal] will not be used by enough physicians to make a significant difference in the care pro- vided to Medicaid enrollees,” he said. Dr. Schneider added that the state pi- lot is critical to sort out these issues be- fore the new portal goes live statewide.
“Assuming that the pilot is successful, it could be made more widely available,” he said.
Texas State-Compliant Prescription Pads & Paper
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TMA advised the state to make sure the pilot included a representative sam- ple of physicians based in various set- tings, including offices, clinics, children’s hospitals, and inpatient and emergency settings; and a good mix of patients, in- cluding newborns, adolescents, those who are transient, and patients with complex conditions. TMA also requested that HHSC allow
the association’s Select Committee on Medicaid, CHIP, and the Uninsured to review the pilot results before the pro- gram expands.
CVS policy targets “problem prescribers” A TMA Group Discount Program Member 1.800.667.9723 42 TEXAS MEDICINE January 2014
Pharmacy efforts to crack down on prescription drug abuse and diversion reached a new level when CVS Caremark announced in August that it stopped fill- ing controlled substance prescriptions written by dozens of physicians and other health care professionals across the country.
The national pharmacy chain touted its “unique program” for identifying what it described as “problem prescrib- ers” in a September New England Jour- nal of Medicine (NEJM) article (http://
bit.ly/1eNmz3S).
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