“I’m not the world’s policeman. I’m just collecting the information.”
ines that during that process, practices could wipe out many hassles with a sim- ple swipe of a patient’s driver’s license for automatic — and accurate — data entry of their personal information. Under TMA’s bill, that could become
reality.
reporting system that requires physicians to query the database could help cut down on illicit doctor-shopping before it leads to widespread criminal activity. One mental health watchdog group pro- posed auditing “top prescribers” within the Medicaid program. TMA member Larry C. Driver, MD, a cancer pain physician in Houston and a professor in the Department of Pain Medicine at The University of Texas M.D. Anderson Cancer Center, called for a bal- anced approach.
He testified on behalf of TMA and the American Cancer Society that he was “delighted” to have access to the online prescription drug-monitoring database to “help patients stay safe.” But for doc- tors, “this is not a matter of ‘gotcha.’ This is a matter of not prescribing something a patient already has.” Doctors are working “hand-in-hand with law enforcement in their efforts to curb misuse, abuse, and diversion of pre- scription pain medication and other con- trolled substances,” Dr. Driver said. “At the same time, we want to look out for the best interests of people with chronic pain.”
He said doctors are on board with
programs to educate the public and health care professionals at all levels. Physicians also support the establish- ment of a multidisciplinary workgroup. But Dr. Driver, also president-elect
of the Texas Pain Society, reminded the Senate panel that some patients, includ-
44 TEXAS MEDICINE December 2012
ing the cancer patients he treats, can have lifelong debilitating pain as a result of their disease and its treatment. As a physician, “I have to find a bal- ance between pain relief [for patients] and the side effects” of a particular drug,” he said. Doctors “want to help law enforcement find a balance, too,” in their efforts to pursue criminal activity. “I hope we can meet in the middle.” Sen. Joan Huffman (R-Houston), vice chair of the criminal justice committee, echoed that sentiment, saying whatever direction the legislature takes, “there is a legitimate place in the medical world for these drugs and we don’t want to inflict hardship” on either the physicians who are legitimately prescribing pain medica- tions or the patients they treat. Lawmak- ers will “keep tweaking” the prescription drug-monitoring database and other tools “to outsmart the crooks” and bal- ance valid medical needs, she said.
Swipe away hassles A more secure and user-friendly data- base could help practices streamline and enhance routine patient intake. For instance, when staff members check pa- tients’ insurance, they could query the prescription drug database; it would populate the patient’s electronic medical record; and automatic flags of suspicious patterns could pop up versus doctors checking every patient.
San Antonio occupational medicine specialist Bernard T. Swift Jr., DO, imag-
One swipe could save 30 to 60 sec- onds per patient registration, estimates Dr. Swift, chair of TMA’s Council on Socioeconomics. Multiply that by the 400,000 patients seen annually in the dozen or so Texas MedClinic urgent care clinics he runs as chief executive officer, and “you can do the math on what that means as far as enhancing productiv- ity. And that’s just in our facility. If we expand that to the entire state, you can see the significant efficiencies that can be achieved.” Hospitals already possess such ca- pabilities thanks to a 2007 state law. It would take additional legislation to grant doctors the same access, which TMA would pursue in its bill. Pharma- cies also are permitted to swipe patients’ driver’s licenses to help enforce certain state laws that, for example, aim to pre- vent drug diversion and tobacco sales to minors.
Physician practices similarly could
benefit from the additional risk-manage- ment applications to cut down on fraud and related costs, particularly urgent care clinics like Dr. Swift’s, which see patients on an episodic basis. Again, privacy concerns arose at the time the hospital-related law passed. But physician practices and clinics al-
ready verbally collect and store the same personal information contained within the driver’s licenses, Dr. Swift says. The magnetic stripe contains no more infor- mation than that presented on the front of the card, and existing law gives pa- tients the right to opt out if they prefer not to have it swiped.
“I’m not the world’s policeman. I’m just collecting the information,” Dr. Swift said. “As physicians face declining reimbursements, we have to enhance our practices and these processes to make sure we keep costs low. Physicians are looking for efficiencies all the time, and this is one inefficiency in the system now that could easily be resolved.
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