Sheriffs Want Prescription Records

[Xiphos]

Sheriffs in North Carolina want access to state computer records identifying anyone with prescriptions for powerful painkillers and other controlled substances.

Read more: Sheriffs want lists of patients using painkillers - Crime/Safety - NewsObserver.com

I don't like this.

[cajunguy]

I am, of course, not a lawyer (thank God), but would this not be prohibited under HIPAA laws?



.

[Five-0]

WTH, I really wish administrators wouldn't do stupid things.

[Pudge]

I don't like this.

We have that access here. It's fantastic.

The amount of doctor shoppers that get prosecuted due to our system is huge. We have full run of any Rx record, and can walk into a pharmacy and ask for Rx records on a person without a subpoena.

On a different note, Psuedo logs have been great as well.

[Five-0]

Psuedo logs I agree with. Medical records without PC, not so much.

[Xiphos]

The only way I could think of making something like this respect privacy is assigning every patient a unique ID number (and maybe rotating them periodically) before giving LE the records. Seeing one person getting scripts at different pharmacies for the same drug at the same time (or other indicators,) LE could then seek a search warrant for their specific records with identifying information.

The problem I see is the new bureaucracy to track all this and assign/rotate id numbers, and comply with warrants and court orders. I also see this creating a boom in fake identity and you run into the problem with pharmacists having to detect altered or forged driver licenses.

I just don't like it all around. I'm not sure there's a workable solution.

[MacLean]

Psuedo logs I agree with. Medical records without PC, not so much.

+1

And if Ohio is doing it, it is only a matter of time before someone sues under HIPAA and shoves that where the sun doesn't shine.

[Pudge]

Psuedo logs I agree with. Medical records without PC, not so much.

Its not the medical records themselves, simply what prescriptions and dosages are being received. HIPAA doesn't apply in this case.

[213th]

If there is nothing that identifies the patient, then I guess I'd be more comfortable about it. But if it identifies the patient, I don't see how it's not a hippa violation, or how it's legal without a warrant.

[Pudge]

If there is nothing that identifies the patient, then I guess I'd be more comfortable about it. But if it identifies the patient, I don't see how it's not a hippa violation, or how it's legal without a warrant.

Hippa is severely misunderstood and misinterpreted. Protection under Hippa only applies to what a patient is being treated for, or has been diagnosed with.

Accessing prescription records does not violate HIPPA in that you have no access to patient assesment, treatment, or diagnosis. If I run an OARRS report here (our statewide system) on a resident, it's first submitted to an agency supervisor by the system for approval. Its much like a CCH check in that you need to show a report number from your agency, and it's logged, and audited periodically. Once the report is returned you have the name of the prescription, dosage, doctor who issued, pharmacy that dispensed the meds, and method of payment.

If a report shows possible deception to obtain, you then go to each doctor for a statement, pharmacy for copies of the prescription, etc.

As far as HIPPA protection goes, if I see that you've been issued Oxycodone, I can't determine exactly what your medical problem is, other than you have pain of some sort. It could be from a tooth ache, chronic back issues, etc etc.

Also, a little known fact, if criminal activity is suspected in any way relating to the treatment rendered or problems reported, HIPPA does not apply. Even with HIPPA being in effect as long as it has, you'll find alot of medical proffessionals from Assistants all the way up to Doctors either misunderstand it entirely, or have become paranoid about privacy and use it as a blanket excuse not to give information. As recently as 6 months ago I had a ward clerk in the ER who is also a paramedic with a Fire Department tell me when I called in (mind you, she knew who I was, and knew I was working) that she could not tell me who the ER doc and nursing staff on duty was due to HIPPA. I actually kept her on the phone, drove to ER and walked in with my cell phone still to my ear. Looked and saw that the Doc I needed was not working, and then walked out, hanging up.


Copy and pasted from the Privacy section of the OARRS public website http://www.ohiopmp.gov/privacy.htm

We Take Privacy Seriously
Privacy and personal information are our highest priority. This notice explains our online information practices to protect privacy and personal information. The privacy policy covers www.ohiopmp.gov and all information collected by the Ohio Automated Rx Reporting System.

The Information We Collect
As authorized by ORC 4729.77, the type of prescription information we collect includes patient’s identification, prescriber’s identification, pharmacy identification, prescribed drug identification, quantity of drug prescribed, date of prescription, date of dispensing and days supply of drug prescribed. We may also collect the IP address and non-identifying settings of a computer such as type of browser, operating system, and screen resolution. We do not collect patient’s Social Security number or anyone’s credit card information. Ohio law limits the retention of patient identification to two years.

Who May Access Information
Pursuant to ORC 4729.79, the board may provide personal information and prescription drug history to a pharmacist or prescriber who is treating a patient; to a law enforcement official who is investigating a drug related offense; or to an official of a government agency that licenses, regulates, or disciplines a licensed healthcare provider who is authorized to prescribe drugs. Any person who is permitted to obtain information from OARRS has the legal authority to obtain the same information from other sources. Information stored in the OARRS database is NOT subject to Open Record laws.

How Information is Used
Information is provided to healthcare professionals who are treating a patient. It helps them know what drugs could be potentially beneficial or harmful based on prior prescriptions. Information may also be used by law enforcement to investigate the illegal prescribing and use of prescription drugs. Data that does not identify a patient may be used for educational or research purposes.

[Pudge]

Psuedo logs I agree with. Medical records without PC, not so much.

Actual medical records themselves still require a Prosecutor's Subpoena or a signed release from the patient.

[BigDawg]

On the other hand there are a lot of prescriptions that are specific to certain conditions. So if you see a patient taking that prescription then you know what they have been diagnosed with. How do you get around HIPPA laws on this??

[Pudge]

On the other hand there are a lot of prescriptions that are specific to certain conditions. So if you see a patient taking that prescription then you know what they have been diagnosed with. How do you get around HIPPA laws on this??

I see your point, but the actual diagnosis isn't being released, so one would just be left to assume what the diagnosis is, even with a specific medication. We could just as easily see someone entering a cancer treatment facility or dialysis center and assume what the diagnosis is. HIPPA has a place, but obviously can't assure complete privacy from deduction or assumption.

[ms1600]

Its not the medical records themselves, simply what prescriptions and dosages are being received. HIPAA doesn't apply in this case.

Is it only DEA Schedule narcotics or all prescriptions?

[Cidp24]

Our system is much like Pudge's state. You can get presecription info without a warrant on anyone, as long as you document the reason that you need the info and a case number. I really don't have a problem with that because in most cases it does not give direct info into diagnosis.

It's a great tool.

[Pudge]

Is it only DEA Schedule narcotics or all prescriptions?

All prescription medication.

[MacLean]

There are all sorts of problems with this idea. No law enforcement agency has any business accessing this information without a warrant. I'm reviewing the recent HIPAA stuff, and will address those points later.

[cntryboy0531]

I agree. I don't think this is something a government agency needs to have access to with a warrant or subpeona.

[Pudge]

There are all sorts of problems with this idea. No law enforcement agency has any business accessing this information without a warrant. I'm reviewing the recent HIPAA stuff, and will address those points later.

To each their own, but with the current system it works well, and the way its setup there isn't really a lot you can do with the information to abuse it when you have it.

[Pudge]

All prescription medication.

I stand corrected, it's not all prescriptions as I had orginally thought. I did some more looking and found the following sections of the Ohio Revised Code. It covers Scheduled Drugs, as well as drugs labeled "Dangerous" that are not scheduled. Alot, but not all Prescription drugs that aren't scheduled are labeled as dangerous.

4729.75
The state board of pharmacy may establish and maintain a drug database. The board shall use the drug database to monitor the misuse and diversion of controlled substances, as defined in section 3719.01 of the Revised Code, and other dangerous drugs the board includes in the database pursuant to rules adopted under section 4729.83 of the Revised Code. In establishing and maintaining the database, the board shall electronically collect information pursuant to sections 4729.77 and 4729.78 of the Revised Code and shall disseminate information as authorized or required by sections 4729.79 and 4729.80 of the Revised Code. The board’s collection and dissemination of information shall be conducted in accordance with rules adopted under section 4729.83 of the Revised Code.
Effective Date: 05-18-2005

4729.83
For purposes of establishing and maintaining a drug database pursuant to section 4729.75 of the Revised Code, the state board of pharmacy shall adopt rules in accordance with Chapter 119. of the Revised Code to carry out and enforce sections 4729.75 to 4729.82 of the Revised Code. The rules shall specify all of the following:
(A) A means of identifying each patient, terminal distributor of dangerous drugs, and each purchase at wholesale of dangerous drugs about which information is entered into the drug database;
(B) Requirements for the transmission of information from terminal distributors and wholesale distributors of dangerous drugs for purposes of the database;
(C) An electronic format for the submission of information from terminal distributors and wholesale distributors of dangerous drugs;
(D) A procedure whereby a terminal distributor or a wholesale distributor of dangerous drugs unable to submit information electronically may obtain a waiver to submit information in another format;
(E) A procedure whereby the board may grant a request from a law enforcement agency or a government entity responsible for the licensure, regulation, or discipline of licensed health care professionals authorized to prescribe drugs that information that has been stored for two years be retained when the information pertains to an open investigation being conducted by the agency or entity;
(F) A procedure whereby a terminal or wholesale distributor may apply for an extension to the time by which information must be transmitted to the board;
(G) A procedure whereby a person or government entity to which the board is authorized to provide information may submit a request to the board for the information and the board may verify the identity of the requestor;
(H) A procedure whereby the board can use the database request records required by division (B) of section 4729.79 of the Revised Code to document and report statistics and law enforcement outcomes;
(I) A procedure whereby an individual may request the individual’s own database information and the board may verify the identity of the requestor;
(J) A reasonable fee that the board may charge under section 4729.82 of the Revised Code for providing an individual with the individual’s own database information pursuant to section 4729.79 of the Revised Code;
(K) The specific dangerous drugs other than controlled substances that must be included in the database;
(L) The types of pharmacies licensed as terminal distributors of dangerous drugs that are required to submit prescription information to the board pursuant to section 4729.77 of the Revised Code.
Effective Date: 05-18-2005

4729.77
(A) If the state board of pharmacy establishes and maintains a drug database pursuant to section 4729.75 of the Revised Code, each pharmacy licensed as a terminal distributor of dangerous drugs that dispenses drugs to patients in this state and is included in the types of pharmacies specified in rules adopted under section 4729.83 of the Revised Code shall submit to the board the following prescription information:
(1) Terminal distributor identification;
(2) Patient identification;
(3) Prescriber identification;
(4) Date prescription was issued by prescriber;
(5) Date prescription was dispensed;
(6) Indication of whether prescription dispensed is new or a refill;
(7) Name, strength, and national drug code of the drug dispensed;
(8) Quantity of drug dispensed;
(9) Number of days’ supply of drug dispensed;
(10) Serial or prescription number assigned by the terminal distributor;
(11) Source of payment for the prescription.
(B) The information shall be transmitted as specified by the board in rules adopted under section 4729.83 of the Revised Code.
(1) The information shall be submitted electronically in the format specified by the board, except that the board may grant a waiver allowing the distributor to submit the information in another format.
(2) The information shall be submitted in accordance with any time limits specified by the board, except that the board may grant an extension if either of the following occurs:
(a) The distributor suffers a mechanical or electronic failure, or cannot meet the deadline for other reasons beyond the distributor’s control.
(b) The board is unable to receive electronic submissions.
(C) This section does not apply to a prescriber personally furnishing or administering dangerous drugs to the prescriber’s patient.
Effective Date: 05-18-2005